A social-ecological framework: A model for addressing ethical practice in nursing

Area of Science:

• Nursing Ethics
• Healthcare Management
• Social Determinants of Health

Background:

• Rapidly evolving healthcare landscapes present complex ethical dilemmas for nurses.
• System pressures, cost reduction, and an aging population exacerbate ethical challenges.
• Ethical issues are often treated abstractly, hindering practical application in nursing.

Purpose of the Study:

• To develop a framework for discussing and addressing ethical issues in nursing practice.
• To create a structured approach for formulating interventions to improve ethical care.
• To provide a foundation for enhancing ethical practice and supportive work environments.

Main Methods:

• Conceptual framework development.
• Comprehensive literature review utilizing the social-ecological framework as an organizing construct.

Main Results:

• The framework identifies eight interactive levels influencing ethical practice: individual (patient/nurse), professional relationships, patient-nurse relationships, organizational context, professional regulation, community, and socio-political-economic factors.
• Ethical practice is viewed as an outcome of interactions across these multiple levels.
• The framework highlights the interconnectedness of various influences on nursing ethics.

Conclusions:

• The social-ecological framework offers a practical tool for developing targeted interventions to promote ethical nursing practice.
• This framework is valuable for policy, practice, education, and research in nursing.
• Applying this framework can assist nurses in developing strategies to navigate daily ethical challenges effectively.