Assessment of

Knowledge and Practice

Regarding Professional
Ethics among Nurses in a
Tertiary care hospital,
Coimbatore.
by
DR.A.Jayasudha
PSG College of Nursing
 INTRODUCTION
In present health care scenario with high disease burden, rising
patient awareness and scarcity of healthcare resources
especially nurses, ethical issues are not considered in depth.
Nurses are confronted with a situation in which a difficult
decision must be made based the determination of right or
wrong. Nursing ethics are necessary because nursing is
concerned with providing service that impact on human life and
their health. Nursing ethics provides the standards of
professional behaviour for nurses and the principles of
knowledge right from a wrong conduct during the implementation
of nursing duties and responsibilities. All nurses should respect
their patients, maintain patients’ dignity and protect patients’
rights. Ethical nursing makes up a framework for maximum
patient care. Ethics is at the forefront of nursing, but nurses
should balance the requirements of the healthcare systems that
they work in and needs of their patients.
 INTRODUCTION
Ethics are fundamental to nursing. Nursing profession
requires knowledge of ethics to guide performance. Nursing
ethics is professional ethics of care .

Nurses must create an environment of mutual trust and

respect between patients and healthcare professionals. This
collaboration between nurses, colleagues and physicians is
important to the safety and quality of patient care.

Knowledge in ethics has been shown to enhance nursing

practice in identification of ethical questions within practical
problems, development of innovative solutions for prevalent
problems and development of sound ethical beliefs and
practices.
 INTRODUCTION
Nurses must create an environment of mutual trust and respect
between patients and healthcare professionals. Nurses work
alone and with other healthcare professionals. This collaboration
between nurses, colleagues and physicians is important to the
safety and quality of patient care.

• Ethics is very important to nursing because nurses practice

ethics on a daily basis and they need assistance in ethical
decision making .Therefore, nurses should be adequately
prepared to deal with the ethical challenges amidst the high
workload and resource-constrained settings.
NEED FOR THE STUDY:
Nurses are one of the largest group of health care
professionals in the health care system, who play a vital role
in focussing rights of patients and the quality of care as well
as they are responsible for the patient welfare throughout the
day in the ward. Nursing ethics provide the standards of
professional behaviour of nurses and principles of knowledge
right from a wrong conduct.

Hence, nurses should be well aware of legal and ethical

aspects of care in treatment of patients. Thus, it was felt by
the researcher that there is emerging need of study in this
area. Therefore, this study is undertaken to assess
knowledge and practice regarding professional ethics among
nurses in Selected Hospitals, Coimbatore.

STATEMENT OF THE PROBLEM

A descriptive study to assess the knowledge and practice
regarding professional ethics among nurses in Medical
Intensive Care Unit at a tertiary care hospital, Coimbatore.
OBJECTIVES
To assess the knowledge and
practice regarding professional
ethics among nurses.
To correlate the level of
knowledge and practice regarding
professional ethics among nurses.
To find out the association
between knowledge and practice
regarding professional ethics
among nurses with their
demographic variables.
 REVIEW OF LITERATURE
Fatma E. Et al (2016) conducted a study on Assessment of Nurses'
Knowledge and Practice Regarding Professional Ethics in Outpatient
Clinics at Mansoura University Hospital, Egypt. A descriptive design
was used, a sample consisted of 300 nurses working in outpatient
clinics at Manosoura University hospitals. Self administered
knowledge questionnaire, observation check list along with personal
& job characteristics data sheet was used. The results revealed that
63.3% of nurses had satisfactory knowledge and 75% had adequate
practice regarding professional ehics. The knowledge had significant
correlation with their age and years of working whereas practice was
not influenced by their personal and job characteristics.

