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Learning Objective 1: Undertand the use of comfor medication for the dying care of neonates.
Learning Objective 2: Understand the use of DNR order in the dying care of neonate.
Methods: The design of this study is retrospective, purposive sampling was used to select 192 cases that died in the neonatal intensive care unit. The date collection tools included a self-structured questionnaire and NTISS (Neonatal Therapeutic Intervention Scoring System).
Results: The results of this study were as below: 1.) The use of comfort medication within 8 hours before death were 12% received analgesics, 17.8% received sedatives and 13.6% only received sedatives without analgesics. 2.) 67.2% families of neonates decided to sign DNR. The median time of decision made till death is 8.2 hours (range, 1 hour ~ 80 days). 86% neonates had high NTISS scores (> 21) while DNR decision was made. 72.1% newborns had received cardiopulmonary resuscitation before the DNR decision was made, yet still 5.4% newborn received cardiopulmonary resuscitation after the DNR decision was made. 3.) 13.5% families of neonates attended the family conferences. 57.7% newborns received cardiopulmonary resuscitation before the conference, and 65.3% newborns had high NTISS scores (>21) while the conference was held.
Conclusion:This study described the dying care process in neonates, results showed clinical situations need to be improve, we proposed suggestions to develop dying care guideline for high risk neonates, including the policy of comfort medication use and medical decision making on dying care, the content framework of family conference, execute of ethical review committee and the curriculum of palliative care in school and clinical continuous education. The results may provide some usefully inputs for the dying care of newborn.
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