What are the 4 areas of nurses accountability?

According to the code of ethics of the American Nurses Association (ANA), “Accountability means to be answerable to oneself and others for one’s own actions.” Accountability in nursing requires nurses to follow an ethical conduct code based in the “principles of fidelity and respect for the dignity, worth, and self-determination of patients.”

According to Joshua O’Hagan and David Persaud, writing for NursingCenter, accountability is important because it improves quality of patient care and creates more value for money spent on healthcare services. O’Hagan and Persaud note that accountability enhances the use of evidence-based practices, boosts learning and reduces variability in care. Learning the principles of accountability and how to apply them is a part of most online RN to BSN program.

The ANA states nurses are accountable for the judgments and actions involved in nursing practice, regardless of directives, policies or providers. However, organizations also need to create a culture of accountability that holds people to high standards.

According to O’Hagan and Persaud, creating a culture of accountability requires people to believe in the concept. Healthcare leaders should provide the training, tools, resources and performance feedback that nurses need to succeed.

Although definitions of accountability vary, Marcia M. Rachel, writing for American Nurse Today, states that accountability in nursing must include five concepts:

1. Obligation: a duty that usually comes with consequences.
2. Willingness: accepted by choice or without reluctance.
3. Intent: the purpose that accompanies the plan.
4. Ownership: having power or control over something.
5. Commitment: a feeling of being emotionally compelled.

Rachel goes on to say that creating an environment of accountability requires three elements:

1. Clarity: set clear and specific expectations, goals and metrics.
2. Commitment: after making a request, ask for a commitment or discuss alternative options.
3. Consequences: develop action plans for failure to commitments.

The ANA considers accountability in nursing a personal matter for nurses, regardless of organizational culture. Personal accountability includes factors such as the following:

• Commitment to doing your best.
• Learning best practices and advocating for patients.
• Taking responsibility for your mistakes and learning from constructive feedback.
• Actively supporting your teammates and helping them remember to honor their commitments.
• Serving as a positive role model.

Being accountable means making commitments and keeping them. An online RN to BSN program can introduce you to principles of accountability, and you can apply them to your own personal accountability as well as your workplace.

Learn more about the Arkansas State University online RN to BSN program.

Sources:

American Nurses Association code of Ethics for Nurses with Interpretive Statements. (n.d.). Retrieved from American Nurses Association: Code of Ethics for Nurses with Interpretive Statements

O’Hagan, J., & Persaud, D. (2009, April/June). Creating a Culture of Accountability in Health Care. Lippincott Nursing Center: Creating a Culture of Accountability in Health Care

Rachel, M. M., (2012, March). Accountability: A concept worth revisiting. American Nurse Today: Accountability: A Concept Worth Revisiting

Sherman, R. (2013, May 30). 5 Ways to Promote Professional Accountability in Nursing. Emerging RN Leader: 5 Ways to Promote Professional Accountability in Nursing

The concepts of responsibility, accountability and autonomy are intrinsically linked in determining the scope of nursing and midwifery practice. Nurses and midwives hold positions of responsibility and are, therefore, expected to be accountable for their practice. Responsibility and accountability are the cornerstones of professional nursing and midwifery practice, and are represented as a key principle in the Code of Professional Conduct and Ethics for Registered Nurses and Registered Midwives.

Responsibility is explained as the obligation to perform duties, tasks or roles using sound professional judgement and being answerable for the decisions made in doing this. A nurse or midwife who is considering expanding their scope of practice should realise that this will involve greater responsibility.

Accountability is understood as being able to give an account of one’s nursing and midwifery judgements, actions and omissions. Accountability is about maintaining competency and safeguarding quality patient care outcomes and standards of the profession, while being answerable to those who are affected by one’s nursing or midwifery practice.

Accountability means being answerable for the decisions made in the course of one’s professional practice. A nurse or a midwife should be able to give reasons for the decisions they make in their professional practice and should justify their decisions in the context of legislation, professional standards and guidelines, evidence-based practice and professional and ethical conduct.

Nurses and midwives are accountable both legally and professionally for their practice, that is, for the decisions they make and the consequences of those decisions. Nurses and midwives are accountable to the patient, the public, their regulatory body, their employer and any relevant supervisory authority. Legal accountability involves nurses and midwives being responsible for ensuring they have appropriate professional indemnity insurance, as patients have a right to expect them to hold this insurance in case there is a substantiated claim of professional negligence.

Accountability cannot be achieved unless the nurse or midwife has autonomy to practise. Autonomy refers to a nurse or midwife’s ability to “make some decisions within their own profession and their right and responsibility to act according to the shared standards of that profession” (Varjus et al. 2010). Professional autonomy stems from the ability to use various kinds of knowledge in a critical manner, which offers safe, quality health care to patients. Individual levels of autonomy can vary depending on legislative, organisational and individual factors.

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