Koshy.P. (2016) conducted a study to assess knowledge regarding

legal and ethical concepts in care of children among staff nurses. A
survey approach and descriptive design was used for the study. The
sample consisted of 100 nurses and tool used for the study was
structured questionnaire. The result of the study revealed that mean
knowledge score was 20.88and standard deviation is5.90 indicates
that majority of them had good and average knowledge regarding
legal & ethical concepts in care of children.
REVIEW OF LITERATURE
Osingada.C.P .et al (2015) a cross-sectional survey was conducted
to evaluate the nurse’s knowledge in ethics and their perceptions
regarding continuing ethics education among nurses at three
hospitals in Uganda.The aim of the study was to determine the
level of ethics knowledge and associated factors and to document
the perceptions about continuous nueses ethics education.114
samples were selected purposively. The knowledge and their
perception were assessed using self administered
questionnaire..The findings concluded that 18 (15.8 %) of the
nurses obtained a score > 50 % in the ethics knowledge
assessment test.
Bharadwaj.A. (2014) , conducted a descriptive cross-sectional
study on current status of knowledge, attitude and practices
towards health care ethics among doctors and nurses from
northern India.298 Physicians and 107 nurses participated. The
results concluded that there exists a gap in the knowledge
about practical aspect of health care ethics among physicians
and nurses .Practical education in ethics could assist in bridging
the gap in ethical approaches among different levels of health
care staff. e mean percentage score was 37.1 and it ranged from
14 to 68 % .
MATERIALS & METHODS

A Descriptive Study design was used

to assess the knowledge and practice
regarding professional ethics among
nurses. The study was conducted in
MICU at PSG Hospitals, Coimbatore.
The total bed strength of PSG hospital
is 1400 and MICU is 21 bedded unit
with world class infrastructure and
high tech equipments complimented
by highly competent staff nurses. The
population of the study comprised of
nurses working in MICU. The target
population was 30 staff nurses.
DATA COLLECTION PROCEDURE

A formal permission was obtained from

the Dean, PSGIMSR Nursing
superintendant and IHEC to conduct
this research. Data was collected by a
self administered structured
questionnaire regarding knowledge of
nursing ethics and practice was
assessed by an observation checklist
by observing their activities related to
professional ethics by the faculty who
are involved in clinical supervision of
students in MICU.
 Outline of the Research Study

Assessment of Nurses Knowledge and practice regarding Professional ethics in selected wards, at selected hospitals, Coimbatore.

Research approach

Quantitative research approach

Research design

Descriptive Research design

Population

MICU Staff Nurses

Sampling technique

Purposive sampling technique

30 samples

Setting

PSG Hospitals

Data Collection
Study Variables- Demographic Variables- Age, Sex, Religion,
Knowledge on Professional ethics Education, Total years of clinical experience,
Observational checklist on Professional Years of experience in ICU, Position held…
ethics Data analysis

Descriptive Statistics
Inferential Statistics
•Percentage and frequency •Correlation
•Mean and standard deviation •Chi-square

Finding the result of the study

 • INSTRUMENTS AND TOOL FOR DATA COLLECTION
• Tool consists of three sections
• Section A: Demographic data
• Section B: Questionnaire regarding knowledge on
professional ethics among nurses
• SCORE INTERPRETATION

S.NO SCORE INTERPRETATION

1. >60% Adequate Knowledge

2. <60% Inadequate Knowledge

 Section C: Observation checklist

S.NO SCORE INTERPRETATION

1. >60% Satisfactory practice

2. <60% Unsatisfactory practice

DATA ANALYSIS AND INTERPRETATION
Data was analyzed by descriptive and inferential statistics.
Descriptive statistics were used to analyze the frequency,
mean,standard deviation and percentage distribution.
Demographic data were analyzed in terms of frequency and
percentage.
Level of knowledge and practice were analyzed in terms of
frequency, percentage, mean, standard deviation

Inferential statistics :
Karl pearson co-relation co-efficient was used to correlate
the level of knowledge and practice regarding professional
ethics.
Association of level of knowledge and practice with
demographic variables.
Table1: Distribution of demographic variables among the staff nurses
S. No DemographicVariables Frequency %
n=30
1 Ageinyears
a.20-30 30 100
b.31-40 0 0
c.41-50 0 0
d. 50-60 0 0
2 Sex
a.Male 3 10
b.Female 27 90
3 Religion
a.Hindu 19 63
b.Christian 11 37
c.Muslim 0 0
d. Others 0 0
4 Education
a.GNM 9 30
b.B.SC(N) 21 70
c.M.SC(N) 0 0
5 Total yearsofexperience
a.<5 19 63
b.5-10 1 3
c.10-15 0 0
d. >15 0 0
6 Yearsofexperiencein ICU
1. <1 19 63
2. 1-5 11 37
3. 6-10 0 0
4. >10 0 0
Table2: Nurse’s Knowledge percentage about the professional ethics in study sample
n=30
S. No Knowledgeof Knowledge Frequency %
professionalEthics
1. ProfessionalEthics Adequate 20 67
Inadequate 10 33
2. Autonomy Adequate 19 63
Inadequate 11 37
3. Beneficence topatient Adequate 15 50
Inadequate 15 50
4. Patient rights Adequate 27 90
Inadequate 3 10
5. Non-maleficience Adequate 19 63
Inadequate 11 37
6. Sincerity&Integrity Adequate 25 83
Inadequate 5 17
7. Honesty Adequate 15 50
Inadequate 15 50
8. Equity Adequate 21 70
Inadequate 9 30
9. Privacy Adequate 25 83
Inadequate 5 17
10. Respectthepatient Adequate 9 30
Inadequate 21 70
TotalKnowledge
*Adequate 25 83
**Inadequate 5 17
 Table3:Practicepercentageof professional ethicsas
observed among the nurses in the study sample
n=30
Practice of professional
ethics Frequency %
Adequate 25 83
Inadequate 5 17
Table4: Correlation between the nurse’s knowledge &
practice of professional ethics
n=30
Correlation
Variables Mean S.D coefficient Value
30. r=0.73
72.6
Knowledge 8
42.
89.3
Practice 6
 Knowledge Practice

