Digital ethical reflection in long-term care: Leaders' expectations.

Abstract

Healthcare leader support and facilitation for ethics work are of great importance for healthcare professionals' handling of ethical issues, moral distress, and quality care provision. A digital tool for ethical reflection in long-term care was developed in response to the demand for appropriate tools. This study aimed to explore healthcare leaders' expectations of using a digital tool for ethical reflection among their home nursing care staff. A qualitative research design with vignettes and focus group interviews was used. The data were analyzed using reflexive thematic analysis. The sample comprised ten healthcare leaders from municipal long-term care in Norway. Participation was voluntary and based on informed consent. The Norwegian Agency for Shared Services in Education and Research approved this study. The analysis resulted in the development of three themes representing leaders' expectations of the tool: (i) giving staff a voice, (ii) revealing ethics in practice, and (iii) keeping the pot boiling. Leaders must be informed about the ethical issues experienced to engage in supportive measures for their staff. Digital channels can increase the democratization, safety, and efficiency of communication between employees and leaders and increase awareness of ethical aspects in daily care work. The leaders had positive expectations of employees' activities and benefits from using the tool for ethical reflection. However, they admitted that realizing the tool's potential to ensure continuity in ethics work requires considerable organizational and leader involvement. This study shows that healthcare leaders are open to digital solutions for managing ethics work in home nursing care. Both opportunities and important prerequisites for successfully implementing the digital tool were identified.