Example of Helping Children Living in an Endangered or Finite Environment

Executive Summary:

Palliative child care is necessary element for the children having the life limiting conditions. This report provides a detailed example of helping children living in an endangered or finite environment. A consultation is also provided on developing a hair care program, as well as working with parents and children. Barriers are shown to ensure effective childcare and possible solutions. The American Academy of Pediatrics promotes the development and accessibility of services to help children on the basis of texts and standards for children. Such services will require care for the upbringing of children. Respect for caring for children is important for hospitals and other childcare centers. The development of programs in the field of childcare and access to public and public education should be a key element of high-quality childcare centers.

Minimum levels of care for young children should include a way to ensure inappropriate changes between settings, including at least one permanent provider, access to childcare care for the child 24 days a day, 365 days a year, and an international care group with sufficient knowledge to meet the emotional, emotional, emotional and spiritual needs of the child and family. At least, the team will include a doctor, a nurse, a social worker, a spiritual adviser and a nurse for children’s health. Although palliative care services are not needed by all families, it is necessary to provide a full range of clinics and educational resources. In addition, full-fledged care can not be achieved without a chosen guardian who can continue to ensure that the care provided meets the goals of the child and the family, despite the care and departure of senior staff associated with higher-level centers. The coordinator can ensure that the care system is integrated with community care workers to ensure system availability. Higher education institutions should provide a clear education to community providers in the field of childcare, and consultations with childcare services should be conducted 24 hours a day.

Ways to create links between higher education institutions and the community can include the integration of one video or other forms of electronic communication. Life in the family and in the family for the care of children should support the family inviolability, safety and well-being of the sick child. Finally, support for death must be found in the family, guardians and other victims of the death of the child, if necessary. These important services must be reimbursed equally. The initial inclusion of the palliative care team’s insurance fund can help achieve some of these goals.This project also shows that it is possible to systematically check, register and analyze patients’ options at the place of death in a special care center. Following this quality improvement program, popular information is available to all patients who die with hospice. Most patients (81%) had a formal choice; because 19% of the remaining reason for the unpopular acquaintance was available.

Updated documents and allows you to choose the preferences of entries and preferences; so that all the doctors could see how preferences changed each patient over time. During this quality improvement program, the number of patients participating in the discussion on the benefits of caring for the children is growing. Obviously, more effective diagnosis and counseling of patients in collaboration with the introduction of a new eradication service have a significant impact on the success of all patients, especially those who want to die at home. Typically, the number of deaths in the home has doubled during recovery compared to the baseline test. This increase in the number of homeless patients can cost, and recent reports indicate that the cost of care for animals at home is much lower than the cost of inpatient treatment or illness.

Personnel skills have also improved over time. Discussion of PPOD at the weekly meetings on MDT provided an opportunity for more experienced staff to provide advice and support to some employees so that discussion of the chosen death scene was difficult. Over time, employees were more confident in their skills and developed their communication strategies to explore the patient’s preferences. Such conversations are usually conducted as suggestions for planning patient care. Our recovery data showed that mortality at home at home increased to 71%; but patients who die at home do not always have an end to their desire compared to patients who choose hospice or home care. Increasing the success of your home death can be difficult, unless the premises are ready to support it.

Testing the entire area of ​​death led many of our patients to participate in discussions about future violations and helped improve the planning and implementation of an important element of heart treatment. However, the quality of the quality of palliative care is not limited to. We did not consider our ability to bring your interests to the point of care. It is important that patients can die when they want, but it is very important that they can remain in their beloved condition. Finally, good work steps, such as reducing hospital stays (and deaths in hospitals), should not be taken into account, by achieving your death preferences-ratios.

Rationale:

The (Craft, 2007) emphasizes that, despite the increased availability of special services for special children and inpatient care, in many places it is proved that all children continue to die in the hospital. According to (Bennett, 2012), some people may think of a “good death” that cannot be achieved, but continue to discuss that it is important to do everything possible to die as dignified as possible in order to try and give a good basis for a better death. The choice is highlighted as an important factor in the end of childcare; namely, the place of death, (Chang et al., 2013) question whether the hospital is for any reason a favorite place of death for most children and their families or that some optional options are not available to all in this way reflect an inequality in ministry and lack of choice.

The author believes that a formal review of obstacles and facilitators in using the death scene will reveal current trends that can benefit from changing fair care and caring for children at the end of life. Most importantly, it will contribute to the promotion of honorable death.

Background:

Child mortality or adult growth can impair the predictability of a child with a life-threatening / threatening lifestyle. Child Bereavement UK (2011) indicates that, despite this loss, it is difficult to predict when death will occur. One of the reasons for this is that the Department of Children, Schools and Families can predict the phase of the child’s illness, as circumstances and variables can be faster. At the beginning of the 19^th century, as emphasized by (Craft, 2007), the death of the child will occur at home, without any exceptions. But large medical advances and surgeries were a factor in the death of the hospital at the usual rate. In the 1980s, teachers began to doubt. The Department of Health (2008) indicated that these events were identified in the area of ​​childcare and that the house was chosen for a nursing institution. In the midst of convictions and standards, which included careful care, it became apparent that the choice was the key element of the death scene. (Ling,2012), however, discusses that, despite the choice of a home, ideal hospitals or hospitals at the end of life when achieving the goal of death may for some reason be true to many families.

Introduction:

Palliative care is a set of specialized treatment and care centers for people with life-threatening diseases. It focuses on providing assistance for indicators, pain, physical stress and mental stress in the terminal diagnosis. The goal is to improve the quality of life of a person and his family. Evidence in 2016 confirms the effectiveness of palliative care in improving the patient’s quality of life.

Palliative care is provided by a team of nurses, nurses, physiotherapists, medical workers and other medical personnel who work with the primary caregiver and the doctor, as well as with other hospital staff or a hospital to provide additional support. It is suitable for any age and at any stage of a serious illness and can be given as a primary goal of care or treatment. Although this is an important factor at the end of life, it is not limited to this stage. Palliative care can be provided for all of the many parameters that include the hospital, at home, as part of public health programs, as well as in professional medical centers. Interdisciplinary groups of palliative care work with people and their families to clarify the principles of care and provide symptom management, psychological and emotional support.

Sometimes doctors use the name for palliative care in such a way that the treatment is a medicine for treatment, where there is no unexpected treatment (usually found in the late stage of cancer).

“Palliative care for young children and young people with life-threatening conditions is an effective way to maintain care, diagnosis, or awareness of childhood, death and death. It involves physical, emotional, social and spiritual things and focuses on improving the quality of support for children / teenagers and family. It includes the management of symptoms of depression, the provision of small times and the care of death and loss”. (ACT & RCPCH 2009)

Childcare (PPC) focuses on the suffering of children and the family from pain and other stressful symptoms, combining the psychological and spiritual aspects of care, providing support programs that enable children and their families to live as actively and healthily as possible, and to support families to help cope with losses. This is an important element of medical care for all children with limited health (LLC) or for life threatening life or for which an end to life is required. The problems they face when caring for a child with LLC are numerous and understandable, and they are very different from those who care for adults. Children need care for children with their unique problems.

