Exploring the barriers to palliative care practice in neonatal nursing: A focus group study

Abstract

Palliative care for the neonatal population has become more topical in recent years given the escalation of technological and medical advances and higher neonatal survival rates. Some newborns, however, will still die in the neonatal intensive care unit, often as a result of extreme prematurity and other complex medical problems. This paper explores previously identified barriers to palliative care practice in neonatal nursing. These barriers were inadequate staffing, unconducive physical environment, technological imperatives and parental expectations. Using an interpretive research framework, focus groups were conducted at three tertiary neonatal intensive care units (NICU) in Australia to elicit individual views to aid in clarifying the barriers to neonatal palliative care. A purposive sampling method accessed 24 registered nurses with neonatal intensive care experience. The three barriers identified by the survey data were discussed at each of these focus groups. The three themes discussed at the focus groups emerged as central to the successful adoption of a palliative model of care in the NICU. The recommendations identified in this research can be translated into policy, curriculum development and training in the clinical environment.