SPECIAL DELIVERY: THE IMPORTANCE OF PERINATAL LOSS CARE AUDIO OPTIONS Bradcast Audi: Please ensure cmputer vlume and speakers are enabled Dial-in: 303-248-0285 Access Cde: 5041508 All participants will autmatically be placed in listen-nly mde On demand recrding will be available n the NPIC website: www.npic.rg The Natinal Perinatal Infrmatin Center is dedicated t the imprvement f perinatal health thrugh cmparative data analysis, prgram evaluatin, health services research and prfessinal cntinuing educatin. EMPOWERED by Data. CONNECTED by Purpse.
NURSE PLANNER Carlyn L. Wd, PhD, RN, Clinical Nurse Cnsultant Purpse/Gal(s) f this Educatin Activity The purpse/gal(s) f this activity is t enable healthcare prviders t have a better understanding f the imprtance f perinatal lss care. 1.0 Cntact Hur(s) This cntinuing nursing educatin activity was apprved by the Nrtheast Multi-State Divisin (NE-MSD), an accredited apprver by the American Nurses Credentialing Center s Cmmissin n Accreditatin. Maine, New Hampshire, New Yrk, Rhde Island, Vermnt Nurses Assciatins are members f the Nrtheast Multi-State Divisin f the American Nurses Assciatin. 1.0 AMA PRA Categry 1 Credit Accreditatin: Wmen & Infants Hspital is accredited by the Rhde Island Medical Sciety t spnsr intrastate cntinuing educatin fr physicians. Wmen & Infants Hspital designates this nline educatinal activity fr a maximum f 1.0 AMA PRA Categry 1 Credit. Physicians shuld nly claim credit cmmensurate with the extent f their participatin in the activity.
DISCLOSURES AND SUCCESSFUL COMPLETION OF THIS ACTIVITY N cmmercial supprt has been prvided fr this activity. N persns invlved in planning r presenting this prgram has a cnflict f interest. There will be n discussin f ff-label usage f any prducts. In rder t successfully cmplete this activity and receive 1.0 Cntact Hur/1.0 AMA PRA Categry 1 Credit yu must attend/watch the prgram and return the cmpleted psttest/evaluatin t NPIC.
OBJECTIVES Develp a better understanding f the imprtance f quality perinatal bereavement care Describe the imprtance f prviding perinatal palliative care supprt Describe tw methds t educate and supprt staff caring fr families with a perinatal lss Explain the rle f cmprehensive supprt and fllw-up in patient utcmes
Special Delivery: the imprtance f perinatal lss care Melissa Petersen, RNC, MS, WHNP-BC Perinatal Bereavement Clinician H.E.A.R.T.strings Perinatal Bereavement Office f Nrthside Hspital
Psitin Statements Supprting Quality & Evidence-Based Perinatal Lss Care The Jint Cmmissin Reslve Thrugh Sharing PLIDA Natinal Perinatal Assciatin ACOG American Academy f Pediatrics Nenatal Assciatin f Nenatal Nurses (Psitin Statement #3063) American Academy f Pediatrics and the American Cllege f Obstetrics Perinatal Care. AAP/ACOG Guidelines fr Perinatal Care. 4th edn. Elk Grve Village: American Academy f Pediatrics; 1997. Nenatal special cncerns; pp. 183 206.
Perinatal Lss Statistics Accrding t the CDC, in 2013, 23, 595 fetal deaths at 20 wks r mre were reprted The mrtality rate was 5.96 fetal deaths per 1000 live births Rates were highest fr teenagers, wmen >35 years ld, unmarried wmen, and wmen with multiple pregnancies These numbers d nt include lsses < 20 weeks gestatin
Relative Magnitude f Nenatal/ Infant Deaths and Fetal Deaths 20 wks gestatin r greater
Fetal Mrtality is an Overlked Public Health Issue When we factr in the lsses earlier than 20 weeks, the numbers rise expnentially The Natinal Survey f Family Grwth, a survey cnducted by the CDC s Natinal Center fr Health Statistics (NCHS), estimates that mre than 1 millin fetal deaths ccur in the US every year Limitatins t the data cllectin include variatin f reprting prtcls per state Surce: Natinal Vital Statistics Reprts, U.S. Department f Health and Human Services, Vlume 64, Number 8
Why is Perinatal Bereavement Care S Imprtant? The experience a patient has in the hspital directly affects their bereavement jurney. A negative hspital experience leaves a family feeling unsupprted, unfunded in their grief and can lead t a higher risk f cmplicated grief prcess A psitive hspital experience with a standard supprt prtcl in place and with supprtive and knwledgeable staff increases the rate f psitive healing, a general feeling f being supprted, and less rate f cmplicated grief
Just as peple wh experience trauma tend t recall vivid memries, stries that parents tell abut experiencing a perinatal lss almst always include very detailed memries. Parents interviewed years later will ften recall much f the detail abut the lss, cmments peple made t them, upsetting aspects f their experiences, etc. (Rsenblatt PC. Parent Grief: Narratives f Lss and Relatinship. Taylr and Francis: Lillingtn, Nrth Carlina, 2000.)
