BEREAVEMENT CARE SUB-GROUP

(NATIONAL IMPLEMENTATION GROUP

HSE/HIQA MATERNITY SERVICES INVESTIGATIONS)

HSE National Incident Management Team

(NIMT) 50278 (2013)

“ensure that the psychological impact of inevitable

miscarriage is appropriately considered and that a member of

staff is available to offer immediate support and information

at diagnosis. Members of staff should also advise of the

availability of counselling services for women and partners at

diagnosis. Care given, including counselling and support,

should be documented. The availability of counselling

services for women, partners and families who have

suffered any incident or bereavement in childbirth should

be reviewed, considered and developed as appropriate at

each maternity site”.

set up February 2014 to develop guidelines for bereavement

care in maternity hospitals/units

multidisciplinary sub-group with national representation

Leader Ciarán Browne (National Lead Acute Hospitals)

Project Manager Anne Bergin

Bereavement Care Sub-group

Surname First Name Professional Role Place of Employment

Bergin Anne Project Manager Health Service Executive

Browne Ciarán National Lead Acute Hospital Services Health Service Executive

Byrnes Helen CNM University Hospital Galway

Bolger June National Lead for Service User Involvement, Patient Advocacy Unit Health Service Executive

Coughlan Barbara Psychologist and Midwifery Lecturer University College Dublin

Fenton Joanne Perinatal Psychiatrist Coombe Women and Infants University Hospital

Hunt Marie Bereavement Counselling Clinical Midwife Manager University Maternity Hospital Limerick

Keegan Orla Head of Education, Research and Bereavement Services Irish Hospice Foundation

Kennelly Máiread Fetal Medicine Specialist Coombe Women and Infants University Hospital

McKeown Anne Bereavement Liaison Officer University Hospital Galway

Moran Mary Ultrasound Lecturer University College Dublin

Mulligan Fiona Bereavement Support Midwife Our Lady of Lourdes Hospital, Drogheda

Mulvihill Aileen Senior Social Worker Palliative Care Longford / Westmeath

Nuzum Daniel Chaplain Cork University Maternity Hospital

O’Donoghue Keelin Consultant and Senior Lecturer, Obstetrics & Gynaecology Cork University Maternity Hospital

O’Sullivan Grace National Development Coordinator, Acute Hospitals. Hospice Friendly

Hospitals Programme Irish Hospice Foundation

Rock Sara CNM2 Neonatology National Maternity Hospital, Holles Street

Rooney-Ferris Laura Information and Library Manager Irish Hospice Foundation

Shine Bríd Clinical Midwife Specialist, Bereavement & Perinatal Mental Health Coombe Women and Infants University Hospital

White Martin Consultant Neonatologist Coombe Women and Infants University Hospital & Our Lady’s

Children’s Hospital, Crumlin

Woods Kathryn Midwife Midland Regional Hospital Mullingar

Bereavement Sub-group Members

examine current bereavement services in maternity hospitals /

units

explore the needs of bereaved spouses/partners following a

maternal death

develop a national guideline for bereavement care following a

maternal death

develop standards for bereavement care following

pregnancy loss and perinatal death

Tasks

1. Bereavement Care

Bereavement care is central to the mission of the

hospital and is offered in accordance with the religious,

ethnic, social and cultural values of the parents who

have experienced a pregnancy or perinatal loss.

2. The Hospital

The hospital has systems in place to ensure that

bereavement care and end-of-life care for babies

is central to the mission of the hospital and is

organised around the needs of babies and their

families.

3. The Baby and Parents

Each baby receives high quality end-of-life care that is

appropriate to his/her needs and to the wishes of

his/her parents.

4. The Staff

All hospital staff have access to education and

training opportunities in the delivery of

compassionate bereavement and end-of-life care

in accordance with their roles and responsibilities

The 4 Standards

All hospital staff are trained to sensitively communicate bad news to parents in a quiet and private environment and with special consideration of individual needs and preparedness for the emotional and physical management of their diagnosis

Standard 1: Bereavement Care

Staff are responsible for:

• providing bereavement care at time of diagnosis

• discussing treatment options

• assisting parents to prepare for the birth

• sensitively following the parents preferences for the birth

• providing holistic post natal care

• offering preparation for discharge from hospital

• providing follow-up bereavement Care after Discharge

Standard 1: Bereavement Care

The hospital has systems in place to ensure that bereavement care and end-of-life care for babies is central to the mission of the hospital and is organized around the needs of babies and their families.

Standard 2: The Hospital

a culture of compassionate bereavement care

good governance policies, clear guidelines and care pathways for staff to follow

effective communication with parents

maintain transparent healthcare records

a safe hospice-hospital friendly environment

continuous monitoring and evaluating of bereavement care

for all of baby’s end-of-life care needs

for the allocation of clinical responsibility and multidisciplinary working

pain and symptom management in accordance with the baby’s needs

clinical ethics support

best practice when caring for the deceased baby

post-mortem examination in accordance with HSE and RCPI guidelines

anticipatory and follow-up bereavement care

Standard 2: The Hospital The Hospital is committed to provide

Each baby receives high quality end-of-life care that is appropriate to his/her needs and to the wishes of his/her parents.

Standard 3: The Baby and Parents

provide clear and accurate information

explore parental preferences

pay due attention to pain and symptom management

provide holistic care to the dying baby

accommodate discharge home/out of hospital

in the event of a sudden decline in the baby’s health staff communicate sensitively with the family about the sudden or unexpected decline in their baby’s health leading to death

Standard 3: The Baby and Parents When communicating a diagnosis of a need for end-of-life care staff

All hospital staff have access to education and training opportunities in the delivery of compassionate bereavement and end-of-life care in accordance with their roles and responsibilities. Staff are supported through training and development to ensure they are competent and compassionate in carrying out their roles in bereavement care.

Standards 4: The Staff

Hospital Management commits to:

cultivating a culture of compassionate bereavement care among all staff

providing staff induction in bereavement care at commencement of employment

providing for staff education and development needs

introducing staff education and training programmes

providing staff support in a timely fashion

Standards 4: The Staff

Where are we now?

Launch of Draft Standards for Public consultation

Consultation process / Circulation of Standards

Forums (Voluntary Support Groups, Sligo, Cork,

Dublin, Mullingar, Limerick and Galway)

Web feedback

Feedback analysis

Finalising of the standards

Bereavement Care Standards following

Pregnancy Loss and Perinatal Death

1. Implementation Strategy

2. Research in to the impact of maternal death on partners

3. National Guideline for Bereavement Care Following

Maternal Death within a Hospital Setting

On-going Activities

Thank you for your time

Anne Bergin Project Manager, Bereavement Care Sub-group

jabergin@coombe.ie