• Moving and handling and managing physiological deterioration of deceased children in hospice cool rooms: practice guidelines for care after death

      Tatterton, Michael J.; Honour, A.; Billington, D.; Kirkby, L.; Lyon, J.A.; Lyon, N.; Gaskin, G. (2021)
      Children’s hospices provide a range of services for babies, children and young people who have life-shortening conditions, including care after death in specialist ‘cool bedrooms’. Caring for children after death is a challenging area of hospice care, with variation seen within, and between organisations. The study aims to identify current practices and to produce guidelines that promote safe practice in moving and handling and managing physiological deterioration of children after death. An electronic questionnaire was sent to all 54 British children’s hospices; 33 responded (=62% of hospices). Variation in the way in which children’s hospices delivered care after death was identified, in terms of the length of stay, care provision and equipment used, owing to demands of individual families and the experience and confidence of practitioners. Internal variation in practice can lead to practitioner anxiety, and risk-taking when providing care, particularly in the presence of family members. Practice recommendations have been made that reflect the practical demands of caring for a child’s body after death; these have been split into two parts: moving and handling considerations and managing physiological deterioration. These recommendations should be used to support the development of policy and practice, allowing organisations to standardise staff expectations and to support practitioners when caring for children after death.
    • Moving and handling children after death: an inductive thematic analysis of the factors that influence decision-making by children’s hospice staff

      Tatterton, Michael J.; Honour, A.; Kirby, L.; Billington, D. (Lippincott Wolters Kluwer, 2022-02)
      Hospices for children and adolescents in the United Kingdom provide care to the bodies of deceased children, in specially-designed chilled bedrooms called ‘cool rooms’. In an effort to develop resources to support hospice practitioners to provide this specialist area of care, the study aimed to identify the factors that influence decision-making when moving and handling children’s bodies after death in a hospice cool bedroom. An internet-based survey was sent to all practitioners employed by one children’s hospice. A total of 94.9% of eligible staff responded (n=56). An inductive approach to thematic analysis was undertaken, using a six-phase methodological framework. Three core themes were identified that inform practitioners’ perception of appropriateness of moving and handling decisions: care of the body, stages of care, and method of handling. The complexity of decision-making and variation in practice was identified. Practitioners relied on both analytical and initiative decision-making, with more experienced practitioners using an intuitive approach. Evidence-based policy and training influence the perception of appropriateness, and the decisions and behaviour of practitioners. The development of a policy and education framework would support practitioners in caring for children’s bodies after death, standardising expectations and measures of competence in relation to moving and handling tasks.