Code of ethics ppt

Code of ethics

1. CODE OF ETHICS PRESENTED BY: PRASEEDHA. S 1 ST YEAR MSC NURSING EMCH COLLEGE OF NURSING

2. DEFINITON A CODE OF ETHICS IS A FORMAL STATEMENT OF GROUP’S IDEALS AND VALUES

3. PURPOSES STANDARDS FOR THE BEHAVIOURS OF NURSE& PROVIDE GENERAL GUIDELINES FOR NURSING ACTION HELPS TO DISTIGUISH BETWEEN RIGHT& WRONG ENABLES A CORRECT DECISION PROTECT THE RIGHTS OF INDIVIDUAL

4. USES Acknowledges the rightful place of Individuals in health care delivery system. Contributes towards empowerment of individuals to become responsible for their health and well-being. Contributes to quality care. Identifies obligations in practice, research and relationships. Informs the individuals, families, community and other professionals about expectations of a nurse.

5. ETHICAL PRINCIPLES RESPECT & AUTONOMY BENEFICENCE JUSTICE VERACITY FIDELITY

6. Ethical dilemma Occurs when there is conflict between two or more ethical principles. No correct decision exists. Ethical reasoning

7. International code of nursing ethics THE ICN CODE OF ETHICS FOR NURSES An international code of ethics for nurses was first adopted by the International Council of Nurses (ICN) in 1953. It has been revised and reaffirmed at various times since, most recently with this review and revision completed in 2005. PREAMBLE Nurses have four fundamental responsibilities: to promote health, to prevent illness, to restore health and to alleviate suffering. The need for nursing is universal. Inherent in nursing is respect for human rights, including cultural rights, the right to life and choice, to dignity and to be treated with respect. Nursing care is respectful of and unrestricted by considerations of age, colour, creed, culture, disability or illness, gender, sexual orientation, nationality, politics, race or social status. Nurses render health services to the individual, the family and the community and co-ordinate their services with those of related groups.

8. THE ICN CODE The ICN Code of Ethics for Nurses has four principal elements that outline the standards of ethical conduct. ELEMENTS OF THE CODE 1. NURSES AND PEOPLE The nurse’s primary professional responsibility is to people requiring nursing care. In providing care, the nurse promotes an environment in which the human rights, values, customs and spiritual beliefs of the individual, family and community are respected. The nurse ensures that the individual receives sufficient information on which to base consent for care and related treatment. The nurse holds in confidence personal information and uses judgement in sharing this information. The nurse shares with society the responsibility for initiating and supporting action to meet the health and social needs of the public, in particular those of vulnerable populations. The nurse also shares responsibility to sustain and protect the natural environment from depletion, pollution, degradation and destruction

9. 2.NURSES AND PRACTICE The nurse carries personal responsibility and accountability for nursing practice, and for maintaining competence by continual learning. The nurse maintains a standard of personal health such that the ability to provide care is not compromised. The nurse uses judgement regarding individual competence when accepting and delegating responsibility. The nurse at all times maintains standards of personal conduct which reflect well on the profession and enhance public confidence. The nurse, in providing care, ensures that use of technology and scientific advances are compatible with the safety, dignity and rights of people

10. 3. NURSES AND THE PROFESSION The nurse assumes the major role in determining and implementing acceptable standards of clinical nursing practice, management, research and education. The nurse is active in developing a core of research-based professional knowledge. The nurse, acting through the professional organisation, participates in creating and maintaining safe, equitable social and economic working conditions in nursing .

11. 4. NURSES AND CO-WORKERS The nurse sustains a co-operative relationship with co-workers in nursing and other fields. The nurse takes appropriate action to safeguard individuals, families and communities when their health is endangered by a co- worker or any other person .

12. 5. NURSES AND SOCIETY Participate and share responsibility with other citizens & other health professionals. Recognize and perform the duties of citizenship Aware of laws and regulations which affect the practice of medicine and nursing.

13. INC CODE OF ETHICS FOR NURSES IN INDIA I) The nurse respects the uniqueness of individual in provision of care 1.1 Provides care for individuals without consideration of caste, creed, religion, culture, ethnicity, gender, socio-economic and political status, personal attributes, or any other grounds

14. INC CODE OF ETHICS FOR NURSES IN INDIA I) The nurse respects the uniqueness of individual in provision of care 1.2 Individualizes the care considering the care considering the beliefs, values and cultural sensitivities.

