DQ: Outline the concept of professional accountability as it pertains to nursing
“Accountability is defined as the acceptance of responsibility for honest and ethical conduct” ( Darby Faubion, 2022). I think that professional accountability in nursing refers to being aware and accountable for our nursing practice, work environment, and patient safety. Taking the responsibility to commit to and work through the nursing process to better the safety and health of our patients. The nurse is held to high standards, and I think we should be proud to obtain and keep these standards by being honest, ethical and accountable in our everyday practice. From clocking in on time, to procedures such as donning sterile gloves correctly, to being honest if a medication error occurs. We should be willing to accept professional responsibility and be forthcoming when we do not work within standard of care, or when an error occurs. Feeling a sense of pride in the nursing profession while being fully engaged in the work will demonstrate a sense of ownership.
When taking the oath to be a nurse, that nurse is accepting and dedicating themselves to being personally professionally accountable; thus, committing to their career to advance, grow, improve and adapt in the workplace (Sherman, Cohn, 2019). Nursing is an autonomous profession and maintaining accountability for oneself can not only allow the nurse to grow but the patient to grow through the nursing process and evidence-based practice. When setting up a sterile field for delivery, I need to be professionally accountable to perform sterile technique keeping the field sterile. I need to educate the patient and visitor, through evidence-based practice, not to touch or disturb the sterile field; keeping both myself and the patient accountable in continuing this standard of care. This is being responsible by following policy and procedures to work within scope of practice while meeting expectations in standards of care through evidence-based practice.
Durby Faubion. (2022). 10 Ways to Demonstrate Accountability in Nursing Practice. https://www.nursingprocess.org/accountability-in-nursing.html
Rose O. Sherman, Tanya M. Cohn. (2019, February, 20). Promoting Professional Accountability and Ownership.
Professional accountability is taking ownership of one’s nursing practice. Sherman & Cohn tell us that nurses are “responsible for the quality of their practice” (2019). What does that mean? It is an obligation that nurses have to continually learn, grow, and adapt to improve patient outcomes. Nursing is seen as a complex profession that requires continuing education, licensure, and certain specialized certifications therefore it is vital that nurses are held to standards that utilize evidence-based practice, collaboration with other members of the healthcare team (Sherman & Cohn, 2019).
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A nurse can exhibit professional accountability in many ways under many different circumstances. Whether that be through continuing education or keeping up with evidence-based practices (EBPs) to ensure positive patient outcomes. Nolan et. al. provide an instance where the causes of ventilated-associated pneumonia (VAP), which can cause an increased length of stay (LOS) as well as increased cost and morbidity were studied and interventions or strategies were put in place to improve outcomes (2010). Even though EBPs were effective, nurses were found to not be implementing them. Nurse accountability in this instance was not ideal. “Reasons for noncompliance with practice standards included fluctuating staffing and acuity levels, responsibility accorded to another professional, or simply forgetting – each pointing the finger elsewhere rather than accepting professional ownership and accountability” (Nolan, et. al. 2010).
The study that Nolan, et. al. provided used the Morbidity and Mortality Peer Review Conference (MMPRC) EBP model where peers review undesired outcomes and looks at process errors and solutions (2010). These MMPRCs were instrumental in finding better ways to ensure nurse compliance with EBP interventions. Not did patients experiencing a decreased LOS but cost to the hospital, which is directly correlated with LOS, decreased after the MMPRC was completed. “Nursing compliance with EBPs is essential to optimal patient care. The use of MMPRCs is one approach to improve professional accountability, ownership of clinical nursing practice, and quality outcomes (Nolan, et. al., 2010). This demonstrates how effective a nurse who exhibits professional accountability by using evidence-based outcomes can influence the quality of care for patients. The nursing process drives both accountability and EBPs by looking at the using assessment tools to identify the problem, think about ways to manage said problem, implement possible solutions, then evaluating whether or not they worked. MMPRCs demonstrate exactly how this process, when implemented correctly, works!
Nolan, S., Burkard, J., Clark, M., Davidson, J., Agan, D. (September 2010). Effect of Morbidity and Mortality Peer Review on Nurse
Accountability and Ventilator-Associated Pneumonia Rates. The Journal of Nursing Administration, 40(9), 374-383.
Sherman, R.O., Cohn, T.M. (February 1, 2019). Promoting professional accountability and ownership: Nursing leaders set the tone
for a culture of professional responsibility. American Nurse Today, 14(1).
Nursing is a highly regulated practice since care professionals must always act ethically and ensure optimal patient care. The nursing standards of practice provide nurses with a framework for their routine work to ensure they provide high-quality care and are accountable for their work. As Dickerson and Durkin (2022) stated, nursing practice standards reflect the desired performance level for nurses to ensure they engage in safe and clinically competent practice. Understanding the development process of nursing practice standards and their implementation should be a priority for nurses across states.
In Georgia, the state’s Board of Nursing is primarily mandated to develop the practice standards for registered nursing professionals. The process starts by defining the minimal standards of acceptable nursing practice. Next, the Board defines the major responsibilities of registered nurses in the nursing practice (Rules and Regulations of the State of Georgia, 2023). The standards are related to nursing professionals’ responsibility in applying the nursing process, as members of the nursing profession, and in conducting patient-related activities. The Board also reviews the standards as situations necessitate. Different entities are involved in developing the standards of practice. At the state level, Board of Nursing members are solely responsible for defining nurses’ roles and expectations. Other entities include the American Nurses Association and federal regulators. At all levels, the objective is to ensure safe, competent care.
Regardless of their specialties, nurses should be committed to delivering the best possible care to patients. One way to achieve this goal is to implement the nursing process that involves comprehensive assessment, diagnosis, planning, implementation, and evaluation (Werezak, 2023). Georgia’s standards of practice influence the nursing process for my specialty since it recognizes that it is the nurses’ responsibility to apply the nursing process. For instance, nurses are obliged to assess patients systematically and in an organized manner and formulate diagnoses based on accessible and recorded data (Rules and Regulations of the State of Georgia, 2023). The care plan should also include goals and nursing interventions derived from the nursing diagnosis. Applying the nursing process ensures patients receive high-quality care, whether being served by one nurse or a team of nursing professionals.
References
Dickerson, P. S., & Durkin, G. J. (2022). Nursing professional development standards of practice: Standards 1–6. Journal for Nurses in Professional Development, 38(4), 248-250. DOI: 10.1097/NND.0000000000000900
Rules and Regulations of the State of Georgia. (2023). Rule 410-10-.01 Standards of practice for registered professional nurses. https://rules.sos.ga.gov/gac/410-10
Werezak, L. (2023). What is the nursing process? nurse.org. https://nurse.org/education/nursing-process/