Integration of Trauma-Informed Practices for End-of-Life Care in the NICU
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Neonatal end-of-life care is traumatic for patients, families, and healthcare providers. Parents and neonatal clinicians report gaps in the quality of end-of-life care associated with communication, teamwork, staff support, and training. The American Academy of Pediatrics recommends fully integrating trauma-informed care into all organizations providing pediatric care. This evidence-based, quality improvement project integrated trauma-informed best practices to improve neonatal end-of-life care. Using a hybrid of the Institute for Healthcare Improvement’s Model for Improvement and Lean methodology with a trauma-informed approach, this project targeted huddles, communication, staff support, and training as critical points for enhanced team effectiveness. During an initial six-month intervention, staff who provided end-of-life care received a survey invitation to share their observations and reflections on interdisciplinary communication and collaboration, the EOLC process strengths and weaknesses, and the demonstration of trauma-informed principles. An interdisciplinary improvement team used the survey data to evaluate the integration of trauma-informed principles and guide additional interventions to improve the quality of end-of-life care with facilitated end-of-life huddles.
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Open Access (fully available)