Ebook Ethical competence in nursing practice (edition): Part 2

94
defined, 296
developing, 194
function of, 295–297
meta-­analy­sis, 186
ethical motivation, 33–36
ethical outcome, and evaluation, 39–40
ethical princi­ple(s), 35
ethical research, components of, 163–171
ethical sensitivity, 26–30
ethical situations, responses to, 77–79
ethical skills
strategies to develop, 41–42
and values, 24–26
ethics, 4
brief history of nursing, 10–11
of care, 14–15
clinical, 115–133
committees, 118–120
con­sul­tants, 120–123
consultation, 115–116, 288
defined, 7
develop and utilize resources of, 198–199
and evidence-­informed practice, 172–175
levels of quality of, 284–287
preventive, function of, 291–293
princi­ples, 216–222, 308–312
priority, 195
public health, 211–215
quality, 279, 285
quandary, 142

role model and communicate expectations,
197–198
and technology, 268–269


Index  333
theories, 13–14
violation, 7
ethics cases, 291
ethics education, 89
engage in continuing, 194–195
ethics hotline, 121
ethics police, ­121
evidence-­informed practice, ethics and, 172–175
expert patient, 258
fabrication, 170
fair subject se­lection, 165
falsification, 170
­Family Caregiver Alliance, 245
fatigue, 28–29
Florence Nightingale Pledge, ­10
four-­component model, James Rest’s, 24, 58
Gadow’s existential advocacy concept, 144
Ge­ne­tic Information Nondiscrimination Act (2008),
256
Georgia Institute of Technology, 261
Gilligan, Carol, 14
goals establishment, 62–63
Golden Rule, 10
Gretter, Lystra E., 10

hard paternalism, 218–219
health
defined, 220
disparities and social determinants of, 223
health care
and decision making, 49–50
ethics domain, 286–287
­factors influence decision making of, 51–60
and ­human right, 219–220
importance and types of decisions, 50–51
provider, decision making, 55–57
health disparities, 221
health equity, 221
Health Insurance Portability and Accountability Act
(HIPAA), 145
health ser­vices, access to, 222
Healthy Nurse Health Risk Appraisal survey, 95
Heller, Jean, 9
HIPAA. See Health Insurance Portability and
Accountability Act
Hippocratic Oath, 10
Hospital Ethical Climate Survey, 200–203
­human ele­ment, technology and, 259–264
­human right, 219
health, and health care, 219–220
­human subjects committees, 166
ICJME. See International Committee of Medical
Journal Editors
implied consent, 168
INANE. See International Acad­emy of Nurse Editors

incivility, 82, 86–89, 97, 99, 102

in­de­pen­dent review, 166–167
inequalities, 221
inequities, 221
informed consent, 167–169
Institute of Medicine (IOM), 35, 157, 211, 304
instrumental values, 25
Integrated Ethics model, 284, 296
goal of, 287
International Acad­emy of Nurse Editors (INANE),
171
International Committee of Medical Journal Editors
(ICMJE), 171
Internet, 262–263
IOM. See Institute of Medicine
ISSUES approach, 293–295
John J. Reilly Center, 256, 257, 264, 267, 270–271
Johns Hopkins University, 97
Jonsen, Albert, 122
Journal of the American Geriatrics Society, 236
justice, 18
patient and ­family care, 321–322
practice and leadership, 322–324
justificatory conditions, 217
Kant, Immanuel, 15
knowledge, skills, attitude (KSA), 146
KSA. See knowledge, skills, attitude
lateral or horizontal vio­lence, 87. See also bullying;
incivility; workplace vio­lence

leadership
au­then­tic, 184
collaborative, 315
defined, 182–183
ethical, 83, 186–194
and nursing practice, 182–183, 314–317, 318,
319–321, 322–324
theories, 184–186
transactional, 184
transformational, 184
WalkRounds (WR), 321
libertarian theory, 216
liberty theory, John Stuart Mill’s, 217
Maimonides Medical Center in Brooklyn, 91
Markkula Center for Applied Ethics, 265
MDCS. See Moral Distress Consult Ser­vice
MDS. See Moral Distress Scale
medical ethics, 79
microethics, 90, 142
misconduct, 171
misinterpretation, 242
moral certainty, 30
moral community, 30
moral conflict, 78
moral conscience, 29
moral courage, 34
components of, 35


334  Index

moral distress, 77
bullying, lateral vio­lence, incivility, and workplace
vio­lence, 86–89
­causes, 80–105
and Code of Ethics, 97
defined, 79–80
effective communication and conflict engagement
competencies, 91–93
emotional stability, 81–82
inadequate and incompetent staff, 84
orga­nizational ­factors, 82–89
orga­nizational policies and support ser­vices, 97–105
past experiences, 80–81
personal and professional competencies, 89–90
personal and professional ­factors of, 80–82
self-­care competencies, 93–96
Moral Distress Consult Ser­vice (MDCS), 103
Moral Distress Scale (MDS), 84
moral motivation, 18
moral princi­ples. See codes of conduct
moral residue, 81
moral suffering, 82
morality, 7–8. See also ethics
morbidity, among older adults, 235–236
NAQC. See Nursing Alliance for Quality Care
National Center for Ethics in Health Care, 278, 279,
284, 287, 295
National Council on Aging, 235
National Institute for Nursing Research (NINR), 160
National Institute for Occupational Safety and

