Ethics, Narrative
Conditions
Keywords
End of life decisions in the ICU, Multidisciplinary team meetings, Ethical decision making climate, Nurses job satisfaction
Brief summary
Most patients who die in the intensive care unit do so after a withholding or withdrawing of life sustaining treatments (WWLST) decision. The implementation of formalized interdisciplinary team meetings for ethical deliberation in the ICU may improve nurses participation in WWLST decisions. The investigators decided to implement such team meetings in their ICU. At this occasion, the investigators will measure job satisfaction, job related frustration and ethical decision making climate climate.
Detailed description
Most patients who die in the intensive care unit do so after a withholding or withdrawing of life sustaining treatments (WWLST) decision. Because those decisions are value-laden, guidelines as well as french regulations recommend that they should involve not only medical doctors but also nurses. Despite that, nurses' involvement remains incomplete. Poor collaboration between doctors and nurses on ethical decisions is associated with job dissatisfaction, burnout and desire to quit. The implementation of formalized interdisciplinary team meetings for ethical deliberation in the ICU may improve nurses participation in WWLST decisions. For those reasons the investigators decided to implement such team meetings in their ICU. At this occasion, the investigators will measure job satisfaction, job related frustration and ethical decision making climate climate.
Interventions
None listed
Sponsors
University Hospital, Tours
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* All patients admitted in the ICU
Exclusion criteria
* Age below 18
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in nurses perception of ethical decision making climate in the ICU | june 2023, january 2024 | Nurses answers to the questionnaire "Ethical Decision-Making Climate Questionnaire (7 factors evaluated, for each factor score ranges from 1 to 5, higher scores indicate a better climate)". |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in nurses psychological well being at work | 2 evaluations: may 2023, january 2024 | Nurses answers to the Index of psychological well being at work (5 factors, for each factor score ranges from 1 to 5, higher scores indicate more well being). |
| Change in nurses frustration of job's related psychological needs | 2 evaluations: may 2023, january 2024 | Nurses answers to the Job related psychological needs frustration score (3 factors, for each factor score ranges from 1 to 5, higher score indicate more frustration) |
| Change in nurses desire to leave | 2 evaluations: may 2023, january 2024 | Nurses answers to a one question questionnaire: "I have thoughts about leaving my current position/job" (lickert scale, score range from 1 to 5, higher score indicate a higher desire to leave) |
| Non beneficial care | January 2024 | Duration of mechanical ventilation in patients who ultimately die (number of days) |
Countries
France
Contacts
PRINCIPAL_INVESTIGATORROMAIN MIGUEL MONTANES, MD
University Hospital of TOURS
PRINCIPAL_INVESTIGATORServane Barrault, PhD
University of Tours
Outcome results
None listed