
Moral Distress Matters: A Quality Improvement Project to Identify, Educate, and Manage Moral Distress in Critical Care Nurses
Abstract Background: Moral distress becomes a significant factor contributing to nurse burnout, turnover and negative impact on patient safety and quality of care. Critical care nurses (CCN’s) experience moral distress at higher rates than non-CCN’s. The original, in-person 4A’s To Rise Above Moral Distress (4A’s) has shown a positive impact on reducing moral distress; however, an online format has not been evaluated. Purpose: 1) Describe CCN’s moral distress level, 2) Adapt and evaluate the online 4A’s program in reducing CCN’s moral distress, and 3) Evaluate the CCN’s acceptability of online 4A’s program. Methods: A quasi-experimental pretest-posttest design was used to describe baseline then post-intervention changes in moral distress using the Moral Distress Scale-Revised (MDS-R). The 4A’s in-person education program was adapted to an online format. Nurses’ acceptability of the program was evaluated using an acceptability survey. Results: CCN’s (N=27) were recruited from a hospital in Central Pennsylvania. Results showed that CCNs’ experienced moderate levels of moral distress (N=27, M=74.9, SD =35.5, range=9-164). Among the five participants who completed the pretest and posttest assessments, four participants had a decreased moral distress levels (decreases ranged from 12 to 76 points) post- intervention, while one had increased distress (increased 20points). The 4A’s online program was reported as helpful and acceptable (N=6, M=100%). Discussion: This 4A’s online program could be a feasible and sustainable approach to reduce moral distress for CCN’s. Due to the large missing data for post-intervention results, the findings need to be verified in future research.
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Work Title | Moral Distress Matters: A Quality Improvement Project to Identify, Educate, and Manage Moral Distress in Critical Care Nurses |
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License | All rights reserved |
Work Type | Project |
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Publication Date | April 16, 2018 |
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DOI | doi:10.18113/S1291M |
Deposited | April 16, 2018 |
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