Applying Ethical Principles- The Missing Needle Protector

Applying Ethical Principles- The Missing Needle Protector

Summary of Case Study

This is a summary of incident 9. The case involves an ethical challenge due to a missing needle. It includes Cutrite, who has had physical and mental problems over the years but still carries out procedures, and Mr. Straight, the clinic’s director; the operating room (OR) supervisor; Mrs Jameson, the patient; the scrub nurse; and the chief of surgery. The OR supervisor reported to Mr Straight a surgical error in which they suspected that they had left a plastic needle protector in Mrs Jameson’s belly after surgery (Ethical case studies topic: The Missing needle protector., n.d.). The surgery had been conducted by Cutrite. The scrub nurse also confirmed that the syringe was used during the surgery but did not remember about the needle protector. Mr Straight suggested they recall Mrs Jameson and check for the missing item in her belly without her knowledge. However, it gets complicated since Mrs Jameson had been discharged two days earlier. Although the OR supervisor had talked to Dr. Cutrite, the doctor did not see the missing needle protector as an issue, citing that the patient would only experience some discomfort. The doctor also warned that they do nothing about it. The chief of surgery suspects something is wrong after consultation with Mr Straight but ignores it. Mr Straight was afraid to cross off with Dr Cutrite on the matter as he was very powerful politically, and he feared for his employment.

Analysis of Ethical Issues Using the Ethical Decision-Making Model

The three components of the Ethical Decision-making Model include moral awareness, moral judgment, and ethical behaviour. The ethical decision-making model improves the capabilities of healthcare professionals to make rationally explainable ethical healthcare decisions (Grote & Berens, 2020). The model can be applied in the case above to identify the ethical issues and failure to satisfy the ethical challenges presented in the case by the various individuals through ethical decisions.

The majority of the ethical issues, in this case, can be linked to Straight and Dr. Cutrite. Straight’s suggestion to recall the patient and reoperate her to search for the missing needle protector without the patient’s knowledge shows ignorance of making moral judgments as a health professional. He lacks honesty. He is also afraid to confront Dr. Cutrite on the issue in the case and his clinical decline, fearing for his employment since the doctor has strong political affiliations. This further shows poor moral judgment. Dr Cutrite is morally unaware and lacks acceptable ethical behaviour for his profession. He suggested ignoring the case even though it may cause harm to the patient. This shows a lack of moral judgment and moral awareness. Dr. Cutrite breaks all the fundamental ethics of healthcare to do no harm and provide care that is beneficial to the patient. Moral judgments inform ethical decisions through micro-level factors that determine moral decisions, such as being mindful of actions and having a moral responsibility for actions and decisions (Small & Lew, 2019). Dr. Cutrite lacks moral responsibility and is less mindful of the health of the patient. His actions are of less interest to the patient’s well-being. All of the individuals involved in the case lack accountability. The scrub nurse and the operating room supervisor did not account for every item, while the chief of surgery ignored Straight’s question even if he suspected something was amiss.

Academic Peer-Reviewed Journal Articles as Evidence to Support Analysis of the Case

Steelman et al.’s (2019) article is relevant to this case as it aims to describe the various Unintentionally Retained Foreign Objects (URFOs) with a focus on the types of URFOs, location, contributing factors, and the URFOs harm. The aim of the study was to develop recommendations to improve perioperative safety. The study reviewed 308 incident reports. Based on the study, the most common URFOs include instruments, catheters and drains, needles and blades, packaging, implants, and specimens. The URFOs had the potential to extend stay and cause temporary to severe and permanent harm and death. The contributing factors to the incidents were linked to either human, leadership, or communication factors. The authors provide recommendations to manage these factors, including team and individual training, elimination of disruptive and distractive factors, accounting for all objects used during surgery, exploring the surgical site before closure, inspecting tools after surgery, and promoting a safety culture, including reporting events and near misses, and proactive risk assessment. This article is credible as it was published by the Joint Commission Journal on Quality and Patient Safety and developed by authors with authority on the subject.

