Interprofessional ethics rounds concerning dialysis patients: staff’s ethical reflections before and after rounds

Svantesson, Mia; Anderzén‐Carlsson, Agneta; Thorsén, Håkan; Kallenberg, Kjell; Ahlström, Gerd

doi:10.1136/jme.2007.023572

Cited by 25 publications

(47 citation statements)

References 29 publications

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“…Only three studies directly focused on support for ethical competence: ethics rounds from the viewpoint of ethical reflection (Svantesson et al . ,b) and a training programme including ethics round from the viewpoint of moral distress (Kälvemark Sporrong et al . ).…”

Section: Resultsmentioning

confidence: 99%

“…Staff meetings (Raines ), clinical ethics committees (Levine‐Ariff , Svantesson et al . ) and ethics rounds (Levine‐Ariff , Raines , Kälvemark Sporrong et al . , Svantesson et al .…”

Section: Resultsmentioning

confidence: 99%

“…, Svantesson et al . ,b) were seen as different formal organizational arenas for ethical discussion (Gjerberg et al . ).…”

Section: Resultsmentioning

confidence: 99%

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A mixed‐method systematic review: support for ethical competence of nurses

Poikkeus

Numminen

Suhonen

et al. 2013

Journal of Advanced Nursing

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There is a need to develop evidence-based support at the organizational and individual level to support nurses' ethical competence. Barriers for multiprofessional cooperation in ethical issues should be recognized and addressed as part of the development of organizational ethical practices. Research should pay more attention to the conceptual, theoretical and practical perspectives of ethical competence.

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Section: Resultsmentioning

confidence: 99%

“…Staff meetings (Raines ), clinical ethics committees (Levine‐Ariff , Svantesson et al . ) and ethics rounds (Levine‐Ariff , Raines , Kälvemark Sporrong et al . , Svantesson et al .…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

A mixed‐method systematic review: support for ethical competence of nurses

Poikkeus

Numminen

Suhonen

et al. 2013

Journal of Advanced Nursing

View full text Add to dashboard Cite

show abstract

“…One strategy that has proved efficient in this area is to develop so called 'ethics rounds', i.e., institutionalized, interprofessional ethics discussions on authentic patient cases in hospital settings [16]. Recent studies have reported that such rounds can be a working strategy to handle moral distress [22,40]. Interprofessional ethics rounds may be a suitable model also for research nurses and the staff they work with, but this has yet to be investigated.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have established that nurses can develop negative stress symptoms in situations where they assume they know the morally right thing to do, but organisational factors hinder them from following through upon the preferred action [23,36,45]. Studies have also indicated that moral distress can be reduced through competence strengthening, for example, in the form of interprofessional ethics rounds [22,40].…”

Section: Introductionmentioning

confidence: 99%

Ethical Dilemmas and Ethical Competence in the Daily Work of Research Nurses

2009

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In spite of the growing interest in nursing ethics, few studies have focused on ethical dilemmas experienced by nurses working with clinical studies as 'research nurses'. The aim of the present study was to describe and explore ethical dilemmas that Swedish research nurses experience in their day-to-day work. In a qualitative study a purposeful sample of six research nurses from five wards of differing disciplines in four Swedish hospitals was interviewed. The analysis displayed several examples of ethical dilemmas, primarily tensions between the nurses' obligations to the study and to the patients involved. A guiding moral principle for the nurses was patient-centeredness, where the interest of research must not override the interest of the patient. In situations where tensions between research and patient interests occurred, and doctors and nurses disagreed upon the judgement, the nurses sometimes chose to follow the doctors' advice, and thus acted against their own moral judgment. Such situations seemed to create feelings of moral distress among the nurses. They described their profession as being 'invisible' and as lacking opportunities for ethical competence building. The conclusion is that research nurses frequently experience severe and difficult ethical dilemmas in their daily work. They need to be acknowledged as a particular profession in the health care organisation and encouraged to develop their specific ethical competence.

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Clinical Ethics Support for Healthcare Personnel: An Integrative Literature Review

et al. 2017

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This study describes which clinical ethics approaches are available to support healthcare personnel in clinical practice in terms of their construction, functions and goals. Healthcare personnel frequently face ethically difficult situations in the course of their work and these issues cover a wide range of areas from prenatal care to end-of-life care. Although various forms of clinical ethics support have been developed, to our knowledge there is a lack of review studies describing which ethics support approaches are available, how they are constructed and their goals in supporting healthcare personnel in clinical practice. This study engages in an integrative literature review. We searched for peer-reviewed academic articles written in English between 2000 and 2016 using specific Mesh terms and manual keywords in CINAHL, MEDLINE and Psych INFO databases. In total, 54 articles worldwide described clinical ethics support approaches that include clinical ethics consultation, clinical ethics committees, moral case deliberation, ethics rounds, ethics discussion groups, and ethics reflection groups. Clinical ethics consultation and clinical ethics committees have various roles and functions in different countries. They can provide healthcare personnel with advice and recommendations regarding the best course of action. Moral case deliberation, ethics rounds, ethics discussion groups and ethics reflection groups support the idea that group reflection increases insight into ethical issues. Clinical ethics support in the form of a “bottom-up” perspective might give healthcare personnel opportunities to think and reflect more than a “top-down” perspective. A “bottom-up” approach leaves the healthcare personnel with the moral responsibility for their choice of action in clinical practice, while a “top-down” approach risks removing such moral responsibility.

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Interprofessional ethics rounds concerning dialysis patients: staff’s ethical reflections before and after rounds

Abstract: The findings show the need for interprofessional reflective ethical practice but a balance between ethical reflection and problem solving is suggested if known patients are discussed. Further research is needed to explore the most effective leadership for reflective ethical practice.

Cited by 25 publications

References 29 publications

A mixed‐method systematic review: support for ethical competence of nurses

A mixed‐method systematic review: support for ethical competence of nurses

Ethical Dilemmas and Ethical Competence in the Daily Work of Research Nurses

Clinical Ethics Support for Healthcare Personnel: An Integrative Literature Review

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