scholarly journals The relationship between professional autonomy and moral distress among nurses working in children's units and pediatric intensive care wards

2017 ◽  
Vol 4 (2) ◽  
pp. 117-121 ◽  
Author(s):  
Zahra Sarkoohijabalbarezi ◽  
Arash Ghodousi ◽  
Elham Davaridolatabadi
Keyword(s):  
Intensive Care ◽  
Moral Distress ◽  
Pediatric Intensive Care ◽  
Professional Autonomy ◽  
The Relationship

Relationship between perceived organizational justice and moral distress in intensive care unit nurses

2017 ◽  
Vol 26 (2) ◽  
pp. 460-470 ◽  
Author(s):  
Ghazaleh Haghighinezhad ◽  
Foroozan Atashzadeh-Shoorideh ◽  
Tahereh Ashktorab ◽  
Jamileh Mohtashami ◽  
Maasoumeh Barkhordari-Sharifabad
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Organizational Justice ◽  
Moral Distress ◽  
Interactional Justice ◽  
Significant Negative Correlation ◽  
Moral Decision Making ◽  
Informed Consent Form ◽  
Intensive Care Unit Nurses ◽  
The Relationship

Background: The nature of the nursing profession pays more attention to ethics of healthcare than its therapeutic dimension. One of the prevalent moral issues in this profession is moral distress. Moral distress appears more in intensive care units due to the widespread need for moral decision-making regarding treatment and care in emergency situations. In this connection, organizational justice is of high importance and, as a significant motivational tool, leaves important impacts upon attitude and behavior of personnel. Aim/objective: This study aimed at investigation of the relationship between perceived organizational justice and moral distress in intensive care unit nurses. Research design: This is a descriptive-correlational research which examined the relationship between perceived organizational justice and moral distress in intensive care unit nurses. Participants and research context: A total of 284 intensive care unit nurses were selected via census sampling. The data were collected through questionnaires and then were analyzed via SPSS-20 using Pearson and Spearman correlation tests. Ethical considerations: This study was approved by the Committee of Ethics in Medical Research. Completion of informed consent form, guarantee of the confidentiality of information, explanation on purposes of the research, and voluntary participation in the study were moral considerations observed in this study. Findings: There was a statistically significant negative correlation between the total perceived organizational justice and the total moral distress (p = 0.024, r = −0.137) and also between “procedural and interactional justice and errors” and “not respecting the ethics principles.” Meanwhile, no relationship was found by the findings between distributive justice and dimensions of moral distress. Conclusion: According to the results of the study, there was a reverse significant relationship between moral distress and perceived organizational justice; therefore, the head nurses are expected to contribute to reduce moral distress and to increase perceived organizational justice in nurses.

scholarly journals The relationship between professional autonomy and moral distress in ICU nurses of Guilan University of Medical Sciences in 2017

2019 ◽  
Author(s):  
Mohammad Reza Yeganeh ◽  
Moluk Pouralizadeh ◽  
Atefeh Ghanbari
Keyword(s):  
Decision Making ◽  
Standard Deviation ◽  
Moral Distress ◽  
Cross Sectional Study ◽  
Professional Autonomy ◽  
Full Time ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Relationship Of ◽  
The Relationship

Background & Aim: Professional autonomy is a key component of decision-making and empowerment of the nurses. However, ICU nurses sometimes experience a degree of moral distress in their decision-making but the relationship of this distress with their autonomous performance in intensive care units is unclear. The aim of this study is determining the relationship between professional autonomy and moral distress of ICU nurses. Methods & Materials: In this correlational cross-sectional study, 180 ICU nurses were selected by census method from educational hospitals of Guilan University of Medical Sciences in 2017. Research tools were Varjuss professional autonomy and Corely et al. moral distress questionnaires. Data were analyzed using SPSS software version 16. Results: Most of the subjects were female (93.89%), full-time nurses (61.67%), with age mean and standard deviation of 35±5.97. Mean and standard deviation of professional autonomy and moral distress were 77.04±4 and 140.85±5.45, respectively. Moral distress of most nurses (55.6%) was moderate. There was a positive and significant correlation between professional autonomy and moral distress scores (p<0.001, r=0.33). Conclusion: This study showed that by increasing the professional autonomy, the moral distress of ICU nurses increases as well. These results, by informing nursing mangers, remind the necessity of using some approaches for reducing the moral distress of nurses along with improving their professional autonomy.

