Ethical Issues Recognized by Critical Care Nurses in the Intensive Care Units of a Tertiary Hospital during Two Separate Periods.
10.3346/jkms.2015.30.4.495
- Author:
Dong Won PARK
1
;
Jae Young MOON
;
Eun Yong KU
;
Sun Jong KIM
;
Young Mo KOO
;
Ock Joo KIM
;
Soon Haeng LEE
;
Min Woo JO
;
Chae Man LIM
;
John David ARMSTRONG
;
Younsuck KOH
Author Information
1. Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Intensive Care Units;
Ethics;
Critical Care;
Nurses;
Behavior;
Questionnaires
- MeSH:
Critical Care Nursing/*ethics;
Humans;
*Intensive Care Units;
Nurses;
Retrospective Studies;
Terminal Care;
Tertiary Care Centers
- From:Journal of Korean Medical Science
2015;30(4):495-501
- CountryRepublic of Korea
- Language:English
-
Abstract:
This research aimed to investigate the changes in ethical issues in everyday clinical practice recognized by critical care nurses during two observation periods. We conducted a retrospective analysis of data obtained by prospective questionnaire surveys of nurses in the intensive care units (ICU) of a tertiary university-affiliated hospital in Seoul, Korea. Data were collected prospectively during two different periods, February 2002-January 2003 (Period 1) and August 2011-July 2012 (Period 2). Significantly fewer cases with ethical issues were reported in Period 2 than in Period 1 (89 cases [2.1%] of 4,291 ICU admissions vs. 51 [0.5%] of 9,302 ICU admissions, respectively; P < 0.001). The highest incidence of cases with identified ethical issues in both Periods occurred in MICU. The major source of ethical issues in Periods 1 and 2 was behavior-related. Among behavior-related issues, inappropriate healthcare professional behavior was predominant in both periods and mainly involved resident physicians. Ethical issue numbers regarding end-of-life (EOL) care significantly decreased in the proportion with respect to ethical issues during Period 2 (P = 0.044). In conclusion, the decreased incidence of cases with identified ethical issues in Period 2 might be associated with ethical enhancement related with EOL and improvements in the ICU care environment of the studied hospital. However, behavior-related issues involving resident physicians represent a considerable proportion of ethical issues encountered by critical care nurses. A systemic approach to solve behavior-related issues of resident physicians seems to be required to enhance an ethical environment in the studied ICU.
