Transforming Care at the Bedside:
Adhering to the Ethical Principles of Patient Autonomy, Beneficence, and Nonmaleficence
The Nursing Role

Abstract
This paper explores several published articles following the national program, Transforming care at the Bedside (TCAB), developed by the Robert Wood Johnson Foundation (RWJF) and the Institute for Healthcare Improvement (IHI); and how it supports the ethical principles of patient autonomy, beneficence, and nonmaleficence in patients, especially amongst the geriatric population. By describing and focusing on three main points of the TCAB, safe and reliable care, patient-centered care, and value-added care and their relative goals and high leverages; this will show how they benefit the
The sensory cart held items such as fuzzy balls with tentacles for patients to hold and distract them from pulling at their intravenous lines, and stuffed animals to be placed on their laps when sitting in their chairs to prevent them from getting up and falling (Stefancyk, 2009). By using this sensory cart, patients were distracted from putting themselves in potentially harmful situations like falls; profuse bleeding from intravenous sites, and also reduced the need for restraints. These changes developed by TCAB model improved patient safety in the hospital setting, therefore decreasing patient injury and extended hospital stays, adhering to the ethical principles being discussed. The second theme in the TCAB framework, patient centered care, influences patient autonomy by using its vision described by Rutherford et al (2009) as “truly patient-centered care on medical and surgical units honors the whole person and family, respects individual values and choices, ensures continuity of care”. Providing patients with information and education, respecting patient preferences by encouraging input on plan of care goals, ensuring comfort with pain management, and addressing their needs, especially with medication administration and care times (Stefancyk, 2009), gives the patient a sense of empowerment, a voice and more involvement