Workshops in End-of-Life Training for Health Professionals in Children's Hospitals

patient holds newborn in hospital bed while hospital staff looks on

Image courtesy of CS Mott Children's Hospital Pediatric Palliative Care Team under a Creative Commons license: BY.

Term:
2010 - 2014
Published:
November 10, 2010
Revised:
February 24, 2017

This series of workshops provides skills to pediatric physicians, nurses, respiratory therapists and other health professionals that will improve their ability to care for pediatric patients who are dying in the hospital. We have developed three workshops which each take about 90 minutes.  These workshops feature videos of simulated doctor/patient interactions, worksheets, self-evaluations, and more. Click the "Sessions" tab for a complete view of the content for each workshop.  

We are working this year on interactive modules that will be useful for self-study and reinforcement of key knowledge and skills.

Creators:

CS Mott Children's Hospital Pediatric Palliative Care Team, University of Michigan

Ken Pituch, Tricia Keefer, Jim Azim, Terry Murphy, Matthew Niedner, Rita Ayyangar, Cecilia Trudeau, Karyn Schoem, Maureen Giacomazza, Pat Lyndale, D'Anna Saul,  Adam Marks.

Structure: Professional Development Workshop Series with Videos

Learning Objectives

Case 1: Anticipated death on the newborn unit

  1. Identify the sources of distress in the family and the support staff
  2. Learn questions and answers to the common sources of distress in those caring for a dying baby.
  3. Assess dyspnea and pain
  4. Know doses and routes of at least one opioid
  5. Learn phrases that can reassure the family that using an opioid is safe and appropriate.
  6. Understand and explain the benefits vs. burdens of artificial hydration/nutrition.
  7. Learn one intervention for decreasing bothersome secretions.
  8. Give anticipatory guidance regarding how the death might look.
  9. Identify three ways that families may be able to create valuable memories.
  10. Perform a legal death exam.
  11. Review the ‘check list’ of post-mortem care items.
  12. Learn phrases that may comfort family members.

Case 2: Adolescent Death on the Ward

  1. Identify the sources of distress in the patient, the family and the support staff
  2. Practice using language that can comfort and reassure patients and families.
  3. Recognize the need for autonomy in the ill and dying adolescent
  4. Assess dyspnea and pain
  5. Know doses and routes of at least one opioid
  6. Learn phrases that can reassure the family that using an opioid is safe and appropriate.
  7. Distinguish delirium from agitation near end of life
  8. Identify sources of agitation in a dying patient
  9. Describe at least one pharmacologic and one non-pharmacologic method to treat agitation near the end of life.
  10. Explain the process for approaching patients and families regarding autopsy and gift of life.
  11. Review the ‘check list’ of post-mortem care items.
  12. Learn phrases that may comfort family members.

Case 4: Death in the Hospital from Terminal Cancer

  1. Identify the sources of distress in the patient, the family and the support staff
  2. Practice using language that can comfort and reassure patients and families.
  3. Assess dyspnea and pain
  4. Know doses and routes of at least one opioid
  5. Use phrases that can reassure the family that using an opioid is safe and appropriate.
  6. Recognize treatable causes of nausea and vomiting
  7. Describe at least one pharmacologic and one non-pharmacologic method to treat significant nausea and vomiting near the end of life
  8. Describe at least one pharmacologic and one non-pharmacologic method to minimize the distress of bleeding near the end of life
  9. Demonstrate language that can reassure patients or family members who are worried about bleeding
  10. Explain the process for approaching patients and families regarding autopsy and gift of life.
  11. Review the ‘check list’ of post-mortem care items.
  12. Demonstrate language that may comfort family members after a death

About the Creators

CS Mott Children's Hospital Pediatric Palliative Care Team

The Pediatrics Palliative Care Team offers active, comprehensive support for managing patients with life-threatening or life-limiting conditions. Palliative care can be appropriate at all stages of illness, not just the terminal phase, and can be provided at the same time as active or life-prolonging treatments. The group assists with many aspects of care, including symptom management, communication challenges, complex decision-making, advance care planning and transitions throughout the course of an illness. The team works closely with unit and hospital-based resources to offer seamless support to our primary teams, patients and families. The Palliative Care team is multidisciplinary, represented by a physician, an advance practice nurse, a social worker and a pastoral care professional.

For more information, visit the CS Mott Children's Hospital Palliative Care Consultation Services page.

patient holds newborn in hospital bed while hospital staff looks on

Image courtesy of CS Mott Children's Hospital Pediatric Palliative Care Team under a Creative Commons license: BY.

