The delivery of nursing care and service is essentially guided by principles of nursing professionalism. An essential role in the nursing profession relates to the autonomous practices that relate to self-direction in nursing care with emphasis on a system of professional functioning. Nurses need to imbibe leadership skills in view of the nature of their responsibilities, must strive constantly for professional development and for advanced learning in technical skills. Nurses are accountable professionally, which involves self-direction in nursing practices and the need to take lot of participative initiatives in inter professional education and practices. Nurses must be systems thinkers with the ability to support quality improvement initiatives as also in being able to bring about safe systems for health care and delivery. Nurses need to function within an exhaustive scope of practices that require them to be aware of the best nursing practices and evidence within the scope of their work. They are expected to evaluate and use appropriate evidence as also to encourage critical thinking at the points of care as required by their specific job requirements at the given time. The more time that nurses spend with their patients, results in better outcomes for them, which is an essential prerequisite in the principle of promoting nursing care. The nurses as a managers or administrators must maintain, establish and promote conditions of their employment in a way that enables their peers to function and practice in accordance with the best nursing standards and practices so as to bring about an environment that meets the guidelines and standards of nursing practices.
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Accountability with responsibility has often been referred to as comprising of a strong foundation in nursing practice as nurses are accountable for patient outcome in their care and in surgical experiences. Since accountability implies being answerable it is implied that nurses are answerable for their actions in regard to their duties and expectations from them. The provision also relates to the loyalty of nurses while on duty in supporting the rights of patients to be taken care of with competent nursing practices. The expertise and knowledge of nurses has to be embedded in their daily practice so as to be supportive of their accountability and responsibility. The acts of nursing practice in maintaining the required standards in regard to diagnosis, identification of outcomes, implementation, planning, evaluation and assessment indicate the foundation for nurses in detailing their accountability for the profession. These activities must be a part of the daily routine of nurses so that they are competently empowered to provide safe care to patients. Additionally nurses have the accountability to demonstrate before the nursing profession as also to the patients the maintenance of licensure and the ability to continuously gain knowledge in regard to new lines of treatment and technologies. Many authorities require nurses to demonstrate this ability before their licenses are renewed. In nursing practice, accountability also applies to their involvement in activities relating to delegation, teaching, research and administration. Nurses are accountable to their profession, to the public and to their employers, and are expected to take responsibility for their actions and decisions. Hence accountability is a major concern for nurses since they are responsible to provide cost effective, evidence based and good quality care.
- Laura C Harrington, Nursing Peer Review: A Practical Approach to Promoting Professional Nursing Accountability, 2008, HCPro
- Mike Walsh, Nursing Frontiers: Accountability and the Boundaries of Care, 2000, Butterworth-Heinemann
- Roper, Kristin, The Effect of Peer Review on Professionalism, Autonomy, and Accountability. 1997, Journal of Nursing Staff Development. 13(4):198-205
- Stephen Tilley and Roger Watson, Accountability in Nursing and Midwifery, 2004, Blackwell Publishing