Issue

Mean^*

Rank

Percent Indicating 4 or 5

1. Failure to provide service of the highest quality in the eyes of the consumer regardless of social or economic status, personal attributes or the nature of health problems

2.73

8

29

2. Failure to provide service of the highest quality in the eyes of the health care providers not employed by the organization

2.48

16

21

3. Failure to provide service of the highest quality in the eyes of the purchasers of care (e.g., insurance companies)

2.71

10

29

4. Failure to provide service of the highest quality in the eyes of the health care providers employed by the organization

2.64

11

26

5. Failure to provide service of the highest quality consistent with the standards of the  nursing profession

2.83

7

34

6. Failure to provide service of the highest quality due to economic constraints determined by the organization

3.32

2

52

7. Failure to provide service of the highest quality consistent with the ANA Code of Ethics

2.41

20

12

8. Failure to provide honest information regarding resources, employee competence or service

2.35

23

21

9. Showing partiality toward clients perceived as influential

2.58

12

25

10. Showing partiality toward providers perceived as influential

2.72

9

30

11. Lack of knowledge or skills to competently perform one’s duties

2.40

21

18

12. Misrepresenting or concealing limitations in one’s abilities to perform the assigned task

2.15

30

12

13. Failure to identify the consumer’s needs and provide services that meet those needs (e.g., referrals)

2.52

14

19

14. Failure to provide quality end-of-life care

3.13

4

44

15. Failure to adequately assess the unique needs of the geriatric population

3.19

3

44

16. Withholding or withdrawal of life-sustaining treatment against the patient’s and/or family’s wishes or best interest

2.13

31

16

17. Failure to provide the patient and/or family full disclosure essential to informed consent

2.42

18

22

18. Failure of providers to discuss a patient’s DNR status

2.95

5

38

19. Rationing of some forms of medical treatment due to scarcity of health care resources

2.23

26

16

20. Providing treatment when a positive outcome is highly unlikely

3.38

1

53

21. Providing misleading information to a patient regarding a diagnosis or prognosis

2.35

23

18

22. Failure by clinicians to use consults to address ethical issues regarding patient care

2.89

6

35

23. Failure to be objective with others in discharging one’s professional responsibilities

2.51

15

18

24. Conflicts of interest involving consulting, marketing, business, or financial relationships that influence, or appear to influence, one’s ability to carry out his or her responsibility

2.23

26

17

25. Misuse of proprietary information

1.78

39

8

26. Misuse of sensitive information related to consumers and employees

1.87

36

9

27. Making disparaging remarks about competitors

2.45

17

22

28. Making disparaging remarks about vendors

2.13

31

12

29. Misuse of the organization’s assets or property

2.07

34

15

30. Giving gifts or entertainment in an effort to influence decisions

1.74

40

9

31. Offering or soliciting payments or contributions for the purpose of influencing legislation, regulations or accreditation

1.88

35

13

32. Exaggerating the seriousness of a problem to obtain price or other concessions

1.87

36

11

33. Abuse of expense accounts

1.81

38

10

34. Department closings and layoffs

2.55

13

27

35. Discrimination in the work place

2.23

26

16

36. Drug and alcohol abuse in the workplace

2.38

22

18

37. Employee theft

2.20

29

12

38. Relationships with local communities

2.10

33

12

39. Relationships with other health care providers

2.33

25

15

40. Conflict between organizational and professional philosophy and standards

2.42

18

21