Ethics, Confidence, and Training as Predictors of Decision-Making by Nurses During Disasters

I am pleased to present the ABSTRACT of the Ph.D. Dissertation prepared in May, 2012, by Dr. Joan Bold to Walden University.

Abstract

 Ethics, Confidence, and Training as Predictors of Decision-Making by Nurses During Disasters 

by

Joan A. Bold

MEd, University of West Florida, 1983

BSN, University of San Diego, 1981

Dissertation Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Philosophy

Health Services

Walden University

May 2012

Abstract

The American Nurses Association (ANA) 2008 Code of Ethics and Adapting Standards of Care Under Extreme Conditions describes how nurses are placed in the forefront of all phases of disaster relief, from planning to recovery efforts.  A 20-question quantitative instrument was developed and tested for feasibility in the field using ethics theory and Dillman’s tailored design method. The tool was assessed by an expert panel of 5 and then administered to 26 nurses from the public and community health departments. Research questions addressed (a) the ability of nurses familiar with the 2008 ANA Code of Ethics to verbalize knowledge of their professional responsibilities, (b) nurses ability to make confident decisions, assume leadership roles, and treat patients fairly, (c) ethics training beyond the basic nursing coursework. Data analysis technique included 6 ANOVA tests for the hypotheses. The result of the analyses supports 2 of 3 hypotheses (a) confidence in ethical decisions-making, (b) training during all-hazard situations. Both are associated with decision-making for entire group years licensed (11-40 years) and years worked (10-35 years) p= .01 respectively. Two other ANOVA test failed to accept or reject the null for confidence p= .91 and training p= .80. The results failed to reject the null hypothesis for (a) professional responsibility for years licensed (11-15 years) and years worked (11-15 years), nurses had moderate ethical concerns for decision-making p= 1.90, (b) professional responsibility (self-determination) also revealed nurses had difficulty placing their needs before their patient’s needs p= 1.19 regardless of years licensed (11-40 years) or years worked (10-35 years).  Implications for positive social change include better ethical decision making which can lead to higher quality of care for victims of disasters and improved medical outcomes.