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dc.contributor.authorSilverman, Henry
dc.contributor.authorWilson, Tracey
dc.contributor.authorTisherman, Samuel
dc.contributor.authorKheirbek, Raya
dc.contributor.authorMukherjee, Trishna
dc.contributor.authorTabatabai, Ali
dc.contributor.authorMcQuillan, Karen
dc.contributor.authorHausladen, Rachel
dc.contributor.authorDavis-Gilbert, Melissa
dc.contributor.authorCho, Eunsung
dc.contributor.authorBouchard, Kerri
dc.contributor.authorDove, Samantha
dc.contributor.authorLandon, Julie
dc.contributor.authorZimmer, Michele
dc.date.accessioned2022-04-22T14:03:43Z
dc.date.available2022-04-22T14:03:43Z
dc.date.issued2022-04-19
dc.identifier.urihttp://hdl.handle.net/10713/18635
dc.description.abstractBackground: Commentators believe that the ethical decision-making climate is instrumental in enhancing interprofessional collaboration in intensive care units (ICUs). Our aim was twofold: (1) to determine the perception of the ethical climate, levels of moral distress, and intention to leave one's job among nurses and physicians, and between the different ICU types and (2) determine the association between the ethical climate, moral distress, and intention to leave. Methods: We performed a cross-sectional questionnaire study between May 2021 and August 2021 involving 206 nurses and physicians in a large urban academic hospital. We used the validated Ethical Decision-Making Climate Questionnaire (EDMCQ) and the Measure of Moral Distress for Healthcare Professionals (MMD-HP) tools and asked respondents their intention to leave their jobs. We also made comparisons between the different ICU types. We used Pearson's correlation coefficient to identify statistically significant associations between the Ethical Climate, Moral Distress, and Intention to Leave. Results: Nurses perceived the ethical climate for decision-making as less favorable than physicians (p < 0.05). They also had significantly greater levels of moral distress and higher intention to leave their job rates than physicians. Regarding the ICU types, the Neonatal/Pediatric unit had a significantly higher overall ethical climate score than the Medical and Surgical units (3.54 ± 0.66 vs. 3.43 ± 0.81 vs. 3.30 ± 0.69; respectively; both p ≤ 0.05) and also demonstrated lower moral distress scores (both p < 0.05) and lower "intention to leave" scores compared with both the Medical and Surgical units. The ethical climate and moral distress scores were negatively correlated (r = -0.58, p < 0.001); moral distress and "intention to leave" was positively correlated (r = 0.52, p < 0.001); and ethical climate and "intention to leave" were negatively correlated (r = -0.50, p < 0.001). Conclusions: Significant differences exist in the perception of the ethical climate, levels of moral distress, and intention to leave between nurses and physicians and between the different ICU types. Inspecting the individual factors of the ethical climate and moral distress tools can help hospital leadership target organizational factors that improve interprofessional collaboration, lessening moral distress, decreasing turnover, and improved patient care.en_US
dc.description.urihttps://doi.org/10.1186/s12910-022-00775-yen_US
dc.language.isoenen_US
dc.publisherSpringer Natureen_US
dc.relation.ispartofBMC Medical Ethicsen_US
dc.rights© 2022. The Author(s).en_US
dc.subjectDecision making for end-of-life careen_US
dc.subjectEthical climateen_US
dc.subjectIntention to leaveen_US
dc.subjectInterprofessional collaborationen_US
dc.subjectMoral distressen_US
dc.subjectNursesen_US
dc.subjectPhysiciansen_US
dc.titleEthical decision-making climate, moral distress, and intention to leave among ICU professionals in a tertiary academic hospital center.en_US
dc.typeArticleen_US
dc.identifier.doi10.1186/s12910-022-00775-y
dc.identifier.pmid35439950
dc.source.journaltitleBMC medical ethics
dc.source.volume23
dc.source.issue1
dc.source.beginpage45
dc.source.endpage
dc.source.countryEngland


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