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The role of teams in resolving moral distress in intensive care unit decision-making

机译:团队在重症监护病房决策中解决道德困扰方面的作用

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Conflicts arise within teams and with family members in end-of-life decision-making in critical care. This creates unnecessary discomfort for all involved, including the patient. Treatment plans driven by crisis open the team up to conflict, fragmented care and a lack of focus on the patient's wishes and realistic medical outcomes. Methods to resolve these issues involve planned ethical reviews and team meetings where open communication, clear plans and involvement in decision-making for all stakeholders occur. In spite of available literature supporting the value of these techniques, patient care teams and families continue to find themselves involved in spiraling conflict, pitting one team against another, placing blame on family members for not accepting decisions made by the team and creating moral conflict for interdisciplinary team members. Through a case presentation, we review processes available to help resolve conflict and to improve outcome.Keywords: critical care, moral distress, physician–nurse relationship, team interaction
机译:在重症监护室的生命周期决策中,团队内部以及与家庭成员之间会发生冲突。这给包括患者在内的所有人都带来了不必要的不​​适。危机驱动的治疗计划使团队面临冲突,零散的护理以及对患者意愿和现实医疗结果缺乏关注。解决这些问题的方法包括计划进行的道德审查和团队会议,其中进行了公开交流,明确计划并参与了所有利益相关者的决策。尽管有可用的文献支持这些技术的价值,但患者护理团队和家人继续发现自己陷入了螺旋式冲突,使一个团队与另一个团队陷入冲突,将责任归咎于家庭成员,因为他们不接受团队做出的决定,并为他们造成道德冲突。跨学科团队成员。通过案例演示,我们回顾了可用于帮助解决冲突和改善结果的过程。关键字:重症监护,精神困扰,医护关系,团队互动

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