Objective To explore the mediating role of hospital ethical climate in the relationship between ethical support system and the moral courage of emergency triage nurses,and to provide practical insights for clinical practice to enhance the ethical standards and decision-making abilities of emergency triage nurses. Methods From October to December 2023,396 emergency triage nurses were selected from three tertiary hospitals in Shiyan City through convenience sampling. Based on the theory of social support,it was hypothesized that the hospital ethical climate mediated the impact of ethical support systems on the moral courage of emergency triage nurses. Data were collected using a general information questionnaire,Emergency Triage Nurses‘ Ethical Support System Perception Questionnaire,Hospital Ethical Climate Scale,and Moral Courage Scale for Nurses. Structural Equation Modeling（SEM） was utilized for data analysis and hypothesis testing. Results Descriptive analysis indicated that the scores for emergency triage nurses‘ perceptions of the ethical support system,hospital ethical climate,and moral courage were （83.35±10.01）,（100.64±13.49）,and （81.52±10.56）,respectively. Correlation analysis showed strong positive correlations between scores of the ethical support system and hospital ethical climate（r=0.833,P<0.01）,and moral courage（r=0.820,P<0.01）. The hospital ethical climate also had a strong positive correlation with moral courage scores（r=0.887,P<0.01）. SEM analysis indicated excellent fit indices,the hospital ethical climate significantly mediated the relationship between perceptions of the ethical support system and moral courage,with an indirect effect value of 0.492,95%CI of 0.489-0.685,and a relative effect of 51.52%. Conclusion The hospital ethical climate significantly mediates the relationship between ethical support system and the moral courage of emergency triage nurses,underscoring the critical role of the hospital ethical climate in enhancing professional ethical standards in nursing.
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