ETHICAL ISSUES AFFECTING NURSES' EFFECTIVE PROVISION OF CARE IN KENYAN GOVERNMENT HOSPITALS: A CASE STUDY OF KENYATTA NATIONAL HOSPITAL
Keywords:
possible risk to health, nurse- physician conflicts, informed consent, information confidentialityAbstract
Purpose: The purpose of the study was to establish the ethical issues affecting nurses' effective provision of care in government hospitals with Kenyatta National Hospital as the case study.
Methodology: The research design was a descriptive survey. The target population comprised of all nurses in KNH. Stratified random sampling was used to group respondents per department and simple random sampling was used to select respondents per stratum. A sample of 366 respondents was used. Questionnaires were then be used to obtain primary data. The Statistical Package for Social Sciences (SPSS version 12) was used to analyse quantitative data and presented using descriptive statistics.
Results:The findings indicated that risk to health had a positive and significant effect on provision of care as indicated by (r=0.455, p=0.000).Nurse_ Physicians conflict had a positive and significant effects provision of care as supported by (r=0.310, p=0.005). Informed consent had a positive and significant association to provision of healthcare as supported (r=0.513, p=0.02). Finally, Consent to treat Information with confidentiality also had a positive and significant association with provision of health care (r=0.051, p=0.000).
Policy recommendation: The results will be used by the management of KNH to understand the ethical issues faced by nurses, so as to make policies and procedures that will broaden areas that nurses can make decisions concerning effective patients' care. Management in public hospitals and colleges can also incorporate ethical trainings into the curriculum and short training courses. They can also form ethical committees to help nurses deal with ethical issues encountered. Future researchers will find the research findings helpful as they will use them as reference points or benchmarks in their endeavour to do more research.
Downloads
References
Akyuz, E., & Erdemir, F. (2013). Surgical patients' and nurses' opinions and expectations about privacy in care. Nursing Ethics, 20 (6), 660-671.
American Nurses Association. (2015). Optimal Nurse Staffing to Improve Quality of Care and Patient Outcomes. Avalere Health LLC.
American Society of Registered Nurses . (2008). Nurses at risk. American Society of Registered Nurses .
Amsalu, E., Boru, B., Getahun, F., & Tulu, B. (2014). Attitudes of nurses and physicians towards nurse-physician collaboration in northwest Ethiopia: a hospital based cross-sectional study. BMC Nursing .
Bagheri, H., Yaghmaei, F., Ashktorab, & Zayeri, F. (2011). Patient dignity and its related factors in heart failure patients. Nursing Ethics , 19(3) 316-327.
Barnoy, S., & Tabak, N. (2007). ISRAELI NURSES AND GENETIC INFORMATION DISCLOSURE. Nursing Ethics, 14 (3).
Beauchamp, T., & Childress, J. (2001). Principles of biomedical ethics. (5th, Ed.) New York: Oxford University Press.
Berg, J. W. (2011, August 17). Patients Cofidentiality: Privvacy and Public Health. Retrieved April 27, 2016, from Bioethics: http://www.thedoctorwillseeyounow.com/content/bioethics/art3401.html
Bord, J. D., Burke, W., & Dudzinski, D. M. (2013). Confidentiality. ETHICS IN MEDICINE .
Brann, M. (2006). The Influence of Illness Factors on Physicians' Likelihood of Disclosing Confidential Health Information to Relatives of Patients,. Communication Studies, 57 (3), 259-276.
Campbell, T. (2006). Rights: A critical introduction. London: Routledge.
Centers for Disease Control and Prevention. (2012). Frequently Asked Questions on Ethical Issues Related to Mental Health Care in Emergencies. Johns Hopkins Bloomberg School of Public Health.
Chenaud, C., Merlani, P., & Ricou, B. (2007). Research in critically ill patients: standards of informed consent. Geneva: BioMed Central Ltd.
Chritensen, B. J. (2004). Educational Research: Quantitative, Qualitative, and Mixed Approaches, Research Edition, Second Edition. South Carolina: Allyn & Bacon.
Clarke, S. P., & Donaldson, N. E. (2013). Nurse Staffing and Patient Care Quality and Safety. California: National Centre for Biotechnology Information.
Clever, L. H., & LeGuyader, Y. (1995). Infectious Risks for Health Care Workers. San Francisco, California: Annual Review Public Health.
