SHM Converge Scientific Abstract ePoster Gallery-Healthcare Worker Perceptions of Moral Distress in Caring for Critically-Ill Patients Determined Not to Benefit From Icu Level Care

Healthcare Worker Perceptions of Moral Distress in Caring for Critically-Ill Patients Determined Not to Benefit From Icu Level Care

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This document describes a quality improvement effort focused on moral distress among hospitalists, nurses, and social workers caring for patients who were evaluated for ICU admission but ultimately remained on the medical floor because they were judged unlikely to benefit from ICU care (“ICU non-benefit”). Survey respondents were asked about clinical scenarios related to these patients and whether those situations caused moral distress.<br /><br />The report highlights that caring for critically ill patients who do not receive ICU escalation can create ethical and emotional strain for frontline staff. In response to the survey findings, the institution developed new support processes to reduce distress and improve care. These include increasing access to palliative care consultations, ethics consultations, and chaplaincy services when escalation to the ICU is not appropriate.<br /><br />Additional support measures were also implemented, such as regular check-ins by chief residents with housestaff caring for these patients and recurring Ethics involvement. The overall goal is to better support clinicians, improve communication and decision-making, and address the moral challenges that arise when treatment escalation is limited.<br /><br />The document situates these findings within broader literature on moral distress, non-beneficial treatments at the end of life, and distress among physicians, nurses, and trainees.

Asset Subtitle

Kyle Nelson

Meta Tag

Author List Ari Zimmer, Beth Raucher, Krishna A. Chokshi, Kyle Nelson, Vinh-Tung P. Nguyen

Category Research

Concept ICU Non-Benefit

Concept Critically Ill Patients

Concept Moral Distress

Concept Multidisciplinary Team

Concept Medical Floor

Distinguished Non-Finalist

Presenter Organization The Mount Sinai Hospital

Presenting Author Kyle Nelson

Track Quality Improvement

Keywords

moral distress

ICU non-benefit

hospitalists

nurses

social workers

palliative care

ethics consultation

chaplaincy

critical care

quality improvement

ICU Non-Benefit

Critically Ill Patients

Moral Distress

Multidisciplinary Team

Medical Floor