Clinicians’ moral distress and family satisfaction in the intensive care unit

2018 ◽  
Vol 25 (12) ◽  
pp. 1894-1904 ◽  
Author(s):  
Giulia Lamiani ◽  
Matteo Ciconali ◽  
Piergiorgio Argentero ◽  
Elena Vegni
Keyword(s):  
Decision Making ◽  
Intensive Care ◽  
Emotional Support ◽  
Moral Distress ◽  
Family Satisfaction ◽  
Satisfaction With Care ◽  
Decision Making Process ◽  
The Family ◽  
Distress Scale ◽  
The Relationship

This study explored the relationship between clinicians’ moral distress and family satisfaction with care in five intensive care units in Italy. A total of 122 clinicians (45 physicians and 77 nurses) and 59 family members completed the Italian Moral Distress Scale-Revised and the Family Satisfaction in the ICU questionnaire, respectively. Clinicians’ moral distress inversely correlated with family satisfaction related to the inclusion in the decision-making process. Specifically, physicians’ moral distress inversely correlated with satisfaction regarding the respect shown toward the patient. Nurses’ moral distress inversely correlated with satisfaction regarding breathlessness and agitation management, provision of emotional support, understanding of information, and inclusion in the decision-making process.

Patterns of Delirium in a Pediatric Intensive Care Unit and Associations With Noise Pollution

2021 ◽  
pp. 088506662110556
Author(s):  
Jeffrey R. Weatherhead ◽  
Matthew Niedner ◽  
Mary K. Dahmer ◽  
Nasuh Malas ◽  
Toni Owens ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Correlation Coefficient ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Noise Pollution ◽  
Noise Levels ◽  
Sound Levels ◽  
Risk Of Mortality ◽  
The Relationship

Objective Delirium is a common problem in the Pediatric Intensive Care Unit (PICU) and is associated with increased length of stay, cost and mortality. This study evaluated the relationship between noise pollution and delirium risk. Design: This is a Quality Improvement (QI) initiative at an academic PICU. Sound levels were monitored and patients were screened for delirium using the Cornell Assessment of Pediatric Delirium (CAPD). Setting PICU Patients: All PICU patients Interventions: None Measurements and Main Results: Over the 83-week study period (2015-2017), the median [IQR] CAPD score was 8 [3 to 14]. Nursing compliance with the CAPD was 72.2%. The proportion of patients screening positive for delirium (CAPD ≥ 9) was 45.9%. A total of 329 711 hly decibel (dB) measurements were collected and reported. Occupied rooms were louder than unoccupied rooms (51.8 [51.6-51.9] dB vs. 49.8 [49.7-49.9] dB, respectively, p < 0.001). Days (10 AM to 4 PM) were louder than nights (11 PM to 5 AM) (52.8 [52.7-53.0] dB vs. 50.7 [49.9-51.5] dB, respectively p < 0.001) in occupied rooms. Winter (Nov-Feb) months were louder than summer (May-Aug) months (52.0 [51.8-52.3] dB vs. 51.5 [51.3-51.7] dB, respectively, p < 0.002) in occupied rooms. Median weekly nighttime noise levels and CAPD scores demonstrated a correlation coefficient of 0.6 ( p < 0.001). Median weekly risk of mortality (ROM) and CAPD scores demonstrated a correlation coefficient of 0.15 ( p < 0.01). Conclusions: Significant noise pollution exists in the PICU with a moderate correlation between nighttime noise levels and CAPD scores. This could potentially implicate noise pollution as a risk factor for the development of delirium.