As an adult care service, the goal is to allow every child with a serious illness to live until he dies. Care for the end of life is just a small thing, although it is an integral part of better care for the sick. The PPC principles do not include the urgency or delay of death, helping to transform the focus of attention on health into a quality of life (QOL) and to measure the burden and achievement of all proposed infections. Since PPC is a philosophy of care, it can be possible for any child.

All health care workers involved in the care of children / adults who currently live with the LLC (Limiting life conditions) must understand the key principles of the PPC and be able to respond adequately. Any child with LLC can have automatic help, which is often associated with a primary care group. Therefore, not all children in need of caring for problems in need of care will have to take care of cerebral care. The role of the PPC specialist (SPPC) is to provide comprehensive and professional advice and experience to many of the MDTs who have already taken care of these children and, if necessary, supported the child and the family.

What are life limiting Conditions?

The life span of a limited life refers to any disease that has no hope of healing and when the child cannot live until adulthood. Many of these situations make a continuous breakdown, leaving the child more dependent on their family or their guardians. These diseases were divided into four categories:

Group 1:

The threatening conditions under which treatment may be possible, but can be achieved. Access to childcare services may be required if treatment is not successful. Children in long discussion or after effective treatment are not included. Examples: cancer, failure of heart failure, liver, kidney.

Group 2:

Conditions in which premature death cannot be avoided, when there can be long-term treatment aimed at improving health and ensuring participation in normal activities. Example: cystic fibrosis.

Group 3:

Existing conditions without emergency medical services, where treatment only emphasizes and can often increase for many years. Examples: Batten disease, mucopolysaccharidoses, muscular dystrophy.

Group 4:

Consistent, but incessant causes of serious disability that lead to health problems and premature death. Examples: basic cerebral disorders, many disorders, such as cerebral or spinal disorder (ACT, 2003).

In Ireland, 370 children die each year with LLC. Of these, 57% died in the first year of life (DOHC, 2005). In accordance with international experience, it is very difficult to find visual statistics for the distribution of children from LLC. The first estimate of the rate of spread of 12 children per 10,000 people reported that there were about 1,400 children living with a decline in life. As predicted, this is believed to be less than the estimate based on the last 32 UK figures for 10,000 people, almost three times predicted (Fraser et al, 2012). Irish experts recently recommended an overview of national policies based on these high figures (see IMJ Letter, March 2015). The technical perspective suggests that almost half of the children shown by LLC need proper care at any time (ACT, 2007).

It is important to note that, in contrast to caring for an adult, four children and cancer are just a few of those who focus on the care of the heart. In the country, drugs account for only 22% of the AUC transfusion, with a nervous system infection (39.1%), reproductive conditions or birth defects (22.1%) or other infections (16.7%) that make up the majority (Widger, 2007). The transfer of opportunities for growth can be increased with increasing care for children with disabilities. Many children with different health needs live for many years and are well kept for regular nurses who have been adequately trained to meet their medical needs. It is possible that there are nutritional times that have been inserted in significant periods of the disease, when palliative care can be high.

Global Experience:

At international level, child care for children has emerged from the choice of children, not the care of adults. This is in line with the United Nations Children’s Rights Convention, which insists that children and children should first be trained in the care of children and young people. Ireland’s careful care policy also suggests that, properly, trained personnel should care for children with living conditions. In the case of Ireland, the support and provision of adult care services will continue to be used to ensure that children with LLC are cared for as close to home as possible and may die at home if this is their desire or their family.

The United Kingdom (UK) has a leading role in the development of childcare services and the recognition of childcare as special. In the UK, it specializes in the care of animals, especially for children, for the first time developed childcare services, as well as animal care centers themselves. Associated Life (formerly called the Association for Children and Threatened for Life or Terminal Terminals and their Families or ACP), the Royal College of Pediatrics and Children’s Health (RCPCH) in the UK, helped create several texts important about the needs of young children. These include key recommendations for children with health problems.

Since childhood treatment (and pediatric medicine) was further developed in the UK, the need for a more widely distributed care group was found. This led to a recommendation in 2007 that a specialty should be observed for the treatment of children caring for children in each region and a specialist in each area (Craft, 2007). The Curriculum Coordinated in Medicine Palliative Medicine (BSPPM, 2007) was prepared by the British Institute of Pediatric Palliative Medicine (BSPPM) and the Association of Children’s Hospice Physicians (ACHD). The purpose of the curriculum is to inform about the education of all children of the birth rate, who face children with less life-threatening conditions.

Four level of competencies:

• Level 1: Understands the basic principles of childcare

• Level 2: You can apply the basic principles of treatment in direct childcare. He can identify the causes of the variability of symptoms in children, regardless of whether they are a loss of health or not.

• Level 3: to be able to control the most common symptoms of safety and effectiveness. You are ready to access technical assistance requirements and, if necessary, reach them.

• Level 4: you can cope with unusual symptoms; you understand the purpose of developing a reasonable path, even if there is no evidence. A deep emphasis on leading services and development within and outside the local hospice, as well as on the support and training of other trained professionals and children with less rehabilitated medicines. This level will only be available if the doctor receives FRCPCH or the same variety.

Review Questions:

According to the National Institute of Clinical Excellence (NICE 2012), a sensible and unprecedented sense of purpose has a good question to consider. You can focus on some concrete evidence available. According to (Higgins,2008), each question should determine the community that should be examined, interventions and, if necessary, compare, lead and complete the study. Using a frame describing the question, we can separate them, and then give the building. (Lacey, 2010) discusses that the name of the PICOS name quickly reminds us of some of the key elements of the query. To consider this, the question to review:

Who is the organizer and prevents the use of the death scene for children with life-threatening / life-threatening children?

This question was used for the PICOS structure, as defined in the table below.

Population	Intervention	Comparators	Outcome	Study Design
Children with a life limiting / life threatening illness	Choice of location of death	None	Achieving choice of location of death	Qualitative study

Within the framework of the review, the following tasks will be considered:

• What are the obstacles to choosing a place of death?

• Opponents who want to choose a place of death?

• How can we ensure that families find the place of death of their child?

Research Methodology:

Data sources

The risk of choosing a complete product search from many sources will be reduced. Failure to conduct a comprehensive study of the relevant primary documents adopted by Boland and others (2013) affects the level of the review, since it can actually reduce the search for electronic data. The search strategy will also be developed using the Cochrane Collaboration guide; namely the Cochrane Qualitative and Implementation Methods Group and will include the following:

Databases:

The most common databases related to health will be studied; namely MEDLINE, CINAHL and EMBASE, DoHC and others.

Journals:

To conduct a search in relevant newspapers, as discussed by the Center for Review and Dissemination (CRD, 2009), we can successfully work on viewing newspapers from database producers. In addition, it may be impossible to obtain certain articles using information. As for the review of the proposed review journals that will be evaluated, the focus will be on childcare and care, and will include newspapers from both the UK and international media. Any newspaper accessible from the review of the data review will be included.

Other sources:

Despite the inability to repeat the search results, the Internet is still the correct way to identify the relevant sites for educational organizations and relevant organizations. As proposed by (CRD, 2009), various search engines will be tested, as different results can be found even using the same search terms.

Books:

They can give an overview of the revised topic. (Boland et al., 2013) say that it is worth remembering that some subjects are not yet fully published, but can be considered as a chapter in the book. Due to the problem of the required resources, this will be done in the library directory.