15. INC CODE OF ETHICS FOR NURSES IN INDIA I) The nurse respects the uniqueness of individual in provision of care 1.3 Appreciates the place of the individual in family and community and facilitates participation of significant others in the care.

16. INC CODE OF ETHICS FOR NURSES IN INDIA I) The nurse respects the uniqueness of individual in provision of care 1.4 Develops and promotes trustful relationship with individual(s). 1.5 Recognizes uniqueness of response of individuals to interventions and adapts accordingly.

17. INC CODE OF ETHICS FOR NURSES IN INDIA I) The nurse respects the uniqueness of individual in provision of care 1.5 Appreciates the place of the individual in family and community and facilitates participation of significant others in the care.

18. INC CODE OF ETHICS FOR NURSES IN INDIA 2) The nurse respects the rights of individuals as partner in care and helps in making informed choices 2.1 Appreciates individual’s right to make decisions about their care and therefore gives adequate and accurate information for enabling them to make informed choices.

19. INC CODE OF ETHICS FOR NURSES IN INDIA 2) The nurse respects the rights of individuals as partner in care and helps in making informed choices 2.2 Respects the decisions made by individual (s) regarding their care. 2.3 Protects public from misinformation and misinterpretations. 2.4 Advocates special provisions to protect vulnerable individuals/groups .

20. INC CODE OF ETHICS FOR NURSES IN INDIA 3) The nurse respects individual’s right to privacy, maintains confidentiality, and shares information judiciously. 3.1 Respects the individual’s right to privacy of their personal information. 3.2 Maintains confidentiality of privileged information except in life threatening situations and uses discretion in sharing information.

21. INC CODE OF ETHICS FOR NURSES IN INDIA 4) Nurse maintains competence in order to render Quality Nursing Care 4.1 Nursing care must be provided only by registered nurse. 4.2 Nurse strives to maintain quality nursing care and upholds the standards of care. 4.3 Nurse values continuing education, initiates and utilizes all opportunities for self development.

22. INC CODE OF ETHICS FOR NURSES IN INDIA 4) Nurse maintains competence in order to render Quality Nursing Care 4.4 Nurse values research as a means of development of nursing profession and participates in nursing research adhering to ethical principles.

23. INC CODE OF ETHICS FOR NURSES IN INDIA 5) The nurse is obliged to practice within the framework of ethical, professional and legal boundaries 5.1 Adheres to code of ethics and code of professional conduct for nurses in India developed by Indian Nursing council. 5.2 Familiarizes with relevant laws and practices in accordance with the law of the state.

24. INC CODE OF ETHICS FOR NURSES IN INDIA 6) Nurse is obliged to work harmoniously with the members of the health team. 6.1 Appreciates the team efforts in rendering care. 6.2 Cooperates, coordinates and collaborates with the members of the health team to meet the needs of the people.

25. INC CODE OF ETHICS FOR NURSES IN INDIA 7) Nurse commits to reciprocate the trust invested in nursing profession by society 7.1 Demonstrates personal etiquettes in all dealings. 7.2 Demonstrates professional attributes in all dealings.

26. INC CODE OF PROFESSIONAL CONDUCT FOR NURSES IN INDIA Professional Responsibility and accountability 1.1 Appreciates sense of self-worth and nurtures it. 1.2 Maintains standards of personal conduct reflecting credit upon the profession. 1.3 Carries out responsibilities within the framework of the professional boundaries.