Effectiveness of Communication Approaches in the Case Study

Effective communication between patients, departments, and healthcare providers can help solve and prevent medical errors (Hassan, 2018). Failure in communication during the treatment process could lead to serious medical errors with a negative outcome on the patient’s health and care goals (Shahid & Thomas, 2018). The communication between the individuals is ineffective and risks adverse effects on the patient’s health and, eventually, negative reputational and professional outcomes for the facility and the team. For instance, the operation room operator noticed the missing needle protector and reported it to the management for further action. However, Mr Straight was not open to the chief of surgery during his inquiry about the effects of leaving a needle protector in the belly of the patient, which led to the chief ignoring the issue and also being afraid to confront Dr Cutrite. Straight also thought it would be best to recall the patient and reoperate her without her knowledge. This could lead to a scandalous breach of health ethics and medical malpractice. Further, Dr. Cutrite does not explain the effects of needle protectors on the patient’s health and does not want further action on the case.

Applying Ethical Principles to Resolve the Ethical Dilemma

The four fundamental principles of healthcare ethics are autonomy, beneficence, nonmaleficence, and justice. Autonomy grants respect to patient choices. Beneficence seeks to provide beneficial care to patients. Nonmaleficence means providing care that does not harm the patient, while justice means the patient receives fair care. By considering the principle of justice and autonomy, Mr Straight would consider informing Mrs Jameson of the needle protector and let her decide on the next action to take. Suppose Dr. Cutrite considers the fundamental principles of beneficence and nonmaleficence. In that case, he would be concerned about the health of Mrs. Jameson and be willing to conduct her inform her of the case, and provide suggestions on what can be done to ensure the best health outcomes for her. He would also have been careful during the surgery. The ethical principles combined with effective communication can resolve the suspected surgical error and the related ethical dilemma. Effective communication approaches to manage medical errors can improve patient safety and achieve patient autonomy in health decisions (Rodziewicz et al., 2022).

Conclusion

Ethical dilemmas are a normal part of everyday practice for healthcare professionals. Ethical dilemmas in healthcare challenge the values, norms, and professionalism of healthcare providers. Healthcare professionals must base their decisions on their morals and values guided by the ethical decision-making model and the four fundamental principles of health care.

References

Ethical Case Studies Topic: The Missing Needle Protector. (n.d.) Incident 9: The Missing Needle Protector. https://sso3.capella.edu/openam/UI/Login?goto=http%3A%2F%2Fmedia%2Ecapella%2Eedu%2FCourseMedia%2Fnhs4000element18655%2Fwrapper%2Easp

Grote, T., & Berens, P. (2020). On the ethics of algorithmic decision-making in healthcare. Journal of Medical Ethics, 46(3), 205–211. https://doi.org/10.1136/MEDETHICS-2019-105586

Hassan, I. (2018). Avoiding Medication Errors through Effective Communication in Healthcare Environment. SSRN Electronic Journal. https://doi.org/10.2139/SSRN.3573437

Shahid, S., & Thomas, S. (2018). Situation, Background, Assessment, Recommendation (SBAR) Communication Tool for Handoff in Health Care – A Narrative Review. Safety in Health 2018 4:1, 4(1), 1–9. https://doi.org/10.1186/S40886-018-0073-1

Small, C., & Lew, C. (2019). Mindfulness, Moral Reasoning and Responsibility: Towards Virtue in Ethical Decision-Making. Journal of Business Ethics 2019 169:1, 169(1), 103–117. https://doi.org/10.1007/S10551-019-04272-Y

Steelman, V. M., Shaw, C., Shine, L., & Hardy-Fairbanks, A. J. (2019). Unintentionally Retained Foreign Objects: A Descriptive Study of 308 Sentinel Events and Contributing Factors. The Joint Commission Journal on Quality and Patient Safety, 45(4), 249–258. https://doi.org/10.1016/J.JCJQ.2018.09.001

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Develop a solution to a specific ethical dilemma faced by a healthcare professional by applying ethical principles. Describe the issues and a possible solution in a 3-5 page paper.

