Constructing educational content for neonatal palliative care: A Delphi method and needs analysis

Background: High-risk newborns face significant mortality risks and potential for recovery, making neonatal palliative care essential. However, existing neonatal palliative care education for neonatal intensive care unit (NICU) nurses often prioritizes end-of-life care and overlooks family involvement and long-term management needs. Aim: To develop and prioritize neonatal palliative care educational content tailored for NICU nurses, addressing gaps in current curricula and supporting family-centered, evidence-based practice. Methods: A three-round Delphi survey was conducted to identify key educational topics for neonatal palliative care, followed by a cross-sectional online survey to assess NICU nurses' perceived performance and importance for each topic. Participants included 148 NICU nurses from tertiary hospitals in South Korea with over six months of experience, excluding those with administrative roles. Educational needs were analyzed using the Locus for Focus model, Borich needs analysis, and Importance-Performance Analysis. Results: This study identified 66 educational topics grouped into five domains: “Physiological care,” “Family-centered care,” “Continuity of care,” “Nursing professional development,” and “Multidisciplinary team approach.” High-priority topics included balancing critical and palliative care, managing stress, and navigating ethical challenges. Family-centered care was emphasized throughout the NICU stay, emphasizing family involvement in care, guidance on growth and development, and addressing social challenges. Continuity of care post-discharge was also highlighted, particularly rehabilitation, bereavement support, and community health resources. Conclusion: This study offers a robust framework for developing evidence-based neonatal palliative care educational programs. By addressing contemporary issues and emphasizing long-term, holistic approaches, these findings contribute to advancing family-centered care and enhancing nursing competencies globally.