Bereavement care practices: A national survey of Australian paediatric intensive care units

Hospital-based bereavement care is an important source of support for families following the death of a child in a paediatric intensive care unit (PICU) but has been identified as lacking in many critical care units worldwide. Recent surveys exploring bereavement practices in intensive care units have not reported comprehensive paediatric data, meaning the extent of this problem within the PICU setting is currently unknown. The aim of this study was to describe current bereavement care practices in Australia PICUs. A cross-sectional, self-reported, online survey, conducted between November 2024 and April 2025. A validated 34-point critical care bereavement survey was adapted for the paediatric setting and assessed for face validity with five PICU nurses before circulation. Representatives from Australian PICUs were surveyed via the Australian and New Zealand Intensive Care Society Paediatric Study Group mailing list. Completed surveys were received from 11 dedicated PICUs in Australia (100% response rate). Most respondents reported more than half of the 10 elements of bereavement care provided within their PICUs, but only two PICUs (2/11 [18%]) provided a formal bereavement follow-up service. Six PICUs (6/11 [55%]) provided an informal service, while a further three PICUs (3/11 [27%]) provided no follow-up service. Only one unit (1/11 [9%]) reported paid, dedicated time allocated to bereavement. This national survey showed bereavement care provided within Australian PICUs was similar across units, but formal bereavement follow-up services were lacking. Bereavement follow-up in most Australian PICUs was delivered by clinicians within their other roles or in unpaid time. We suggest further research into family bereavement needs to strengthen the evidence-base for PICU bereavement care, along with increased training, resourcing, and funding for PICU clinicians to deliver bereavement follow-up services.