Improving Moral Distress and Provider Perceptions with an Integrated Palliative Care Conference in the Neonatal Intensive Care Unit (NICU) (TH370B)

•Describe how domains of palliative care can be integrated into the care of high-risk infants in the Neonatal Intensive Care Unit (NICU).•Delineate the effects of an integrated palliative and neonatal interdisciplinary conference on staff moral distress and neonatal providers’ perceptions towards palliative care. Despite national recommendations to incorporate palliative care (PC) into the Neonatal Intensive Care Unit (NICU), providers’ (MD and APN) perceptions may prevent optimal PC delivery in this setting, leading to moral distress in staff. Objectives were to investigate the efficacy of a weekly case-conference to improve moral distress and perceptions of PC in the NICU and to increase consultation rate to specialty PC for newborns at high risk for mortality and/or morbidity. An interdisciplinary PC/NICU case-conference served as a platform for educating providers on incorporating palliative care domains into the care of high-risk NICU infants. NICU providers’ PC perceptions were measured at baseline and after 12 months of implementation (follow-up) using a published survey. Providers and multidisciplinary NICU staff completed the Moral Distress Scale-Revised at baseline and follow-up. NICU consultation rate to PC at follow-up was compared to baseline. Surveys were completed by 57 MDs/APNs and 176 NICU staff, mostly RNs. Compared to baseline, providers were significantly more likely to endorse that they provide families with PC options (84% v. 95%; p