Iranian Journal of Medical Ethics and History of Medicine

Medical errors in pediatrics if different from adults. This study aimed to investigate type and frequency of medical errors and the related contributing factors from pediatric residents' point of view. This descriptive and cross sectional study was done in 2016. After determining validity (face and content) and reliability the final questionnaire with 17 questions categorized in six parts was used for data collection. Data were analyzed descriptively using SPSS v.22. ''Errors of diagnosis or delay in diagnosis' (8.6)', ''choosing appropriate dose (8.3) and medication (8.2)'' had the highest average weights. Fellows of pediatrics (12.6) and pediatrics’ professors (12.1) with the highest average weights had the most dominant role in diagnosis and prevention of errors. The most and the least average weights of the errors was reported for urban general physicians and pediatrics’ professors, respectively. Errors could occur at 2-8 AM more likely. Junior residents were the ones with the most chance of doing errors. Medical errors were mostly reported to occur in the group of children (70.6%) than neonates (29.4%). Reconstruction and strengthening educational and supervision role of pediatric fellowships and attending with the aim of in time diagnosis and then prevention of medical errors could be considered as a must in teaching hospitals. Holding purposeful educational courses and control of contributing factors like workload, exhaustion, inexperience, etc. are among duties of educational and executive managers.
 

Failure to follow professional ethics in midwifery will lead to harmful risks, including an increase in maternal and infant mortality. The aim of this study was to investigate the barriers to professional ethics in midwifery clinical care from midwives ’viewpoints in hospitals specializing in obstetrics and gynecology in North Khorasan province in 2018. This cross-sectional descriptive study was performed with the participation of 141 midwives working in specialized obstetrics and gynecology hospitals in North Khorasan province, using classified sampling. The data collection tool was a questionnaire consisting of two parts: demographic information and barriers to professional ethics, in three areas: environmental and managerial and personal care. Data were analyzed using SPSS software version 22 and descriptive and inferential statistics. From the perspective of midwives, all three categories of environmental factors (73.94%), personal care (64.66%) and management (64.97%) were among the barriers to professional ethics. The most important barriers to professional ethics in the managerial dimension are staff shortages (80%), in the environmental dimension, biological changes in the body during work shifts (85.2%) and in the personal dimension, dissatisfaction with basic needs, such as insufficient income or adequate rest in midwifery (80.9%), was. Given the importance of observing professional ethics and the issues and problems arising from non-compliance, it is suggested that managers and officials make the necessary planning by hospitals to remove the barriers mentioned by midwives.

The nursing profession has a moral nature. Explaining and clarifying the role of moral reasoning in the quality of nursing care in nurses helps improve the quality of services in the treatment system and, as a result, increases the satisfaction of patients. This study aimed to determine the relationship between moral reasoning and the quality of nursing care in nurses affiliated with Yasuj University of Medical Science in 2024.  The present study is cross-sectional and correlational, which was conducted on 187 nurses working in the clinical departments of Shahid Jalil, Shahid Beheshti and Imam Sajjad  hospitals in Yasuj City in 2024. Participants were selected using systematic random sampling. Questionnaires of nursing ethical dilemmas and the quality of nursing care were used to collect information. T-test, one-way analysis of variance (Bonferroni post hoc test), and linear regression were used. Data analysis was done using SPSS 26 software. In this study, the mean and standard deviation of moral reasoning and quality of nursing care are 38.86 ± 5.39 and 199.34 ± 18.83, respectively. These results indicate the average level of moral reasoning and the desired level of nursing care quality. Also, the results of the study showed that there is a significant and positive relationship between moral reasoning and the quality of nurses' care (p = 0.01 and r = 0.188). On the other hand, with the increase in familiarity with ethical challenges and problems, the quality of nursing is decreased (p=0.007 and r=0.188) The findings of this study showed that nurses' moral reasoning is positively and significantly related to the quality of nursing care. This shows that nurses' ability to analyze and solve ethical issues can lead to providing better and more responsible care. However, reducing the quality of care by increasing nurses' awareness of ethical dilemmas highlights an important challenge. This may be due to the complexities involved in ethical decision-making, conflicts in the workplace, or the pressures of dealing with ethically difficult situations. Based on this, it is suggested to design and implement educational and support programs to strengthen the moral and psychological skills of nurses to prevent the negative effects of awareness of moral dilemmas on the quality of care and at the same time strengthen their moral reasoning.