Ethico-legal aspects and ethical climate: Managing safe patient care and medical errors in nursing work

Abstract

Background The nursing profession requires ethical and legal regulations to guide nurses’ performance. Ethical climate plays a part in shaping nurses’ ethical practice. Therefore, ethico-legal aspects and ethical climate contribute to improving nurses’ ethical practice and competencies with reducing medical errors in hospital settings. Objective This study examined the effect of ethico-legal aspects and ethical climate on managing safe patient care and medical errors among nurses. Materials and methods A cross-sectional correlational study was carried out on 548 nurses. Data were collected through self-administered questionnaires about nurses’ knowledge in both ethical and legal aspects, ethical practice, competencies, ethical climate and experience with medical error. Results The main sources of nurses’ knowledge of ethical and legal aspects were undergraduate lectures, job experience and colleagues. Nurses’ knowledge in both ethical and legal aspects, nurses’ ethical practice and competencies were insufficient. Nurses fairly perceived their ethical climate. Also, nurses experienced medical errors about 22.6% in their units. Nurses’ knowledge of ethical and legal aspects, as well as the ethical climate were positive predictors of inadequate nurses’ ethical practice and competencies. Additionally, nurses’ knowledge in both ethical and legal aspects, ethical climate and practice had a negative influence on the occurrence of medical errors. Conclusion Enhancing nurses’ knowledge in both ethical and legal aspects as well as ethical climate could significantly influence improving nurses’ ethical practice, competencies and reducing medical errors in the study units. Therefore, planning for enhancing the nurses’ ethico-legal learning and ethical climate seems to be mandatory.

Conceptual framework for the ethical climate in health professionals

“…Many problems in health services are related to unethical behavior, misconduct, lack of knowledge, practice, and skills of professionals in patient care. 52 Ethical problems are even more complex in the hospital area, where professionals are often challenged to work with many patients in a severe clinical condition, with inadequate structuring of the work process, scarce human resources, and intense work overload. 1 Briefly, based on what has been presented so far, the ethical climate is considered in its procedural model, being articulated with organizational elements, as established in the literature, and with conceptual expansion, to the worker's health and the ethical expressiveness at work.…”

“…Many problems in health services are related to unethical behavior, misconduct, lack of knowledge, practice, and skills of professionals in patient care. 52…”

Effect of Educational Intervention on Psychiatric Nurses’ Knowledge Regarding Ethical and Legal Issues for Psychiatric Patients

“…Besides, psychiatric nurses play a very important role from the time of patient admission to discharge such as, meeting all types of patient biological and emotional needs, maintaining and protecting patient rights, maintaining confidentiality, and taking informed consent, all come under legal responsibilities of a psychiatric nurse (Kumar, Mehta, & Kalra 2011). Accordingly, nurses should strengthen their legal and ethical knowledge because these issues guide, protect, and enhance professional nursing practice (Aly et al, 2020). The aim of this study was to assess the effects of an educational interventionon psychiatric nurses' knowledge regarding the legal and ethical issues associated with the treatment of psychiatric patients.…”

“…Therefore, nurses must be highly aware of psychiatric patients' needs and legal rights in accordance with established ethical and legislative standards (Eren, 2014; Barloon and Hilliard, 2016). Nurses' knowledge of legal and ethical aspects is critical for all nursing professionals because nurses are expected to be professionally competent and provide ethical, high-quality care (Aly et al 2020).…”

The relationship between organizational ethical climate and components of nursing error reporting in selected hospitals of Tehran University of Medical Sciences in 2020

“…The importance of creating a proper ethical climate has always been emphasized in nursing texts (Zhang et al, 2019). Nurses' awareness of ethical and legal issues and the favourable ethical climate in the clinical settings have a negative impact on the occurrence of nursing errors (Aly et al, 2020). The ethical climate of hospital has also been found to be effective in reporting nursing errors (Levine et al, 2020).…”