Efforts in the implementation of the Clinical Ethics Guidelines: Efforts of nurse managers and changes in the awareness and behavior of nurse managers and teams

Abstract

Objective: To elucidate the efforts of nurse managers in the implementation of the Clinical Ethics Guidelines, as well as changes in the awareness and behavior of nurse managers and teams due to implementation of the Guidelines. Methods: Subjects were 10 nurse managers who participated in the implementation trial of the Clinical Ethics Guidelines, and the data obtained from semi-structured interviews were analyzed qualitatively and inductively. Results: A total of five categories were identified for the efforts of subjects in the implementation and the changes perceived by subjects: “awareness of managers regarding implementation”, “arrangements made by managers for the implementation”, “approaches made by managers toward staff”, “method of use of the Guidelines”, and “changes in the managers and teams”. Discussion: These findings suggest that the Clinical Ethics Guidelines have the functions of reminding nursing staff of important matters, and serving as a guide that enables daily reflections of care. The implementation was also thought to have resulted in an improved ethical sensitivity and behavioral changes in the subjects and teams. These findings indicate that in order for the entire team to focus on ethics, it is important for nurse managers to communicate with the team.