N246 ethics, quality of care, IOM pp.ppt

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    Essentials of Nursing Leadership & Management, 4th Edition

    N246 LeadershipEthics & Quality

    S. Buckley, 2010

    (Adapted from Nursing Leadership and Management,Whitehead, Weiss, Tappen)

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    Early nursing leaders

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    finances

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    1960s

    Technological advances allowed for thedevelopment of intensive care units

    New biomedical developments

    Advances in surgical techniques, such asopen heart surgery

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    Reasons for new inquiries innursing

    Technological advances created new questions for health-care

    professionals regarding the use of technology, RN role and outcomes Changing views and perspectives on the concepts of life and death Dissatisfaction of RNs with traditional manner of learning (mentoring)

    and desire to have a scientific base for practice (professionalscientists)

    Interest by healthcare practitioners about application of values in

    professional practices, and how to discuss these issues.

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    Bioethics

    A sub discipline of ethics The study of medical morality

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    Concepts of EthicsEthics evolve from moral perspectives, which form

    values and standards. Influenced by families,

    environment, social issues, culture, religion,cognition, law.Ethical action depends, in part, on the ability of

    people to recognize that a moral issue exists in agiven situation, knowing how to take appropriateethical action if and when required, and onpersonal commitment and a genuine desire toachieve a moral outcome

    (Johnstone, 1999, from:Ethics in Nursing Practice, 2nded, Fry,

    S.T,Johnstone, M.)

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    Value Systems

    definitions

    A set of related values

    Intrinsic values-located within, the real nature of a thing.

    Extrinsic values-from without

    Personal values

    Professional values

    Social principles, goals or standards held or accepted byan individual class, society. That which is desirable orworthy of esteem for its own sake, thing or quality havingintrinsic worth.

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    Historical values ofnursing:

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    Nursing today Values in nursing

    today:

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    Value Formation

    Values are learned-therefore, influenced by

    family, culture, environment, cognition. Values change with maturity and

    experience

    The number of values an individual holds isnot as important as what values theyconsider important

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    Types of Values Personal

    Cultural Religious

    professional

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    Values Clarification

    Critical thinking Choosing

    Identifying-verbalizing?

    Acting

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    Belief Systems These are organized ways of thinking about

    why people exist within the universe

    Their purpose is to explain such conceptsas:

    Life and death

    Good and evil

    Health and illness

    Individualism/rights

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    ETHICS AND MORALS

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    Morals An individuals own code for acceptable

    behavior

    Standards of goodness or rightness thatarise from an individuals conscience

    They act as a guide for individual behavior

    Learned Capable of making a distinction between

    right and wrong in conduct

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    Values Social principles, goals or standards held or

    accepted by an individual class, society.That which is desirable or worthy of esteemfor its own sake, thing or quality havingintrinsic worth.

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    Standards Something established for use as a rule or

    basis of comparison in measuring orjudging quality, value, extent.

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    Laws Rule of conduct established and enforced

    by the authority, legislation or custom of agiven community, state, or other group.

    May change with fluctuating social moralsand viewpoints.

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    Ethics Having to do with moral standards,

    conforming to the standards of conduct of a

    given professional group. Impliesconformity with an elaborated, ideal code ormoral principles.

    Concerned with the motivation behind thebehavior

    Bioethics is the application of theseprinciples to life-and-death issues

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    Ethical Theories

    Deontological-based on duty to commitment, considers

    the intention of the action, not the consequences of theaction. It is the individuals goodwill that determinesworthiness, not the outcome.

    Teleological-(utilitarianism)-what makes an action right orwrong is its usefulness. Right encompasses actions that

    have positive outcomes, wrong is composed of actionsthat result in poor outcomes. Principalism-involved in biomedical issues, integrates

    ethical principles to resolve conflicts in situations.

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    Ethical Principles

    Autonomy

    Nonmaleficence Beneficence Justice Fidelity

    Confidentiality Veracity Accountability

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    Autonomy

    The freedom to make decisions aboutoneself

    Nurses need to respect clients rights to

    make choices about health care

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    Nonmaleficence

    Requires that no harm be caused to anindividual, either unintentionally ordeliberately

    This principle requires nurses to protectindividuals who are unable to protectthemselves

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    Beneficence This principle means doing good for

    others

    Nurses need to assist clients in meeting alltheir needs

    Biological

    Psychological

    Social

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    Justice

    Every individual must be treated equally

    This requires nurses to be nonjudgmental

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