title: Community health nursing, wound care, and...ethics?
abstract: Because of changing demographics and other factors, patients receiving care for wounds, ostomies, or incontinence are being referred in increasing numbers to community health nursing organizations for initial or continued care. As home-based wound care becomes big business, little discussion is being focused on the moral and ethical issues likely to arise in the high-tech home setting. Progressively more complex and expensive home care relies on family members to take on complicated care regimens in the face of decreasing numbers of allowable skilled nursing home visits. A framework and a principle-based theory for reflection on the character and content of moral and ethical conflicts are provided to encourage informed and competent care of patients in the home. Common moral and ethical conflicts for WOC nurses in the United States are presented. These conflicts include issues of wound care supply procurement; use of documentation to maximize care or profit; problems of quality, care consistency, and caregiver consent; and dilemmas of tiered health care options. The advantages of a framework to address ethical conflicts are discussed.
authors.affiliation: Wayne State University, College of Nursing, Detroit, Michigan 48202, USA. aj1162@wayne.edu
authors.forename: Sue Ellen
authors.initials: SE
authors.lastname: Bell
mesh_terms: D003152:Community Health Nursing / Q000191:economics / Q000941:ethics*; D003657:Decision Making; D005190:Family; D006801:Humans; D028681:Moral Obligations; D024802:Nurse's Role; D010030:Ostomy / Q000191:economics / Q000941:ethics / Q000451:nursing; D014947:Wounds and Injuries / Q000191:economics / Q000451:nursing*