268: Initiation of Ethics Rounds in the Medical Icu: Feasibility Pilot Study

Introduction: High rates of moral distress amongst critical care providers underscore the urgent need for interventions to address this issue due to its impact on burn-out and resiliency. Currently, there are few evidence-based interventions to reduce moral injury. This study evaluates the initiation of bi-monthly multidisciplinary ethics rounds, intended to provide an informal setting for discussing current patient cases that present ethical challenges or moral ambiguity. We hypothesized that ethics rounds would be feasible to implement, well received by an interdisciplinary staff, and beneficial in reducing perceived moral distress among participants. Methods: Four sessions were conducted over a 7-month period in a medical intensive care unit at an academic medical center. Each session was 45-minutes, led by ethics-trained facilitators, and featured collaborative interdisciplinary team (RNs, APPs, medical trainees and attendings) discussions centered on ethical dilemmas. Feasibility data was gathered using the Acceptability of Intervention Measure (AIM) and the Feasibility of Intervention Measure (FIM), which are previously validated implementation tools. Each of these scales is comprised of four items, rated on a five-point likert scale. Demographic data and subjective assessments regarding the efficacy of ethics rounds in ameliorating moral distress were also collected as secondary measures. Results: 17 participants completed the survey, with 47% (n=8) identifying as advanced practice providers. Participants reported high acceptability (mean AIM score of 4.93, SD= 0.25) and high feasibility (Mean FIM score of 4.76, SD= 0.39). Additionally, 71% (n=12) of providers reported experiencing moral distress frequently in the last six months. All participants agreed or completely agreed that ethics rounds were useful in helping them process cases that led to moral distress. All participants indicated they were very likely to participate in future sessions. Conclusions: Ethics rounds were successfully implemented in a busy academic critical care unit and were positively received by all participants. To our knowledge, this is the first initiative of its kind to address a multidisciplinary audience, and may serve as a promising intervention to reduce moral distress across interprofessional staff.