The usability, feasibility and fidelity of the Ethics Quarter e-learning intervention for nurse managers.

BACKGROUND: Nurse managers (NMs) expect support to carry out their ethical activities in a complex health care environment. In this study, the Ethics Quarter (EQ) is suggested as a new educational ethics e-learning intervention for nurse managers. The aim of this study was to evaluate the usability, feasibility and fidelity of the EQ. The goal was to create a new way to support NMs' ethical activity profile (developing one's own ethics knowledge, influencing ethical issues, conducting or implementing ethics research, identifying and solving ethical problems) for the use of healthcare organizations. METHODS: The EQ was developed under guidance of the criteria for complex interventions in health care (CReDECI2) guideline. A cross-sectional survey was conducted within the intervention group after a randomized controlled trial (the main study is registered in ClinicalTrials.gov with the identifier: 04234503). The participants were NM members of the Union of Health and Social Care Professionals in Finland (n = 95). RESULTS: A system usability scale (SUS) assessed the overall usability of EQ as good (a mean SUS score of 85.40 out of 100). Positive feedback about the EQ's feasibility was reported in structured and open questions (a good, necessary and practical research knowledge-based e-learning intervention for all nurse managers) and recommendations for further development (intervention contents could be even more challenging and interactive) were highlighted. Fidelity, measured with Google Analytics, reported shorter time used by NMs on the EQ education than estimated. CONCLUSIONS: The findings support the high usability, feasibility and average fidelity of the EQ intervention and its potential while also providing evidence for the development of future ethics education. Health care organizations would benefit from adopting the EQ to support the ethical activities and ethical activity profile of NMs. Additionally, this study provides an example of ethics intervention development and evaluation in nursing research.

The effectiveness of the Ethics Quarter intervention on the ethical activity profile of nurse managers: A randomized controlled trial.

AIM: To test the effectiveness of a new ethics educational e-learning intervention, Ethics Quarter, in supporting nurse managers' ethical activity profile. BACKGROUND: Health care organisations need evidence-based ethics interventions to support nurse managers' ethical activity profile. METHODS: A parallel-group, individually randomized controlled trial was conducted in 2020. Finnish nurse managers nationwide [members of the Union of Health and Social Care Professionals in Finland (Tehy) trade union] were randomly allocated to intervention (n = 169) or control group (n = 172). The intervention group participated in the Ethics Quarter comprising twelve 15-min evidence-based educational 'quarters' spread over 6 weeks. The control group had standard organisational ethics structures. The primary and secondary outcomes were ethical activity profile and ethics knowledge, respectively. The Consolidated Standards of Reporting Trials (CONSORT) statement for study design and reporting was adopted. RESULTS: Ethical activity profile showed statistically significant differences in mean changes between the groups from baseline to 10 weeks: all five dimensions were statistically significantly higher in the intervention group compared with the control group (p = <.0001). CONCLUSION: The Ethics Quarter was effective in increasing nurse managers' ethical activity profile. IMPLICATIONS FOR NURSING MANAGEMENT: Applying this ethics educational e-learning intervention would benefit nursing management education and health care organisations. TRIAL REGISTRATION: clinicaltrials.gov: NCT04234503.

Solving work-related ethical problems.

BACKGROUND: Nurse managers are responsible for solving work-related ethical problems to promote a positive ethical culture in healthcare organizations. OBJECTIVES: The aim of this study was to describe the activities that nurse managers use to solve work-related ethical problems. The ultimate aim was to enhance the ethical awareness of all nurse managers. RESEARCH DESIGN: The data for this descriptive cross-sectional survey were analyzed through inductive content analysis and quantification. Participants and research context: The data were collected in 2011 using a questionnaire that included an open-ended question and background factors. Participants were nurse managers working in Finnish healthcare organizations (n = 122). Ethical considerations: Permission for the study was given by the Finnish Association of Academic Managers and Experts of Health Sciences. FINDINGS: Nurse managers identified a variety of activities they use to solve work-related ethical problems: discussion (30%), cooperation (25%), work organization (17%), intervention (10%), personal values (9%), operational models (4%), statistics and feedback (4%), and personal examples (1%). However, these activities did not follow any common or systematic model. DISCUSSION AND CONCLUSION: In the future, nurse managers need a more systematic approach to solve ethical problems. It is important to establish new kinds of ethics structures in organizations, such as a common, systematic ethical decision-making model and an ethics club for nurse manager problems, to support nurse managers in solving work-related ethical problems.

Ethical activity profile of nurse managers.

AIM: To describe the ethical activity profile of nurse managers (NM). BACKGROUND: Ethical responsibilities require nurse managers to perform certain ethical activities. In this study, these activities are referred to as an ethical activity profile and are divided into five dimensions: (1) developing one's own ethics knowledge, (2) influencing ethical issues, (3) conducting or implementing ethics research, (4) identifying and (5) solving ethical problems. This paper focuses on the first four dimensions. METHODS: Survey data were collected in 2011 using a questionnaire (mainly open questions) amongst managers at the ward, middle and strategic levels (n = 122). The data were analysed using inductive content analysis and quantification. RESULTS: The ethical activity profile of nurse managers was high, referring to the identification of various work-related ethical problems [related to staff (31%), the nurse managers themselves (29%), resources (17%), patients (12%), superiors (7%) and organisations (4%)]. However, developing one's own ethics knowledge, influencing ethical issues and conducting or implementing research dimensions of the ethical activity profile were low. CONCLUSIONS: There is room to improve the ethical activity profile of nurse managers. IMPLICATIONS FOR NURSING MANAGEMENT: Organisations have to demand that nurse managers meet all their ethical responsibilities and support this via organisational structures.