Implementing a palliative care program in a newborn intensive care unit.

In the United States the majority of infants who die in the first 27 days end their lives in the neonatal intensive care unit (NICU). This article describes the implementation of a NICU-based team approach to providing end-of-life care to dying infants and their families. Timeline, activities, and resultant improvements in family care and staff support are described. Moral distress among nurses caring for dying infants is discussed. A case study, neonatal palliative care policy, palliative care pathway, and lactation suppression guidelines for mothers following infant death are presented. More research is needed to verify improvements in neonatal, family, and staff support with palliative care programs in the NICU.