Jurnal f Perinatlgy Publishes a Review f Articles Addressing Health Care Interactins with Perinatal Lss Patients KJ Gld published the review in 2007 Systematic review f mre than 1100 articles frm 1966-2006 Included 61 studies, 6000 parents Parents valued emtinal supprt, attentin t mther AND baby and grief educatin Avidance, insensitivity and pr staff cmmunicatin were mst distressing 25 f the articles mentined smething psitive abut hw they were treated by physicians, but mst rated physicians as less helpful and supprtive than nurses In many studies, interactin with nurses was psitive, but in ne study, 18 f 28 parents described their nurses as cld r neutral Parents in 5 studies reprted a lack f cmmunicatin in fllw up visits, with physicians r nursing staff asking abut hw the baby was ding r asking abut lactatin Surce: Navigating Care After a Baby Dies: a Systematic Review f Parent Experiences with Health Prviders, January 2007.
Apprximately 71 babies are brn still every single day in America. www.starlegacyfundatin.rg
Cnclusin: Hw we care fr these families matters Hw we care fr their babies matter Each ne f us becmes a part f the grief jurney We each have a chice whether r nt t make ur care f the patient a psitive r negative experience.
Cnsider this questin D yu take care f dying patients?
The H.E.A.R.T.strings Perinatal Bereavement Mdel pe. mpathy. lliance. esurces. eamwrk
Wh is H.E.A.R.T.strings? Central ffice staffed with nurses and bereavement specialists Vlunteers Cmmunity at large
Hw did we get here? We started tiny.dn t be afraid t start small. Small is smewhere and that is all yu need. Sacred space nt just physical space but mental space That sacred space (and persistence) will lead t bigger things. Resurces t educate staff Leadership supprt Risk management supprt Cmmunity supprt
Sustaining Yur Prgram Desire t prvide quality bereavement care What are yu able t ffer right nw? Wh can serve as a resurce fr the unit? Funding? Hw will yur prgram sustain itself? Leadership supprt
Wh will head the initiative? What will yur prgram lk like? Are yu a small hspital with small perinatal lss numbers r a larger facility with mre lss? D yu already have a prgram in place? If s, what can be better? What d yu d well? If yu dn t have an established prgram, what can yu d nw t make sure patients feel supprted and that staff caring fr perinatal lss families feel supprted? Designate nurses n each shift that can serve as resurces Are there vlunteers wh can help yu?
Leadership supprt N prgram, big r small, will ever succeed withut leadership supprt.
Funding-$$$$ What d yu need t supprt yur patient ppulatin? What are yur numbers? What supplies can yu prvide? What is yur perating budget? Des the prgram fall under the L&D budget? What areas in the hspital d yu serve? Can varius units help yu peratinally? Make relatinships! Yur hspital Fundatin Yur patient cmmunity the mre psitive the care and supprt, the greater the likelihd that families will want t give back Where can families dnate in rder t help yur prgram?
What can yu get fr free? Gwns, hats and blankets Staff members that knit r crchet Auxiliary members Cmmunity grups that prvide keepsake items Camera dnatins Cnsider putting a list in a hspital newsletter f items that yu need.
Our prgram is sustained by the cmmunity f families we serve
Find yur mtivatr.
Quality patient care begins with staff educatin and supprt Educatinal fferings: new nurse rientatin, ld nurse educatin, peridic CNE fferings, drive by learning Use yur cmmunity! Past parents shuld be a part f staff training-use them fr parent panels t really impact yur staff. Lastly, make sure yu have a way t prevent cmpassin fatigue. Taking care f dying patients is very hard. Chaplains We have a Gd Grief Club Regular pprtunities fr staff t share frustratins and feelings
Supprt ffered Inpatient Patients experiencing a lss in L&D r SCN Patients in the ED r Surgical Services-hw are they managed? What is the plan fr their supprt? Palliative Care what percentage f yur perinatal lss ppulatin includes palliative care families? Hw d yu help them plan? Hw d yu supprt them? After discharge Supprt mailings Remembrance events and cmmunity building, where the peple benefitting frm supprt becme a surce f supprt fr the newer families Supprt grups/ frums Listen t yur patients what d they need? What wuld they like t see ffered?
Supprt grups Are yu able t ffer a general supprt grup? If nt, what grups are in yur area? Is there a SHARE grup? Heartstrings grups Caring & Cping ANEW Time t Heal Rainbw PALS Peer-t-peer supprt thrugh the Cmpanins prgram
Remember hw I mentined that peple never frget the experience they had? When the experience they have helps them heal in a psitive way, usually they will return back t yu.
The greatest strms bring the mst beautiful rainbws.
Rainbw PALS We celebrate these babies They keep us with a psitive balance Hearing frm the families we supprt that they are expecting a rainbw gives us the validatin that we have met ur gal f cmmunity
We have ne f 2 chices: We can be amazing and give amazing care Or We can give care that is nt amazing t smene wh is experiencing a traumatic, lifealtering event What yu chse is cmpletely up t YOU
QUESTIONS AND COMMENTS Participants are encuraged t ask questins and share cmments. Please use the chat bx fr questins r cmments. Questins and cmments are visible nly t presenters. Questins will be answered in the rder in which they are submitted. Shuld there nt be enugh time t address yur questin(s), please email educatin@npic.rg s we may fllw-up with yu.
THANK YOU FOR ATTENDING ATTENTION: Fr 1.0 Cntact Hur r 1.0 AMA PRA Categry 1 Credit **DO NOT CLOSE YOUR BROWSER WINDOW** POST-TEST WILL AUTOMATICALLY APPEAR WHEN THE WEBINAR HAS ENDED Please cmplete the pst-test within 24 hurs Certificates f Attendance & Cmpletin will be emailed within 14 business days