G532(P) The care never stops: improving child death management

ContextEvery year almost 3000 children and young people die between the ages of 1 and 19 (ChildBereavementUK). The care that a child receives from medical professionals around the time of their death has lifelong implications for the family.ProblemAt our hospital 70% of paediatric staff surveyed were not confident to offer support to bereaved families.Assessment of problem and analysis of its causesThe current bereavement leaflet was out of date and only relevant to the death of an adult. The staff surveyed felt they had not had adequate training.InterventionsDevelopment of an updated Paediatric Bereavement Support Pack containing relevant information to support bereaved families and guidelines for staff on completion of legal formalitiesTraining to increase the confidence of paediatric doctors and nurses in supporting bereaved familiesTraining to improve the confidence and understanding of the procedures required after a child has diedStudy designWe surveyed 22 doctors and nurses working across the paediatric department including the ward, the paediatric emergency department and the special care baby unit. We asked them whether they were aware of the current bereavement pack, how to access it and whether they knew what support was available to grieving families. We asked them to identify agencies and professionals who should be informed of the death of a child.Strategy for changeWe used a focus group to guide our development of a new leaflet appropriate for the death of a child and sensitive to a multicultural society. This highlighted that a checklist would be useful. The checklist included legal documentation required, professionals and agencies to inform, and references bereavement support references. We created bereavement packs containing all essential forms, the checklist and the updated bereavement leaflet and placed them in each of the main paediatric hospital departments. We conducted several multidisciplinary teaching sessions involving the named consultant for child death, the named nurse for safeguarding and a representative from the Child Death Overview Panel. They aimed to demystify the processes surrounding child death and to increase people's confidence in dealing with the death of a child.Measurement of improvementFollowing our interventions and training we used the same questions to reassess the knowledge and confidence of 22 paediatric doctors and nurses.Effects of changesAwareness of the bereavement pack increased from 55%(12) to 100%(