SS: Standardizing Nurses’ Bioethics Decisions With Innovative Interactive Technologies

Description/Overview: The data on lack of nurses’ educational preparation in ethics is clear. Despite the knowledge that nurses are likely to encounter a host of ethical issues in their practice, recent research finds that nurses are not adequately prepared to handle ethical issues that arise in the current complex health care environment. Such unpreparedness can have a variety of adverse outcomes for nurses and their patients. In particular, nurses may feel significant “moral distress,” which is characterized by the feeling that one knows the proper and ethical course of action to take but is prevented from taking action due to a variety of institutional or other factors that limit or prescribe nurses’ ability to implement decisions. While ethics education can provide analytical and decision-making tools to mediate the personal dimensions of moral distress, research also reveals that ethics education remains inaccessible to many nurses. In particular, Grady et al. found that in a survey of 1,215 nurses and social workers regarding their ethics education experience, nearly 23% of the nurses questioned reported having received no formal ethics education, either in their pre-professional training or in subsequent continuing education. This finding was correlated with a general lack of knowledge, ability, or moral confidence of these professionals to: (1) identify and resolve ethical issues; (2) access institutional ethics resources; and (3) provide moral action and advocacy for patients, which is a hallmark of the ethical practice of nursing. Thus it is of paramount importance that nurses be able to access ethics education that is clinically based and practical, accessible, and consistent. Consistency is an important hallmark in reaching clinical decisions involving ethical values and conflicts. The ideal is that consistent application of ethical principles, approaches, and frameworks in similar clinical contexts should yield similar options to resolve ethical problems in the care of patients. The author has developed and tested an innovative decision enhancement tool called YouDecide™ with a variety of nurses and nursing students to help standardize the process used to analyze ethical issues. YouDecide™ is a web-based education and business enhancement software application that allows learners to build their own answer to a challenge or problem posed by an expert. The goal of YouDecide™ is to harmonize complex decisions faced by groups with diverse educational backgrounds and values through knowledge reinforcement, working with the group to develop a consensus answer to a challenge or problem based on the results of building one’s own answer to the challenge, ranking individual answers, comparison to a subject matter expert’s answer, and facilitated discussion. Evaluation data from testing a standardized ethics case with several populations of nursing professionals involving the concept of brain will be presented. Coupled with other work on the use of standardized frameworks to enhance nurses’ diagnostic skills in detecting and analyzing ethical problems, the evaluation data show the promise of YouDecide™’s unique sequence, structure, and organization to achieve consistency, practicality, and accessibility in ethics education for nurses.