Cockcroft, S., Sandhu, N., & Norris, A. (2009). How does national culture affect citizens' rights of access to personal health information and informed cosent? Health Informatics Journal, Vol 15x (3), 229-243.
Cohen, J., & Ezer, T. (2013). Human rights in patient care: A theoretical and practical framework. Health and Human Rights, 15 (2).
Cooper, D. R., & Schindler, P. S. (2006). Business research methods (9th ed.). McGraw- Hill Companies. INC.
Crossroads Hospice Charitable Organization. (2016). Challenges Facing the Kenyan Health Workforce. Retrieved April 22, 2016, from CRHCS: https://crhcf.org/
Dehghani, A., Leili, M., & Nahid, D. (2015). Factors affecting professional ethics in nursing practice in Iran: a qualitative study. Bio Med Central Medical Ethics .
Deshefy-Longhi, T., Dixon, J. K., Olsen, D., & Grey, M. (2004). ISSUES IN PRIMARY CARE: VIEWS OF ADVANCED PRACTICE NURSES ANDTHEIR PATIENTS. Nursing Ethics, 11 (4).
Donatus, G. (2011). Ethical Issues in Health Care in Kenya. A Critical Analysis of Health Care Stakeholders. Research Journal of Finance and Accounting , 2 (3).
Ermak, L. (2014, January 27). Beating the burnout: Nurses struggle with physical, mental and emotional exhaustion at work. Retrieved April 23, 2016, from National Nurses United: http://www.nationalnursesunited.org/news/entry/beating-the-burnout-nurses-struggle-with-physical-mental-and-emotional-exha/
Farley, M. (2002). Compassionate respect. Mahwah: Paulist Press.
Ferri, P., Muzzalupo, J., & Di Lorenzo, R. (2015). Patients' perception of dignity in an Italian general hospital: a cross-sectional analysis. BioMed Central .
Fraser, V., & Powderly, W. (1995). RISKS OF HIV INFECTION IN THE HEALTH CARE SETTING. Annu. Rev. Med. , 203-211.
Green, J., Darbyshire, P., Adams, A., & Jackson, D. (2015). A burden of knowledge :A qualitative study of experiences of neonatal intensive care nurses' concerns when keeping information from parents. Journal of Child Health Care, 19 (4), 485-494.
Hammami, M., Al-Gaai, E., Al-Jawarneh, Y., Amer, H., Eissa, A., & Al Qadire, M. (2014). Patients' perceived purpose of clinical informed consent: Mill's individual autonomy model is preferred. BMC Medical Ethics .
Hartog, C., & Benbenishty, J. (2014). Understanding nurse-physician conflicts in the ICU. Jena Germany: Springer-Verlag Berlin Heidelberg and ESICM.
Heijkenskjold, K. B., Lindwall, L., & Ekstedt, M. (2010). The patient's dignity from the Nurse's Perspective. Nursing Ethics , 17(3) 313-324.
Jostine, M. (2012). Ethical Dilemmas Experienced by Nurses working in Critical Care Units in Kenyatta National Hospital. University of Nairobi Repository Journals .
Judith, E. (2001). The Nursing Shortage, Patient Care, and Ethics. Orthopaedic Nursing Journal, 20 (6), 61-65.
Kenyatta National Hospital. (2014, August 5th). Retrieved March 5th, 2015, from Kenyatta National Hospital: www.knh.or.ke
Kombo, D. K., & Tromp, L. A. (2006). Proposal and thesis writing: An introduction. Africa: Paulines Publications.
Kothari, C. R. (2008). Research methodology: Methods and techniques, (2nd ed.). India: New Age Publications.
KPMG. (2013). Devolution of Healthcare Services in Kenya: Lessons learnt from other countries. KPMG Services (Proprietary) Limited.
Lowrie, L. (2016). Ethics & Legal Issues in Nurse Staffing. Hearst Newspapers .
Mahmud, S. M., & Ahmad, A. (2010). Patients as Teaching Tools: Merely Informed or True Consent. Acad Ethics Journal , 255-260.
Matlakala, M. C., & Mokoena, J. D. (2011). Student nurses' views regarding disclosure of patients' confidential information. South African Family Practice, 53 (5), 481-487.
Matthews, E., Haimes, E., Duguet, A. M., Clark, B., Swine, C., & Toussaint, O. (2005). Informed consent of very old patients and modern genomics? Springer.