Satisf Calc Tab Calc

Demogr actor Unsatisfa ulate ulate Adeq Inadequat ulate
S. aphic y ctory d d uate e d
N Variable Valu Valu Valu Tabulate
o s F % F % e e F % F % e d Value
Age in
1 years
20-30 25 83 5 17 <1 3.84 25 83 5 17 <1
3.84
31-40 0 0 0 0 NS 0 0 0 0 0 0
2 Sex
Male 2 7 1 3 0.6 3.84 1 3 2 7
*6 S 3.84
Female 23 77 4 13 NS 24 80 3 10
3 Religion
Hindu 17 57 2 6 15 50 4 14
Christian 8 27 3 10 1.4 10 33 1 3 0.7
3.84 3.84
Muslim 0 0 0 0 NS 0 0 0 0 NS
Others 0 0 0 0 0 0 0 0
Table5: Association of knowledge & practice among nurses with demographic variables.
Knowledge Practice

Satisf Unsatisfac Calc Tabu Adeq Inadequat

S. Demogra actory tory ulate lated uate e Calcu
N phic d Valu lated Tabulated
o Variables F % F % Value e F % F % Value Value
Age in
1 years
20-30 25 83 5 17 <1 3.84 25 83 5 17 <1
3.84
31-40 0 0 0 0 NS 0 0 0 0 0 0
2 Sex
Male 2 7 1 30.6 3.84 1 3 2 7
*6 S 3.84
Female 23 77 4 13 NS 24 80 3 10
3 Religion
Hindu 17 57 2 6 15 50 4 14
Christian 8 27 3 10 1.4 10 33 1 3 0.7
3.84 3.84
Muslim 0 0 0 0 NS 0 0 0 0 NS
Others 0 0 0 0 0 0 0 0
 Demograp Satisfac Unsatisfacto Calcul Tabul Adequ Calcul
S. hic tory ry ated ated ate Inadequate ated Tabulated
No Variables F % F % Value Value F % F % Value Value
4 Education
GNM 8 27 1 3 7 0 2 7
B.SC(N) 17 57 4 13 0.2 NS 3.84 18 0 3 10 0.2 NS 3.84
M.SC(N) 0 0 0 0 0 0 0 0
Total years
of
5 experience
<5 24 80 5 17 25 83 4 14
<1 NS 3.84 <1 NS 3.84
5-10 1 3 0 0 0 0 1 3
Years of
experience
6 in ICU
<1 16 53 3 10 15 50 4 14
1-5 9 30 2 7 10 33 1 3
<1 NS 3.84 0.7 NS 3.84
6-10 0 0 0 0 0 0 0 0
>10 0 0 0 0 0 0 0 0
 DISCUSSION
In the health care organizations , nurses are
held accountable to comply with the standards
of ethical practice and to ensure that other
nurses also comply. In the scope of dealing
with the professional ethics, it is very important
to focus on the nurses knowledge and
practice. Hence, this study was conducted
with the goal of filling a gap of important
information regarding nurse’s professional
ethics that practiced in MICU at selected
hospitals, Coimbatore.
 CONCLUSION
The present study concluded that the practice of
professional ethics is better than their knowledge,
though it is still inadequate regarding respect for
patients. Finally the study concluded that there is
statistically significant correlation between nurses
knowledge and practice of professional ethics. So
the findings pointed for upgrading nurses'
knowledge and practice regarding the ethics
through educational programs and a need to create
awareness regarding code of ethics, ethical
principles and standards of nursing practice in
clinical areas.