DOI Number: 10.5958/0973-9130.2018.00217.

Evaluation of Nurses’ Commitment to

Ethical Codes in Patients Care

Dergham Majeed Hameed1, Sameer Razzaq Oleiwi2, Ali Hussein Ali Aldakheel3
1
Assistant Professor, 2Instructor, 3Assistant Instructor, University of Al Muthanna, Iraq_Al Muthanna City

Abstract

Background: Nurses are faced daily with different and difficult issues and dilemmas in clinical practices
which need fast and accurate decision making. Ethics provides a set of standards for behavior that helps us
decide how we ought to act in a range of situations. This study aims to: Evaluate the nurses’ commitment
to codes of ethics. Determine the relationship between Nurses demographic characteristics and their
commitment to codes of ethics. Method: A descriptive design has been carried out to evaluate nurse’s
commitment toward nursing ethics in Al-Hussein Hospital on 100 staff nurses. Self-report questionnaire
was used to collect data from participants. The questionnaire consists of two main parts as follows: part one;
socio-demographic characteristics sheet which is consist of (5) items, Part two; consists of 38 questions to
evaluate nurse’s commitment toward nursing ethics. Results showed that participated nurses had moderate
commitment to codes of ethics. Conclusion: nurses’ needs frequent training to enforce their commitment
and attitudes toward nursing ethics control. Recommendations Create a code of ethics for Iraqian nurses to
suit the Iraqian culture.

Keywords: Ethics, code of ethics, decision making models, nursing practice.

Introduction latin statement “mores. “ (signifying “traditions”)

. Ethics would the planned examination under
(3)

Nurses are faced daily with different and difficult
issues and dilemmas in clinical practices which need
fast and accurate decision making. There are many
changes in nursing profession overtime which need
different decisions; some of them are ethical decisions.
But despite these changes nurses still have stable
expressions, applications, commitments of nursing, and
central ethical values based on codes of ethics (1). Ethics
is tied in with making “right” or “great” decisions and
the reasons that we give for our decisions and activities.
Morals advances intelligent practice in the conveyance
of human services (1).
The term ethics may be gotten from the Greek
expressions “ethos” (signifying “character”) and the
Corresponding author:
Dr. Dergham Majeed Hameed
Assistant Professor, PHD degree in Nursing science
AL Muthanna University, Iraq_ Al Muthanna City
E-mail: derghamsuh@yahoo.com
principles from claiming beneficial and terrible direct,
for uprightness and awful habit, and about great Also
clever Concerning illustration they recognizing for lead
Also human thriving, those ability to a chance to be
moral, will decide, What’s more on go about clinched
alongside a ethically legitimized (3).
Ethics provides for a strategy about measures
should lead that urges us to lift how we ought to act
On a degree from claiming states. You quit offering on
that one might state, we might state that morals need
aid all for admiration to settling looking into choices,
Also around providing for reasons the reason we ought
further bolstering settle on these decisions. Morals
are a part of the occasion when conflated or blended
dependent upon to Different methodologies to settling
for choices, including religion, theory alternately good
personal satisfaction. Different religions propel moral
key activity yet don’t to the mossycup oak part deliver
the full degree of the beneficial decisions that we face. A
respectable strategy for theory ought further bolstering
a chance to be moral, make that Likewise it may, the
 Indian Journal of Forensic Medicine & Toxicology, October-December 2018, Vol. 12, No. 4
theory might bring a troublesomeness occasion when
orchestrating or sanctioning measures On a few essential
domains. , and Possibly move back to address new
issues. Both law Furthermore ethics manage appeal
about how we ought to live independently with others,
nonetheless, morals would throughout in such as way
thought with apply to how people demonstration in spite
of At others would excluded. (4).
The standard based way to deal with morals joins
components of both utilitarian and deontological
hypotheses and offers particular activity guides for
training. The Beau-champ and Childless standard
based way to deal with bioethics recognizes four
key standards: self-rule, non-perniciousness, value,
and equity. Numerous attendants include devotion,
veracity, responsibility, security, and classification
to this rundown since they assume a focal part in the
convention of nursing (and therapeutic) morals and
guide the conduct of medicinal services experts toward
patients and their families (5).
Medical caretakers focused on excellent care
construct their training with respect to proficient
principles of moral direct. How do medical attendants
take in the guidelines for proficient moral conduct? In
any event, medical caretakers ought to distinguish and
build up the basic components of moral office, develop
the ideals of nursing, comprehend moral hypotheses that
direct and legitimize proficient lead, and be acquainted
with bioethical models for proficient nursing conduct (6).
According to the American Nurses Association
(2001), people who progress toward becoming medical
caretakers are depended upon not solely to hold quick
to the moral measures of the calling yet, moreover, to
clutch them as a component of being a specialist. The
ethical tradition of nursing is self-astute, persevering,
and unmistakable. A code of morals is an arrangement
of rules that mirror the essential objectives, qualities,
and commitments of the calling (7).
161
Objectives
1. Evaluate the nurses’ commitment to codes of
ethics.
2. Determine the relationship between Nurses
demographic characteristics and their commitment to
codes of ethics.
Methodology
A descriptive design has been carried out to evaluate
nurse’s commitment toward nursing ethics in Al-Hussein
Hospital. The study was initiated from January, 2018 to
April, 2018. 100 staff nurses are selected for the present
study with probability systemic random sampling
technique. Self-report Questionnaire might have been
used to gather information from. participants. The
questionnaire consists of two main parts as follows: part
one; socio-demographic characteristics sheet which is
consist of (5) items, they include age, gender, education
level for nurses, and unit\ward. Part two; consists of
38 questions to evaluate nurse’s commitment toward
nursing ethics and scored as follow Yes=3, I don’t
know=2, No=1.
The questionnaire validity and reliability was done
and necessary modifications done accordingly. The
validity tested through a committee consists of five of
experts in nursing field. Reliability was done by inter
rater method, calculation was done by kappa correlation
formula and the reliability coefficient of the tool was
70% and this consider reliable.
Data analysis was done by using descriptive and
inferential statistics.
A pilot study was conducted on (10) staff nurses
in Al-Hussein Teaching Hospital to ensure the clarity
of the tool; they were from another unit differ from
sampling units.
 162 Indian Journal of Forensic Medicine & Toxicology, October-December 2018, Vol. 12, No. 4