Citation:

The selection of the selected documents for consideration will be reviewed with targeted links that will be evaluated in relation to the studies.

Numerous supporting evidence and government reports will be reviewed and include:

1. National Center for Clinical Excellence (NICE) (published estimates)
2. Department of Health
3. World Health Organization
4. Association for Children with Life-threatening or Terminal Conditions and their Families
5. Department of Health and Children etc.

Research Strategy:

Search can begin when data sources are explored. There are many ways to improve the search strategy, but (Booth et al., 2012) indicates that avoiding unnecessary work is important so that your searches are straightforward. (Lacey, 2010) has expanded, which means ensuring that searches are well organized with respect to what is expected to avoid important ignored information. First of all, the key words from the PICOS structure will be integrated into the ideas, and an additional list of keywords and different types of spelling will be made. In addition to this regulated vocabulary, topics for medical topics (MeSH) will be used to determine the relevant names. Thus, concepts can integrate with Boolean “users” and “,” or “and”, rather than “grow” to look for and produce other results. (Booth et al., 2012) shows that the use of “or” allows us to increase search results that include any derivatives using the “and” limitations of search terms. This will be available for papers, including both detailed search terms. Using “not” allows us to slow down the search, as this will result in the removal of invalid words. The announcement of the release is made before this protocol is made, as suggested by (Arksey, 2005) to provide sufficient courses to support the proposed review, and this is indicated in table below. The search criteria are very useful when viewing any other search conditions. The search will be recorded in detail, as suggested by (Levay, 2011), and will identify the keywords, database, newspapers and websites needed for the relevant dates, and find the following. These results will be recorded using the appropriate version control package as a laptop. The details of this record will be the way that the search engine can be replicated. This will also further refine the methods of review, allowing the student to assess the quality of the review.

1	(MH “Parents”) OR (MH “Parents of Disabled Children”)
2	(MH “Attitude to Death”) OR “location of death”
3	(MH “Palliative Care”) OR (MH “Terminal Care”) OR (MH “Hospice Care”) OR (MH “Age Specific Care”)
4	“choice theory”
5	“paediatrics” OR (MH “Pediatrics)
6	S2 OR S3 OR S4 OR S5
7	(S2 OR S3 OR S4 OR S5) AND (S1 AND S6)
8	(MH “Parents of Disabled Children”) OR (MH “Hospices”) OR (MH “Child, Disabled”) OR “children’s hospice”
9	(MH “Parents of Disabled Children”) OR (MH “Hospices”) OR (MH “Child, Disabled”) OR “children’s hospice”) AND (S8 OR S9) AND (S6 OR S9)
10	(MH “Parents of Disabled Children”) OR (MH “Hospices”) OR (MH “Child, Disabled”) OR “children’s hospice”) AND (S8 OR S9)) AND (S6 OR S9)) AND (S1 AND S10)
11	“preferred place of death”
12	(“preferred place of death”) AND (S6 OR S9 OR S12)
13	(MH “Child, Disabled”) OR “preferred place of death for a child”
14	“life limiting”
15	(MH “Critical Illness”) OR “life threatening
16	“complex needs”
17	(“complex needs”) AND (S14 OR S15 OR S16 OR S17)
18	“location of death”
19	(“location of death”) AND (S18 OR S19)

Criteria:

The studies to be considered will be devoted to documents that include children’s ideas and young people with a life expectancy or life-threatening diseases or their parents and guardians regarding the chosen scene of death. The reviews will include courses using appropriate data collection methods. There will be no restrictions on the day set for the search, but the language restrictions will be used due to translation problems and problems. Therefore, the purpose of these review documents containing information from other countries will be considered, but only written documents in English. This, of course, will allow us to get many views on the universe.

Quality Assessment and criticality:

According to (Hill, 2001) on a formal review done to provide health professionals with a lot of historical evidence, develop policies and guidelines that determine the suitability, integrity and integrity of these important issues. Amendments to this reduction in the withdrawal of cash by eliminating these substandard books. As discussed by (Crombie, 1996), special exams provide a systematic assessment of each subject and have a sense of research, methods and results. Although it is difficult to recall all the issues that should be taken into account when considering the study (Tinder, 2008), which suggests a specific tool in this work, allows us to carefully study the published study. By doing this, we can choose research studies on its relevance and uncertainty without any significant research on the revision or deficiency of both low and inadequate quality. This should allow the trainer to conduct a targeted assessment of the information. Special tests conducted in accordance with the (Burls, 2009), have certain problems; that is, there is time, until a person is familiar with the process, he does not always have to answer “simple” or “mental”, and can emphasize that a “good” study is limited in such a way that it requires a certain commitment and commitment to a full formal review. Despite the fact that there are many important diagnostic tools, there is little evidence that one is superior to another, and, according to (Katrack et al., 2004), there is no integrated health research tool. Indeed, the creation and implementation of new testing tools is an ongoing process, as the understanding of the sources of these studies associated with various training projects is evolving.

In order to assess the quality of the study in connection with this review of the tool developed by (CASP, 2013), a program will be implemented. This tool allows us to reduce the ten-dimensional evaluation of the portfolio and even without direct guidance from (Gaines, 2004). We discuss the assistance of the trainer to determine the key features of the research article and determine which functions may not be available. Discovering the CASP management overview allows the evaluator to create a data-based account, based on the review process. To minimize the reduction of reviewers and to provide a more reliable and reliable assessment of (Green, 2008), this suggests that more than one person should carefully examine the selected studies and third-party analysts available to address, if necessary. Because of the underestimated stress of the proposed review, it cannot include this, and therefore one reviewer will be used to display the assessment evaluation of the assessment in the assessment area.

Data extraction:

Data extraction is a way to minimize the limited content of a published research subject by allowing the discovery of a principal to be released by providing data. (Barroso, 2003) argued that research is often published and published in a variety of ways, such as an example of research or content, therefore, how the data cited should be consistent with the issue under consideration and the type of review and should be transparent and informative. (Pope et al., 2007) suggests that the method used can influence the results, because it will depend on the data that has been published, for which data is used for the review section. The data output is continuous and fair, the template of the data template can be applied to the selected study so that you can allow the referee to form data formally. The template to be used for this study is intended for the general form of data transmission. The data on quality control is a way to improve and, with caution, any deleted data can begin to contain defining contexts. This means that (Hedges, 1994) suggest that avoiding concern about this section in the review process is important not to think about what the data or significance of the data is. In addition, it is assumed that the implementation of this process should be reduced prejudice, even two good people. But, as mentioned earlier, due to fixed circumstances only one person will perform the data storage operation for this update. The data extraction tool will be verified in accordance with and was properly modified when significant changes are not forgotten or the tool is considered unacceptable for its current, which is incompatible with all subjects, unreasonable sections, and insufficient information.

