It has been identified that the greatest challenges for staff providing end of life care relate to staff discomfort in initiating conversations with patients and carers; incomplete documentation; failure to recognise when patients are starting to die and then developing and documenting appropriate treatment plans; and poor communication between staff and patients and carers .
The following tools are a valuable resource in assisting clinicians in caring for patients with life-limiting illness.
Paediatric Resuscitation Plan
The general principles and process guiding the completion of a resuscitation plan are the same for children as for adults, with a focus on communication and exploration of goals of care with the person/s responsible, and where appropriate, the child.
NSW Health Resuscitation Plans are not valid for community patients under the medical care of a doctor who is not a NSW Health staff member. General Practitioners with admitting rights are considered NSW Health staff.
Palliative care for children and young people with life-limiting conditions is an active and total approach to care, embracing physical, emotional, social and spiritual elements. It focuses on enhancement of quality of life for the child and support for the family and includes the management of distressing symptoms, provision of respite, and care through death and bereavement .
The NSW Paediatric Palliative Care Programme is a website that provides valuable information to parents, carers and health professionals caring for children with life-limiting illnesses.
 Clinical Excellence Commission (CEC) 2013. Safer Systems Better Care - Quality Systems Assessment Statewide Report 2012. Sydney: CEC
 Association for Children with Life Threatening or Terminal Conditions and their Families and the Royal College of Paediatrics and Child Health. ' A Guide to the Development of Children's Palliative Care Services' London 1997.