TITLE:
The Impact of Health Care Reform Initiatives on Ethical Conflict and Opportunities for Nurses to Improve Quality of Care While Enhancing Their Work Environments
AUTHORS:
Robert Cooper, Garry Frank, Cherry Shogren
KEYWORDS:
Cost Control, End-of-Life Care, Ethical Consults, Futile Treatment, Healthcare Reform, Nursing Ethics, Patient Satisfaction, Quality of Care
JOURNAL NAME:
Open Journal of Nursing,
Vol.4 No.9,
August
11,
2014
ABSTRACT: Background: After more
than a decade of the nursing profession contending that healthcare
reform based almost exclusively on cost cutting was creating an array of serious
ethical issues for nurses, healthcare organizations and other providers are now
facing increasing demands primarily from payers to demonstrate improvement in both
quality of care and patient experience along with continued cost reduction. Research
Question: Have efforts by healthcare organizations to comply with these recently
imposed requirements influenced the ethical environment faced by nurses and nurse
leaders and if so, how? Materials and Methods: Data for assessing the current ethical
environment was gathered with a close-ended survey mailed in October 2012 to a random
sample of 3000 members of the American Organization of Nurse Executives. Results
and Discussion: Statistical analysis of the data and comparison with the findings
of a similar study conducted in 2000 indicated that along with five highly rated
issues in the earlier study attributed largely to economic constraints imposed by
healthcare organizations, the top-10 key ethical issues today included five issues
primarily attributable to interprofessional conflict. Conclusion: Given the success
of many ongoing efforts aimed at weakening these key sources of ethical conflict
that have blocked many proposals to improve the quality of care, opportunities should
arise for the nursing profession to more fully achieve its goals of improving the
quality of care, safety and patient satisfaction and enhancing nurses’ work environments
essential to that effort.