Applying Ethical Principles

Applying Ethical Principles

Healthcare workers all over the world strive to give their patients the best possible care. Misfortunes may occur during treatment, threatening the lives of patients and caregivers in a medical or legal context. An example of a mishap in the surgical department is accidentally leaving a material, equipment, or tool in the patient’s body during surgery. This is an uncommon but preventable surgical complication known as gossypiboma or textiloma in surgical pedagogy (Alemu & Tiruneh, 2020).

Gossypiboma has medicolegal ramifications, including mental agony, patient morbidity, and mortality, as well as massive financial compensation and imprisonment on the part of the surgeon (Alemu & Tiruneh, 2020). While referencing a case study, the objective of this paper is to provide a summary of a surgical theatre mishap, followed by a discussion of the approach used to solve the problem.

Summary of the Facts in the Case Study

            A hospital’s administration and clinical services are reliant on each other. When one department is broken down, the other is similarly jeopardized. Mr. Straight is the director of health services at Hopewell hospital and occupied the position 2 years ago. Since his inauguration into the office, Hopewell hospital has streamlined its provision of care services, and at the same time, care quality has improved.

Dr. Cutrite, a Hopewell hospital general surgeon, is the facility’s longest-serving doctor. Despite being astute in clinical in his job, he is aging and waning in physical strength, mental ability, and performance of duties. Straight contemplates reducing his privileges, but in the meantime, Dr. Cutrite continues to perform his full range of duties.

An incident at Hopewell hospital frightened the administration and surgical department staff. Mr. Straight is informed by the operating room supervisor that she suspects a plastic needle protector was left inside a patient’s abdomen following surgery. What could have triggered this occurrence? A syringe was accidentally placed inside a surgical pack while it was being assembled. When questioned, the scrub nurse remembered using a syringe, but when doing the count at the end of the surgery, she forgot about the plastic needle protector.

Furthermore, the protector was a red-pink color that was nearly impossible to distinguish from the mucosa’s red-pink color. Such an incident would not have occurred if the count had been done correctly. To avoid such occurrences, the WHO recommends that the count be done separately and consistently by two different people, with their names recorded on the nursing count sheet (Hindosh, 2019). Furthermore, an intraoperative X-ray can be used if there is a suspicion of a gauze being left inside the patient’s body after surgery.

Straight requested that the operating room supervisor return the patient to the operating room to resolve the incident; however, this was a difficult option because the patient had already been discharged home. Dr. Cutrite was summoned, and he was opposed to returning the patient to the theatre because the needle protector would not be a problem and would only cause mild pain. When questioned, the chief of surgery stated that the needle protector would not be life-threatening and would only cause minor discomfort. They decided not to bring the patient back to the operating room after all of the consultations.

According to Gothwal et al. (2019), returning the patient to the operating room and informing her of the reason will have a medicolegal consequence. Knowing of the doctor’s wrongdoing, the patient may file a complaint and seek restitution. As a result, it was prudent for the staff not to call her back. A problem may arise, however, if the patient develops complications from the needle protector, necessitating a second surgery.

Effectiveness of the Communication Approaches Present in the Case Study

            Following the occurrence of the incident, a series of communications occurred in the case study. First, the operating room supervisor approaches Mr. Straight in his room in the morning and discusses the problem with him. When the sender and receiver of a message are close to each other, oral, face-to-face communication is used (Zhu et al., 2019). Since one can read the emotions in the room and see the reaction of the message’s recipient, oral face-to-face communication is very effective.

This mode of communication allows you to pick up on nonverbal cues and body language, which reinforces the message. The other mode of communication used in the case study is still oral, but it is facilitated via phone call. When the sender and recipient of a message are far apart, this type of communication is used (Zhu et al., 2019). Dr. Cutrite is called by the operating room supervisor and informed of the situation. In response, Dr. Cutrite is opposed to returning the patient to the operating room.

Mr. Straight, on the other hand, calls the chief of surgery and inquires indirectly about the consequences of leaving a material inside a patient’s body following surgery. In response, the chief of surgery notes that it would only cause minor discomfort on rare occasions.

The problem with this type of communication is that you can’t read each other’s emotions and reactions, you can’t pick up on nonverbal cues, and you might miss the gravity of the situation, which is possibly why Dr. Cutrite and the chief of surgery were opposed to returning the patient to the operating room. The best type of communication used in the case study was oral face-to-face; however, due to the proximity of the individuals, it may not be applicable in all cases.

Effectiveness of the Approach Used by the Professional in the Case Study: Relate to the Components of the Ethical Decision-Making Model

            Daily, the majority of care providers’ responsibilities revolve around decision-making. However, the decisions made must be moral and have a moral justification. Ethical decision-making is the process of evaluating and selecting alternatives in accordance with ethical principles (Bomhof-Roordink et al., 2019). Moral sensitivity (awareness), moral judgment, moral motivation (intention), and ethical behavior are the four components of the ethical decision-making model (Bomhof-Roordink et al., 2019).

