Conference Year

2016

Hospital/Entity

Baptist Hospital

Category of Abstract

Research

Presentation Title

Addressing Moral Distress in Critical Care Nurses

Abstract

Background: Moral distress can affect critical care nurses caring for complex patients. It can result in job dissatisfaction, loss of capacity for caring, and nurse turnover, resulting in a negative impact on quality care.

Purpose: This project was completed to determine how moral distress impacts critical care nurses (adult and pediatric) and to implement improvement strategies to reduce moral distress, improve job satisfaction, and retention.

Theoretical Framework: Nathaniel’s Theory of Moral Reckoning was the grounded theory used to show the application of the improvement interventions.

Methods: Phase 1 was a cross-sectional design using the 26-item Hospital Ethical Climate Survey (HECS) and the 21-item Moral Distress Scale-Revised (MDS-R). Phase 2 consisted of a mixed-method design employing focus group interviews, interventions, and pre- and posttest.

Results: Pediatric nurses reported lower mean moral distress composite scores 21.71 (15.47) as compared to the adult nurses 88.75 (64.7). For adult nurses, a strong correlation existed between ethical climate and moral distress (rs =-.62, n = 10, p = .05), with high levels of ethical climate associated with lower levels of moral distress. The cohort group identified personal and professional impact of moral distress with some differences between the pediatric and adult nurses related to the source of moral distress responses to suffering. The 3-month post survey showed a total moral distress score for one adult critical care nurse decreased from 158 to 74. The remaining three nurses’ scores were unchanged. All four nurses were not considering leaving their position now. All participants either agreed or strongly agreed the education and action plan reduced their moral distress.


Objective of Presentation

1. To identify critical care nurses’ (adult and pediatric), perception of the ethical climate of their work environment and their level of moral distress. 2. To identify personal and professional effects of moral distress on critical care nurses. 3. Evaluate the effectiveness of improvement strategies in reducing moral distress, improving job satisfaction, and retention.

Summary of Presentation

Conclusion: A blended-learning training to include American Association of Critical Care Nurses’ (AACN) 4As, communication and ethical reasoning skills, and personal action plans helped manage moral distress, aided retention, and improved satisfaction of critical care nurses.

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Addressing Moral Distress in Critical Care Nurses

Background: Moral distress can affect critical care nurses caring for complex patients. It can result in job dissatisfaction, loss of capacity for caring, and nurse turnover, resulting in a negative impact on quality care.

Purpose: This project was completed to determine how moral distress impacts critical care nurses (adult and pediatric) and to implement improvement strategies to reduce moral distress, improve job satisfaction, and retention.

Theoretical Framework: Nathaniel’s Theory of Moral Reckoning was the grounded theory used to show the application of the improvement interventions.

Methods: Phase 1 was a cross-sectional design using the 26-item Hospital Ethical Climate Survey (HECS) and the 21-item Moral Distress Scale-Revised (MDS-R). Phase 2 consisted of a mixed-method design employing focus group interviews, interventions, and pre- and posttest.

Results: Pediatric nurses reported lower mean moral distress composite scores 21.71 (15.47) as compared to the adult nurses 88.75 (64.7). For adult nurses, a strong correlation existed between ethical climate and moral distress (rs =-.62, n = 10, p = .05), with high levels of ethical climate associated with lower levels of moral distress. The cohort group identified personal and professional impact of moral distress with some differences between the pediatric and adult nurses related to the source of moral distress responses to suffering. The 3-month post survey showed a total moral distress score for one adult critical care nurse decreased from 158 to 74. The remaining three nurses’ scores were unchanged. All four nurses were not considering leaving their position now. All participants either agreed or strongly agreed the education and action plan reduced their moral distress.