Nursing Ethics and Patient Safety

This assignment delves into the crucial intersection of nursing ethics and patient safety. It examines various ethical dilemmas faced by nurses in clinical settings, emphasizing the importance of upholding patient autonomy, beneficence, non-maleficence, and justice. The assignment encourages critical analysis of barriers to ethical practice, such as electronic health records and moral distress, while highlighting strategies for promoting a culture of ethical conduct and safeguarding patient well-being.

Running head: NURSING INFORMATION SYSTEM
Nursing information system
Name of the Student
Name of the University
Author note

1NURSING INFORMATION SYSTEM
Electronic health records of patient offers enhanced communication and maintenance of
quality of care between the healthcare professionals. It provides patient’s medical history and
key clinical data of a person who is under a particular healthcare provider. There is a need to
ensure documentation integrity as there might be invalid auto-population data field entry or
manufactured documentation to enhance the reimbursement. There is also requirement of data
integrity like ensuring security and privacy in health information that help to build trust and
improve healthcare quality and equity in services. However, there are ethical and legal
implications related to data integrity confronting health personnel like respect for autonomy,
non-maleficence and beneficence along with privacy and confidentiality. Therefore, the
following assignment deals with the legal and ethical implications in data integrity in electronic
health records (EHRs).
Data integrity refers to the data quality where there should be maintenance and assurance
of consistency and accuracy of data over the entire life cycle. The data entered in the healthcare
records should be reliable and valid. There is a responsibility to protect data as it is of extreme
importance in healthcare as it is used to identify, track patients when they move from one care
level to another. At every level, healthcare data integrity is important as it help providers to make
use of this data in taking decisions regarding patient care. Failure to protect data has serious
impact on patient safety and poses risks. There might be wrong data entry, delayed, missing data
delivery, or any sort of associated errors like data entry from another patient record (Huffman &
Rittenmeyer, 2012). These pose serious implications on healthcare as poor EHRs system
designing and improper use can cause errors in the electronic system that can jeopardise that
information integrity in EHR resulting in errors and endangering patient safety and quality of
care. Unintended consequences may increase abuse and fraud posing serious legal implications.

2NURSING INFORMATION SYSTEM
It can contribute to the suboptimal quality of healthcare and error can occur from the improper
system use. The faulty functionality of EHRs can mislead doctors and clinicians due to incorrect
values or confusing screen display resulting from program error entering data of wrong
medication or patient (Fowler & Davis, 2013).
Apart from healthcare delivery, data integrity affects the nursing care on a large scale.
Nurses have the responsibility to protect patient information as it has a significant impact on
overall healthcare system affecting communication and patient safety. They have the obligation
to protect and safeguard patient rights as according to Code of Ethics for Nurses, American
Nurses Association, they have the responsibility to promote and advocate patient privacy and
confidentiality (Winland-Brown, Lachman & Swanson, 2015). Wrong entry in health records
pose patient safety risk issues in every level of care, therefore there should be data integrity that
safeguard patient safety and quality of care. The ethical implications include beneficence, non-
maleficence and respect for autonomy. The patient is the owner of his or her information and
nurses have the responsibility to protect data and share only relevant information with other
healthcare professionals for clinical decision-making with prior patient consent (Johnstone,
2015).
Although, EHRs improve the quality of care, there are problems that affect the data
integrity in healthcare system. The primary goal of implementation of EHR is to reduce medical
errors that compromise patient safety and integrity (Ayatollahi, Mirani & Haghani, 2014).
However, intentional or unintentionally, nurses enter wrong data regarding patient information
that is unsafe and breach of conduct. For example, the treatment cancer of a patient was delayed
by many years because a piece of information was wrongly entered in the EHR system. The

