Perception of Ethical Principles by Hemodialysis Nurses in Khartoum, Sudan

Background: In the nursing process the nurse must be able to make correct ethical decisions. This primarily requires knowledge of the basic ethical concepts and rules. Nursing curricula are not uniform in teaching nursing ethics and there is concern about applications of ethical principles during nursing practice. Objectives: To determine the perception of ethical principles by hemodialysis (HD) nurses at dialysis centers in Khartoum state, Sudan. Methods: A descriptive cross sectional hospital based study was used. Participants were nurses working in five HD centers from the period of July 2015 to February 2016. A total number of 120 dialysis nurses who agreed to participate in the study were included in the analysis. Data were collected through a self administrated questionnaire developed in accordance with current literature on nursing ethics and approved by a panel of five experts. Results: All 120 nurses who agreed to participate completed the study. The respondents mean age was 34.8 years. Ethical principles studied included five ethical concepts; beneficence, nonmaleficence, autonomy, consent, and justice. Only about half of the participants (53%) reported that they formerly studied the principles of ethics during their nursing education. The scores for the principles of beneficence, nonmaleficence and justice were, in general, quite good. However, when analyzing the responses to questions related to patient autonomy, 60% of the nurses would not comply with patient's wishes if they contradicted with relatives wishes. Moreover, 30% of the nurses would leave decision making to relatives regarding care rather than patients. Nearly a quarter of the nurses did not seem to care for consent taking. This is alarming as patients' autonomy and consent-giving did not seem to be well respected in dialysis centers.