rules of behaviors based on ideas about what is morally good and bad. (merrium & webster, 2014) ...

Mike CzechowskyjFerris State University

Nursing Ethics Education and Support

Ethics

Rules of behaviors based on ideas about what is morally good and bad. (Merrium & Webster, 2014)

Health care professionals encounter ethical situations on a constant basis.

For the best patient outcomes nurses need to be able to identify these situations and react appropriately.

The gap

What is the current state of ethics in the continuing care setting?

How are nurses involved? What is the future state the

CNO would like to see?

The Proposed Plan

What is the root cause and the barriers related to a lack of recognizing ethical situations?

A fishbone diagram was used to visually identify the issues.

Unable to act on ethical concerns

Health System

Nursing StaffAdministration

Physicians

Resources

Money

Infrastructure

Education

How to get support

Baseline knowledge

Capacity to help

Ethicist

Knowledge of problem

Identify the need

Provide finances

Prioritize the project

Fishbone for Unrecognized Ethical Situations

The Proposed Plan The plan starts by working with key

stakeholders to develop a survey, education presentation and algorithm.

The survey will be given to nurses in the facility identified

The same nurses will then be taught using the education presentation.

They will also be taught the algorithm they can use when ethical situations are identified.

There will then be a post survey to validate that the nurses understand the new plan.

Change Theory Used

Influencer Model (Patterson, Grenny, Maxield, McMillan, &

Switzler, 2008)

Change the environmentHarness peer pressureFind strength in numbersDesigning rewards and demand

accountability

Leadership Theory Used

Authentic Leadership (Waite, Mckinney, Smith-Glasgow, &

Meloy, 2014).

Understands sense of one’s selfPerceived as open, optimistic, and resilient.Genuine

Evidence to Support This Plan

In the current environment the CNO has identified a lack of ethical awareness.

Lack of good ethical education in nursing school (Vynckier, Gastmans, Cannaerts, & Dierckx de Casterle, 2014).

No continuing education currently in the workplace at Spectrum Health Continuing Care.

Having an algorithm will help with decision making.

Better ethical identification would lead to less burnout and turnover (Blacking, 2011).

Implementation Support

Using QSEN competencies (QSEN Institute, 2014) Teamwork and CollaborationSafety

ANA Scope & Standards (American Nurses Association

2009)

CollaborationEthicsResource Utilization

Facility Identified

Spectrum Health Continuing Care Hospice Why this unit? Who will be educated?

Preceptor

Deb Cress, MSN, RN, NE-BC. CNO Why is she qualified to oversee this

project?Years of experienceAccess to resourcesAbility to break down barriers

Evaluation

Two different result evaluationsSurvey resultsNumber of ethics consults

Conclusion

This plan should set up Spectrum Health Continuing Care for…Better recognition of ethical situationsImproved support for the patientsAdded support for the nursing staffLess burnout and frustration

ReferencesAmerican Nurses Association. (2009). Nursing Administration: Scope and standards of practice. Silver

Spring, MD: Nursebooks.org.

Blacking, C. (2011). Empowering nurses to participate in ethical-decision making at the bedside. Journal of Continuing Education in Nursing, 42(1), 19-24. dio: 10.3928/00220124-20100601-03.

Merriam- Websters. (2014). Ethics. Retrieved from http://www.merriam-webster.com/dictionary/ethics

Patterson, K., Grenny, J., Maxield, D., McMillan, R., & Switzler, A. (2008). Influencer: The Power to Change Anything, New York, NY: McGraw-Hill.

QSEN institute, (2014). Graduate KSAS. Retrieved from http://qsen.org/competencies/graduate-ksas/

Vynckier, T., Gastmans, C., Cannaerts, N., & Dierckx de Casterle, B. (2014). Effectiveness of ethics education as perceived by nursing students: development and testing of a novel assessment instrument. Nursing Ethics. dio: 10.1177/0969733014538888.

Waite, R., Mckinney, N., Smith-Glasgow, M. E., & Meloy, F. A. (2014). The embodiment of authentic leadership. Journal of Professional Nursing, 30(4), 282-291. dio: 10.1016.j.profnurs.2013.11.004.