Improving ethical practice at neonatal intensive care unit in Buee primary hospital

Abstract

Introduction: Ethics is defined as a moral philosophy or code of morals practiced by a person or group of people. There agreed ethical principles are autonomy, beneficence, non-maleficence, and justice, which are widely accepted in the neonatal practice. However, within the context of diverse values, beliefs and interests’ fundamental variations exist and they hugely influence the plans of new born management. There is limited information in Ethiopia regarding the practice of these ethical principles. The ethical principles of new born care are not clearly stated and not applied well by NICU staffs, in Buee Primary Hospital (BPH). The parents are not part of decision making and treatment of choice. Objectives: The objective of the project is to improve the practice of ethical principles at NICU in Buee Primary Hospital. Methods: Pre-post interventional study and descriptive qualitative approach was conducted to explore the practice of ethical principles at NICU in Buee Primary Hospital. The study populations are all health professionals working in the hospital. Key informant interview guide was conducted face to face by the investigator. The recorded audio note interviews were transcribed, and analyzed thematically using open code software version 4.2. Result: In the pre-intervention we conducted observation, document review and discussion to verify the root cause of the problem. In the- post intervention we developed implementation plan and the health professionals started to implement the plan. During this period, we evaluated the problem whether it has improved or not. Qualitative finding: The key informant interviews indicated gaps in the practice of ethical principles in NICU. The results of the selected strategies showed a significant improvement on the practice of low ethical principles in the unit. This was objectively measured using the observational checklist from 27% to 80% during the evaluation period of pre and post intervention. Conclusion and Recommendation: The results of this project suggested that a simple set of intervention was effective on improving the practice of ethical principles. The finding also proved the effectiveness of selected strategies, but it will be better to implement in a large scale in the hospital.