Accountaability In Nursing

Accountability means:” being accountable for one’s own action”. The American Nursing Association (ANA) states in its code that the nurse will assume accountability for individual nursing judgments and actions. Professional nurses are accountable in several areas including accountability to the public, client, profession, employer, and self (Hood, 2010, p. 307). All professional nurses have the responsibility to work within their scope of practice to provide the best possible care to patients. Nurses’ should have a thorough knowledge about their accountability in specific areas of practice. The level of responsibility and accountability depends on professional levels. A nursing supervisor has more responsibility than a charge- nurse. A

Delegation in the health care setting is very important for the nurses, unlicensed assistive personnel, and for the patients. The delegation of indirect and direct patient care allows the Registered Nurse (RN) to spend more time toward the patient care, education, and patient advocacy. This delegation of patient care helps to improve patient outcomes and increases satisfaction for the patient and the nurse (Snyder, Medina, Bell, & Wavra 2004). “Nurse delegation is considered a “professional right and responsibility” requiring a “skill that must be taught and practiced for nurses to be proficient in using it.”

It is up to the nurse/delegator to determine the delegatee’s knowledge, skills, abilities, and any training that will ensure that the task will be handled appropriately and safely. If it is necessary the nurse/delegator must provide instruction and direction to the delegatee. The nurse/delegator or another qualified nurse must be available to supervise the delegate and delegated task. The level of supervision needed will be determined by the training, capability, and willingness of the delegate to perform the task. A delegate may not delegate to another person or expand the delegated task without the permission of the nurse/delegator. Once the delegated task is completed the nurse must evaluate the delegated task, patient’s health status, determination if the goals are being met and if the delegation of the task may be continued (UT Admin Code R156-31b. Nurse Practice Act Rule, 2013). In section R156-31b-704 the rules for the recognized scope of practice of an RN are outlined. It states that the RN, RN managers, and RN administrators should practice

Florence Nightingale stated, “To be ‘in charge’ is certainly not only to carry out the proper measures yourself but to see that everyone else does too. It is neither to do everything yourself nor to appoint a number of people to each duty, but to ensure that each does that duty to which he is appointed” (Hill & Howlett, 2009, p. 285). Delegation is empowering another person to perform a task or responsibility that are in the job description of the charge nurse to a competent unregulated care provider (UCP) in selected situations (College of Nurses of Ontario [CNO], 2013). Essentially this is “transferring the authority to perform a controlled act procedure to a person not authorized to perform that act” (CNO, 2013, pg. 7). An example of delegation would be an RPN and a UCP working within a long-term care facility where the RPN determines the UCP is competent in administering a rectal suppository to a resident who’s condition is both stable and predictable. The RPN then instructs the UCP to give feedback concerning the results of the suppository. Assigning tasks encompasses the job description of the RPN/RN charge nurse position by allocating responsibility for providing care to another individual (CNO, 2013). An example of assigning would incorporate an RPN who is giving the responsibility of taking a client’s vital signs to a UCP in a long-term care facility as it is in their education and training and the facilities policy and procedure guidelines. The UCP is accountable

I believe that accountability is crucial throughout an entire shift. Nurses are accountable for their patients once they receive report from the off-coming nurse and take over. They must deliver good patient care, follow physician orders, complete constant assessments, follow facility protocol with procedures, document, manage aide staff, etc. All these tasks and more take place in any and every nurse shift. Problems with accountability can occur in many situations where responsibilities and duties are not completed or done correctly. For example, a nurse who does not complete a full assessment, could essentially miss something very important such as an infection in an incision. Patterson, Grenny, Maxfield, McMillian, & Switzler (2013)

“Responsibility is a process that is both allocated and accepted” (Weydt A, 2010). An RN in a hospital who just take of the patient by assisting her to the bathroom and changing her mattress cloth just did the work of a nursing assistance, all these will lead RN getting overwhelmed combined with her own responsibility. Therefore, for an equal responsibility delegation has to be done

RN should complete an assessment of the patient as well as reviewing the patient individualized plane of care before delegating a task. In addition, the RN should ensure proper training, and that the UAP is competent to handle the task before

