Ethical issues in patient safety

2013 ◽  
Vol 20 (8) ◽  
pp. 904-916 ◽  
Author(s):  
Mari Kangasniemi ◽  
Mojtaba Vaismoradi ◽  
Melanie Jasper ◽  
Hannele Turunen

The purpose of this article is to discuss the ethical issues impacting the phenomenon of patient safety and to present implications for nursing management. Previous knowledge of this perspective is fragmented. In this discussion, the main drivers are identified and formulated in ‘the ethical imperative’ of patient safety. Underlying values and principles are considered, with the aim of increasing their visibility for nurse managers’ decision-making. The contradictory nature of individual and utilitarian safety is identified as a challenge in nurse management practice, together with the context of shared responsibility and identification of future challenges. As a conclusion, nurse managers play a strategic role in patient safety. Their role is to incorporate ethical values of patient safety into decision-making at all levels in an organization, and also to encourage clinical nurses to consider values in the provision of care to patients. Patient safety that is sensitive to ethics provides sustainable practice where the humanity and dignity of all stakeholders are respected.

2021 ◽  
Vol 31 (4) ◽  
pp. 254-262
Author(s):  
Mostafa Roshanzadeh ◽  
◽  
Zohreh Vanaki ◽  
Afsaneh Sadooghiasl ◽  
Ali Tajabadi ◽  
...  

Introduction: Ethical decision-making by nursing managers is influenced by various essential factors, such as courage, without which it is impossible to act on them. Objective: This study aimed to explore the experiences of nursing managers about courage in ethical decision-making. Materials and Methods: The current study was conducted in Iran by a qualitative content analysis approach in 2018. Nineteen nurse managers were selected purposefully from hospitals in Tehran and Shahrekord cities. Data were collected using semi-structured, in-depth, face-to-face interviews, and after transcription, they were analyzed according to the Graneheim and Lundman method. Results: Based on data analysis, we extracted 2 categories (obligation, decisiveness) and 8 subcategories (clearness in expressing decisions, the ability of the manager to make decisions in critical and complex situations, authority/decision-making as a religious responsibility, follow the decision process, being responsible, making compensatory decisions, making preventive decisions). Conclusion: The findings showed that managers who are committed to ethical decision-making have enough assertiveness to make the decisions. Educating, empowering, and sensitizing managers and enhancing their insight into ethical issues through problem-solving and role-playing techniques can play an essential role in promoting their commitment and responsibility.


2016 ◽  
Vol 50 (1) ◽  
pp. 109-117 ◽  
Author(s):  
Rodrigo Jensen ◽  
Erika de Souza Guedes ◽  
Maria Madalena Januário Leite

Abstract OBJECTIVE To identify informatics abilities essential to decision making in nursing management. METHOD Survey study with specialist nurses in health informatics and management. An electronic questionnaire was built based on the competencies Information Literacy (five categories; 40 abilities) and Information Management (nine categories; 69 abilities) of the TIGER - Technology Informatics Guiding Education Reform - initiative, with the guiding question: Which informatics abilities are essential to decision making in management? Answers were sorted in a Likert scale, ranging from 1 to 5. Rasch analysis was conducted with the software WINSTEPS ®. Results were presented in logits, with cutoff value zero. RESULTS Thirty-two specialists participated, coming from all regions of Brazil. In the information literacy competency, 18 abilities were considered essential and in Information Management, 38; these were sorted according to their degree of essentiality. CONCLUSION It is believed that the incorporation of these abilities in teaching can support the education of nurse managers and contribute to evidence-based practice, incorporation of information and communication technologies in health and information management.


2018 ◽  
Vol 18 (3) ◽  
pp. 577-591
Author(s):  
Alexssandro da Silva ◽  
Garibaldi Dantas Gurgel Júnior ◽  
James Anthony Falk ◽  
Marcel de Moraes Pedroso

