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Asked by: Ramonita Gramaca asked in category: General Last Updated: 23rd May, What is accountability and responsibility in nursing? What are the 4 pillars of accountability? These four pillars for accountability — responsibility, answerability, trustworthiness and liability — create a strong platform for work and life. How do you show accountability in nursing?
Provide direction about how work should be accomplished. Develop clear standards and metrics against which professional performance is measured. Hold professionals accountable for their behavior. Build a culture of accountability. How do you explain accountability? Accountability is an assurance that an individual or an organization will be evaluated on their performance or behavior related to something for which they are responsible.
The term is related to responsibility but seen more from the perspective of oversight. What is the best definition of professional accountability? Why is accountability necessary in nursing?
As such, it's a vitally important part of health care. The RCN has provided information on accountability and delegation for all members of the nursing team. Why is it important to be accountable? Accountability eliminates the time and effort you spend on distracting activities and other unproductive behavior. To be accountable, one needs the authority to be able to decide whether to act and how to act.
A practitioner cannot be accountable if told how to carry out an action and is not able to make the decision on the way the action is to be performed or even whether the action should be carried out at all. When these preconditions are present, one can then be held accountable for the actions one takes. Figure 2. From Bergman, R. Accountability — definition and dimensions. Int Nurs Rev , 28 2 : Reproduced with permission from Blackwell Science Publishers.
Professional accountability involves accepting responsibility for professional decisions. The RCN suggests the following working definition of professional accountability for nurses:.
It is that obligation on the practitioner that binds her [sic] to a code of conduct, based on the expectations of society that she will use her discretion and skill to safeguard her patients and act in every way to uphold professional standards.
This obligation, and the values of the profession provide a framework for professional and ethical behaviour within which nurses must personally and professionally conduct themselves and within which the primacy and vulnerability of those served is observed and protected.
In view of the substantial clinical role of practitioners, the Standards of conduct, performance and ethics for registrants HCPC , NMC b appropriately focuses on professional accountability to patients and clients. Generally, practitioners are in little doubt about their professional accountability towards their patients and clients.
It was not until the publication of the NMC Standards to support learning and assessment in practice NMC a , that accountability for student learning and assessment in clinical practice started to receive due attention.
There can be few health care practitioners who are not in some way involved in the training and supervision of others. These roles are frequently part of the contract of employment. NMC registrants who support pre-registration nursing or midwifery students and make summative assessment decisions are termed mentors. The educational role of nurses and midwives in clinical practice is formalized by the NMC in the Standards to support learning and assessment in practice NMC a.
These standards specify the responsibility and accountability of NMC registrants who are mentors to pre-registration nursing and midwifery students. Those registrants on the NMC register who make summative assessment decisions that determine whether students have met the relevant standards of proficiency for entry to the register must be on the same part or sub-part of the register as that which the student is intending to enter NMC a.
Also, they must hold professional qualifications equal to, or at a higher level than, the students they are supporting and assessing. Additionally, the designation of sign-off mentor has been introduced to sign-off proficiency for all nursing students at the end of the programme. In addition to the possession of the other criteria of a sign-off mentor, a sign-off mentor must have clinical currency and capability in their field of practice and an in-depth understanding of their accountability to the NMC for the decision to pass or fail a student NMC a , section 2.
However, the HCPC recognizes that there are other appropriate practice placement educators whose backgrounds do not match the specific profession that the student is studying. For example, occupational therapists may supervise physiotherapy students in areas such as hand therapy, and nurses may supervise radiographers in aseptic techniques HCPC a The requirements for training, supervision and support of pre-registration health care students, and the concomitant assessment of learning, mean that more and more practitioners must take on these roles.
However, an awareness of the potential pitfalls and problems associated with these roles may prevent grief from arising. The rest of the chapter therefore examines accountability issues surrounding the assessment of clinical practice; there is an exploration of the moral and legal obligations that practice educators have to fulfil. The rights of learners and why they have legal means of redress will be explained. Before going on to explore this section, consider the questions posed in Activity 2.
What are practice educators responsible and accountable for? Who are practice educators responsible and accountable to? In its document Making a Difference Department of Health , the government made it clear that it wants practitioners who are fit for purpose, with excellent skills and the knowledge and ability to provide the best care possible in a modern National Health Service NHS.
The point was made that every practitioner shares responsibility to support and teach the next generation of health care professionals. Both the NMC b and the HCPC a expect that students who complete pre-registration programmes must have met the standards of proficiency. To enable the fulfilment of these professional requirements, practice educators need to be cognizant of their responsibility and accountability for the supervision and assessment of clinical practice.
The following section examines WHAT the practice educator is responsible and accountable for when supervising and assessing learners. For nurses and midwives, direct reference is made to professional accountability for the support and supervision of learners, and, by inference, the assessment of standards of practice, in the NMC Standards of conduct, performance and ethics NMC b.
The Standards state:. The NMC states:. As a professional, you are personally accountable for actions and omission in your practice and must always be able to justify your decisions. As an autonomous and accountable professional, you need to make informed and reasonable decisions about your practice to make sure that you meet the standards that are relevant to your practice.
Both sets of Standards also make it clear that, if you delegate work to someone, your responsibility and accountability is to make sure that the person who does the work is able to carry out your instructions safely and effectively and that proper supervision and support are provided.
The NMC further state that nurses and midwives must also confirm that the outcome of any delegated tasks meets required standards. It is suggested here that the practice educator can be answerable for standards of personal professional practice, with its inevitable impact on learning, and the following aspects of supervision and assessment:.
It is discussed in Chapter 1 that one purpose of assessment in pre-registration health care education is as a form of quality control for the outcome of the educational process. The educational and professional outcome is a nurse or midwife or physiotherapist or social worker, and so on, who is able to apply knowledge, understanding and skills to perform to the standards required in employment. This professional must have met the standards of proficiency, and prior to entry to the NMC and HCPC professional registers; students must also meet the standards of conduct, performance and ethics, and the health and character requirements of registration.
The full realization of this outcome is dependent on the successful achievement of both theoretical and clinical learning and professional development measured by assessment. Assessment is an integral part of professional health care programmes. The processes of clinical teaching, learning and assessment are complex.
The committed input of practice educators is required to plan and implement these processes if learning outcomes are to be achieved successfully. Role modelling is an important Fowler , Pollard , Spouse , Wood , and an almost inevitable, learning strategy in this environment. Within social learning theory, Bandura suggests that, in role modelling, one person sets a pattern of behaviour that is then copied by another.
Learning takes place constantly from observing role models deliver care — these practices are subsequently emulated Charters Students who worked alongside knowledgeable and respected practitioners developed an enthusiasm and commitment to their professional development that was unparalleled by any other learning experience Spouse It is therefore important for the practice educator to adhere to high standards of professional practice so that students learn this high standard of care and are assessed against these professional practices.
A high standard of care from students cannot be expected if this is not role modelled. Without modelling high standards of practice one aspect of professional and moral accountability will not be fulfilled.
The usual relationship that exists between a student and a practice educator is hierarchical in nature. Neary pointed out that many practice educators take for granted their position of power in the assessment relationship. Students felt powerless in challenging practice owing to their lack of status and the fear of jeopardizing their clinical assessment and securing a job. This assumption is of course open to debate.
Hepworth expressed her disagreement when she said that:. Our assessments, then, are likely to be based on our own standards of practice and perceptions of the situation. Therefore, as practitioners who are also practice educators, there is the responsibility for maintaining competent practice so that assessments are made against these standards.
Furthermore, in exercising professional accountability, the NMC b and the HCPC require their practitioners on the professional registers to maintain and improve professional knowledge and competence.
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