Care provided after death:
The primary purpose of the NI Regional Paediatric Pathology Service (NIRPPS) is to conduct autopsies on babies and children to establish the factors contributing to their death, detecting and diagnosing obstetric and paediatric conditions if possible. Their role includes:
- Carrying out post mortem examination to establish the cause of death if possible
- Documenting the nature of any disease present, its extent and whether it contributed towards death
- Determining whether death is due to an inheritable condition that could affect future children
- Providing information that may be relevant to the future reproductive health of the parents, and the siblings of the deceased infant
- In the case of sudden and unexpected infant death: determining if possible whether death was the result of natural disease, accidental injury or non accidental injury or SIDS, and if present, documenting and evaluating all injuries.
- Ensuring that post-mortem results are provided to clinicians and thus the family, in a timely and appropriate manner
- Undertaking discussion with medical staff caring for the family regarding the autopsy results, in order to provide helpful clinicopathological correlation.
- Providing families with support and information, assist in the collection of keepsakes (if not already done at ward level), such as hand and foot prints, and photographs
- Working together with other agencies to secure the health or welfare of other children in the family
- Ensuring that all remains regardless of gestational age, are respectfully and sensitively disposed of; to include liaison with the crematorium superintendent, funeral directors, Belfast City hall registration staff, and other mortuaries and HSC Trusts.
- Providing a placental examination for all babies born dead if the family has decided not to consent to an autopsy examination.
- Maternity, Paediatric, Neonatal and Emergency Departments in the Region.
- Regional Genetic Service, Fetal Medicine, Paediatric Radiology, Other Laboratories, Forensic laboratory, State Pathologists Department (Northern Ireland Regional Forensic Mortuary)
- HM Coroner ,Northern Ireland Police Service, Court Service Northern Ireland
- SANDS, The Miscarriage Association
- Royal College of Midwives
- MBRRACE (previously CEMACE/CEMACH )
- Child Death Review teams- social workers, GPs, family care workers, health visitors
- DHSS and Public Health Agency
- Registrars office, Crematorium staff
The Standard of Bereavement Care is enhanced when:
- Professionals have been trained with regard to consent, HTA legislation and coroner regulations
- Documentation required for local and regional government bodies for disposal of remains is completed
- Ward based staff adhere to the guidance produced by NIRPPS in all aspects of completing documentation, arranging an autopsy and disposal of the remains, in order that the examination may be carried out in a timely manner
- Ward staff attend an autopsy examination for professional development to ensure that any information they provide to parents about the role and methodology of the examination is current and accurate.
Standards and Guidelines
- Human Tissue Act 2004 http://www.legislation.gov.uk/ukpga/2004/30/contents
- HSC Trust/Employers policies and procedures in relation to pregnancy loss, death and bereavement care
- Code of Practice 3, Post Mortem, September 2009, Human Tissue Authority
- Code of practice 5, Disposal, September 2009, Human Tissue Authority
- ‘The Retention and Storage of pathological records and archives (4th edition 2009)Royal College of Pathologists/IBMS Guidelines
- HSC Regional Policy on Post Mortem Examination
- DHSSPSNI ‘Consent for Histopathological Examination and Disposal of Early Miscarriages’
- DHSSPSNI ‘Consent for Hospital Post-Mortem Examination of a Baby’
- Royal College of Pathologists guidelines http://www.rcpath.org/training-education
- Coroners Service http://www.courtsni.gov.uk/en-GB/Services/Coroners/publications/Pages/coroners_Publications.aspx
- Miscarriage Association recommendations
- SANDS guidelines http://www.uk-sands.org/improving-care/the-sands-guidelines-2007.html