Term:
2010 - 2014
Published:
November 10, 2010
Revised:
February 24, 2017

Demos

Document Title Creator Downloads License

01(c): Please Keep Our Baby Comfortable: An Anticipated Death on the Newborn Unit

CS Mott Children's Hospital Pediatric Palliative Care Team

02(c): Tell Mom I'm Not Afraid to Die: Adolescent With End-Stage Cystic Fibrosis

CS Mott Children's Hospital Pediatric Palliative Care Team

04(c): Death in the Hospital from Terminal Cancer: But She's Always Been Such a Fighter

CS Mott Children's Hospital Pediatric Palliative Care Team

Exercises

Document Title Creator Downloads License

01(b): Anticipated Death on the Newborn Unit: Blank Worksheet

CS Mott Children's Hospital Pediatric Palliative Care Team

02(b): Adolescent Death on the Ward: Blank Worksheet

CS Mott Children's Hospital Pediatric Palliative Care Team

04(b): Death in the Hospital from Terminal Cancer: Blank Worksheet

CS Mott Children's Hospital Pediatric Palliative Care Team

Handouts

Document Title Creator Downloads License

01(d): Anticipated Death on the Newborn Unit: Filled Out Worksheet, Case 1

CS Mott Children's Hospital Pediatric Palliative Care Team

02(d): Adolescent Death on the Ward: Filled Out Worksheet, Case 2

CS Mott Children's Hospital Pediatric Palliative Care Team

04(d): Death in the Hospital from Terminal Cancer: Filled Out Worksheet, Case 4

CS Mott Children's Hospital Pediatric Palliative Care Team

Values-Guided Decisions Support

CS Mott Children's Hospital Pediatric Palliative Care Team

Miscellaneous

Document Title Creator Downloads License

01(a): Anticipated Death on the Newborn Unit: Learning Objectives

CS Mott Children's Hospital Pediatric Palliative Care Team

02(a): Adolescent Death on the Ward: Learning Objectives

CS Mott Children's Hospital Pediatric Palliative Care Team

04(a): Death in the Hospital from Terminal Cancer: Learning Objectives

CS Mott Children's Hospital Pediatric Palliative Care Team

05: Self-evaluation Form for End of Life Skills

CS Mott Children's Hospital Pediatric Palliative Care Team

06: End-of-Life Algorithms Pocket Card

CS Mott Children's Hospital Pediatric Palliative Care Team

Course/Resource Archive in Institutional Repository (October 2012)

CS Mott Children's Hospital Pediatric Palliative Care Team

End-of-Life Algorithms Pocket Card - Instructions on iPhone download

CS Mott Children's Hospital Pediatric Palliative Care Team

End-of-Life Algorithms Pocket Card Reference List

CS Mott Children's Hospital Pediatric Palliative Care Team

ICU Case Cards

CS Mott Children's Hospital Pediatric Palliative Care Team
patient holds newborn in hospital bed while hospital staff looks on

Image courtesy of CS Mott Children's Hospital Pediatric Palliative Care Team under a Creative Commons license: BY.

Term:
2010 - 2014
Published:
November 10, 2010
Revised:
February 24, 2017

Session Workshop Guide

Document Title Creator Downloads License

Values-Guided Decisions Support

CS Mott Children's Hospital Pediatric Palliative Care Team

Workshop 1: An anticipated death on the newborn unit

Document Title Creator Downloads License

01(a): Anticipated Death on the Newborn Unit: Learning Objectives

CS Mott Children's Hospital Pediatric Palliative Care Team

01(b): Anticipated Death on the Newborn Unit: Blank Worksheet

CS Mott Children's Hospital Pediatric Palliative Care Team

01(c): Please Keep Our Baby Comfortable: An Anticipated Death on the Newborn Unit

CS Mott Children's Hospital Pediatric Palliative Care Team

01(d): Anticipated Death on the Newborn Unit: Filled Out Worksheet, Case 1

CS Mott Children's Hospital Pediatric Palliative Care Team

05: Self-evaluation Form for End of Life Skills

CS Mott Children's Hospital Pediatric Palliative Care Team

06: End-of-Life Algorithms Pocket Card

CS Mott Children's Hospital Pediatric Palliative Care Team

Workshop 2: Death of an adolescent with end-stage cystic fibrosis; dying on the ward

Document Title Creator Downloads License

02(a): Adolescent Death on the Ward: Learning Objectives

CS Mott Children's Hospital Pediatric Palliative Care Team

02(b): Adolescent Death on the Ward: Blank Worksheet

CS Mott Children's Hospital Pediatric Palliative Care Team

02(c): Tell Mom I'm Not Afraid to Die: Adolescent With End-Stage Cystic Fibrosis

CS Mott Children's Hospital Pediatric Palliative Care Team

02(d): Adolescent Death on the Ward: Filled Out Worksheet, Case 2

CS Mott Children's Hospital Pediatric Palliative Care Team

Workshop 4: Death in the hospital from terminal cancer

Document Title Creator Downloads License

04(b): Death in the Hospital from Terminal Cancer: Blank Worksheet

CS Mott Children's Hospital Pediatric Palliative Care Team

04(c): Death in the Hospital from Terminal Cancer: But She's Always Been Such a Fighter

CS Mott Children's Hospital Pediatric Palliative Care Team

04(d): Death in the Hospital from Terminal Cancer: Filled Out Worksheet, Case 4

CS Mott Children's Hospital Pediatric Palliative Care Team