NRS 430 Topic 4 Discussion Question 2
NRS 430 Topic 4 Discussion Question 2
Outline the concept of professional accountability as it pertains to nursing. Provide examples of how a nurse demonstrates professional accountability in clinical expertise, the nursing process, and evidence-based practice.
Re: Topic 4 DQ 2
Accountability means to be answerable to oneself and others for one’s own actions. In order to be accountable, nurses act under a code of ethical conduct that is grounded in the moral principles of fidelity, loyalty, veracity, beneficence, and respect for the dignity, worth, and self-determination of patients (Smith &Karakarshian, 2018). Accountability helps Nurses improve patient quality, work within the evidence-based practice and improve clinical skills. It also created a good work environment and helps overcome challenges and provide direction to work. For example, a critical fall has to be in CT by the designated door time, it is the nurse’s responsibility to make sure that patient is in CT STAT to avoid any serious complications due to a delay in care. Nurses also demonstrate professional accountability by having clear communication with their patient and listens to the patients’ needs and concerns. For example, an incontinent patient needs to be straight cathed for clean urine to rule out a UTI, some patients are opposed to this because of the discomfort and the unknown. In this case, the nurse is accountable for clearly explaining the procedure to the patient as well as working within the scope of practice and explain the importance of the clean sample and provide support to the patient through the process for positive patient outcome.
Smith, N., &Karakarshian, A. (2018, April 6). Accountability in Nursing Practice. https://www.ebscohost.com/assets-sample-content/NRCP_EBCS_Accountability-in-NursingPractice.
Bonnie, you are right. Accountability is associated with various advantages in nursing practice such as improvement of quality of patient care, fosters evidence-based practice, improves clinical skills, creates good working environment, and provides direction of work. Therefore, it is undeniable that accountability is a vital component of nursing practice and patient safety. Fundamentally, accountability aims at safeguarding the patients, health care providers, and employers from consequences of poor, negligent, and unsafe clinical practices. As such, accountability is a valuable part of health care, which can potentially lead to public trust in nursing practice (Dekker, 2018). Accountable nurses strive to create patient trust for an individual and the entire nursing profession as well. In turn, patients earn the trust of the nursing profession by observing nursing collaborating to ensure quality and positive patients’ outcomes. However, accountability connotes an intricate issue and nurses should strive to assess the professional practice relative to the requirements of patients and the critical nursing roles in health care system.
Dekker, S. (2018). Just culture: restoring trust and accountability in your organization. Crc Press.
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Re: Topic 4 DQ 2
The concept of professional accountability as it pertains to nursing can be viewed as taking responsibility for a set of activities and for
explaining or actions one’s actions (Emanuel & Emanuel, 1996). A nurse not reporting an adverse reaction or withholding care is not providing professional accountability as it pertains to nursing. Nurse’s accountability guides them to do the right thing by providing the highest patient care.
An example that can be seen in the nursing process with pic lines brings in clinical expertise, nursing process, and evidence-based practice. The procedure has to be done properly by infection control, washing hands, and following preventive measures of evidence-based practice (Sawyer et al., 2010). If the proper guidelines are not practiced the nurse needs to know she or he can be held responsible where the professional accountability comes into play. Hand washing, barrier protection, decontamination, and antibiotic stewardship are examples of guidelines for the prevention of infections set by The Joint Commission National Patient Safety Goals and the World Health Organization, and the Centers for Disease Control. Best practice can be seen when nurse-to-nurse shift change, prevention of infection, and patient care and discharge (“Handoffs: Implications for nurses – Patient safety and quality – NCBI bookshelf,” n.d.). Without proper communication, great mistakes can be made by nurses unaware of the current patient’s condition (“Patient Safety and Quality: An Evidence-Based Handbook for Nurses,” n.d.).
Handoffs: Implications for nurses – Patient safety and quality – NCBI bookshelf. (n.d.). National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK2649/
Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (n.d.). https://www.ncsbn.org/Defining_and_Assigning_Accountability.pdf.