27. INC CODE OF PROFESSIONAL CONDUCT FOR NURSES IN INDIA Professional Responsibility and accountability 1.4 Is accountable for maintaining practice standards set by Indian Nursing Council 1.5 Is accountable for own decisions and actions 1.6 Is compassionate 1.7 Is responsible for continuous improvement of current practices

28. INC CODE OF PROFESSIONAL CONDUCT FOR NURSES IN INDIA Professional Responsibility and accountability 1.8 Provides adequate information to individuals that allows them informed choices 1.9 Practices healthful behavior

29. INC CODE OF PROFESSIONAL CONDUCT FOR NURSES IN INDIA 2. Nursing Practice 2.1 Provides care in accordance with set standards of practice 2.2 Treats all individuals and families with human dignity in providing physical, psychological, emotional, social and spiritual aspects of care 2.3 Respects individual and families in the context of traditional and cultural practices and discouraging harmful practices

30. INC CODE OF PROFESSIONAL CONDUCT FOR NURSES IN INDIA 2. Nursing Practice 2.4 Presents realistic picture truthfully in all situations for facilitating autonomous decision-making by individuals and families 2.5 Promotes participation of individuals and significant others in the care 2.6 Ensures safe practice 2.7 Consults, coordinates, collaborates and follows up appropriately when individuals’ care needs exceed the nurse’s competence.

31. INC CODE OF PROFESSIONAL CONDUCT FOR NURSES IN INDIA 3. Communication and Interpersonal Relationships 3.1 Establishes and maintains effective interpersonal relationship with individuals, families and communities 3.2 Upholds the dignity of team members and maintains effective interpersonal relationship with them 3.3 Appreciates and nurtures professional role of team members 3.4 Cooperates with other health professionals to meet the needs of the individuals, families and communities

32. INC CODE OF PROFESSIONAL CONDUCT FOR NURSES IN INDIA 4. Valuing Human Being 4.1 Takes appropriate action to protect individuals from harmful unethical practice 4.2 Consider relevant facts while taking conscience decisions in the best interest of individuals 4.3 Encourage and support individuals in their right to speak for themselves on issues affecting their health and welfare 4.4 Respects and supports choices made by individuals

33. INC CODE OF PROFESSIONAL CONDUCT FOR NURSES IN INDIA 5. Management 5.1 Ensures appropriate allocation and utilization of available resources 5.2 Participates in supervision and education of students and other formal care providers 5.3 Uses judgment in relation to individual competence while accepting and delegating responsibility 5.4 Facilitates conducive work culture in order to achieve institutional objectives

34. INC CODE OF PROFESSIONAL CONDUCT FOR NURSES IN INDIA 5. Management 5.5 Communicates effectively following appropriate channels of communication 5.6 Participates in performance appraisal 5.7 Participates in evaluation of nursing services 5.8 Participates in policy decisions, following the principle of equity and accessibility of services 5.9 Works with individuals to identify their needs and sensitizes policy makers and funding agencies for resource allocation

35. INC CODE OF PROFESSIONAL CONDUCT FOR NURSES IN INDIA 6. Professional Advancement 6.1 Ensures the protection of the human rights while pursuing the advancement of knowledge 6.2 Contributes to the development 6.3 Participates in determining and implementing quality care 6.4 Takes responsibility for updating own knowledge and competencies 6.5 Contributes to the core of professional knowledge by conducting and participating in research

36. Autonomy & accountability Autonomy means that individual are able to act themselves to the level of their capacity Accountability is the process that mandates that individuals are answerable for their actions and have an obligation to act. Attributes of accountability: answerability& responsibility

37. Accountability of nursing personnel Provide safe & therapeutic environment Deliver competent & personalized care Maintaining adequate supplies of material in the ward Maintaining accurate and up to date records Maintaining good IPR Protect client’s legal rights& privacy Work within ethical& legal boundaries Keep pace with changing health needs& developing technology Delivering care as per standards Delegating responsibility appropriately Contribute to development of profession

38. assertiveness Tool for expressing ourselves confidently Way of saying yes or no in an appropriate way Benefits: Less friction & conflicts Increased self respect Enhances self esteem Increased productivity at work & home Less stress at work

39. Aims of assertiveness Find the best possible solution for all people. Increases chances of our needs being met Allows to remain control Brings self confidence Have more friends Reduced stress A-S-E-R-T MODEL: See chart

40. Strategies For Improving Assertion At Work ASK BRING ENERGY TO THE JOB GET YOUR EMOTIONS UNDER CONTROL FIND A GOOD PLACE TO TALK TIMING IS IMPORTANT EFFECTIVE ASSERTION REQUIRES A LISTENER.

