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Am J Perinatol 2012; 29(09): 687-692
DOI: 10.1055/s-0032-1314889
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Perceptions of a Strategy to Prevent and Relieve Care Provider Distress in the Neonatal Intensive Care Unit

Felix A. Okah
1   Department of Pediatrics, Children's Mercy Hospitals and Clinics, Kansas City, Missouri
,
Dawn M. Wolff
2   Department of Strategic Planning, Children's Mercy Hospitals and Clinics, Kansas City, Missouri
,
Virginia D. Boos
3   Department of Clinical Effectiveness, Children's Mercy Hospitals and Clinics, Kansas City, Missouri
,
Barbara M. Haney
4   Department of Nursing, Children's Mercy Hospitals and Clinics, Kansas City, Missouri
,
Adebayo A. Oshodi
1   Department of Pediatrics, Children's Mercy Hospitals and Clinics, Kansas City, Missouri
› Author Affiliations
Further Information

Publication History

27 December 2011

14 February 2012

Publication Date:
25 May 2012 (online)

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Abstract

Background A Midwestern neonatal intensive care unit (NICU) employs a multidisciplinary conference, the Comprehensive Care Round (CCR), to facilitate communication and consensus building and thereby prevent or address moral distress within the health care team.

Methods A cross-sectional survey, 3 years after implementation of CCR, to evaluate health care providers' (HCP) perceptions of comfort with expressing distress, support from team members in care situations that evoke moral distress, barriers to communication, and attainment of CCR objectives.

Results Of 370 HCP, 116 (31%) participated in the survey (42% nurses, 37% allied health, and 21% medical); 51% had previously attended CCR. CCR attendance was higher among HCP aged >35 years, those who cared for CCR patients, and nonnurses. Neonatologist were more likely than others (44% versus 4%, p <0.01) to report that referred cases were not overdue for discussion and that families appreciated the attention their child received from CCR. Of note, HCP who were comfortable with expressing distress also felt supported by team members (R = 0.5, p <0.001).

Conclusion CCR, developed to prevent or address moral distress, occurs later than most NICU HCP consider appropriate and appears to better serve HCP who are already comfortable with discussing moral distress. Helping HCP become comfortable with crucial conversations should support meaningful participation and contribution to multidisciplinary conferences.

Keywords

moral distress - NICU - communication - multidisciplinary
 

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