Ethical Deliberation in the Intensive Care Unit, Impact of Formalized Multidisciplinary Team Meetings, a Pilot Study

Recruiting

• Conditions: Ethics, Narrative

• Registration Number: NCT05722431
• Lead Sponsor: University Hospital, Tours

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.

Study Timeline

• Study First Submitted: 2023-01-11
• Study First Submitted QC: 2023-01-31
• Study First Posted: 2023-02-10
• Study Start: 2023-02-15
• Status Verified: 2023-05
• Last Update Submitted: 2023-05-10
• Last Update Posted: 2023-05-11
• Primary Completion: 2024-03-31
• Study Completion: 2024-07-31

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 200

Inclusion Criteria

• All patients admitted in the ICU

Exclusion Criteria

• Age below 18

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
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 Outcome Measures

Name	Time	Method
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)
Non beneficial care	January 2024	Duration of mechanical ventilation in patients who ultimately die (number of days)
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 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)

Trial Locations

Locations (1)

Trauma and surgical intensive care unit, Tours University Hospital; 🇫🇷 Tours, France