An Ethics Early Action Protocol to Promote Teamwork and Ethics Efficacy

Area of Science:

• Medical Ethics
• Critical Care Medicine
• Healthcare Professional Well-being

Background:

• Ethical conflicts and moral dilemmas are frequent in critical care settings.
• These issues can lead to negative outcomes such as mistrust, patient suffering, and clinician moral distress.
• Team-based ethics assessments may enhance communication and mitigate moral distress.

Purpose of the Study:

• To investigate the impact of an early ethics intervention on intensive care unit (ICU) clinicians' moral distress and ethics self-efficacy.
• To compare changes in moral distress, ethics self-efficacy, and hospital climate among nurses and physicians over time.
• To assess the effect of the intervention on perceptions of the ethical climate within ICUs.

Main Methods:

• Nurses and physicians in six ICUs completed surveys on moral distress, ethics self-efficacy, and ethical climate.
• Data were collected at baseline, and at 3 and 6 months post-implementation of an ethics protocol.
• A comparative analysis was performed between nurses and physicians regarding their survey responses.

Main Results:

• Nurses initially reported higher moral distress and lower ethics self-efficacy than physicians.
• Following the intervention, nurses showed significant decreases in moral distress and increases in ethics self-efficacy and ethical climate over time.
• Physicians' scores for moral distress and ethics self-efficacy did not change significantly over the study period.

Conclusions:

• Routine, team-based ethics assessment and planning can decrease moral distress and enhance ethics self-efficacy in ICU nurses.
• This intervention may foster improved teamwork and contribute to the reduction of burnout among critical care staff.
• The findings suggest a positive impact of structured ethical support on nursing staff well-being in ICUs.