Result

Table (1): Conveyance from claiming nurture agreeing their demographic aspects.

Socio-demographic Groups Freq. Percent

19< 25 27 27

25<30 30 30

30<35 26 26

Age Groups 35<40 7 7

40<45 5 5

45<50 3 3

More than 50 2 2

Mean ± SD 30.8 ± 8.7 yrs.

Female 55 55
Gender
Male 45 45

Nursing school 71 71

Level of Education Nursing institute 26 26

university 3 3

Medical unit 23 23

Surgical unit 19 19

Unit of work Burn unit 19 19

ICU 15 15

Operating room 24 24

Table (1) show that (30%) of the study sample are within age group (25-30) years old, regarding of gender the
result of study show that more than half of the study sample (55%) are females. Also the study results show the
majority of study (71.0%) is graduated from nursing school. Less than twentieth of them (18.0%) work in medical
unit.

Table (2): Nurses’ Commitment to code of ethics

Low moderate High

Commitment to code of ethics
Overall Mean
No % No % No %

Toward patients 20 20 65 65 15 15 2.51

Toward hospital policy 40 40 50 50 10 10

2.51

Table (2) shows that the Mean of scores of the nurses’ commitment toward nursing ethics. It reveals that more
than half of nurses reflect a moderate patients’ care. In addition the same table shows that half of nurses reflect a
moderate commitment to codes of ethics regarding hospital policy.
 Indian Journal of Forensic Medicine & Toxicology, October-December 2018, Vol. 12, No. 4
Table (3): Association between Sample Socio-Demographical Characteristics with their Overall
Commitment to code of ethics
Main Domain Demographic characteristics
Age Groups
Gender
Demographical
variables
Level of Education
Setting of Unit
HS : Highly Significant at P<0.01 ; S : Significant at P<0.05 ; NS : Non Significant at P>0.05;
C.S=correlation significant
Discussion
Therapeutic attendants are ever-progressively
confronted with complex worries Previously, their
preparing. Codes for ethics would the vital heading for
nursing the same amount. of different callings. Medical
caretakers are mindful to give their customers/patients
with the fantastic care. They are point of fact went up
against various good challenges in their master rehearse,
so they should be OK with ethic understood principles
and the essentials of good fundamental administration
(8)
. power and support to respond as per the code, and here
The results of this study revealed that the mean age
of the studied subjects was 30.8 ± 8.7 yrs. As for the
overall commitment to ethical codes toward patients
it can be observed that nurses demonstrate moderate
commitment toward patients as they demonstrate
fairness to the wellbeing and development of all patients
when they convey mind, for instance, among the
patients in the gathering of patients that they are dealing
with. Care was reasonably, legitimately, and impartially
conveyed among a gathering of patients.
This result was in disagreement with Borhani
(2009) and Hassanpour (2011) as they have demonstrated
attendants’ shortcomings in the information of morals
and its application practically speaking in Iran (9,10).
Regarding the overall commitment to ethical codes
toward hospital policy half of studied nurses have
moderate commitment toward hospital policy as they
provide concerns to apply the hospital policy regardless
apply balance between patients’ rights and the policy;
this may be results from difficulty in application of some
of codes as it inconsistent with the culture of Iraq. This
163
Approx.
C.S.(*)
Sig.
0.77 NS
0.95 NS
0.29 NS
0.08 NS
result was in accordance with Negarandeh etal (2005)
as they found in their qualitative study that the medical
attendants distinguished “absence of code of morals” as
a hindrance to persistent support in Iran (11).
