Integrating Trauma-Informed Principles in Neonatal End of Life Care: Lessons and Opportunities from an Interprofessional Project
Saturday, September 21, 2024
10:15 AM – 11:15 AM CT
Location: Midway 5 (First Floor)
Abstract: There are 5.4 infant deaths per 1000 live births in the United States, with over half occurring in the neonatal intensive care unit (NICU). The experience of infant death is heartbreaking and traumatic for both families and staff, leading to negative effects that ripple through communities. The American Academy of Pediatrics recommends integrating trauma-informed principles into care delivery to address this issue. By adopting these principles, systems can reduce traumatic stress for families and secondary traumatic stress for staff. This approach, when applied holistically across roles, relationships, and contexts within complex adaptive systems, emphasizes safety, trust, support, voice, and cultural-historical context. This framework can guide interactions, fostering a sense of collective caring. Though widely endorsed, questions remain on how to trauma-informed principles should be optimally incorporated in the clinical setting, particularly emotionally charged situations like death of a newborn. While trauma-informed care may provide a potential framework, the need for shared ethical spaces and real-time ethical discourse remains unmet. In this session, we will discuss practical recommendations to integrate trauma-informed principles into care provision for critically ill neonates at end-of-life. Using findings from an evidence-based quality improvement project, led by an interdisciplinary work group at an 84-bed, level IV NICU, we will discuss challenges and opportunities identified through surveys of interprofessional care-team members providing direct care during an infant death. This work, when viewed through the lens of interdisciplinary ethics, highlights the importance of shared meanings to healthy team performance and the importance of readily articulated, consensus values across disciplines.
Learning Objectives:
After participating in this conference, attendees should be able to:
1. Explore the value of trauma-informed principles as a potential framework for interprofessional teams
2. Described the challenges to implementing trauma-informed care as a shared mental model
3. Consider trauma mitigation as an ethical responsibility of high-functioning professional teams
Stephanie Kukora, MD – Assistant professor, Bioethics and Neonatology, Neonatology, Children's Mercy Hospital
