In Campinas, a city located in the state of São Paulo (Brazil) is a Neonatal Palliative Care Group within the ICU of the Women’s Hospital José Aristodemo Pinotti / CAISM. This university hospital is a national hospital and has as its mission the comprehensive healthcare of women and newborns. It is also a reference hospital for maternity risk deliveries, extremely premature infants and children with congenital malformations.
The hospital complex is integrated into the State University of Campinas – UNICAMP, through the Departments of Paediatrics and Obstetrics and Gynaecology, Faculty of Medical Sciences. The inpatient unit has 15 intensive care beds and 15 beds for intermediate care. In 2011 the service attended 2908 births, with 587 hospitalisations (328 in NICU), with 102 with a birth weight less than 1500g.
In 2001, at the initiative of professionals working in this NICU, the Neonatal Palliative Care Group (NPCG) was created in order to improve patient care at the end of life and provide care for their families. It also provides care to alleviate the stress of professional staff who work there. Since January 2002, the professionals involved hold weekly meetings to discuss scientific articles and clinical cases, with the gradual incorporation of improvements in care, such as care protocols, weekly meetings with families of hospitalised infants and monthly meetings with bereaved parents.
In August 2002 the group presented the first guidelines for care related to death. In October of the same year, the process was designed for the Neonatal Palliative Care (NPC), through discussion of eligible patients and treatment proposals. After some discussion, these proposals were incorporated into the practices of the service in order to improve this care pathway.
The first group consists of one doctor, two social workers, one nurse, one nurse technician, two physical therapists, two psychologists and one speech therapist. Apart from integrated assistance provided by the staff, they are also involved in developing, sharing and disseminating research in Neonatal palliative care through events and scientific studies to raise the awareness of other health professionals.
These professionals also seek to invest in in-service training and conduct educational activities with paediatric residents of, undergraduate speech therapists, physiotherapy students as well as to the experts in social work.
Those attended to by the NPCG are newborns admitted or discharged from the inpatient unit of the Women’s Hospital, their families and the bereaved parents. The NPCG participates in clinical discussions with professionals in the NICU, develops guidelines for treatment of eligible patients, organises and participates in meetings with relatives and, in recent years, has become a reference in the proposal care.
These actions have led to higher quality and the humanisation of care. We are guided by institutional ordinance and the comprehensive care programme from the Ministry of Health.
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