Moral sensitivity and attitudes towards patient safety among critical care nurses

Nurs Ethics. 2025 Sep;32(6):1848-1860. doi: 10.1177/09697330251313788. Epub 2025 Feb 3.

Abstract

IntroductionPatient safety is essential for healthcare quality and a global concern. The rapid advancement of medical technology presents ethical challenges for critical care nurses, who navigate complex decision-making processes. Given their close relationships with patients, nurses are uniquely positioned to address patient safety issues. Thus, enhancing nurses' moral sensitivity and ethical values is increasingly important.ObjectiveThis study aims to explore the relationship between moral sensitivity and attitude towards patient safety in critical care nurses.MethodsThis cross-sectional, descriptive-correlational study was conducted from June to September 2022 in three hospitals affiliated with Hamadan University of Medical Sciences in Iran. Participants were nurses in intensive care units (ICUs), selected via convenience sampling. A total of 382 nurses completed questionnaires assessing demographic information, moral sensitivity, and patient safety attitudes. Data analysis was performed using descriptive statistics, t-tests, ANOVA, Pearson's correlation, and multiple regression in SPSS 26.Ethical considerations: This research received ethical approval from the Ethics Committee of Hamadan University of Medical Sciences. Participants provided informed consent regarding the study's objectives, and their confidentiality was strictly upheld throughout the research.ResultsThe nurses' average age and work experience were 38.6 years and 12.4 years, respectively. Mean scores for moral sensitivity and patient safety attitude were 81.65 ± 2.69 and 51.47 ± 2.21, indicating high levels and a significant positive correlation. Factors such as increasing age, work experience, fewer working hours, and completion of ethics training were linked to more positive attitudes towards patient safety (p < .05). Regression analysis showed that 42.8% of the variability in attitudes towards patient safety could be explained by moral sensitivity and demographic characteristics.ConclusionThis study highlights the relationship between moral sensitivity and patient safety attitudes among critical care nurses, emphasizing the importance of education, experience, and training in shaping ethical values. Enhancing moral sensitivity is vital for reducing risky behaviors and improving patient safety outcomes in critical care settings.

Keywords: Moral sensitivity; clinical ethics; critical care nursing; intensive care units; patient safety.

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Critical Care Nursing* / ethics
  • Critical Care Nursing* / methods
  • Critical Care Nursing* / standards
  • Cross-Sectional Studies
  • Female
  • Humans
  • Intensive Care Units / organization & administration
  • Iran
  • Male
  • Middle Aged
  • Morals*
  • Nurses* / psychology
  • Nurses* / statistics & numerical data
  • Patient Safety* / standards
  • Surveys and Questionnaires