Beyond Reporting: A Qualitative Approach to Managing Ethical Incidents in Healthcare

Patient safety incident reporting systems foster a nonblaming culture and support organizational learning. By incorporating an ethical dimension, these systems can support nursing managers in addressing ethical incidents, strengthen healthcare professionals' ethical competence and conduct, and promote the delivery of high-quality patient care.

This study aimed to describe the types of reported ethical incidents, outline the actions and measures implemented to prevent recurrence, and reflect on how our findings inform the organization of ethical incident prevention management.

This retrospective register study was conducted using an artificial intelligence-based closed data analysis program and inductive content analysis. The standards for reporting qualitative research (SRQR) checklist was used.

Data were collected using the HaiPro system at a university hospital in Finland from 2018 to 2021. During this time, 3615 patient safety incident reports were submitted, of which 579 (16%) were categorized as ethical incidents and subsequently analyzed.

Ethical requirements were met. According to the Finnish ethical guidelines, an ethical review was unnecessary for this register study. The research permit was provided by the participating organization.

We found two main categories: (1) ethical incidents, with subcategories of professional conduct and patient care management and (2) actions and preventive measures, emphasizing continuous improvement, enhancing professional competence, fostering professional communication and conduct, improving data management, and enhancing patient care through the reporting system.

Cultivating an ethical culture through the strategic management of ethical incidents is vital. An efficient structure for handling such incidents can improve decision-making, ensure accountability, support professionals, and reduce their burden, ultimately enhancing care quality.

This study provides valuable insights for nursing managers on effectively addressing ethical incidents. Their role is pivotal in shaping an ethical culture through strategic leadership, promoting educational initiatives, and supporting the implementation of ethical practices.