McFarnon, E. (2013, February 6). Stafford Hospital deaths scandal- the background. Retrieved April 4, 2016, from The Sentinel: http://www.stokesentinel.co.uk/Stafford-Hospital-deaths-scandal-background/story-18068645-detail/story.html#ixzz2K7J1CFuk
McGrail, K., Morse, D., Glessner, T., & Gardner, K. (2009). What is Found There: Qualitative Analysis of Physician-Nurse Collaboration Stories. Journal of General Internal Medicine, Volume 24 (Issue 2), 198-204.
Mugenda. (2008). Social science research: Theory and principles:. Nairobi: Applied research and training services.
Mugenda, O. M. (1999). Research Methods: Quantitative and Qualitative Approaches. Nairobi: African Centre for Technology Studies.
Musa, M. B., Rashid, H., & Sakamoto, J. (2011). Nurse managers' experience with ethical issues in six government hospitals in Malaysia: A crosssectional study. BMC Medical Ethics, 12 (23).
National Nurses Association of Kenya. (2009). Code of Conduct and Ethics. Nairobi.
Nayeri, N. D., Karimi, R., & Sadeghee, T. (2011). Iranian nurses and hospitalized teenagers' views of dignity. Nursing Ethics , 18(4) 474-484.
Oberle, K., & Tenove, S. (2000). Ethical Issues in Public Health Nursing. Nursing Ethics .
Occupational Safety & Health Administration. (2015). Safety and Health Topics. United States Department of labour.
Olsen, D. P. (1998). Ethical considerations of video monitoring psychiatric patients in seclusion and restraint. Arch Psychiatry Nursing .
Park, M., Jeon, S. H., Hyun, J. H., & Sung, H. C. (2014). A comparison of ethical issues in nursing practice across Nursing Units. Sage Journals, Vol. 21 (5), 594-607.
Pegueroles, A. F., Canut, T. L., Merino, J. R., Tricas, J. G., & Olmos, J. G. (2015). Ethical conflict in critical care nursing: Correlation between exposure and types. Sage Journals Nursing Ethics, 22 (5), 594-607.
Preshaw, D., Brazil, K., McLaughlin, D., & Frolic, A. (2015). Ethical issues experienced by healthcare workers in nursing homes: Literature review. Sage Journal Nursing Ethics .
Rainbow, C. (2002). Descriptions of Ethical Theories and Principles. Davidson: Department of Biology, Davidson College, Davidson.
Rand, A. (2016). Ayn Rand's Theory of Rights: The Moral Foundation of a Free Society. The Objective Standard .
Robson, C. (1993). Real world research: A resource for social scientists and practitioner-researchers. Oxford: Blackwell.
Tromp, D. K. (2006). Proposal and thesis writing: an introduction. Nairobi: Paulines Publications Africa.
Ulrich, C., Taylor, C., Soeken, K., O'Donnell, P., Farrar, A., Danis, M., et al. (2010). Everyday Ethics: Ethical Issues and Stress in Nursing Practice. Journal of Advanced Nursing, 66 (11), 2510-2519.
Uys, L. R., & Klopper, H. C. (2013). What is the ideal ratio of categories of nurses for the South African public health system? South African Journal of Science, 109 (5/6).
Vaga, B. B., Moland, K. M., & Blystad, A. (2011). Boundaries of confidentiality in nursing care for mother and child in HIV programmes. Nursing Ethics , 2015.
Welton, J. (2007). "Mandatory Hospital Nurse to Patient Staffing Ratios: Time to Take a Different Approach". The Online Journal of Issues in Nursing., 3 (12).
Wildfire, A., Stebbing, J., & Gazzard, B. (2007). Rights theory in a specific healthcare context: "Speaking ill of the dead". Postgraduate Medical Journal, 83 (981), 473-477.
Wildschut, A., & Mqolozana, T. (2008). Shortage of Nurses in South Africa: Relative or Absolute? Pretoria: Department of Labour, Government Printer.
Wood, D. (2014). 10 Best Practices for Addressing Ethical Issues and Moral Distress. Los Angeles: AMN Health Care.
Yeliz, N. (2011). SOME ETHICAL APPROACHES IN BUSINESS. International Congress.Kastamonu Turkey: Kastamonu University Faculty of Arts and Sciences Department of philosophy.
Downloads
Published
How to Cite
Issue
Section
License
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution (CC-BY) 4.0 License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