Indeed, professional accountability in nursing plays a central role in directing nurses to provide appropriate care and ensure the provision of the highest patient care. Therefore, the organization should ensure the establishment of a culture of accountability to help in optimizing the benefits of accountability in professional nursing practice. Accountability should be a process within the organization that supports staff to accomplish it. It is imperative for nurses in leadership positions to consider a thorough reflection of accountability to help in setting the tone of the clinical setting and prompt an individual nurse to understand oneself better. The organization should set an environment that support nurses who make mistakes instead of finding faults to foster an environment where accountability can grow (Semper et al., 2016). Bringing punitive actions creates a barrier in creation of trust and sense of collaboration with peers. Accountability tends to thrive well with support, trust, and encouragement.
Semper, J., Halvorson, B., Hersh, M., Torres, C., & Lillington, L. (2016). Clinical nurse specialists guide staff nurses to promote practice accountability through peer review. Clinical Nurse Specialist, 30(1), 19-27.
Re: Topic 4 DQ 2
I believe professional accountability in the nursing field entails taking full responsibility for your patients as it relates to their total care and yourself as it relates to your actions. As a nurse, we are responsible for our nursing actions and decisions. We are responsible for patient care therefore we have a duty to be well versed with the nursing process. We have an obligation to continue education on our critical thinking and judgement skills. Nursing’s critical thinking is the ability to apply the nursing process effectively and purposefully to solve a problem (Green, 2018). These thinking skills permit us to focus on cause and effect of illnesses and diseases, which leads to improved patient care.
Accountability also refers to upholding ethical practices in nursing. Eight healthcare ethics are Autonomy, Beneficence, Fidelity, Justice, Nonmaleficence, Privacy, Confidentiality, Respect, and Veracity (Green, 2018). Autonomy is supporting a patient’s right to self-determination and supporting their own choices and values. Beneficence is doing good and taking care of our patients. Fidelity is being a loyal nurse and maintaining promises. Justice is avoiding favoritism and treating every patient with love and respect. Nonmaleficence is avoiding intentional harm to a patient. Privacy and Confidentiality are respecting a person’s private information and not sharing it with others. Respect is treating every patient equally and worthy. Veracity is being honest and truthful. (Green, 2018). Nurses must uphold these ethical principles with every single patient to gain professional accountability. We are also liable for ourselves. As professionals, we must make it a duty to care for ourselves so we can care for our patients. Nurses should make sure they have an adequate sleep, nutrition, and exercise schedule. Nurses should consistently educate themselves on nursing research and evidence-based practice. Education leads to improved nursing skill and application.
Green, S. Z. (2018). Advancing professional standards. In Grand Canyon University (Eds.), Dynamics in Nursing: Art and Science of Professional Practice. https://lc.gcumedia.com/nrs430v/dynamics-innursing-art-and-science-of-professional-practice/v1.1/#/chapter/4
Danielle, it is undeniable that nurses should be given continuous training on critical thinking and judgment skills to promote accountability in clinical practice. Critical thinking characterizes autonomous and interdependent decision making. It entails interrogation, analysis, synthesis, understanding, inductive and deductive reasoning, implementation, and creativity. Essentially, critical thinking in nursing is an integral component of quality nursing and professional accountability. Critically thinking nurses tend to demonstrate confidence, creativity, open minded, flexibility, contextual perspective, inquisitiveness, reflective, and perseverance. Moreover, critically thinking nurses possess cognitive skills of analysis, implementing standards, seeking information, futuristic, rational reasoning, and transformative knowledge (LoBiondo-Wood & Haber, 2017). Essentially, these attributes are critical in promoting the professional nursing accountability.
LoBiondo-Wood, G., & Haber, J. (2017). Nursing research-e-book: methods and critical appraisal for evidence-based practice. Elsevier Health Sciences.