The Periviable Infant: The Implementation of a Standardized Perinatal/Neonatal Outpatient Consultation Program

Common ethical principles are the foundation for why we ask parents for informed consent before proceeding with their infant's care. Respecting parental decisions in periviable resuscitation can benefit from adopting a new practice. This evidence-based practice project detailed the identified needs-based practice change for a standardized perinatal/neonatal outpatient consult concerning the periviable infant. Initiating early consultation of high-risk deliveries provides an understanding of parental wishes and satisfaction in decision-making, care of their infant, and bereavement support through a shared decision-making model. The project aligns with value-based care delivery, designed to improve healthcare by focusing on outcomes. Larrabee's Evidence-Based Practice model served as the guiding framework. Appraisal and synthesis of the literature necessitate recommendations to employ a shared decision-making model for developing and communicating a well-designed birth plan following the delivery of the periviable infant. A validated survey, the Parental Stress Scale: Neonatal Intensive Care Unit (PSS: NICU), evaluated parental stress following the perinatal consult and delivery of a periviable neonate admitted to the neonatal intensive care unit. Eight participants were recruited (four women and their identified support person). Parents who received the perinatal/neonatal consult had less critically unstable infants however reported less stress in two of the three subscales.