Conscientious Objection: A Potential Neonatal Nursing Response to Care Orders That Cause Suffering at the End of Life? Study of a Concept

2008 ◽  
Vol 27 (2) ◽  
pp. 101-108 ◽  
Author(s):  
Anita Catlin ◽  
Deborah Volat ◽  
Mary Ann Hadley ◽  
Ranginah Bassir ◽  
Christine Armigo ◽  
...  
Keyword(s):  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Moral Distress ◽  
Pediatric Intensive Care ◽  
Conscientious Objection ◽  
Advanced Technology ◽  
Potential Response ◽  
Small Pilot Study ◽  
Comfort Care ◽  
Life Study

This article is an exploratory effort meant to solicit and provoke dialog. Conscientious objection is proposed as a potential response to the moral distress experienced by neonatal nurses. The most commonly reported cause of distress for all nurses is following orders to support patients at the end of their lives with advanced technology when palliative or comfort care would be more humane. Nurses report that they feel they are harming patients or causing suffering when they could be comforting instead. We examined the literature on moral distress, futility, and the concept of conscientious objection from the perspective of the nurse’s potential response to performing advanced technologic interventions for the dying patient. We created a small pilot study to engage in clinical verification of the use of our concept of conscientious objection. Data from 66 neonatal intensive care and pediatric intensive care unit nurses who responded in a one-month period are reported here. Interest in conscientious objection to care that causes harm or suffering was very high. This article reports the analysis of conscientious objection use in neonatal care.

scholarly journals Central Venous Catheter Types and Association with Bloodstream Infection in the Pediatric Intensive Care Unit: Experience of two Years

2021 ◽  
Author(s):  
Sevgi Topal ◽  
Özlem Sarac Sandal ◽  
Gökhan Ceylan ◽  
Gülhan Atakul ◽  
Mustafa Çolak ◽  
...  
Keyword(s):  
Intensive Care ◽  
Bloodstream Infection ◽  
Pediatric Intensive Care ◽  
Binary Logistic Regression ◽  
Venous Catheter ◽  
Binary Logistic Regression Analysis ◽  
Central Venous ◽  
Indwelling Catheters ◽  
The Relationship ◽  
Central Catheters

Objective: Central venous catheters (CVC) provides great convenience in pediatric intensive care units (PICUs). In this study, we aimed to prospectively examine patients who underwent CVC in the PICU in terms of catheter types and infections Methods: We conducted our monocentric, prospective, and cohort study by including patients between January 2019 and December 2020, involving all central catheters temporarily inserted, except port-line catheters, PICCs, indwelling catheters (cuffed and uncuffed tunnel catheters), and arterial catheters. The main issue we focus on is the rate of catheter-associated bloodstream infection (CLABSI). We analyzed the relationship between infection and risk factors using binary logistic regression analysis. Results: We included 26 CLABSIs with 196 CVCs. The incidence rate was 6.2/1000 catheter days. We found that the incidence of CLABSI increased in femoral catheters (OR: 0.04 p: 0.035, 95% CI: 0.49-3.49). Moreover, the incidence was increased in catheters with 3 lumens (OR: 0.06, p: 0.031, 95% CI: 0.34-1.69). The prolongation of the catheter also increases the risk of infection (OR: 0.06, p: 0.028, 95% CI: 0.56-2.36). Also, we found that the frequency of CLABSI increased in patients with underlying immunodeficiency (OR: 0.19, p: 0.007, 95% CI: 0.85-1.39) and in patients who were given total parenteral nutrition (OR: 0.02, p: 0.041, 95% CI: 0.063-2.38). Conclusion: The number of studies that directly compare catheter types in pediatric patients and their relationship with CLABSI is limited. Moreover, the comparison of unrelated studies is difficult because of heterogeneity in study populations. Multicenter pediatric prospective studies focused on identifying catheter-associated infections are needed.

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