3NURSING INFORMATION SYSTEM
system defaulted to an old test of Pap smear instead of the most recent abnormal findings. As the
result of delayed diagnosis and treatment, patient life was endangered.
The ethical implication in this example is the breaching of beneficence and non-
maleficence. Healthcare professionals have the obligation to promote greater good for the
patients and intentionally should not harm them (Grace, 2017). In the given example, due to
negligence or breach of duty, wrong entry about patient lab findings resulted in hampering
patient life and safety. According to ANA, under Provision 3, nurses have the responsibility to
advocate and protect patient’s health, rights and safety (Taitsman, Grimm & Agrawal, 2013).
They should create an ethical environment and have an affirmative duty to protect and prevent
harm. There is breaching of patient actual data raising ethical implications of privacy and
security. This example also depicts that it is the ethical responsibility of nurses to make proper
patient information as it meet the needs of the patient. It also acts as an efficient communication
tool that creates and ensures continuity in safe delivery and quality of healthcare.
During my placement at the geriatric ward in a hospital, I was instructed to look after a
patient who had underwent a surgery. After my shift, I instructed over the electronic patient
record to the nurse who would be attending after me. When I returned to my duty, I noticed that
structured data indicated one pill twice a day and free-text field showed two pills morning and
one pill in the evening. This gave me an instinct that the data entered was wrong regarding the
inconsistent drug dose and there was some missing information. The positive thing about that
incident was that it noticed and escalated the issue at the right time and negative aspect was that
the previous shift nurse made wrong entry about the medication hampering patient safety. It
could have been improved if previous shift nurse would have made proper data entry regarding

4NURSING INFORMATION SYSTEM
the patient medication dosage breaching the ethical code of conduct of non-maleficence and
beneficence.
From the above discussion, it can be concluded that data integrity in healthcare is an
important aspect regarding patient information. Discrepancies in data protection pose ethical and
legal implications like respect for autonomy, beneficence and non-maleficence, privacy and
confidentiality. There is a responsibility to protect data as it is of extreme importance in
healthcare as it is used to identify, track patients when they move from one care level to another.
It hampers patient safety, pose harm and endanger quality of care provided by the patient.
Among the healthcare workforce, nurses have the ethical responsibility to oblige to the ethical
code of conduct and ensure patient safety and integrity.

5NURSING INFORMATION SYSTEM
References
Ayatollahi, H., Mirani, N., & Haghani, H. (2014). Electronic health records: what are the most
important barriers?. Perspectives in health information management, 11(Fall). Retrieved
from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4272437/
Fowler, M. D., & Davis, A. J. (2013). Ethical issues occurring within nursing education. Nursing
ethics, 20(2), 126-141. Doi: https://doi.org/10.1177/0969733012474290
Grace, P. J. (2017). Nursing ethics and professional responsibility in advanced practice. Jones &
Bartlett Learning. Retrieved from: https://books.google.co.in/books?
hl=en&lr=&id=1OQlDgAAQBAJ&oi=fnd&pg=PR1&dq=beneficence+and+nonmalefice
nce+nursing&ots=eMHCE7AAz8&sig=g-
qysNENqMRSHd5EjjJDRBL30JA#v=onepage&q=beneficence%20and
%20nonmaleficence%20nursing&f=false
Huffman, D. M., & Rittenmeyer, L. (2012). How professional nurses working in hospital
environments experience moral distress: a systematic review. Critical Care Nursing
Clinics, 24(1), 91-100. Doi: http://dx.doi.org/10.1016/j.ccell.2012.01.004
Johnstone, M. J. (2015). Bioethics: a nursing perspective. Elsevier Health Sciences. Retrieved
from: https://books.google.co.in/books?
hl=en&lr=&id=4dRQCgAAQBAJ&oi=fnd&pg=PP1&dq=Code+of+Ethics+for+Nurses,
+American+Nurses+Association&ots=YEsJSWvKdg&sig=yo_bCHEq5-
z6L9Eos8wehCYhgbA#v=onepage&q=Code%20of%20Ethics%20for%20Nurses%2C
%20American%20Nurses%20Association&f=false

6NURSING INFORMATION SYSTEM
Taitsman, J. K., Grimm, C. M., & Agrawal, S. (2013). Protecting patient privacy and data
security. New England Journal of Medicine, 368(11), 977-979. Doi:
10.1056/NEJMp1215258
Winland-Brown, J., Lachman, V. D., & Swanson, E. O. C. (2015). The new code of ethics for
nurses with interpretive statements. 2015: Practical clinical application, Part I. Medsurg
Nursing, 24(4), 268-71.Retrieved from:
http://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNur
ses/Code-of-Ethics-2015-Part-1.pdf