MITIGATING MORAL DISTRESS FOR RESUSCITATION TEAM HEALTHCARE PROVIDERS

Healthcare providers who respond to cardiac arrest events often experience the highest form of moral distress. This distress results from the extreme efforts of cardiopulmonary resuscitation and the pronouncement of death. The aim of this 11-week project was to mitigate moral distress for resuscitation team healthcare provider (RTHPs) through education and the introduction of two interventions. A 20-minute education plan was provided to RTHPs in a non-profit, suburban acute care hospital. Education focused on moral distress, the pause (a moment of silence), and the 4 A’s to Rise Above Moral Distress self-debriefing tool. The moment of silence initiated at the end of unsuccessful resuscitations was used to acknowledge the life of the deceased and to appreciate the effort of the team. The 4 A’s self-debriefing process was accessible through an educational pamphlet on moral distress and the 4 A’s outline. A post education survey was distributed to 99 RTHPs. Thirty-nine survey responses were returned with 28 complete surveys analyzed. Most respondents (89.26%) reported the educational experience helped them talk about morally distressing situations with other healthcare providers. Thirty-seven resuscitation events occurred during the 11 weeks, of which eight were unsuccessful. A moment of silence was implemented in 6 of 8 events (75% utilization). Eighteen of the 29 patients who survived the initial resuscitation did not survive to discharge and 15 moments of silence were performed (83% utilization). The majority of respondents iv (96.43%) indicated the moment of silence allowed them to acknowledge the patient’s life and their teamwork. The 4 A’s debriefing process occurred 86% of the time with 93% of respondents reporting this helped them to acknowledge their own needs in handling moral distress. Based on these responses to the education and resulting changes in procedures, expanded use of the 20-minute education plan is recommended for other nursing departments whose staff experience high levels of moral distress.