Introduction
Whether you are a nurse, a public health professional, a health care administrator, or in another role in the health care field, you must base your decisions on a set of ethical principles and values. Your decisions must be fair, equitable, and defensible. Each discipline has established a professional code of ethics to guide ethical behaviour. In this assessment, you will practice working through an ethical dilemma as described in a case study. Your practice will help you develop a method for formulating ethical decisions.

Instructions
Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance-level descriptions for each criterion to see how your work will be assessed.

For this assessment, develop a solution to a specific ethical dilemma faced by a healthcare professional. In your assessment:

Access the Ethical Case Studies media piece to review the case studies you will be using for this assessment.
Select the case most closely related to your area of interest and use it to complete the assessment.
Note: The case study may not supply all of the information you need. In such cases, you should consider a variety of possibilities and infer potential conclusions. However, please be sure to identify any assumptions or speculations you make.
Include the selected case study in your reference list, using the proper APA style and format. Refer to the Evidence and APA section of the Writing Center for guidance.
Summarize the facts in a case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.
Identify which case study you selected and briefly summarize the facts surrounding it. Identify the problem or issue that presents an ethical dilemma or challenge and describe that dilemma or challenge.
Identify who is involved or affected by the ethical problem or issue.
Access the Ethical Decision-Making Model media piece and use the three components of the ethical decision-making model (moral awareness, moral judgment, and ethical behavior) to analyze the ethical issues.
Apply the three components outlined in the Ethical Decision-Making Model media.
Analyze the factors that contributed to the ethical problem or issue identified in the case study.
Describe the factors that contributed to the problem or issue and explain how they contributed.
Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.
In addition to the readings provided, use the Capella Library to locate at least one academic peer-reviewed journal article relevant to the problem or issue that you can use to support your analysis of the situation. The NHS-FPX4000: Developing a Health Care Perspective Library Guide will help you locate appropriate references.
Cite and apply key principles from the journal article as evidence to support your critical thinking and analysis of the ethical problem or issue.
Review the Think Critically About Source Quality resource.
Assess the credibility of the information source.
Assess the relevance of the information source.
Discuss the effectiveness of the communication approaches present in a case study.
Describe how the healthcare professional in the case study communicated with others.
Assess instances where the professional communicated effectively or ineffectively.
Explain which communication approaches should be used and which ones should be avoided.
Describe the consequences of using effective and non-effective communication approaches.
Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.
Describe the actions taken in response to the ethical dilemma or issue presented in the case study.
Summarize how well the professional managed professional responsibilities and priorities to resolve the problem or issue in the case.
Discuss the key lessons this case provides for healthcare professionals.
Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.
Describe the proposed solution.
Discuss how the approach makes this professional more effective or less effective in building relationships across disciplines within his or her organization.
Discuss how likely it is the proposed solution will foster professional collaboration.
Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
Apply the principles of effective composition.
Determine the proper application of the rules of grammar and mechanics.
Write using APA style for in-text citations, quotes, and references.
Determine the proper application of APA formatting requirements and scholarly writing standards.
Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following APA style.
Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

Assessment 3 Example [PDF].
Additional Requirements
Your assessment should also meet the following requirements:

Length: 3–5 typed, double-spaced pages, not including the title page and reference page.
Font and font size: Times New Roman, 12 points.
APA tutorial: Use the APA Style Paper Tutorial [DOCX] for guidance.
Written communication: Use correct spelling, grammar, and punctuation.
References: Integrate information from outside sources to include at least two references (the case study and an academic peer-reviewed journal article) and three in-text citations within the paper.
APA format: Follow current APA guidelines for in-text citation of outside sources in the body of your paper and also on the reference page.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

Competency 1: Apply information literacy and library research skills to obtain scholarly information in the field of health care.
Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.
Competency 3: Apply ethical principles and academic standards to the study of health care.
Summarize the facts in a case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.
Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.
Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.
Competency 4: Write for a specific audience, in appropriate tone and style, in accordance with Capella’s writing standards.
Discuss the effectiveness of the communication approaches present in a case study.
Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
Write following APA style for in-text citations, quotes, and references.