Synthesis of data:

At the first stage of the review, as noted by (Hedges, 1994), the accessibility of all the lessons learned is reduced to an integrated congregation that can answer the survey question. Integration may include explanatory analysis or discovery, but the purpose of this qualification research will be focused on it. There are many types of methods that were previously used to evaluate Dixon-Woods’ studies in 2005, citing a number of them: automatic analytics, met analytic qualitative analysis, explanatory summary and the following basis. All the methods discussed try to integrate the results in an attempt to deepen the story. At this thematic conference we will be hired, as this will determine a number of topics. By focusing on ideas and personal preferences, (Thomas, 2007) suggested that useful information can be found in favor of preferences, barriers and intermediaries. This will allow us to fully understand the needs of a particular client group, which allows us to understand decision making and plan delivery of services without the information provided to us. Thematic synthesis includes the following stages:

1. Practice yourself with information.

2. Make the first codes.

3. Search for topics.

4. Review the articles.

5. Identify and names.

6. Create the report.

(Charmers et al., 2002) suggest that initial stability arose as researchers playing a role in the definition of data, but it is considered a variable alternative to various issues. In order to ensure loyalty, codes and independent built-in texts will be presented in official reviews. In order to improve the transmission of a clear explanation, some aspects of the subject will be provided, including the context and the setting where the data was published.

Strategic Dissemination:

One of the main objectives of conducting official reviews in accordance with (Rousseau, 2012) is to disseminate the results of the survey so that interested parties have access to information. It is important that, from the very beginning, the reviewer consider how they want to broadcast and how this can be achieved in the interests of others. Successful broadcasting in this respect will hope for raising awareness of the recipients and understanding the topics that will be considered. The (Scullion, 2002) suggests that most of us know that the most popular options for broadcasting in the media are, for example. Newspapers, websites, etc., because they are considered reliable ways, but the use of other tools can increase the target audience. Depending on the area of ​​research in question, it will be possible to find results in different languages ​​to help overcome the language and cultural barriers that they need to take care of. In addition to DVD subtitles, an audio device or the use of Braille can be used for people with hearing impairments and hearing impairments. Attractive posters are in the right place for a more reliable way to attract the target audience. (Szabo, 2010) ensures that social media is used as an excellent tool and, in fact, is seen as one of the fastest growing sources of information exchange. In addition, they agree that one of the ways to reach your audience is to use applications for smart phones. The last two ways will depend on support and inappropriateness for such studies as this review.

The distribution methods for this update are described below.

It is important to remember that identifying existing distribution channels can be an effective way of sharing your information. Associations related to the topic of the review will have technical bodies and newsletters, etc., with which they are faced. It is therefore profitable to use these existing channels than to organize the events and recurrence books that are currently available and to transfer to people already responsible.

Dissemination Method	Reason
newsletters	Target people with an interest in the subject/overview can be presented leaving the individual with the means to access further information.
conferences	Provides wider audience group
One to one	More intimate e.g. talking to patient/parent
workshops	Attracts people with an interest in the subject
websites	Ease of accessibility/means of access to further information
reports	Target professionals working with similar population
Email	Ease of accessibility/target individuals
Academic or professional journals	Target professionals with an interest in this area.
Networking	Target professionals working with similar population and provides opportunity for feedback
Team meetings	Target professionals working with similar population

Timescales:

Organized editing is an aspect of assessing the level of evaluation of the level of authors. As was done outside of his usual career and according to the day of delivery provided by the institution, it is expected that it will be considered for about ten months.

Discussion:

The report of the Committee for the Promotion of Palliative Care (DoHC, 2001) emphasizes the need to revise the childcare services. This report was considered the goal of developing more care services in Ireland and was adopted as a national policy. In the Report on the study of the children’s survey “Elimination of problems with testing of children” is conducted and the results were published in 2005 (DoHC, 2005). The availability of services in Ireland was consistent with what was done in some countries.

Key findings:

• Injustice in the provision of jobs.

• Poor integration and access to services.

• Home care and community support services should be developed.

• There was no dissemination of relevant data on distribution and mortality.

• The “primary” employee needed to develop integration and access to services.

• Further education, training and development of health workers are required.

• Easy access to home sector availability.

• Organize the development of necessary services.

• Some of the needs of children need to be considered.

• The most comprehensive list of losses is the support required for access.

In response to the Evaluation of Results, the Department of Health and Children (DoHC) developed a health system for children with medical conditions – National Policy (DoHC, 2010). This policy is a way to ensure that nutrition care services are developed and exported throughout the country. This policy is aimed at addressing the problems identified in assessing the needs for responding to the response of children and their families.

This policy emphasizes that a complete childcare system wants to work within the framework of a joint project through interaction between general work, a children’s doctor, a medical expert, a nurse and a voluntary sector. Children’s hospitals and children’s unions are the primary guardians and guardians of medical workers. This policy also facilitates the appointment of senior staff, including a specialist consultant in the CPT and child breadwinners in the province. The national policy emphasized that childcare services should be accessible, fair, consistent and appropriate and meet the needs of any child in charge of life with their families. Children with reduced health have the same needs as healthy children, and should maintain a normal life as long as possible. Satisfaction of diet and educational needs of children with LLC is seen as a challenge.

Role of specialist pediatric teams:

Currently (2015), the pediatric palliative care specialist group (SPPC) at Lady’s Children’s Hospital, Crumlin is one of the specialized childcare specialists, two consultations with senior doctors and nurses 1.5WTE in clinics (CNS). There are also specialized doctors (SPR) and regularly trained specialists (SHO) who travel twice a week with an old medical consultant.

The group is committed to ensuring quality equity for all children with health that reduce health and their families with SPC requirements, as defined in the National Policy (DoHC, 2010). Childcare services located in Kraumlin are a consultative, advisory and support organization. The team cares for the child, but works in partnership with the first group of children. Acceptable transfers in all specialties (especially in the hospitals of Crumlin and Coombe Women & Infant University Hospitals), and all transfers appear or are resolved by children or a newborn child. The general transfer (GP) appears in consultation with the primary caregiver.

Patients at Crumlin and Coombe Women & Infant’s University Hospital are reviewed as soon as possible. Usually it depends on where the family (+/- child, where necessary) can fit into the group. Extraordinary transfers are updated within 24 hours, from Monday to Friday. The transfer of transfusions can be revised as an “entry” or transition to another assignment in order to minimize the burden on the family. The emergency clinic SPPC began in 2015 on Crumlin. Palliative Safety Pediatric Palliative Team welcomes delivery of deliveries from the women’s and women’s university hospital Coombe. In these cases, fetal transplantation cannot be seen at the MDT meeting “Prevention of Pregnancy”. Mother / parents are visited to meet with a neonatologist and child care guardian to discuss the diagnosis, prediction and care of their child after birth.

The coordinator of the parental guardian has a national mandate for counseling and support of guardians by birth in the LLC and support for care centers for local communities in the care of children / youth at the end of life. This includes telephone counseling to nurses and theatrical areas that impact households / health facilities (affable and based on love) 24 hours a day, seven days a week.

SPCC service’s aims:

If a child turns to the SPPC service, which is not related to Crumlin then, as far as possible, developmental care technicians can be controlled in the child’s GP’s childhood, public health nurse (PHN) and a certain nurse with help and advice on the phone. If necessary, the palliative + / or “Jack and Gill Foundation” organization is also involved in child care.

• If the baby goes to Crumlin, the SPPC service (usually) is more directly involved in child care management or care or when visiting a clinic with a home-based care service or a nearby Crumlin. SPPC’s contacted parents also have direct access to CNS’s child care and support (support and support) through the Crumlin distribution board.

