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Use of formal advance care planning documents: a national survey of UK Paediatric Intensive Care Units
  1. Sarah Mitchell1,
  2. Adrian Plunkett1,
  3. Jeremy Dale2
  1. 1Paediatric Intensive Care Unit, Birmingham Children's Hospital, Birmingham, UK
  2. 2Division of Health Sciences, Warwick Medical School, Gibbet Hill Campus, University of Warwick, Coventry, UK
  1. Correspondence to Dr Sarah Mitchell, Paediatric Intensive Care Unit, Birmingham Children's Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK; S.Mitchell6{at}nhs.net

Abstract

Objective Advance Care Planning (ACP) is nationally a core element of adult and paediatric palliative care strategies. It is defined as a process of discussion between an individual, their care providers and those close to them, about future care. Formal procedures and processes can help with some of the most difficult elements of communication related to ACP. The majority of children who die do so in a Paediatric Intensive Care Unit (PICU). This survey aimed to identify and compare paediatric ACP documents that are in use within UK hospitals with a PICU.

Design Email survey of lead clinicians from UK PICUs (n=28).

Results 24 (86%) questionnaires were returned. 14 (58%) responded that formal ACP documents were currently in use within their hospital trust. Of the remainder, 2 (8%) detailed plans to launch local ACP documents in the near future, 1 (4%) had a ‘Children and Young Persons Deterioration Management (CAYPDM) Document’ and 3 (12%) listed rapid discharge and extubation pathways. 6 (25%) provided details of the document in use. They varied widely in terms of their presentation, content and intended use with some having been developed locally and others having been adopted across regions.

Conclusions There is variation around the UK in the existence of formal ACP documents for paediatric patients with palliative care needs, as well as variation in the type of document that is used. Consideration of a national policy should be informed by further review and evaluation of these documents, as well as current practice in ACP.

  • Palliative Care
  • Intensive Care
  • Multidisciplinary team-care
  • Nursing Care
  • Paediatric Practice

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