Doctor of Nursing Practice Program

Hyeyeon Park, DNP, MSN, RN, ACNP-BC

Hyeyeon Park
  • Committee Chair Name & Credentials:
    Ty Williams, DNP, RN, ACNP-BC, FNP-BC, CNE


DNP Project Abstract

Routine Debriefing Sessions Decreased Moral Distress Scale Among Critical Care Nurse

The purpose of this DNP project was to decrease moral distress scores among critical care registered nurses by 10% from baseline within three months.

This QI project was implemented at a 600-bed hospital in Pennsylvania to decrease moral distress scores in critical care nurses from July 18, 2022, through October 24, 2022. The project consisted of developing, implementing, and evaluting evidence-based moral distress awareness education and debriefing sessions. This project’s success was measured through qualitative and quantitative mixed-methods. The educational objectives included describing moral distress and its common origins, signs of moral distress and consequences, prevention, and solutions to combat moral distress. The education was a 17-minute lecture delivered through Zoom over four weeks from September 12, 2022, through October 10, 2022. Debriefing sessions were held through Zoom that provided opportunites for participants to share experiences, challenges, limitations, and barriers encountered by nurses in critical care. The pre- and post-surveys consisted of 7 demographic items and 21 Revised-Moral Distress Scale (MDS-R) items.

Forty-five registered nurses working in the ICU participated in the project. The education and debriefing sessions demonstrated an increase in participants’ moral distress awareness. Two items of the Revised-Moral distress scale (MDS-R) showed a 10.6% reduction compared to the pre-survey. During the debriefing sessions, 39 participants (86%) identified that situations involving maintaining nonbeneficial life-sustaining treatment cause severe moral distress. Forty-one Participants (91%) reported that they felt valued and de-stressed through the debriefing sessions.

Implications for Practice
Routine debriefing sessions were associated with significantly decreased moral distress severity among critical care nurses surveyed. This project demonstrated that routine debriefing sessions and the Revised Moral Distress scale (MDS-R) are effective tools for increasing moral distress awareness. Implementing moral distress education with routine debriefing sessions decreased the Revised Moral Distress Scale scores among nurses surveyed. Implementating moral distress education with routine debriefing sessions can improve moral distress in critical care. A recommendation for future tuture education and debriefing sessions should include training and discussion on end-of-life care topics.