• All children who are expelled from “leaving the end of life” are sent to a local group for treatment. The team, along with a pediatrician, nurse children, general physicians, PHN, HSE +/- Laura Lynn at home and “The Jack & Jill Foundation” deals with the child’s symptoms and support for their family and family in their home. The SPPC team in Crumlin provides direct access to the local team.

• The SPPC team also provides support to all the medical teams that, if necessary, provide for children with principles of living. Part of the team’s role in maintaining a multi-disciplinary team, including a shared booklet, a specialist infectious specialist, a special child’s special team, a team of senior care staff, a disability office, a graduate, a special school, Psychology, social work, pastoral care, pharmacy, occupational therapy, massage and movement of the body, food treatment, medical play, musical treatment, and child hospitals and other voluntary donations involved in child care.

Health care professionals giving the palliative services:

Following the publication of the national policy (DoHC, 2010), the nomination of primary medical appointments, including the appointment of May 2011 of a child consultant with special interest in the treatment of children in the UK. The position received funding from the Irish Hospice Foundation (IHF) for five years, after which the HSE would take a sum of money.

When a child calls for the care of local services, a dentist with decorative cancer, if necessary, looks like this:

• A doctoral student who led to the care of the child and his family.

• An old care coordinator in the care of local care services.

Adult palliative services:

Local adult-based care services (both hospital and community caregivers) support and help some children with life-threatening conditions, as well as their families, especially in the management of complex conditions and discontinuation of health care. This passage is very important.

Clinical Nurse Specialists in Pediatric Palliative Medicine:

Any technical activity needs support and clinical information provided by clinical nurses (CNS) in this technical field. Currently, Pediatric Palliative in Cramlin has a 1.5S CNS.

Role:

• Provide clinical support and advice to patients (where appropriate) and their families and health professionals who work with these patients and families.
• Assistance in training and development of nurses and medical workers working with children LLC.
• Do this as other resources / support for nursing care for children and caregivers specifically-CNS

Pediatric Outreach Nurses:

Other key assignments were provided by eight nurses to access children with LLC. During the first three years, the Irish Hospice Support Foundation (IHF) sponsored five nursing centers, and then the HSE continues to fund. Analysis of patient care services for palliative care (DoHC 2005) has shown the need for integration of services, enhanced communication and communication services and is referred to in this reference link as a “key employee”. To fulfill this role, a childcare network has been established to support patients and families in the community. These spaces help to ensure equal access to services around the world for children with conditions for reducing health and their families, regardless of their location.

Initially, nurses outside of eight children were stopped. An overview of this first post, the upload of a similar post, the data of the Central Statistical Office (CSO) in the current age group and the statistics found in childcare centers can lead to the selection of additional requirements. This post should be divided to ensure the availability of a world of accessibility for this service because the role of the progressive nursing nurse may have some opportunities to improve the high level of nurse practice (ANP).

The role of the children’s outreach nurse includes:

• Consolidate the service to ensure continuous care and improve the quality of life of the living conditions and their families.

• To edit, use, implement and evaluate the care of a child with a hearing to reduce the health of their families, in cooperation with health / medical care workers. This paragraph will be applied to both powerful and social services.

• Promote education and training for health workers and social workers in collaboration with stakeholders.

• Support for data collection for children with LLC.

• Make it a source of information and link the child with family care and providers of health care services for children with life-threatening conditions.

• Associate PHNs, Disability Services, Social Network Nurses, Old Age Support Groups and voluntary organizations (for example, Jack and Jill Foundation Nurses).

The main focus of the nurse on childcare is the child and the family. The nurse has clear messages about the relationship with the medical director (DON) or DON assistant at his or her residence and is supported in making decisions about the care of the primary caregiver. Great support is available in the public health center of the province, in the adult care group (if they are caring for children), a rich child doctor who specializes in the treatment of children on the basis of Crumlin and the National Support Network.

A national coordinator for CON was recently selected. This role includes providing leadership and management support to the CON and ensuring high-quality provision and compliance with the National Development Coordinator Committee.

Detailed information on the role and control of childcare clinics is shown in the children’s outreach nurse for children with severe conditions of life; Framework for Education and Framework, published by the National Development Committee in August 2012 (HSE & IHF, 2012).

Champion Pediatricians:

The post was created to support children’s access to nurses. The role is played by nurses, who pay special attention to the care of the children.

Role:

• Champion to support the position and role of nurses’ access to children in the region • Develop a strategy in cooperation with the pediatrician and nurse, the direction of the post.

• Work as a nursing support for children and provide medical advice when needed

• To increase interest in caring for children wires that care for their children within the service

• Contact other health professionals and health care providers in key hospitals, as well as disability services and voluntary caring for children with severe illness in the area

• To communicate and cooperate with local care groups.

• Contact the hospital’s director of the hospital as defined in your area.

• Supporting childcare and childcare programs in childcare

• Supporting a flexible and acceptable area of ​​development

• Childcare services.

Multidisciplinary Team Members Providing Palliative Care Services:

In addition to the above-mentioned medical specialists, the multidisciplinary team includes social work, psychology, pastoral care, physiotherapy, treatment, drug addiction, drug treatment, music therapy, death group. In general, the community of general practitioners, the pharmacist and primary care plays an important role in caring for the child with caution. Group work with good communication is important.

Care model proposed:

Principles and recommendations for the development of a national health care system. Childcare (DoHC, 2005) proposed four goals in which the future development of the health needs of children should be based on:

1. Integration

All children, regardless of their culture, place and age, should have access to proper care. All suppliers must have access to the special care required as needed.

1. Cooperation

It is necessary to ensure the active participation of all stakeholders, including the child. Parents should be united as partners in decision-making and care organization.

1. Caution

Should include focusing on the emotional, educational and spiritual needs of the child and his family.

1. Flexibility

Care should be tailored to the individual needs of the child and the child. Better care for children with a simple need should be provided regardless of location or diagnosis.

Following on from this, the National Policy (DoHC, 2010) has several recommendations for the future development of children’s palliative care services in Ireland. These come under the broad headings of:

• • Policy implementation
• • Clinical control
• • Children and their parents
• • Consultant specializing in special care for children’s care
• • Nurses providing childcare with LLC
• • Emergency services and services
• • Respite services
• • Bereavement services
• • Education
• • Education and training of health workers
• • National Committee on Nursing Development for Children
• • Cooperation with Volunteer Agencies

Current services for current care are not sufficient to meet growing needs. To ensure quality, the same service, development will require many phases.

1 to 4 year:

• Three children with special treatment for child therapists need only childcare. At the same time (WTE) is currently exported to Crumlin (legal fees). Two more WTEs are required; one from Crumlin and one from Durban Street.

• An additional CNS is required, one from Durban Street and one from Crumlin.

• Continuous sources are needed to receive the help of a socialist nurse. There are eight nurses for access to the approval of the other two WTEs.

• A national care guardian is required.

• It is necessary to develop chronic clinics that allow patients to attend several orders.

• In the future, the relationship between childcare and adult care will continue, and it is expected that the management of this clinic should be maintained and developed.