41. Techniques For Being Assertive . Identify your personal rights, wants and needs. . Identify how you feel about a particular Situation Be direct Own your message Avoid assumptions about others thinking Avoid statements that begins with "why", "you". Ask for feedback Stop apologizing all the time Learn to take a compliment Act confident even if you don't feel confident Feel free to say no Evaluate your expectation

42. VISIBILITY OF NURSES A quality or fact of , degree of being visible Degree of exposure to public notice Nurses themselves are responsible when they don't take a stand neither to correct the distorted images not for the visibility of the roles they have performed in their health care.

43. LEGAL CONSIDERATIONS 1 st nursing law : Nursing registration- 1903 Indian nursing council act: enacted in 1947 Amended in 1957 LEGAL IMPLICATIONS: Torts: Torts are when others interfere in individuals' privacy Assault: Assault occurs when a person puts another person in fear of a harmful or offensive contact Battery: It is an intentional touching of another's body without the other's consent Negligence: it is described as lack of proper care and attention carelessness.

44. Malpractice: Failure to meet the standards of acceptable care which results in harm to another person.   Fraud: It results from a deliberate deception intended to produce unlawful gains. False imprisonment: It occurs when a client is not allowed to leave a health care facility when there is no legal justification to detain the client or when restraining devices are used without an appropriate clinical need. Invasion of privacy: It includes violating confidentiality intruding on private client or family matters, and sharing client information with unauthorized persons.

45. Legal documents: it comprised: a) Advance directive: Written document recognized by law that provides directions concerning the provision of care when a person is unable to make his or her own treatment choices. b) Do not resuscitate orders: Written order by a physician when a client has indicated a desire to be allowed to die if the client stops breathing or the client's heart stops beating. c) Informed consent: It is clients' approval [or that of the clients' legal representative to have his or her body touched by a specific individual.

46. Nursing Liabilities And Preventive Measures All nursing observations should be noted carefully, describing accurately  Patients complaints should be recorded as accurately and specifically Nurse must report through proper channels Authorities must be informed regarding any kind of equipment, materials or supplies, which for any reasons less than safe for use in the patient's care Insurance protection

47. Legal Responsibility Registration Licensing is a mandatory procedure for practice of nursing. Registration aims at protecting patients by providing qualified nurses. The nurse is responsible to obtain registration in the respective State Nursing Registration Council Legal Liability/Act Of Negligence License of a nurse can be suspended or cancelled for any act of negligence or mal practice, following a specified procedure. Medico — Legal case (M.L.C.) A medico) legal case is a patient who is admitted to the hospital with some unnatural pathology and has to be taken care of in concurrence with the police and/or court

48. Types of clients which are categorized as MLC in a hospital are. Road traffic accidents. Injuries inflicted during brawls/fights, shooting, bomb blasts etc. Suicide. Burns. Poisoning. Rape victim. Assault.

49. Nurses role in a medico-legal case   1. Obtain complete history from patient or significant others 2. Inform the police officer/constable on duty in the hospital and the CMO. 3. When it is made a MLC, then record it on the patient's case sheet with red ink at right hand top corner. . 4. Do not give any statement about patient's condition to police, magistrate or media. Only a doctor has to give information. 5. When a patient has to be discharged, inform the CMO only. After clearance from them, he/she can be discharged. 6. If a MLC patient absconds, inform the CM0 and the treating doctor immediately

50. 7. No patient can leave against medical advice. 8. Document the care given to patients timely, accurately and duly sign the nurse’s notes. 9. Records and all the documents pertaining to patient should be handled with care, during the stay in the hospital. They must be kept safely and should be handed over to the authorized person as designated by the hospital authority. 10. Incase death of a MLC; the body is not to be handed over to the relatives. It needs to be accurately labeled and sent to the mortuary. CMO and/ or police officer should be informed simultaneously. 11. Appropriately authority must be informed.

