{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T01:00:46Z","timestamp":1790816446568,"version":"4.1.0"},"reference-count":27,"publisher":"AACN Publishing","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early integration of palliative care for pediatric intensive care unit patients and their families is beneficial for establishing goals of care and complex decision-making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To implement the use of a trigger criteria process to deliver palliative care to a specific population of pediatric intensive care unit patients who would most benefit from receiving such care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Trigger criteria were developed through a literature review and interprofessional work group discussions. Medical records were reviewed to compare the frequency of pediatric palliative care consultation 1 year before project implementation and during the 6-month project period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>The pediatric palliative care trigger criteria process was integrated into 3 areas of the pediatric intensive care unit workflow. Staff members identified patients meeting the trigger criteria and initiated team discussion on the appropriateness of palliative care. A pediatric palliative care consultation was requested if the team agreed that it would be beneficial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twelve of 18 patients (67%) had pediatric palliative care consultations during the 6-month project period using the trigger process, compared with 7 of 27 patients (26%) before process implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Implementation of a trigger criteria process to identify patients with high needs for palliative care was successful and effective in the pediatric intensive care unit in the setting of limited palliative care availability. Reassessment of trigger criteria, integration of the trigger process into the electronic health record, and ongoing staff education will be required for long-term sustainability of the project.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4037\/ccn2026109","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:02:27Z","timestamp":1790812947000},"page":"46-52","source":"Crossref","is-referenced-by-count":0,"title":["Palliative Care Trigger Process in the Pediatric Intensive Care Unit: A Quality Improvement Project"],"prefix":"10.4037","volume":"46","author":[{"given":"Cynthia","family":"Myo","sequence":"first","affiliation":[{"name":"Cynthia Myo is a pediatric nurse practitioner at Stanford Medicine Children\u2019s Health Palo Alto, California."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth Nachtsheim","family":"Bolick","sequence":"additional","affiliation":[{"name":"Beth Nachtsheim Bolick is a professor in the College of Nursing and the director of the Acute Care Pediatric Nurse Practitioner Program, Rush University Chicago, Illinois."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Reed","sequence":"additional","affiliation":[{"name":"Julie Reed was a pediatric nurse practitioner at Stanford Medicine Children\u2019s Health Palo Alto at the time this manuscript was written. She is retired."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly A.","family":"Pyke-Grimm","sequence":"additional","affiliation":[{"name":"Kimberly A. Pyke-Grimm is a nurse-scientist, Department of Nursing Research and Evidence-Based Practice, Stanford Medicine Children\u2019s Health Palo Alto, and a clinical associate professor, Department of Pediatrics, Stanford University."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2471","reference":[{"issue":"10","key":"2026093020022222800_b1-0460046","doi-asserted-by":"publisher","first-page":"1832","DOI":"10.1111\/apa.14394","article-title":"Low prevalence of palliative care and ethics consultations for children with chronic critical illness","volume":"107","author":"Boss","year":"2018","journal-title":"Acta Paediatr"},{"key":"2026093020022222800_b2-0460046","doi-asserted-by":"publisher","first-page":"907268","DOI":"10.3389\/fped.2022.907268","article-title":"Palliative and critical care: their convergence in the pediatric intensive care unit","volume":"10","author":"Buang","year":"2022","journal-title":"Front Pediatr"},{"key":"2026093020022222800_b3-0460046","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1016\/j.jpeds.2017.09.078","article-title":"Patterns of care at the end of life for children and young adults with life-threatening complex chronic conditions","volume":"193","author":"DeCourcey","year":"2018","journal-title":"J Pediatr"},{"issue":"2","key":"2026093020022222800_b4-0460046","doi-asserted-by":"publisher","first-page":"e2022058905","DOI":"10.1542\/peds.2022-058905","article-title":"Surgical intervention in patients receiving pediatric palliative care services","volume":"151","author":"Ellis","year":"2023","journal-title":"Pediatrics"},{"issue":"8","key":"2026093020022222800_b5-0460046","doi-asserted-by":"publisher","first-page":"804","DOI":"10.1097\/pcc.0000000000000861","article-title":"Increasing access to the benefits of palliative care in the PICU","volume":"17","author":"Levetown","year":"2016","journal-title":"Pediatr Crit Care Med"},{"issue":"2","key":"2026093020022222800_b6-0460046","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1007\/s40124-018-0169-4","article-title":"Pediatric palliative care and the pediatric intensive care unit","volume":"6","author":"Rhee","year":"2018","journal-title":"Curr Pediatr Rep"},{"key":"2026093020022222800_b7-0460046","unstructured":"World Health Organization\n          . 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