2009 Southern Regional Meeting Abstracts

Purpose of Study: Pain and symptom management is an integral part of pediatric palliative care (PPC), but limited research relates any evidence-based knowledge of healthcare providers caring for children. The purpose of this study was to assess PPC knowledge of interdisciplinary healthcare team members over time, identify areas of clinical strengths, and identify staff needs in caring for children with life-limiting/threatening conditions (LTC).
Methods Used: A cross-sectional convenience sample of interdisciplinary hospital-based healthcare providers caring for children with LTC at Vanderbilt was surveyed in 2002, and again in 2007 after implementing an interdisciplinary PPC team. Respondents (N=133 in 2002, N=168 in 2007) completed a 25 question survey, indicating their knowledge and experiences in caring for children with LTC. The survey was adapted from a published tool by Ross, et al. in 1996 entitled "The palliative care quiz for nursing (PCQN)" (J. Advanced Nursing, 23:126-137) and in 2007 targeted neonatal and pediatric ICU staff. Two open-ended questions asked respondents to describe their opportunities to provide PPC services and their own perceived support needs.
Summary of Results: Responses came from nurses (75%) and physicians (>50% of targeted residents and attending physicians). Significant improvement was seen in the active integration of PPC precepts into care for children at the end-of-life (8% in 2002 vs. 64% in 2007). However, providers’ lack of understanding pediatric palliative care compatibility with cure oriented life-extending care in the ICU environment was evident.
Conclusions: Results demonstrate a need to provide ongoing PPC education for healthcare providers, especially in the ICU environment. Further examination of ICU provider-perceived barriers for early PPC integration requires study. There is a need to provide interdisciplinary educational interventions as a foundation for scientific knowledge, skills, and ethical understanding of pediatric palliative care. This survey provided useful data for baseline staff knowledge assessment, program evaluation, and continuing education needs focused on the PPC provision.