Michelle Rickard, DNP, CPNP-AC
Abstract Purpose/Background Despite the increased use of palliative care in adults, only a tiny percentage of children with life-limiting illnesses or life-threatening conditions receive palliative care before dying. Palliative care has low utilization, and consults are often made late in a child’s hospitalization or diagnosis. Palliative care remains underutilized among hospitalized pediatric patients resulting in unnecessary treatments, costly and lengthy hospitalizations, and deaths occurring in the intensive care unit (ICU) rather than at home. The purpose of this scoping review is to evaluate current literature to determine the use and effect of pediatric palliative care, specifically, whether consultation of palliative care for pediatric patients cared for in the inpatient setting for at least three days decreases death in the ICU setting.
Methods A literature search was conducted using an online database utilizing MeSH headings from 2013 until 2021. Eligibility criteria included peer-reviewed articles from any country but available in English. An annotated literature table was developed to synthesize findings. A critical appraisal tool was then used to narrow the six articles for scoping review.
Results Literature analysis noted that early palliative care involvement could affect mortality, patient and family quality of life, and financially impact hospitals. Palliative care was shown to reduce mortality in the ICU, shift the location of death out of ICU, and provide cost savings to hospitals from unnecessary treatments, and decrease hospitalizations.
Implications for Nursing Practice The scoping review yields insight into the utilization of pediatric palliative care and how it reduces mortality in the ICU and at the same time there are cost savings to hospitals. The adaptation of clear consult criteria has the potential to increase palliative care use in children and be beneficial to children, their families, and to hospitals.
Cain, Shelby Noel BSN, RN, CPN; Zimmerman, Dana Pabalate MSN, RN; Oji, Charis Elizabeth MSN, APRN, CPNP-PC/AC; and Rickard, Michelle DNP, CPNP-AC , "Advantages of Early Utilization of Palliative Care in the Pediatric ICU: A Scoping Review" (2022). Doctor of Nursing Practice Projects. Paper 35. http://dx.doi.org/10.21007/con.dnp.2022.0035.
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