Comfort/palliative care guidelines for neonatal practice: development and implementation in an academic medical center.
OBJECTIVE
To report the multidisciplinary developmental process of a comfort care guideline for the neonatal intensive care unit (NICU) addressing palliative care measures in a tertiary academic medical center. The guideline was developed to be (1) practical, (2) family-centered, (3) respectful of the infant patient, and (4) educational.


METHODS
A consensus-building process involving medical, nursing, administrative, and ancillary professional staff integral to the NICU and Obstetrics units using naturalistic inquiry.


RESULTS
An approved hospital guideline was formulated and implemented over a 16-month period. It described candidates for comfort care, the locale for such care to be rendered, and the construct of essential services to the infant and family. Early reports attest to staff acceptance and it is currently incorporated into trainee education.


CONCLUSIONS
Clinically practical guidelines, comprehensive in their scope of providing comfort care to newborns with life-limiting conditions, can be institutionally derived and locally implemented for both consistency in patient care and educational value for staff and trainees.
Carter
B S
BS
Section of Neonatology, Department of Pediatrics, Medical College of Georgia, Augusta, GA, USA.
Bhatia
J
J
D000046:Academic Medical Centers; D004992:Ethics, Medical; D005845:Georgia; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000628:therapy*; D007363:Intensive Care Units, Neonatal; D010166:Palliative Care; D010348:Patient Care Team; D017410:Practice Guidelines as Topic