5 to 7 year:

• • A full-fledged childcare group is fully required in the new hospital; see below New Children’s Hospital.
• • The appointment of regular nurses with a special interest in patient care (Cork, Galway, Limerick)
• • Increases nursing sisters with health care rehabilitation
• • Improves reproductive health and delivery services
• • Support for development services at home
• • Developing national data for children with limited health

7+ years:

• • Maintain and build for long-term goals
• • Support services for the care of services provided by the Government
• • Childcare for the sub-specialty of pediatrics

New hospital for children:

It is planned that a high-quality child care group will be expanded, and the group will be supported in a new hospital. The group will be categorized as other small children with three children with special care for children and their daughter group (including practitioners), clinicians, social workers, psychologists and support services and access to a wide range of group members (e.g. occupational therapy, physiotherapy, music therapy, play specialist, dietetics, speech and language therapy). At present, the childcare group will provide children and their families with the opportunity to cope with any life-threatening situation in order to ensure the highest quality of medical care, life, and death.

The National Policy (DoHC, 2010) also states that the Children’s Palliative Care Team should be:

• Striving for cooperative and Numeracy productivity in conjunction with partners, children and hospitals in the province, including providing counseling and hospital giving birth, a child of old hospitals, high early health groups and public services, including in relation to and / or direct family care quality life and management of symptoms, psychological management, observance of spiritual loss management. The emphasis should be that we intend to provide care for children as much as possible.

• Designed to improve the provision of health care technology provide children with reduced health, including analysis and the pursuit of high quality, evidence-based behavior and encouragement on behalf of children and families to prevent life situations.

• Provide guidance to clinics, technical development and the role of training of child sisters in rural areas. Every child with medical care must consult a nurse in order to gain access to the Child Care Unit in order to coordinate care if necessary.

Service of integration:

Strong communication is important between professionals who provide services for children and families in all important conditions. For families, it is important that the health system works in a simple, visible, integrated way, and all relevant stakeholders in their childcare are fully guided by the child’s success at any time. Together for the sorting of lives, the 2012 Greatest Lesson underscored the parental concern that their services, especially local services, appear to be distributed in a divided, integrated approach and report that communication, cooperation and continuation of staff should be developed , which do not have the ability to rely on all elements. In facilitating the PPC care process in Ireland, integration methods that combine high-level PPC, nursing care, nursing, general practitioners, local disability groups, adult care (where applicable) and other health care providers Ensure that communication is organized in a timely and timely manner with the appropriate knowledge and frequency.

Requirements needed for successful implementation of the model proposed:

Staffling:

Essential for the development of a comprehensive checkpoint service throughout the country for the development of expertise in the area. The availability of technical personnel is important, and it is important to invest in people. The last article in the newspapers “Pediatric Diseases” made recommendations on the future development of dental care and delivery services in the United States. At the American Academy of Pediatrics (AAP) “All hospitals and large health organizations that always provide children with LLC and provide only care for life should have different prices per click” (AAP 2013).

The current consultant for children in need of help to children should be respected as an integral part of the development of services and their financing. Currently, the nurse’s counseling program and knowledge information are sponsored mainly by the Irish Hospice Foundation. When using 2.5 million Euros in this program, 85% are provided by charity. This responsibility should be accepted by the HSE in five years as previous negotiations.

It is necessary to constantly increase the position of specialists in the treatment of children. Now it is known that out of all 10 children going to the hospital, 40 from the LLC, the problem is that these conditions are rare. Currently, it is recommended that the highest limitations of the LLC be given to the number of nutrition recommendations that should be equal to the number of adults providing care in 1: 4 ratio (Hain, 2013). There is a small need for a second post to support coordinator Crumlin. This post should also be based in Dublin to support other children’s hospitals and links to parental services. Eventually they will meet as one team in the hospital for newborns and third-party counseling. Links with delivery hospitals are important and have a high mortality rate (ESRI, 2012).

The appointment of nurses with special interest in the treatment of children in Ireland will allow children with LLC to take care of them for as long as possible. This can be included in the development of ordinary children in countries.

Medicinal procedures should be respected in Ireland as a specialty of pediatrics and the transfer of sponsored training to include NCHD training. This is important for special development.

As a result of the transfer of foreign countries, the proper development of the support group in Crumlin is necessary to support the expansion of the CNS and the recommended social worker and support for the clerk (DoHC, 2010). Increasing CNS support for the PPC command is required after the workflow is completed by the appointment of the coordinator. The team must be embedded in a new hospital when it comes to stream.

Continuous expansion of nursing care programs will also help ensure that children live and are able to do well. This post is a key element for children and families at home. By providing such an important service and providing key services for employees in the family, nurses can help children at home in many situations and in hospitals. One nurse working in the district is not surprising, and the plan will need to be expanded.

Palliative care is provided with several fines, so children need access to all support services if they are good at it. This includes, if necessary, access to services of psychology, as well as to specialists in social assistance and counseling services for all families. Psychologists, if they exist, play an important role in helping children and families in the treatment of health-related diseases. They help in serious discussions about death and death, encourage ways of solving the problem of child’s adequacy, stress management, etc. and technical support of families. Currently, psychological services are limited, especially in society.

Supporting health professionals for those who work in this complex area is critical to the development and ability of staff to meet the needs of families and children. This is especially true for those who have taken care of important care for many years as senior caregivers at home. This work is extremely difficult physically and emotionally. Observers can support other informal health workers, but the need for legal support in other cases requires recognition.

Infrastructure:

Many families want to take care of their children at home. But some families could not do this because of the special needs of childcare or other obstacles. Only 11 children have unprotected home games, reported in the DoHC, 2005. This compares with 67% of children with cancer. This is part of the physical needs of these children with unexploded LLC for a longer period of time. To fix this without the need to expand effective family support for family recreation, easy access to cars, medical cards, etc. This is especially true at the end of life when there is a great need.

It largely depends on voluntary subjects such as the Jack and Gill Foundation and the Irish Cancer Society to help nurses. These services are not available to all children with LLC. Extensive support for nurses when there is need for children to be sent home at the end of medical care will facilitate their release. Currently, all children can be sent to the local community of local communities, which provides excellent services. However, this is supported by a lawyer, not by “hands” to support family care, which other families need. Children and families (both cancer and non-cancer patients) who prefer to end their lives in their home environment should be supported by providing home care packages at the right time. These HCPs should include nursing support, additional support for other MDT health professionals as a result of the proper provision of specialized items at the right time.

It should be recognized that not all families choose the house as the place where they most need at the end of life. The hospital may be the most favorable option because of the complexity of certain medical conditions requiring continuous treatment or because of complex mental, non-family support or cultural problems. In these cases, children need to receive the assistance that is needed to meet the needs of the hospital groups with special support. Upgrading the support of the LLC with a hospital in the hospital can help improve the life and death of children in Ireland. Modern buildings are often depressed and especially complex when they try to bring care to the elderly. It is expected that these boundaries will be associated with the hospital of the newborn. The national policy states that “hospitals should provide an adequate environment for children with heart needs, including environmental and natural resources, such as training and education personnel” (DoHC, 2010).

Education and training:

It is important to educate and educate existing workers who work with limited children. These care and support centers, such as relaxation and childcare centers, require staff to ensure that employees are able to provide professional assistance when necessary. Continuous training and education must be performed and tested for performance. Although training is available, it may be difficult for workers to achieve the current weather, and this must be taken into account.

