To explore symptom management during end of life care in neonatal settings

About the Project

Each year, around 1200 babies will die in the neonatal period, constituting the largest category of death in children under 5yrs. The main causes of death arise from preterm birth, adverse events during delivery, and sepsis. Whilst palliative care is becoming more well known in neonatal settings there remains very little evidence in this area, in particular around symptom management. As such application of palliative care remains sporadic, and unit and clinician dependant, with healthcare professionals often prescribing different medications towards the end-of-life and leading to different experiences of infants, children, and families around the country. Research is required to understand the different practices, to begin to explore recommendations for best practice.

Aim: to explore the use and range of medications towards the end of life in neonatal and paediatric intensive care units

Objectives:

1. To undertake a document review of patients notes from both neonatal and paediatric intensive care units to explore:
   (a) medications prescribed at the end-of-life
   (b) dosages prescribed for end-of-life care medications
   (c) use of pain scoring charts in neonatal and paediatric intensive care
2. to undertake qualitative semi-structured interviews with parents and neonatal healthcare professionals to explore their views and experiences of symptom management in neonates receiving end of life care

Methods

This mixed methods study will include development of a document analysis framework to audit medication use and dosage for infants in several neonatal units throughout England. This will be supported through semi-structured qualitative interviews with parents and healthcare professionals to explore lived experience, and any barriers or supportive factors.

Proposed impact: This research will inform service standards for the use of medications during end-of-life care in neonatal settings and their evaluation. Future research will explore the impact of these recommendations and their translation into practice

Training opportunities

The student will be based in the well-respected School of Healthcare at the University of Leicester. We have a highly collaborative working environment, with weekly seminar or journal clubs to discuss new and emerging research. The student will have access to high-quality training through the University of Leicester’s masterclass series which is designed to provide all students with strong foundations in research methods. We will also introduce to student to external organisations (e.g., Health Data Research East Midlands) to enhance their collaborations and opportunities.