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

Ethics, Narrative Clinical Trial

Official title:

Délibération éthique en réanimation, Impact de la Mise en Place de réunions éthiques formalisées, Une étude Pilote

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05722431
• Other study ID #: DER
• Status: Recruiting
• Start date: February 15, 2023
• Est. completion date: July 31, 2024

Study information

• Verified date: May 2023
• Source: University Hospital, Tours
• Contact: Romain Miguel Montanes, MD
• Phone: 0247474747
• Email: r.miguelmontanes[@]chu-tours.fr
• Is FDA regulated: No
• Study type: Observational

Clinical Trial 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.

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.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 200
• Est. completion date: July 31, 2024
• Est. primary completion date: March 31, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• All patients admitted in the ICU

Exclusion Criteria:

• Age below 18

Related Conditions & MeSH terms

• Ethics, Narrative

Locations

Country	Name	City	State
France	Trauma and surgical intensive care unit, Tours University Hospital	Tours

Sponsors (1)

Lead Sponsor	Collaborator
University Hospital, Tours

Country where clinical trial is conducted

France, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change in nurses perception of ethical decision making climate in the ICU	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)".	june 2023, january 2024
Secondary	Change in nurses psychological well being at work	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).	2 evaluations: may 2023, january 2024
Secondary	Change in nurses frustration of job's related psychological needs	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)	2 evaluations: may 2023, january 2024
Secondary	Change in nurses desire to leave	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)	2 evaluations: may 2023, january 2024
Secondary	Non beneficial care	Duration of mechanical ventilation in patients who ultimately die (number of days)	January 2024