Abstract Objectives: to establish the decision preferences of nurse managers with emphasis on maternal-child patient safety, in order to understand how to prioritize actions and investments in the application of nursing assignments should be given. Methods: a quantitative research with convenience sampling and a MCDA methodology (Multiple Criteria Decision Analysis) was operationalized by the PROMETHEE algorithm (Preference Ranking Organization Method for Enrichment Evaluations) through the use of a graphical preference capture tool and sensitivity analysis to ensure the robustness of the model. A consolidation of the criteria was carried out by means of the dimensions: reception, classification, assistance, orientation, team integration and administrative services, defined by criteria similarity and calculated by means of weighted preference indexes. Results: a greater decision preference or relative importance was attributed to the professional category Obstetric Nurses (46.47%), which stood out with the highest preferences in three dimensions: Integration (22.74%), Assistance (13.37%) and Administrative Aspects (10.36%). The dimensions not directly involved with the patient (Team Integration and Administrative Aspects), altogether had a high decision-making preference or relative weight (47.96%). Conclusions: the model of decision-making preferences furnished innovative contributions in regard to the priority established on actions and investments to create greater safety for maternal and child patients.


2020 ◽  
Vol 28 (1) ◽  
pp. 28-33
Author(s):  
Izabella Uchmanowicz ◽  
Piotr Gurowiec ◽  
Renáta Zeleníková ◽  
Elena Gurková ◽  
Darja Jarošová ◽  
...  

Author(s):  
Magnus Nord ◽  
Magnus Ysander ◽  
Tim Sullivan ◽  
Mayur Patel

OBJECTIVE: In 2012, Patient Safety (PS) in AstraZeneca was facing a situation with multiple challenges, scientifically and structurally. To meet these and support AstraZeneca’s ambition to return to growth after years of patent expiry, we undertook a project to fundamentally revisit ways of working to create an organisation set up to provide strategic safety in support of drug project decision-making. METHOD: In this paper, we describe the challenges we faced, the project to deliver changes to respond to them, and the methodology used. The project had two main components: creating a new operating model and simplifying the procedural framework. RESULTS: It was delivered in a focused effort by internal PS resources with cross-functional input. The framework simplification resulted in a 71% reduction in procedural documents and a survey of PS staff revealed an increase in satisfaction of 10%–20% across all scores. CONCLUSIONS: With >3 years of observation time, this project has provided AstraZeneca with a PS organisation able to provide strategic safety, supporting successful portfolio delivery, while ensuring patient safety and maintaining compliance with global pharmacovigilance regulations. It has driven efficiency and set the foundation for continued organisational evolution to meet future business needs in an everchanging environment.


Author(s):  
Irina Domozhirova ◽  
E. Mihaleva

The article is devoted to the issues of increasing the efficiency of innovative activity of an industrial enterprise, which ensures the implementation of the formed portfolio of innovative projects. Innovative development of economic entities is possible if new requirements to the content, organization, forms and methods of management activity are met [1], which means that tools for monitoring the innovative development of an industrial enterprise, methods for assessing innovative opportunities and the effectiveness of managerial decision-making in innovation are needed [3]. To solve this problem, it is proposed to use the algorithm presented in the article for the formation of a portfolio of innovative projects of an industrial enterprise, including the developed methodology for their selection according to efficiency and feasibility indicators, the use of which in management practice makes it possible to make a reasonable assessment of the possibility of successful implementation of these projects and ensure an increase in the probability of achieving a positive result. The selection of innovative projects according to efficiency and feasibility indicators for PJSC "CADVI" was carried out and a portfolio of innovative projects for this enterprise was formed.


2021 ◽  
Vol 21 (3) ◽  
pp. 147-161
Author(s):  
Lucia Maria de Araujo Lima Gaudencio ◽  
Rui de Oliveira ◽  
Wilson Fadlo Curi

Production units located in the Brazilian marine environment are responsible for the production of 95.7% of oil and 78.8% of natural gas of Brazil causing economic, environmental, and social impacts motivating us to construct a system of indicators as a tool aimed to improve the sustainable management practice of these production units. To date, one of the tools most used by the oil industry is the sustainability report, oriented by guidelines from international organizations. However, these reports have a corporate character being unable to help the sustainability management of production units’ activities. The indicators were selected based on a systemic approach, using current knowledge on sustainability indicators, together with the survey of aspects relevant to the operation and management of offshore oil and gas production units. This paper describes the proposed indicators and presents the hierarchical structure of the system, built on the economic, environmental, social, and operational dimensions. The application of the proposed system of indicators, based on multicriterial and multiple decision-making analyses, validates a complex decision process, providing improved sustainable management of offshore production units by identifying points for which the necessary measures and actions can be implemented. Keywords: offshore oil and gas production; sustainability indicators; multicriteria and multiple decision-making analyses.


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