Bereavement Care Subgroup (Presentation from Acute Hospital Network, March 2015) [AHN35]

1. BEREAVEMENT CARE SUB-GROUP
(NATIONAL IMPLEMENTATION GROUP
HSE/HIQA MATERNITY SERVICES INVESTIGATIONS)

2. 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”.

3.  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

4. 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

5.  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

6. 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

7. 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

8. 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

9. 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

10.  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

11. 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

12.  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

13. 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

14. 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

15. 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

16. 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

17. Thank you for your time
Anne Bergin
Project Manager, Bereavement Care Sub-group
jabergin@coombe.ie