Ethical Problems Development and Evaluation of Nursing Action Agenda to Ethical Decision Making in Hospital- Participation to the Clinical Ethics Committee

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1. From questionnaires sent to 3115 facilities throughout Japan concerning installation of a clinical ethics committee, details of activities and nursing committee staff, 764 facilities answered (recovery 24.5%), and 759 answers were analyzed. Facilities where the clinical et hics committee had been set up were 242 (31.9% : hospitals 221, nursing department 9 and 12 of both). Regarding their activities, "ethical examination in researching" was most many, and then consultations of the case, information like guideline offering, and education and enlightening followed.Only 67 facilities, 38.8% answered the committee was functioning. The facilities that had 300 beds or more, and/or set up before 1996, and had an external committee gave positive answers.314 facilities 61.2%, among 509 facilities (68.4%) that did not have the committee, were in the installation schedule or had already done the preparation of installing. 195 facilities without committee answered that they had some difficultie … More s in installation in spite of being aware of its necessity.2. From our interview to nursing directors and committee members of 9 facilities that have installed a clinical ethics committee, four types of installation procedure were found : 1) by the lead of the hospital director, 2) by suggestion of nursing department, 3) through personal study meeting of nurses, 4) with direction of municipal management. The installation was prepared through meetings, and meticulous planning such as installing multi committees in a large-scale hospital, or installing an additional ethics committee of nursing department to empower the nursing activities.3. Our survey in two hospitals for more than one year has clarified that, through participation in nursing ethical improvement project committee and attendance to a continuous study meeting purposing nursing staffs ethical empowerment, one hospital established the ethical committee in the nursing department after one year, and another facility indicated more staffs started to act proficiently and ethically. Less