peds pal care

1
FROM THE ART CART TO THE COMFORT
CART Expanding Bereavement Services in the
Pediatric Intensive Care Unit Rebecca Case RNC,
BSN UC Davis Childrens Hospital
UCDAVIS CHILDRENS HOSPITAL
INTRODUCTION In the past, The Pediatric
Intensive Care Units bereavement services were
limited to sympathy cards at the time of death.
In 2000, the PICU bereavement committee met to
create a timeline for follow-up remembrance
cards, and to identify easily accessible
resources to expand our care to the family during
the death of a child. Memorial boxes and hand
molds were the first priority of the units
bereavement program. The committee obtained
volunteer seed money and supplies for the start
up of an art cart. Later the unit received
grant funding to expand services to include a
comfort cart which has the resources for all
family members to participate in therapeutic
bereavement activities. Today the bereavement
committee has expanded to a hospital-wide
multidisciplinary committee with funds provided
by the Childrens Miracle Network. Congruent
bereavement services can now be found all through
the UC Davis Childrens Hospital.

• The UC Davis Childrens Hospital Bereavement
  Committee
• MISSION STATEMENT
• The mission of the UC Davis Childrens Hospital
  Bereavement Program
• is to provide comfort and compassion to families
  experiencing grief and
• loss of a child and to offer the resources and
  support for healing
• Goals were established in the following
  categories
• Staff Education
• Education of family
• Spiritual and emotional support
• Internal and community resources

• DISCUSSION FAMILY SUPPORT
• What are the family's cultural rituals for
  coping and caring for a dying child, the final
  arrangements for the body, and honoring the
  death?
• What are the family's beliefs about what happens
  after death?
• What does the family feel is a normal
  expression of grief and the acceptance of the
  loss? How can the PICU caregiver facilitate this?
  
• What does the family consider helpful from the
  staff? What resources match their needs?
• What follow-up support is beneficial? How do we
  measure positive outcomes?

STAFF EDUCATION SUPPORT Committee members
presented the comfort carts services and
supplies to staff. Educational conferences about
grief and bereavement are provided. Annual ELNEC
(end of life nursing education) classes are
available Arrangements were made for staff
debriefing time when indicated. Interested staff
may participate in the bereavement committee
program
PURPOSE To initiate and expand bereavement
services in the PICU .
Resource Books The COMFORT CART with
Bereavement Supplies

• CONCLUSION
• Parents feel supported when offered bereavement
  supplies,
• Families grieve for their child before the actual
  death
• The comfort cart provides means to memorialize
  their loved ones life by creating tangible
  memory objects. It offers blankets, journals
  music and other supports to families
• Storybooks can facilitate the introduction of
  death to a sibling and help them understand that
  grief reactions and feelings are normal
• Nurses need to be provided in-services to the use
  of the cart and its supplies and direction about
  their role introducing the cart to the family.
  They need education about grief and bereavement
• Many nurses expressed appreciation for the tools
  and support they could give families.
• Many times intense grief reactions were
  temporarily soothed with the memory making
  activities, offering families a short emotional
  break at the hospital setting
• The expansion to the comfort cart and the
  development of a hospital-wide bereavement
  committee has provided more opportunities to
  support families. The committee has helped move
  change, introduce evidence based practices and
  has served to create consistent services through
  out the childrens hospital

• FAMILY SUPPORT EDUCATION
• Correspondence letters bereavement
  /remembrance cards sent at 1 week, 3mos. 6mos. 1
  year and birthdays
• Educational brochures, storybooks on death and
  grief
• Supplies, for handprints locks of hair and
  memory boxes
• Booklets care at the time of death, funeral
  arrangements,
• Newsletters, family bereavement support groups

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ART CART
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