An overview of moral distress and the paediatric intensive care team

Area of Science:

• Pediatric Intensive Care
• Medical Ethics
• Healthcare Management

Background:

• Paediatric intensive care units (PICUs) present a high-pressure environment where moral distress (MD) can negatively impact teamwork.
• MD in PICUs arises from various factors including treatment consent, futile care, end-of-life decisions, and hierarchical issues.

Purpose of the Study:

• To review existing literature on moral distress in PICUs.
• To evaluate the effectiveness of current interventions for resolving MD in PICU settings.
• To propose a novel approach for addressing MD within PICU teams.

Main Methods:

• Systematic literature review of studies on moral distress in paediatric intensive care.
• Analysis of reported interventions and their outcomes.
• Discussion of the role of interprofessional communication and shared experiences.

Main Results:

• Existing literature confirms that MD is a significant issue in PICUs, affecting team dynamics.
• Current administrative and educational interventions have not effectively resolved MD.
• The literature indicates a gap in strategies for fostering mutual understanding among PICU team members regarding MD.

Conclusions:

• There is a critical need to acknowledge and address moral distress within PICU teams.
• Current methods for resolving MD are insufficient.
• Sharing practice stories is proposed as a method to enhance understanding and potentially mitigate MD in PICUs.