Background: Every day, nurses are faced with making decisions for patient care and may come across complicated ethical decisions. Ethical practice is essential in every health care organization in providing care and how they conduct themselves (ANA, 2015). Nurse managers are responsible for ensuring ethical standards are met by nursing staff.

Problem: Nurse managers are faced with ethical problems more than fifty percent of their work time (Aitamaa, 2019). There are studies that show nurse managers and nurses have difficulty solving ethical problems because they lack understanding of ethical principles (Huang, et al., 2020). Evidence shows nurses are deficient in ethical knowledge that affect decisions for patient care (Huang, et al., 2020). In the last three years nurses have been challenged with an increase in complex ill patients, nursing shortage and burnout that encumbers recognizing ethical dilemmas.

Methods: A quantitative cross-sectional study was performed that compared survey results before and after ethics training. Participants included nurse managers and charge nurses from two Indian Health Service hospitals. A sample t-test was performed to determine the effectiveness of education.

Results: The findings of the study indicate there was improvement in knowledge of nursing ethics after receiving training. The t-test revealed a statistically significant increase from pretest knowledge (M = 86, SD = 2.74), to posttest knowledge (M = 95.2, SD = 6.57) is found t (5) = -3.07, p value = 0.037, P value of 0.05 indicating statistical significance.

Implications: The study shows significant results of increased knowledge on nurse code of ethics and suggests implementing ethics training in health care settings for nurses to improve ethical knowledge.

Project Sponsors

Dr. Rachel Marzec

Document Type

Scholarly Project

Degree Name

Doctor of Nursing Practice (DNP)

Second Degree

Master of Science in Nursing (MSN)

Level of Degree


First Advisor

Rachel E. Marzec

Second Advisor

JoEllen Schimmels


Ethics, Education, Nurse Managers, Leadership

Available for download on Monday, January 01, 2024