A small group of the National Committee for the Development of a Kindergarten was named “Palliative Care in the Field of Education in Care”. This group has recommendations for training for all health professionals in the care of Ireland and identifying areas in which education needs to be built and expanded.

Review of choice of place of death:

In the United Kingdom and Europe, there is emphasis on the increasing choice of patients and caregivers in the field of health, including focusing on home care. For those who are approaching the end of their lives, the ability to take care of domestic and domestic deaths is greatly guaranteed by the producers. In the United Kingdom, in particular, there is an urgent need to expand the level of care at home. This is what adults and children with adults and young people (CYP). The documents include the statement “Children often live at home, and families often want to keep their homes with illness and death.” Similarly, an independent review of palliative care states: “Many families would like their child to be taken away from home.” As for children, these beliefs and, again, this policy are not supported by powerful evidence collected from CYP, their families or health workers (HCP). Information was excluded from the recommendations of older people for caring for CYP, not understanding the difference between caring and love between adults and children and their families. Limited studies are shown as depression in previous articles.7-10 most studies also consider and include discussions with lost parents or HCP. In this article, we report a comprehensive review of the preferences of CYP (POD) deaths for life-threatening (LLC) and life-threatening diseases (LTIs).

Findings:

Nine articles and report on the preferences of death at home or report data from them. Six of these studies focus on four children with cancer. Five percent of interviewed parents who died were parents. Vickers et al.23 found that 98 (68%) of 164 households were registered in household chores, such as POD, when attending a meeting, that is, when treatment was considered impossible. During the last month of life (or in a study of 28 children who died in the first month), the death rate at home increased to 132 (80%) of 164 people. Hexter et al 16 say 88% N = 48) of selected families, back at home, as “POD.” In “Grinyer and Thomas’24”, devoted transmitted behavior, as reported by their parents, it was found that “the majority” of 13 of the elective home death “three-thirds of 13 … can die at home, and the person wanted to do it, but died We discovered the discovery of Sussel et al-20, according to which at least 67 (48%) of the 140 families who died at home could not at least prefer to die at least 48% of their home deaths. Heath et al.17 reported that family members had planning time when their child died (N = 61, 63%), 89% (N = 54) said they chose their home for the child (56% N).

One important issue is that the availability of POD or home death can be a cardiac effect. None of the studies have been revised, and many of them give a clear view that the mortality rate, or hospital or hospital, is better. Indeed, Sussel et al. that “the real place of death cannot be more important than the opposition.” Their conclusion is that “the probability of planning a death scene (LOD) may be the best representative at the end of a higher level of medical care than a real LOD, which is more closely integrated and well suited for caring for care.” Lawton writes that focusing on death seems less important to parents than focusing on the positive effect of good care at the end of life. In a study of elderly people with cancer, Waghorn et al. found that home death was seven (or the sixth, depending on) the list of important things in good death. They conclude that POD cannot be a good quality sign at the end of life.

Is the POD option an important issue for future childcare research? The experience of death at home is a complex and difficult situation. These articles have been revised, as well as literature in general, which clearly indicates that CYP can die at home, in a hospital or hospital, as well as accounting provided to their families describing their choices as one who meets their needs and never regrets about it. The upcoming important work aimed at the continuation of basic and simpler things than POD, which allows us to balance the quality of family life and the assistance provided.

Place of death:

Among 50% and 90% of patients with cancer, expressing the desire for death, can choose death at home. A number of studies from different countries have linked patients to their chosen place of death, which indicates that many patients make homework when they are willing to do so. In addition, patients and caregivers agree at home, since the favorite place of death is shown as a strong prediction of the death of the house.

12 properties that are closely related to the death scene have just been communicated by Gomesh and Higginson. Based on the review of 58 lessons, they offer a model for this design of the disease, in personal and environmental issues and emphasize the powerful state of the model on all aspects of this issue. The popular death scene appears to be changing in all types of illnesses, while some studies show that the death of the house is a decline in time, and the house remained a wonderful place for a better world.

The method of conversion was later taught by Thomas and others. Where testing is conducted for cancer patients and informal educators. This highlights the problems associated with the choice of deaths. Thinking factors that affect parental patients include the degree of contact, patient care dialogues, symptom management, fear of loss of dignity, and attitudes to patient / nursing care workers, nursing homes, hospitals and community nurses and community services. The choice of patients seems to be uncertain. Preferences were rarely classified, but they were correctly predicted by chance.

While for all patients with terminal illness the same needs for standard care should be provided, as is usually the case in matters related to the end of life, most subjects at the selected place of death are concentrated on patients with cancer. The findings indicate that the preferences of patients with other diseases and the factors that affect them do not separate from those with cancer. A careful study of the views of elderly patients on home care as a nursing home expressed concern about the quality of care at home, the adequacy of their children to ensure more attentive care and participation in trained home caregivers.

Determining place of death:

Have been promoted so that people can die in their place they want requires large empowerment for patients and their families, an initial risk assessment, and training of the best nursing care caregivers, including those who work in primary care. However, there is very little evidence of how well this should be. Issues related to the selected scene of death will be discussed with other patient issues, including problems related to death, and the status of death. A difficult prediction of the prediction and death regimen can prevent such a conversation. The concept of a positive part of terminal cancer patients that are difficult to achieve, for example, patients with the heart of our end of the disease or disease after the next without any emergencies, following the sequence of actions of the best practices of pursuit and, rather than decreasing faster, as is often due to the upper part of a patient with cancer chronically suffering. Although the definition of a description of cancer patients is a problem, with a tendency to continuous breathing of life, the requirements for clinical diagnostic clinical diagnostic patients have been shown as unemployed; In addition, one study showed that primary care practitioners were more likely to compare the mortality of one year with patients with a heart attack.

The individual expectation of the state of death and how it creates their desires is different. Helping patients to see and determine what you love and what they turn to respond to changes in the patient’s condition, it is necessary to develop communication skills, including differences in price sensitivity. Such conversations can only be achieved in the context of relationships between patients who continue to depend, and may require significant investment over time.

The number of patients who want to discuss their favorite place of death is different from each person. Although some believe that they die, they are outstanding in their desire, and I clearly demonstrate to death, some will deny their ultimate illness, using this as a means of self-defense; the subject in which they want to die can be a boundary. Nevertheless, some patients, perhaps most, will be in the same row with each other. They may not talk about their problems or desires on the street, but they may be ready to discuss this issue when they are connected out loud. It is possible that they would be in appropriate circumstances, but they may not be aware of the circumstances when they approach the time of death will not approve it, and this may be the cause of death.

Advance planning of care:

Preferences will help prepare precancerous and oncological therapy for cancer and should help prevent wrong treatment, especially when entering the hospital, at the end of life. Informing the two providers about the death of the patient at home can simplify the procedure of release, if necessary, can be made concise. However, acquaintance with death seems difficult to perceive, and measuring measurement problems can lead to admission to a hospital (for example, control management), although designed for a short period of time, will result in the removal of the patient. This may be a particular problem for neonacological tests, where it is even more difficult to predict criticism. Although continuous research can stimulate the immune system to predict both cancers and cancer-free diseases, due to the complexity of the disease of the body, the clarity of these residences will always be limited.

