Multi-disciplinary pediatric end-of-life training improves staff preparedness and lessens staff distress

Abstract

Background: Children’s hospital professionals generally receive standardized training in Pediatric Advanced Life Support (PALS) but they are not regularly trained in the provision of end-of-life care in situations where death is anticipated. To address this training gap, we developed a series of training modules and workshops for the provision of end-of-life (EOL) care and have trained over 500 professionals since 2010. Objectives: To assess whether receiving advanced EOL care training can help caregivers provide more effective care for a dying patient and reduce their own stress and anxiety as they deliver that care. Methods: Likert scale surveys were sent to professionals within forty-eight hours of their having been involved in care of a dying child. The survey assessed the degree of agreement that participation in advanced EOL training or PALS training (1) helped them to participate more effectively in the care of dying child and (2) reduced anxiety or stress in the delivery of end-of-life care. Results: Six hundred ninety three caregivers (mostly doctors and nurses) have responded to 134 post-death surveys. Of 321 respondents who had had PALS training, fifty-four percent agreed or strongly agreed that PALS training helped them participate more effectively in the patient’s care; fifty-one percent agreed or strongly agreed that PALS training reduced their anxiety or stress. For those 186 respondents who had had specific palliative-care-team-led EOL training, eighty-nine percent agreed or strongly agreed that EOL training not only helped them participate more effectively, but also reduced their anxiety or stress. Differences in PALS vs. EOL training were significant at p LT 0.01 for both questions. Impact on Practice: Training in advanced end-of-life care may be a useful adjunct in preparing pediatric professionals caring for children in their last hours of life.