2 research outputs found
Ethical Issues Perceived by Clinical Ethicists
“Ethicists often work alone in rural locations while also holding leadership roles. Who helps the ethicist when he/she experiences an ethical dilemma or moral distress?” asked an ethicist. Purposes of this descriptive exploratory convenience research project were to (1) Identify the ethical issues personally experienced by clinical ethicists while fulfilling their professional role, and (2) Describe the resources that clinical ethicists have or desire for resolving these personally experienced ethical situations. A random purposive sampling strategy was implemented. IRB approval was obtained. 12 clinical ethicists participated. Eight of the participants had experienced a personal ethical issue while performing their clinical ethicist role. Ethical issues described include: maintaining confidentiality, non-professional communication, moral distress, identifying the correct decision-maker, acts of deception, and conflicts created by dual roles. Each of these identified work related ethical issues reflects potential or actual communication breakdowns, such as lying, failure to disclose values, or incidents of miscommunication
Recognizing Tick Bites and Risk: An Educational Initiative for Summer Camp Nurses
Purpose: There is a high risk of tick-borne diseases in the summer camp environment. Rapid nursing assessment is essential in identifying camper risk and for the provision of prophylactic antibiotics. The project objectives are to (1) modify the existing evidence-based standing orders for the provision of post-tick exposure prophylactic antibiotics, (2) provide summer camp nurse education, and (3) propose implementation strategies.
Methods: Nurses from fourteen summer camps contracting services from a Northeast pediatric primary care office completed a needs assessment regarding barriers to tick exposure assessment and independent utilization of an existing evidence-based protocol. The existing protocol was revised to include a rapid assessment tool for identification of campers at risk. The updated protocol and educational PowerPoint were disseminated to camp nurses, and feedback collected.
Results: Fifteen nurses completed the needs assessment. Eighty percent (n=12) were not confident with tick assessment skills and 67% (n=10) were not confident independently initiating post-tick exposure prophylaxis. Perceived barriers included inability to identify tick species (n=4) and determine scutal index (n=7), and discomfort with independent initiation of prophylaxis (n=7). Following protocol education, 100% (n=15) of nurses reported increased confidence in tick exposure assessment skills and confidence independently initiating post-tick exposure prophylaxis.
Conclusions: An evidence-based practice protocol addressed knowledge gaps and barriers. Revised protocol will be included in the nurse pre-camp medical orientation. Tick identification skills will need to be verified. Future research includes evaluation of protocol utilization and incidence of tick-borne disease at summer camps