Effects on health care professionals:

A little known about the impact of healthcare providers in the selected death zone. This process can stimulate negative emotions, fearing that the patient will be emotionally affected when the subject is affected. They may have personal concerns about discussing this difficult and emotional issue, including the uncertainty about how to handle the patient’s feelings and guardians, or to be cared for to make sure they cannot. They may have the fear of their own death or their families with friends, or they may have unresolved grief over past losses, making it difficult to talk about the subject of death. Personal information for the patient over time may be helpful to prepare experts and patients to discuss this problem, but, in the same way, it can make it difficult to talk about a problem when the emotional connection has become among them. Experts who have close relationships with patients may be inclined to comment on and not be aware of the upcoming end of the last phase.

It may seem very difficult for medical professionals to talk about the choice of death and patient in providing adequate public services or providing hospitalization clinics, perhaps impossible. Selected death zone may be empty and the promise of choosing malicious deception if services are not available due to lack of funding or other resources. Although simple rhetoric promises to patients, fixed death is deceptive; the truth may be that the complexity of the uncontrollable system of death opens the true choice as the gold of the foolish.

Recommendations and conclusion:

In this report we have summarized the questions that influence the choice and the preferred place of death along with the palliative care for children. Satisfying the patient’s wishes for the place of death is an important function at the end of life, and should be treated with feeling and regular consideration when the patient approaches death, as part of a realistic assessment of the appropriateness of various options. Discussions will include the family of the patient and / or other carers. Preference for clarification can help in planning for prior care so that patients can achieve their goals; however, the complexities associated with clinical course and limited resources are likely to contradict patients’ plans even with the highest level of medical services.

Recommendations:

• Increases the level of childcare to ensure safe, affordable and efficient services.

• Organize the collection of data on basic data for children with livelihoods

• Raise the level of education and training of all care workers for children with health problems

• Promote comprehensive care and delivery of delivery and care

• Promote research to care for small children

• Increased cooperation between the legal and voluntary sectors

Moreover, the patients should be given proper right to choose a place of death and they should be properly taken care of.

Abbreviations and Acronyms:

• AAP American Academy of Paediatrics
• ACT Association for Children with Life-threatening or Terminal Conditions and their Families ANP Advanced nurse practitioner
• ACHD Association of Children’s Hospice Doctors
• BSPPM British Society for Paediatric Palliative Medicine
• CCNE Centre for Children’s Nurse Education
• CNS Clinical nurse specialist
• CON Children’s outreach nurse
• CSO Central Statistics Office
• DoHC Department of Health and Children
• DON Director of nursing
• ESRI Economic and Social Research Institute
• FRCPCH Fellow of Royal College of Paediatrics and Child Health
• GP General practitioner
• HCP Home care package
• HSE Health Service Executive
• IHF Irish Hospice Foundation
• LLC Life limiting condition
• MDT Multidisciplinary team
• NUIG National University of Ireland, Galway
• PHN Public health nurse
• PPC Paediatric palliative care
• QOL Quality of life
• RCPCH Royal College of Paediatrics and Child Health
• SHO Senior house officer
• SPPC Specialist paediatric palliative care
• SpR Specialist registrar
• UCD University College Dublin
• UK United Kingdom
• WTE Whole time equivalent

Bibliography:

Capel, M., Vout, L. & Gazi, T., 2011. Outcome of referrals to a community specialist palliative care service, where do patients die? BMJ Supportive & Palliative Care, 1(2), pp.219–220.

Munday, D., Dale, J. & Murray, S., 2007. Choice and place of death: individual preferences, uncertainty, and the availability of care. Journal of the Royal Society of Medicine, 100(5), pp.211–215.

Corr, C.A., Corr, D.M. & Bordere, T.C., 2013. Death & dying, life & living, Belmont, CA: Wadsworth, Cengage Learning.

Maddocks, I., 2001. Palliative care: a guide for general practitioners, Daw Park, S. Aust.: International Institute of Hospice Studies.

Ward, D., 2006. Hospice and Palliative Care Directory United Kingdom and Ireland 2006, London: Hospice Information.

Craft, A. & Killen, S., 2007. Palliative care services for children and young people in England: An independent review for the Secretary of State for Health, London: DOH.

Roberts, M.C. & Steele, R.G., 2009. Handbook of pediatric psychology, New York: Guilford Press.

Moloney-Harmon, P. & Prevost, S.S., 2005. Pediatric critical care, Philadelphia: Saunders.

Velikova, G., Keding, A., Harley, C., Cocks, K., Booth, L., Smith, A., Wright, P., Selby, P. and Brown, J. (2010). Patients report improvements in continuity of care when quality of life assessments are used routinely in oncology practice: Secondary outcomes of a randomised controlled trial. European Journal of Cancer, 46(13), pp.2381-2388.

Mehta, A. and Chan, L. (2008). Understanding of the Concept of “Total Pain.” Journal of Hospice & Palliative Nursing, 10(1), pp.26-32.

Rhondali, W., Perceau, E., Saltel, P., Trillet-Lenoir, V., Blay, J., Fournel-Federico, C., Coulon, J., Tredan, O., Terra, J., Matillon, Y., Bruera, E. and Filbet, M. (2012). Depression assessment by oncologists and palliative care physicians. Pall Supp Care, 10(04), pp.255-263.

Bruera E, e. (2015). The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of palliative care patients. – PubMed – NCBI. [online] Ncbi.nlm.nih.gov. Available at: https://www.ncbi.nlm.nih.gov/pubmed/1714502 [Accessed 30 Jul. 2015].

Who.int. (2015). WHO | WHO Definition of Palliative Care. [online] Available at: http://www.who.int/cancer/palliative/definition/en/ [Accessed 30 Jul. 2015].

Watterson, G. and Hain, R. (2003). Palliative care: moving forward. Current Paediatrics, 13(3), pp.221-225.

Together For Short Lives (2013). A Core Care Pathway for Children with Life-limiting and Life-threatening Conditions. 3rd ed. [ebook] Bristol. Available at: http://www.togetherforshortlives.org.uk/assets/0000/4121/TfSL_A_Core_Care_Pathway__ONLINE_.pdf [Accessed 27 Jan. 2018].

World Health Organisation (2012). WHO guidelines on the pharmacological treatment of persisting pain in children with medical illnesses. [ebook] World Health Organisation. Available at: http://apps.who.int/iris/bitstream/10665/44540/1/9789241548120_Guidelines.pdf [Accessed 27 Jan. 2018].

Together For Short Lives (2014). Directory of Life-Limiting conditions. [ebook] Cardiff. Available at: http://www.togetherforshortlives.org.uk/assets/0000/7089/Directory_of_LLC_v1.3.pdf [Accessed 29 Jan. 2018].

Association for Children with Life-threatening or Terminal Conditions and their Families (2009). A Guide to the Development of Children’s Palliative Care Services. 3rd ed. [ebook] Bristol. Available at: http://old.rcpcf.ru/Files/pdf/ACT.%20A%20Guide%20to%20the%20Development%20%20of%20Children’s%20Palliative%20Care%20Services.pdf [Accessed 30 Jan. 2018].

Moloney-Harmon, P. & Prevost, S.S., 2005. Pediatric critical care, Philadelphia: Saunders.