Pediatric Resident Experience Caring for Children at the End of Life in a Children's Hospital.
burnout
end-of-life care
palliative care
pediatrics
resident education
Journal
Academic pediatrics
ISSN: 1876-2867
Titre abrégé: Acad Pediatr
Pays: United States
ID NLM: 101499145
Informations de publication
Date de publication:
Historique:
received:
29
11
2018
revised:
11
06
2019
accepted:
16
07
2019
pubmed:
4
8
2019
medline:
12
1
2021
entrez:
4
8
2019
Statut:
ppublish
Résumé
Pediatric residents are expected to be competent in end-of-life (EOL) care. We aimed to quantify pediatric resident exposure to patient deaths, and the context of these exposures. Retrospective chart review of all deceased patients at one children's hospital over 3 years collected patient demographics, time, and location of death. Mode of death was determined after chart review. Each death was cross-referenced with pediatric resident call schedules to determine residents involved within 48 hours of death. Descriptive statistics are presented. Of 579 patients who died during the study period, 46% had resident involvement. Most deaths occurred in the NICU (30% of all deaths); however, resident exposure to EOL care most commonly occurred in the PICU (52% of resident exposures) and were after withdrawals of life-sustaining therapy (41%), followed by nonescalation (31%) and failed resuscitation (15%). During their postgraduate year (PGY)-1, <1% of residents encountered a patient death. During PGY-2 and PGY-3, 96% and 78%, respectively, of residents encountered at least 1 death. During PGY-2, residents encountered a mean of 3.5 patient deaths (range 0-12); during PGY-3, residents encountered a mean of 1.4 deaths (range 0-5). Residents observed for their full 3-year residency encountered a mean of 5.6 deaths (range 2-10). Pediatric residents have limited but variable exposure to EOL care, with most exposures in the ICU after withdrawal of life-sustaining technology. Educators should consider how to optimize EOL education with limited clinical exposure, and design resident support and education with these variable exposures in mind.
Identifiants
pubmed: 31376579
pii: S1876-2859(19)30341-9
doi: 10.1016/j.acap.2019.07.008
pmc: PMC6944767
mid: NIHMS1054311
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
81-88Subventions
Organisme : NHLBI NIH HHS
ID : K23 HL141700
Pays : United States
Informations de copyright
Copyright © 2019 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
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