Health (NIOSH), 88
National Quality Forum (NQF), 305
National Research Act (1974), 160, 166
NEC. See Nursing Ethics Council
New York Times, The, 9
NINR. See National Institute for Nursing Research
nonmaleficence, 16, 18
patient and ­family care, 318–319
practice and leadership, 319–320
NQF. See National Quality Forum
Nuremberg Code, 160
nurse bedside shift report, 148–149
Nursing Alliance for Quality Care (NAQC), 144
Nursing Ethics Council (NEC), 42, 89
nursing practice, and leadership, 314–317
older adults
advance care planning, 248–249
­causes of morbidity among, 235–236
growing population, 235
lack of caregiver support for, 244–246
medically futile care among, 243–244
oppressed group theory, 87
orga­nizational competencies, 96–105
orga­nizational culture, 320
orga­nizational policies, 97–105. See also
support ser­vices
overidentification, 30

past experiences, moral distress and, 80–81
paternalism versus autonomy, 216–219

Pathway for Fostering Or­gan­i­za­tional Civility
(PFOC), 102
patient centeredness, 139
patient experience, 143
Patient Protection and Affordable Care Act, 236
patient quality, 304–305
Patient and Quality Safety Initiative, 306
patient safety, 304–305
patient-­centered care, 238
PDSA. See Plan-­Do-­Study-­Act
perception gap, 52, 69
per­for­mance appraisal, Code of Ethics, 188
peripherally inserted central venous catheter (PICC),
282
person- and ­family-­centered care (PFCC), 142
defined, 142
ethical issues, 142–143
KSA. See knowledge, skills, attitude
skills and practices using selected key, 147–149
Pew Research Center, 52
PFCC. See person- and ­family-­centered care
PFOC. See Pathway for Fostering Or­gan­i­za­tional
Civility
PICC. See peripherally inserted central
venous catheter
plagiarism, ­171
Plan-­Do-­Study-­Act (PDSA), 293
PPM. See Professional Practice Model
practice, and leadership, 182–183, 314–317, 318,
319–321, 322–324

preferences and needs, strategies to elicit patient’s
value, 149–152
preventive ethics, 291–293
Primacy of the Patients’ Interests, 69
Princi­ples of Biomedical Ethics, The, 16
principlism, 16–17
pro­cess consent, 168
Professional Practice Model (PPM), 315–316
prognosis establishment, 61–62
public health, 211–212
defined, 211
emergencies, 224–225
ethics, 211–215
ethics versus clinical ethics, 215
ethics, princi­ples of, 216–222
ethics, theoretical foundations and, 215–216
frameworks for ethics of, 224
Purtilo, Ruth, 122
QSEN. See Quality and Safety Education
for Nurses
quality care, 304
nursing and ethics, 305–307
Quality and Safety Education for Nurses (QSEN),
26, 37, 50, 87, 141, 279
quandary ethics, 142
questionnaires, 311


Index  335
real­ity shock, 79–80

Registered Nurse Safe Staffing Act (2014), 187
research integrity, 170–171
research misconduct, 170
re­spect for potential and enrolled subjects, 169–170
Rest, James, 11, 19
Rest’s model, defined, 11–12, 19, 24, 58, 302
Right to Self Determination, 35
rigor, 93
risk–­benefit ratio, 160, 163, 165–166. See also
Nuremberg Code
Robot Kingdom, 260
robotic walkers, 260
Robotics Institute’s Quality of Life Technology
Center, 261
scientific validity, 164–165
self-­care competencies, 93–96
self-­determination, ­256
self-­governance, ­17
self-­reflection, ­40
self-­soothing, 36
sensitivity, 12
Silver Tsunami, 245
Slater Nursing Competencies Rating Scale, 306
social justice, 220–222
social value, 163–164
Spectrum Health in West Michigan, 91
substituted judgment standard, 168
support ser­vices, 97–105. See also orga­nizational
policies
supportive leadership, 96–97

surrogate, role in decision making, 54–55
Systemic Mindfulness Model of Proactive Patient
Safety, 315
TeamSTEPPS, 91
technology
competence in workforce, 267–268
devices, 263–264

ethical use, 268–269
and ­human ele­ment, 259
Internet, 262–263
robots as caregivers, 260–262
telenursing, 268
terminal values, 25
theories, ethical, 13–14
transformational leadership, 184
TRUST, 323–324
University of California at San Francisco, 122
University Health System in San Antonio, 90, 97,
103, 193
University of Kansas School of Nursing, 307
University of Kentucky, 90
University of Nebraska, 122
University of Reading in ­Eng­land, 261
University of ­Virginia Health System, 103
U.S. Department of Veterans Affairs National
Center for Ethics in Health Care, 278, 279,
284, 287, 295
Utilitarianism, 16, 216
values

defined, 24
and ethical skills, 24–26
instrumental, 25
strategies to elicit patient’s preferences, needs, and,
149–152
terminal, 25
Vanderbilt University Wellness Center, 95–96, 97
Veterans Health Administration, 194
virtue, nurse, 17
vulnerability, 168
WalkRounds (WR), leadership, 320
WHO. See World Health Organ­ization
workforce, technology competence, 267–268
workplace vio­lence, 82, 86–89, 99
World Health Organ­ization (WHO), 220