Morley Georgina, Copley Dianna Jo, Bena James F, Morrison Shannon L, Field Rosemary B, Gorecki Julia, Horsburgh Cristie Cole, Albert Nancy M
Center for Bioethics & Stanley S. Zielony Institute for Nursing Excellence, Cleveland Clinic.
Quantitative Health Sciences, Cleveland Clinic Health System.
Nurs Ethics. 2025 May;32(3):782-797. doi: 10.1177/09697330241284356. Epub 2024 Sep 27.
Pre-licensure ethics nursing education does not adequately prepare and instill confidence in nurses to address ethical issues, and yet ethics education provides nurses with greater confidence to take moral action, which can mitigate the negative effects of moral distress. To assess the feasibility and acceptability of a nursing ethics education programme that included simulated case-based ethics competencies as a form of evaluation. The programme aimed at building nurses' ethical knowledge and confidence to respond to ethical challenges in practice. A prospective, longitudinal, correlational, single-cohort feasibility study using an investigator-developed survey and intervention field data. Registered nurses were recruited from an academic quaternary-care medical center and 9 small- to mid-sized regional hospitals within one health system in the Midwest United States. IRB approval was obtained. Participants could complete the educational programme regardless of research process participation. Of 20 participants, 19 (95%) provided post-programme surveys and 18 completed competencies. Median (IQR) scores with quartiles for scheduling, timing, and length of sessions were all 10.0 [9.0, 10.0], and participants perceived that the content was interesting, increased knowledge and confidence in ethics, increased skills in providing ethical care, and would recommend the programme to colleagues. Of factors, an increase in ethics knowledge had the highest "always agree" (17, 89.5%) response. Most participants reported that ethics competencies were appropriate 9.0 [9.0, 10.0] and sufficiently challenging 10.0 [9.0, 10.0]. The education programme developed nurses' ethics knowledge and confidence. The single-cohort feasibility design provided early-stage intervention outcomes; however, a larger randomized controlled trial would substantiate programme value. This novel ethics education programme was highly feasible and acceptable to hospital-based nurses who reported increased knowledge and confidence in providing ethical care. Simulated case-based ethics competencies were an appropriate evaluation method.
执照前的护理伦理教育并未充分培养护士应对伦理问题的能力,也未向护士灌输应对此类问题的信心。然而,伦理教育能让护士更有信心采取道德行动,从而减轻道德困扰的负面影响。评估一项护理伦理教育项目的可行性和可接受性,该项目将基于模拟案例的伦理能力作为一种评估形式。该项目旨在增强护士的伦理知识和应对实践中伦理挑战的信心。采用研究者自行设计的调查问卷和干预现场数据进行一项前瞻性、纵向、相关性单队列可行性研究。从美国中西部一个医疗系统内的一家学术性四级护理医疗中心和9家中小型地区医院招募注册护士。获得了机构审查委员会(IRB)的批准。无论是否参与研究过程,参与者均可完成该教育项目。20名参与者中,19名(95%)提供了项目后的调查问卷,18名完成了能力评估。课程安排、时间和时长的中位数(四分位间距)分数均为10.0 [9.0, 10.0],参与者认为内容有趣,增加了伦理知识和信心,提高了提供伦理护理的技能,并会向同事推荐该项目。在各项因素中,伦理知识的增加得到的“完全同意”(17人,89.5%)回应率最高。大多数参与者报告称,伦理能力评估合适,评分为9.0 [9.0, 10.0],且具有足够的挑战性,评分为10.0 [9.0, 10.0]。该教育项目提升了护士的伦理知识和信心。单队列可行性设计提供了早期干预结果;然而,更大规模的随机对照试验将证实该项目的价值。这项新颖的伦理教育项目对医院护士而言具有高度可行性和可接受性,这些护士报告称在提供伦理护理方面知识和信心有所增加。基于模拟案例的伦理能力是一种合适的评估方法。