A comparative study to assess the effectiveness of a code of ethics intervention on moral distress and moral resilience among pediatric nurses: A quasi-experimental study

Moral distress among pediatric nurses negatively impacts their well-being and quality of care. Enhancing moral resilience may help mitigate this distress. To assess the effect of a code of ethics intervention on moral distress and moral resilience levels among pediatric nurses in Riyadh and Kanyakumari, a quasi-experimental study was conducted with 243 pediatric nurses (125 in Riyadh, 118 in Kanyakumari) using purposive sampling. Participants received a 15-minute daily ethics teaching intervention over 7 days during shift huddles. Moral distress and moral resilience were measured pre- and post-intervention using validated self-administered questionnaires. Post-intervention, moral distress frequency and intensity significantly decreased, while moral resilience significantly increased among nurses in Riyadh. In Kanyakumari, moral distress showed reduction, but changes in moral resilience were not significant. Significant associations were observed between moral distress, resilience, and demographic variables such as age, gender, and work department. The ethics intervention effectively reduced moral distress and enhanced moral resilience in pediatric nurses, highlighting the importance of ethics education in nursing practice to improve nurses' well-being and care quality.