Mitigating Moral Distress in Neonatal Intensive Care Unit Healthcare Professionals: A Pilot Program.

Abstract

Background: Ethically challenging experiences occur frequently in neonatal intensive care units (NICUs). Unmanaged exposures can lead to moral distress, burnout, staff turnover, and decreased patient care quality. Moral distress etiology is multifactorial and linked to personal, unit-based, and organizational constraints.

Purpose: The purpose of this project was to determine the impact of regularly occurring, standardized, reflective emotional debriefing sessions (REDS) in conjunction with an online education module over a 12-week period on the level of moral distress (MD) reported on the Measure of Moral Distress-Healthcare Professionals (MMD-HP) tool in NICU healthcare providers (HCPs).

Methods: To evaluate MD levels, preintervention and postintervention electronic surveys, including the MMD-HP tool, were offered. Interventions included an online education module and standardized, regularly occurring REDS. Survey respondents were defined using descriptive statistics. An independent samples t -test evaluated the MMD-HP composite score differences.

Results: MMD-HP mean composite scores decreased slightly but did not demonstrate statistical significance ( P = .724). Personal interviews and qualitative survey data indicated clinical significance and positive staff feedback.

Implications for practice: Providing a safe, supportive, regularly scheduled platform, like REDS, prevents disenfranchised grief and promotes a healthy workplace by mitigating isolation, encouraging emotional expression, minimizing bereavement overload, decreasing compassion fatigue, and increasing adaptive coping.

Implications for research: A paucity of information remains regarding which intervention should be considered the standard of care for managing HCP MD. Additional research is needed to identify best practices for managing HCP MD.