Palliative care nurse: A quantitative study of caring for neonates at end-of-life stage

Impact of neonatal palliative care on neonates, their parents, and nurses: a systematic review

Background

Neonatal palliative care (NPC) is a comprehensive approach that addresses the physical, mental, social, and spiritual well-being of neonates in need of palliative care.

Objective and design

The objective of this systematic review was to examine the impact of NPC on the management of symptoms and conditions in neonates admitted to the neonatal intensive care unit, as well as its effects on their parents and nurses.

Methods

This study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Five electronic databases, including Scopus, PubMed, Web of Science (WoS), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the Cochrane Library, were searched up to July 30, 2024. The quality of eligible studies was assessed using the Mixed Methods Appraisal Tool.

Results

A total of 10 studies that met the inclusion criteria were included in the review. The results indicated that the implementation of an NPC program led to an increased use of analgesic drugs, a reduction in invasive therapeutic and diagnostic procedures for newborns, an increase in withdrawal of life support, more do-not-resuscitate orders, and greater parental involvement in the care of newborns. These findings suggest that providing NPC can improve parents' quality of life, as well as enhance symptom management and pain relief in newborns.

Conclusion

The implementation of an NPC program can benefit both neonates and parents. It can improve the quality of life and reduce stress for parents, enhance the quality of newborn care, foster better inter-team collaboration, and prevent unnecessary invasive procedures, leading to greater comfort for newborns and improved pain and symptom management.

A greater nurse and midwife density protects against infant mortality globally

PURPOSE

As the largest profession within the health care workforce, nurses and midwives play a critical role in the health and wellness of families especially children and infants. This study suggests those countries with higher nurse and midwife densities (NMD) had lower infant mortality rates (IMR).

DESIGN AND METHODS

With affluence, low birthweight and urbanization incorporated as potential confounders, this ecological study analyzed the correlations between NMD and IMR with scatterplots, Pearson r correlation, partial correlation and multiple linear regression models. Countries were also grouped for analysing and comparing their Pearson's coefficients.

RESULTS

NMD inversely and significantly correlated to IMR worldwide. This relationship remained significant independent of the confounders, economic affluence, low birthweight and urbanization. Explaining 57.19% of IMR variance, high NMD was implicated in significantly reducing the IMR.

PRACTICE IMPLICATIONS

Countries with high NMD had lower IMRs both worldwide and with special regard to developing countries. This may interest healthcare policymakers, especially those from developing countries, to consider the impacts of global nursing and midwifery staffing shortages. Nurses and midwives are the group of healthcare professionals who spend most with infants and their carers. This may be another alert for the health authorities to extend nurses and midwives' practice scope for promoting infant health.