+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Palliative care in the neonatal unit: neonatal nursing staff perceptions of facilitators and barriers in a regional tertiary nursery



Palliative care in the neonatal unit: neonatal nursing staff perceptions of facilitators and barriers in a regional tertiary nursery



Bmc Palliative Care 16(1): 32



Neonatology has made significant advances in the last 30 years. Despite the advances in treatments, not all neonates survive and a palliative care model is required within the neonatal context. Previous research has focused on the barriers of palliative care provision. A holistic approach to enhancing palliative care provision should include identifying both facilitators and barriers. A strengths-based approach would allow barriers to be addressed while also enhancing facilitators. The current study qualitatively explored perceptions of neonatal nurses about facilitators and barriers to delivery of palliative care and also the impact of the regional location of the unit. The study was conducted at the Townsville Hospital, which is the only regional tertiary neonatal unit in Australia. Semi-structured interviews were conducted with a purposive sample of eight neonatal nurses. Thematic analysis of the data was conducted within a phenomenological framework. Six themes emerged regarding family support and staff factors that were perceived to support the provision of palliative care of a high quality. Staff factors included leadership, clinical knowledge, and morals, values, and beliefs. Family support factors included emotional support, communication, and practices within the unit. Five themes emerged from the data that were perceived to be barriers to providing quality palliative care. Staff perceived education, lack of privacy, isolation, staff characteristics and systemic (policy, and procedure) factors to impact upon palliative care provision. The regional location of the unit also presented unique facilitators and barriers to care. This study identified and explored facilitators and barriers in the delivery of quality palliative care for neonates in a regional tertiary setting. Themes identified suggested that a strengths-approach, which engages and amplifies facilitating factors while identified barriers are addressed or minimized, would be successful in supporting quality palliative care provision in the neonatal care setting. Study findings will be used to inform clinical education and practice.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 060063445

Download citation: RISBibTeXText

PMID: 28490381

DOI: 10.1186/s12904-017-0202-3


Related references

Neonatal palliative care attitude scale: development of an instrument to measure the barriers to and facilitators of palliative care in neonatal nursing. Pediatrics 123(2): E207-E213, 2009

Barriers to provision of developmental care in the neonatal intensive care unit: neonatal nursing perceptions. American Journal of Perinatology 24(2): 71-77, 2007

Fathers' perceptions of the barriers and facilitators to their involvement with their newborn hospitalised in the neonatal intensive care unit. Journal of Clinical Nursing 22(3-4): 521-530, 2013

Barriers and facilitators to preparing families with premature infants for discharge home from the neonatal unit. Perceptions of health care providers. Investigacion Y Educacion en Enfermeria 32(3): 379-392, 2014

Perceptions of European medical staff on the facilitators and barriers to physical closeness between parents and infants in neonatal units. Acta Paediatrica 105(9): 1039-1046, 2016

Staff perceptions concerning barriers and facilitators to end-of-life care in the nursing home. Geriatric Nursing 26(4): 259-264, 2005

Barriers and facilitators to the receipt of palliative care for people with dementia: the views of medical and nursing staff. Palliative Medicine 26(7): 879-886, 2012

Staff perceptions of challenging parent-staff interactions and beneficial strategies in the Neonatal Intensive Care Unit. Acta Paediatrica 107(1): 33-39, 2018

Australian palliative care providers' perceptions and experiences of the barriers and facilitators to palliative care provision. Supportive Care in Cancer 19(3): 343-351, 2011

Adequacy of palliative care in a single tertiary neonatal unit. Journal of Paediatrics and Child Health 53(2): 136-144, 2017

Parents' perceptions of staff competency in a neonatal intensive care unit. Journal of Clinical Nursing 12(5): 752-761, 2003

Why is end-of-life care delivery sporadic?: A quantitative look at the barriers to and facilitators of providing end-of-life care in the neonatal intensive care unit. Advances in Neonatal Care 11(1): 29-36, 2011

Palliative care in a tertiary neonatal intensive care unit: a 10-year review. Bmj Supportive and Palliative Care 2018:, 2018

Medical and nursing staff in the neonatal care unit. Lancet 2(8455): 616-616, 1985

Training neonatal staff for the future in neonatal palliative care. Seminars in Fetal and Neonatal Medicine 18(2): 111-115, 2013