As regards for the relationship between the
demographic characteristics of nurses and their
commitment to codes of ethics there were no relations
with any of the characteristics. This may be due to
numerous medical caretakers do consider the code of
expert morals when looked with moral issues, yet don’t
follow up on it. Much of the time, they don’t have the
and there they basically don’t recognize what to do.
This outcome was as per Bijani etal 2017, as they
found no huge contrasts between the normal scores of
nursing understudies and expert medical caretakers with
respect to their adherence to moral codes identified with
clinical administration arrangement and they meaning
that the nursing understudies clung to these moral codes
more than the working attendants (12).
Conclusion
The findings of this study shed light on the
commitment of nurses towards codes of ethics. This
study has shown that participated nurses had moderate
commitment to codes of ethics.
Recommendation:
Design training programs for nurses about codes of
ethics to improve nursing profession.
Create a code of ethics for Iraqi nurses to suit the
Iraqi culture.
 164 Indian Journal of Forensic Medicine & Toxicology, October-December 2018, Vol. 12, No. 4
Ethical Considerations - Prior permission was
taken from the Dean Nursing college ethics committee
before conducting the study.
Source of Funding- Self funding       K, Parsapour A, Maddah SB, Cheraghi MA,
Conflict of Interest - Nil
References
1. Fowler MD. Guide to the code of ethics for nurses:
Interpretation and application. Nurses books. org;
2008.
2. Spurgin EW. The goals and merits of a business
ethics competency exam. Journal of Business
Ethics. 2004 Mar 1;50(3):279-88.
3. Barnett JE, Johnson WB. Ethics desk reference for
counselors. John Wiley & Sons; 2014 Nov 4.
4. Catalano JT. Nursing now! Today’s issues,
tomorrow’s trends. FA Davis; 2015 Feb 12.
5. Brennan C. Ensuring ethical practice: Guidelines
for mental health counselors in private practice.
Journal of Mental Health Counseling. 2013 Jul
1;35(3):245-61.
6. American Counseling Association. Codes of ethics
and standards of practice. Alexandria, Virginia:
Autor. 2014.
7. Liaschenko J, Peter E. Nursing ethics and
conceptualizations of nursing: profession, practice
and work. Journal of advanced nursing. 2004
Jun;46(5):488-95.
8. Zahedi F, Sanjari M, Aala M, Peymani M, Aramesh
Mirzabeigi GH, Larijani B, Dastgerdi MV. The
code of ethics for nurses. Iranian journal of public
health. 2013;42(Supple1):1.
9. Borhani F, Alhani F, Mohammadi I, Abbaszadeh A.
Professional nursing ethics: it’s development and
challenges. Iranian Journal of Medical Ethics and
History of Medicine. 2009 Sep 15;2(3):27-38.
10. Hassanpoor M, Hosseini M, Fallahi Khoshknab
M, Abbaszadeh A. Evaluation of the impact of
teaching nursing ethics on nurses’ decision making
in Kerman social welfare hospitals in 1389. Iranian
Journal of Medical Ethics and History of Medicine.
2011 Oct 15;4(5):58-64.
11. Negarandeh R, Oskouie SF, Ahmadi FA, Nikravesh
M. Patient advocacy barriers and facilitators in
nurses’ experiences. Razi Journal of Medical
Sciences. 2005 Dec 15;12(47):175-86.
12. Bijani M, Ghodsbin F, Fard SJ, Shirazi F, Sharif
F, Tehranineshat B. An evaluation of adherence to
ethical codes among nurses and nursing students.
Journal of medical ethics and history of medicine.
2017;10.
Copyright of Indian Journal of Forensic Medicine & Toxicology is the property of Institute of
Medico-legal publications Pvt Ltd and its content may not be copied or emailed to multiple
sites or posted to a listserv without the copyright holder's express written permission.
However, users may print, download, or email articles for individual use.