Evaluating the Use of the Trauma-Specific Frailty Index in Older Patients with Hip Fractures

Abstract

one nurses and 24 physicians were surveyed, and 16 clinicians interviewed. MMD-HP data demonstrated high levels of moral distress for nurses (mean total MMD-HP 132AE63.5) and physicians (121.7AE64.7), p¼0.68. Most frequent root causes overall pertained to providing aggressive care that is likely futile. Nurses identified unclear goals of care as a stronger cause of moral distress compared to physicians (9.7 vs 5.6, p¼0.03). Interview data supported these findings, with clinicians recommending improving early communication surrounding goals of care and end-of-life care as potential solutions.CONCLUSION: Providing aggressive care that is likely to be futile and inconsistency in treatment plans or goals of care are primary drivers of moral distress in the SICU. Interventions to improve early communication and access to end-of-life care should be prioritized to improve patient care and decrease moral distress in staff.