Moral awareness is the conscious recognition that one’s actions have the potential to either harm or benefit a patient (Bomhof-Roordink et al., 2019). As evidenced in the case study, the operating room supervisor reports the incident demonstrating that she is fully aware that the action (leaving a plastic needle protector inside the patient’s abdomen) has the potential to harm the patient. This is also why she contacts Dr. Cutrite to report the incident.

In contrast, moral judgment refers to the formulation and evaluation of potential solutions that have moral justifications (Bomhof-Roordink et al., 2019). This step entails considering the various options and their potential consequences before making the most ethically sound decision.

From the case study, the staff had two options: return the patient to the theatre or not. Following a series of consultations, they reach a decision not to return her to the theatre. The solution is based on Dr. Cutrite’s, the general surgeon and chief of surgery, professional opinion that the plastic needle protector would only cause minor discomfort.

Furthermore, informing the patient of why she is returning to the operating room may result in a medicolegal consequence, jeopardizing the doctor’s job and the hospital’s reputation. Finally, ethical behavior refers to an individual’s actions in a given situation (Bomhof-Roordink et al., 2019). Clearly, the staff allowed the patient to remain at home, and the reasoning is moral and professional.

Application of Ethical Principles to a Possible Solution to the Proposed Problem

            The incident of a needle protector being left inside a patient’s abdomen following surgery is a potentially avoidable problem. First, the incident can be avoided by strictly adhering to the WHO’s surgical safety checklist, which requires two people to count separately and consistently, with their names documented. In addition to strict adherence, technology can be used to prevent gossypibomas.

Radiofrequency detectors have been used, with radiofrequency beacons identifying sponges or other surgical pack contents (Iype et al., 2021). Base stations emit a beep when the beacons remain underneath. When the materials are identified, a surgeon will remove them from the patient’s body, ushering in the concept of beneficence while also preventing future complications from the retained materials, implying non-maleficence, an ethical principle.

Conclusion

            While the goal of patient care is to provide medically appropriate and realistic agreed-upon goals for the patient that prevent clinical deterioration, an error in the treatment can occur, putting the patient’s life in jeopardy. Although gossypibomas are uncommon, they have the potential to harm the patient through complications and endanger the care provider’s job through a medicolegal consequence. Thus, prevention of gossypibomas is required, which entails strict adherence to WHO count recommendations, complemented with technology.

When gossypibomas happen, an ethical decision must be made, and every action must be supported by a moral justification. The ramifications could be as trivial as modest patient discomfort or as gross as patient mental agony and mortality, and on the part of the surgeon, huge financial compensation, and even being stopped at work or having their license revoked.

References

Alemu, B. N., & Tiruneh, A. G. (2020). Gossypiboma: A case series and literature review. Ethiopian Journal of Health Sciences30(1), 147–149. https://doi.org/10.4314/ejhs.v30i1.19

Bomhof-Roordink, H., Gärtner, F. R., Stiggelbout, A. M., & Pieterse, A. H. (2019). Key components of shared decision-making models: a systematic review. BMJ Open9(12), e031763. https://doi.org/10.1136/bmjopen-2019-031763

Gothwal, M., Rodha, M., Surekha, B., Singh, P., Yadav, G., & Sethi, P. (2019). Gossypiboma – A nightmare for surgeon: A rare case with review of literature. Journal of Mid-Life Health10(3), 160–162. https://doi.org/10.4103/jmh.JMH_105_18

Hindosh, L. N. (2019). Application of surgical safety checklist in operating theatre at Al-Kindy Teaching Hospital. AL-Kindy College Medical Journal14(2), 64–70. https://doi.org/10.47723/kcmj.v14i2.53

Iype, G. R., Samarasam, I., Senthilnathan, K., Yacob, M., & Abraham, V. P. (2021). Intra-abdominal gossypibomas: Clinical manifestations, risk factors and prevention. The Indian Journal of Surgery83(4), 885–891. https://doi.org/10.1007/s12262-020-02511-5

Zhu, X., Liao, X., & Cheong, C. M. (2019). Strategy use in oral communication with competent synthesis and complex interaction. Journal of Psycholinguistic Research48(5), 1163–1183. https://doi.org/10.1007/s10936-019-09651-0

Applying Ethical Principles Assignment Instructions

Assessment 1 Instructions: Applying Ethical Principles
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Develop a solution to a specific ethical dilemma faced by a health care 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 behavior. 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 health care 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 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 health care 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 health care 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 1 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 point.
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.
SCORING GUIDE
Use the scoring guide to understand how your assessment will be evaluated.

VIEW SCORING GUIDE