Development of Nursing education Model based ethical judgment and clinical judgment

2003 Fiscal Year Final Research Report Summary

• Project/Area Number: 13307070
• Research Category: Grant-in-Aid for Scientific Research (A)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: 基礎・地域看護学
• Research Institution: Kochi Women's University
• Principal Investigator: NOJIMA Sayumi Kochi Women's University, Nursing, Professor, 看護学部, 教授 (00172792)
• Co-Investigator(Kenkyū-buntansha): SUZUKI Shizue Kochi Women's University, Nursing, Professor, 看護学部, 教授 (00149709) ; TAKANO Junko Aichi Medical University College of Nursing, Nursing, Professor, 看護学部, 教授 (00226804) ; TAKADA Sanae Kobe City College of Nursing, Nursing, Professor, 看護学部, 教授 (50226784) ; NAKANO Ayami Kochi Women's University, Nursing, Professor, 看護学部, 教授 (90172361) ; KAWAKAMI Michiko Kochi Women's University, Nursing, Lecturer, 看護学部, 講師 (60305810)
• Project Period (FY): 2001 – 2003
• Keywords: ethical judgment / clinical judgment / restraint / infection

Research Abstract

This study was conducted in order to elucidate the applications of ethical and clinical decisions among nurses with regard to restraint and infection, and related guidelines were created.
Responses to a questionnaire survey on restraint were obtained from a total of 777 nurses. Nurses providing emotional care for restrained patients (n=392) felt "responsible for protecting the dignity of patients and ensuring their comfort", and tended to use "cognitive ability" and "effects on patients" as assessment indicators. Based on these results, the "Care guideline for ensuring the safety, comfort, and dignity of care recipients during physical restraint" was created, and then refined after obtaining evaluations. Responses to a questionnaire survey on infection were obtained from a total of 499 nurses. When implementing seclusion, nurses stated individual plans regarding issues such as "methods and standards of seclusion" and "explanations to the patient and family", but tended not to state individual plans for "stress coping techniques and their assessment".
Nurses reported that in addition to other types of support, the following were constantly implemented during seclusion: "daily living assistance", "responses to limitations on daily living", "monitoring of signs of infection", and "emotional care for patients". Nurses responded that the conditions necessary for appropriate infection control included the following: "changes in the consciousness of doctors and other coworkers", "establishment of a system for collaborating and cooperating with doctors and other coworkers", "changes in the consciousness of nurses", "acquisition of specialized skills by nurses", and "development of a nursing education system". Based on these findings, the "Infection management guideline for ensuring the safety, comfort, and dignity of care recipients" was created.