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Concepts: Accountability and Advocacy

A diabetic foot ulcer is a complex condition that requires systematic treatment and attention on the part of the healthcare team. The role of the nurse is associated with the continuous oversight and the evaluation of the patient’s condition to develop an appropriate treatment strategy, which can include wound offloading, daily dressings, debridement when necessary, and therapy through antibiotics. Both accountability and advocacy are nursing concepts that may help further the care of patients with foot ulcers because they imply positive aspects of practice aimed at enhancing the process of care rather than complicating it.

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Accountability is considered a part of the professional nursing practice foundation and is applicable within the system of nursing paradigms. Accountability implies that professionals in the sphere of healthcare are answerable for their actions taken within the care process and act by an ethical conduct code (Smith & Karakashian, 2018). Such ethical conduct on the part of nurses implies the following principles of human dignity, beneficence, loyalty, and fidelity as well as patient autonomy. Cox and Beeson (2018) described nursing accountability as a “willingness to answer for results and behavior” (p. 25). When nursing professionals take accountability for their actions, they guarantee to own those actions, which leads to learning lessons both from mistakes and successes. With the help of accountability, nurses have the capacity of influencing a range of patient care access, ranging from daily living activities to collaboration with an interprofessional team. Therefore, accountable nurses focus on instilling the trust of patients not only in themselves but also in the nursing profession as a whole.

Advocacy is viewed as a pillar of the nursing practice. It has been shown that nurses usually instinctively advocate for their patients in both the workplace and community settings. Advocacy in the nursing profession implies preserving the dignity of patients, promoting their equality in the access and delivery of care, as well as providing relief from suffering. In addition, it implies ensuring that patients are given the right to make informed decisions about their health and subsequent treatment. Nursing advocacy in practice can take different forms, such as only providing additional information about the expected treatment process or supporting a patient emotionally and mentally through their recovery journey. As advocates of their patients, nurses are expected always to provide objective support and be careful not to show any bias in their attitudes toward patients’ conditions or treatment-related decisions.

Overall, both accountability and advocacy are the practice-specific concepts that are crucial for establishing a positive environment for treating foot ulcers in diabetic patients. By practicing accountability and advocacy, nurses have the opportunity to connect with their patients and develop a reciprocal relationship based on support and understanding. The assumptions related to nursing accountability and advocacy are the following:

  1. Accountability and advocacy challenges are embedded in everyday practice in a variety of nurse settings.
  2. There is an urgent need to strengthen nurses’ accountability and advocacy.
  3. Nurses must define the scope of their professional accountability and advocacy within the practice.
  4. Nurses are in an ideal position to strengthen the understanding of accountability and advocacy within the care process.
  5. Efforts to improve the understanding of both advocacy and accountability within the nursing setting have a direct influence on the quality of care and patient outcomes.


Cox, S., & Beeson, G. (2018). Getting accountability right. Nursing Management, 49(9), 24-30. Web.

Smith, N., & Karakashian, A. (2018). Accountability in nursing practice. Web.

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