Accountability within the nursing profession can be defined as the moral, ethical, and legal responsibility associated with the actions or lack of action when providing patient care. Nurses are held accountable for correctly administering medication, providing accurate health assessments, and quality documentation. Nurses are held to superior standards when providing patient care. The 2016 Gallup poll (as cited in Nurses Rank # 1, 2017) found that nurses have been deemed as the most trusted profession (p.17). Trust is a vital characteristic in the nursing practice, as patients entrust their lives to the nurses that care for them. According to Ulrich (2014), RNs must clearly understand his or her ethical responsibility and accountability as an RN, which includes the nurse-patient relationship, be skilled in the delegation, and fully understand the scope of practice for both RNs and other healthcare providers (p. 241).

Patient autonomy, safety and risk are all important yet the decisions made from the student nurse on Ward 6 will be responsible and accountable, however as the student nurse will be mentored they will not have the accountability which a registered nurse does as “to be accountable; practitioners must: have the ability to perform the activity or intervention, accept responsibility for doing the activity and have the authority to perform the activity through delegation and the policies and protocols of the organisation” (Royal College of Nursing 2016). The student nurses will be responsible for communication with their senior and make sure they seek advice beforehand. Responsibility is mentioned within accountability yet is different as Dohmann (2009) claims that nurses individually have the responsibility to make sure that actions they carry out or delegate to must be done appropriately and they are then accountable for the results from the actions that were taken.

The National Council of State Boards in Nursing defines delegation as “transferring to a competent individual the authority to perform a selected nursing task in a selected situation” (National Council of State Boards of Nursing, Resources section, 4). When delegating, the registered nurse (RN) assigns nursing tasks to unlicensed assistive personnel (UAP) while still remaining accountable for the patient and the task that was assigned. Delegating is a management strategy that is used to provide more efficient care to patients. Authorizing other individuals to take on nursing responsibilities allows the nurse to complete other tasks that need tended to. However, delegation is done at the nurses’

This article discusses about the process of nursing delegation. For the process of nursing delegation, it must have strong communication, empowered staff, and organizational support. The guidelines identify 5 rights of delegation, which include right task, right circumstances, right person, right direction & communication, and right supervision & evaluation. When a delegator, such as a nurse, delegates, they will remain responsible for the tasks that were delegated. Delegation of an action/task is done based on the patient’s safety and their quality of care. Following the process enables a nurse to appropriately delegate to benefit the care of the patient.

Accountability is an extremely important component of professional nursing practice in all settings and at all levels. The great responsibilities closely placed on human service and the commitment. The nursing profession starts with a strong and clear understanding of the responsibility, accountability, confidence with a healthcare discipline. It is of vital importance to nurses are held accountable for their actions, and nurses cannot escape the inevitable consequences of these actions. Therefore critical thinking, and nursing knowledge, continuity of care, lifelong learning, is an essential in order to apply and to practice at workplace, also with everyone involved in health care.

In order to provide adequate delegation, it is important to understand the various aspects involved. Before delegation occurs, understanding the job descriptions and scope of practice that each team member has can help define who can do what. It is also important to understand the level of care a patient needs, determining the severity of

Health care facilities are institutions which provide numerous types of care and in order to provide care to patients there has to be individuals willing and eager to pursue careers in the medical fields. We know that there are a variety of physicians associated with medical facilities and there are also different types of nurses residing in these settings. The duties or roles of these nurses differ in many ways; but the main goal is to provide the best patient care possible. The understanding of the responsibility, authority, and accountability related to delegation is essential in the nursing care process (Mueller & Vogelsmeier, 2013).

Delegation is the transfer of responsibility for the performance of an activity from one individual to another while accountability for the outcome is retained. Registered Nurses transfer responsibility and authority for the performance of an activity but remain accountable for overall nursing care and management. In order for delegation to be effective there must be someone who supervises. Supervision is the act of making sure that the work that has been delegated has been performed effectively and the result has been communicated to the person who delegated the activity. In most cases Registered nurses are the ones who act as supervisors. In this abstract from the information science magazine Liu says, “For instance, a user cannot be