51. Correct identity A nurse/midwife is responsible to make sure that all babies born in hospital are correctly labeled at birth and handed over to right parent. Unknown/unconscious patients must be labeled as soon as their identity is known. Patients who have to undergo surgery should be appropriately identified and labeled. Site of operation to be correctly marked particularly where symmetrical sides or organs are there: Operation theatre (O.T.): scrub nurse has to see all the instruments/ swabs are returned. She has to say OKAY' before closure by the surgeon

52. . Left Against Medical Advice (L.A.M.A.) Inform medical officer in charge. Signatures of both patients and witness to be taken as per institutional policy. Patient's Property Inform patient on admission that hospital does not take responsibility of his belongings. If patient is unconscious/ or otherwise required then a list of items must be made, counter checked by two staff nurses and kept under safe custody. . Dying Declaration Doctor or nurse should not involve themselves in dying declaration, in case where police records the dying declaration. Dying declaration is to be recorded by the magistrate. But if condition of patient becomes serious then medical officer can record it along with two nurses it witness. Dying Declaration can be recorded by the nursing staff with two nurses as witness when medical officer is not present. Then the declaration has to be sent immediately in a sealed cover to the magistrate.

53. Wills For this, doctor has to be present her, he can recode if requested. Examination of rape case Female attendant/female nurse must be present during the examination. Artificial human insemination Written consent should be obtained from both donor and recipient. Donor and recipient must have the same blood group. Donor and recipient's identity should be kept confidential. . All related documents should be kept confidential and safe.

54. Poison case Do not give either verbal or written opinion. Do not allow to take photos unless special permission is granted by appropriate authority. Do not give any information to public or press. Preserve all evidence of poisoning. Collect and preserve all excreta, vomits and aspirates, seal them immediately and send to forensic laboratory at the earliest. .Consumer Protection Act(l986) Consumer protection act was passed by parliament in 1986 RIGHTS OF PATIENT: See leaflet

55. Nurses role to prevent complications 1. Review nursing practice periodically. Update knowledge and improve skill by attending short term courses, in- service education and continuing education programmes. 2. Should have complete knowledge of all rules and regulations of hospital and know their descriptions {duties and responsibilities). 3. Follow nursing practice standards/protocols. 4. Be a keen observer. 5. Written instructions must have rules and code of practice laid down to ensure the safety and well being of patients and nurses.

56. 6. All hospitals must have rules, a code of practice laid down to ensure the safety and well being of patients and nurses. 7. Maintain records and reports of the unit properly. 8. Follow 6 Rights - right patient, right drug, right time and right route with right technique and right of the patient lo know about his/her disease condition. 9. Check the treatment order and use professional judgment before implementing. 10. Do not exceed the limits of nursing procedure laid down by statutory bodies.

57. bibliography ANN ZWEMER (2006), PROFESSIONAL ADJUSTMENTS&ETHICS FOR NURSES IN INDIA, 6 TH EDITION, CHENNAI, B.I PUBLICATIONS PVT.LTD PAGE NO: 95-109, 139-154 BARBARA KOZIER(2006), FUNDAMENTALS OF NURSING, CONCEPTS, PROCESS,&PRACTICE, 2 ND EDITION, NEW DELHI, PEARSON EDUCATION PAGE NO: 111-118 HELEN HARKREADER(2009), FUNDAMENTALS OF NURSING- CARING AND CLINICAL JUDGEMENT, 3 RD EDITION, U. P, ELSEVIER PUBLICATIONS PAGE NO: 17-41 PATRICIA A POTTER, ANN GRIFFIN PERRY(2005), FUNDAMENTALS OF NURSING, 6 TH EDITION, NEW DELHI, ELSEVIER PUBLICATIONS PAGE NO: 388- 392, 407-419 SHEBEER P. BASHEER, A CONCISE TEXTBOOK OF ADVANCED NURSING PRACTICE, BANGALORE, EMMESS MEDICAL PUBLISHERS PAGE NO: 9-20 SUZANNE C. SMELTZER (2009), BRUNNER & SUDDARTH’S TEXTBOOK OF MEDICAL SURGICAL NURSING, 11 TH EDITION, NEW DELHI, WOLTERS KLUWER PVT. LTD PAGE NO: 27-33 WWW.NURSING WORLD.ORG/.../CODE OF ETHICS FOR NURSES WWW.ICN.CH/ABOUT-ICN/CODE OF ETHICS FOR NURSES WWW.DSR.DK/SER/DOCUMENTS/ICN CODE ENGLISH.PDF WWW.NCBI.NLM.GOV/PUBMED