Analysis of Scholarly(Peer-reviewed) resources on the topic of Nursing Accountability

Analyze Scholarly (Peer-Reviewed) Resources On The Topic Of Accountability

For this paper, the student will analyze scholarly (peer-reviewed) resources on the topic of accountability.  The paper will be 5 pages in length NOT including the title and reference pages.  In this paper, the student will define accountability as well as the ethics involved in nursing accountability.  Consider the Texas Board of Nursing regulations regarding accountability.  In addition, the student will discuss how the student nurse demonstrates accountability.  Finally, the student will discuss how accountability is demonstrated in the role of the registered nurse. 

Definition of Accountability

Accountability is a fundamental aspect of nursing that ensures the provision of timely, safe, effective, and patient-centric care efficiently and ethically by nursing professionals. Accountability in nursing has different definitions depending on the sources of the value, whether intrinsic or extrinsic to an individual, and the related outcomes. Similarly, individual perceptions of accountability vary from one nurse to another. The next sections provide a detailed discussion of the definition of accountability and ethics related to accountability. Descriptions of the Texas Board of Nurses regulations on accountability and how it can be demonstrated by the student and registered nurses are also provided. 

Three concepts are prominent in the assessment and discussion of accountability in nursing literature. They include transparency, responsibility, and answerability. Accountability can, therefore, be defined as the individual ability to act transparently, take responsibility for one’s actions, and willingly accept an evaluation of one’s conduct per the set standards (Drach-Zahavy et al., 2018, p.2452). It is also an assessment of the degree to which a nurse’s actions meet the organizational, legal, and ethical constructs that govern the profession. Nurses should confine their behavior, decisions, and actions within the provisions of the employing institution, professional body, society, and the state legislation governing contract, civil, and criminal proceedings. 

Nurses are answerable to themselves and others for their actions per the American Nurses Association (ANA) definition of accountability. ANA identifies accountability in nursing as owning up to one’s actions at an individual level and others (ANA, n.d). Improved accountability improves the performance of healthcare systems by creating a culture of trustworthy and evidence-based practice. Consequently, health systems exhibit positive professional relationships and enhanced regard for the individual well-being of the staff, quality of care, patient outcomes, and appropriate utilization of resources within the clinical settings. 

Ethics Related to Accountability

In nursing, accountability requires that nurses adhere to the code of ethics in the provision of safe and quality care. Ethics are defined as the moral principles that determine the behavior of an individual in specific environments (Haddad & Geiger, 2018). Ethics also govern the decision-making processes to be followed in the delivery of nursing services. ANA outlines nine provisions that constitute the nursing code of ethics. The first provision requires that nurses practice compassionate care while respecting the uniqueness and dignity of each patient and their representatives (ANA, n.d). Nurses are also obligated to treat their patients as their primary concerns in all dealings and advocate for their wellbeing per the second and third provisions.

The fourth and fifth provisions of the ANA Code of Ethics mandate that nurses should be accountable and responsible for making nursing decisions that ensure optimal patient care. They institute a nursing duty to self and others to maintain competence and professional growth. The provisions require that nurses undertake purposeful and well-planned decisions guided by the current trends in practice for optimal outcomes and enhanced professional growth (Haddad & Geiger, 2018). By improving one’s competency and professional standing, nurses contribute to the overall improvement of healthcare systems through fostering safety, quality of care, and conducive work environments. The outcome aligns with the sixth provision of the ANA Code of Ethics. 

Positive nursing outcomes at the individual and organizational level produce a ripple effect on policies governing healthcare. Accountability fostered by the ethics of professional development through scholarly inquiry and research impacts nursing and health policies at all levels (Haddad & Geiger, 2018). It also contributes to the reduction of health disparities and the protection of human rights in line with the seventh and eighth provisions of the ANA Code of Ethics. Further, accountability in nursing requires adherence to the ethics of collective effort through professional organizations in upholding the integrity of the profession and promoting social justice within the healthcare system (ANA, n.d). The realization of socially just health and nursing policies can be achieved by ensuring political awareness among professionals through continuous professional growth. 

The Texas Board of Nursing Accountability Regulations

The Texas Board of Nursing functions to ensure that every licensed nurse in the state of Texas is competent and able to practice safely. Among the strategies employed by the board in promoting accountability is the regulation of the issue of practice licenses to nurses (Huynh & Haddad, 2020). Occupational licensing of nurses ensures that practicing professionals meet the criteria for having received training from an accredited nursing institution. It also demonstrates theoretical and practical competence to practice upon passing the board exams and background checks. 

The Texas BON requires that nurses renew their licenses every two years. The strategy fosters adherence to the codes of conduct and practice standards among nurses for the continuation of their practice. It also ensures that academic institutions meet the curriculum specifics that serve the best interests of the patients and the public (Huynh & Haddad, 2020). Regulation of licensure also allows continuous evaluation of the performance of nurses against the standards of quality and safe patient care. The implementation of such measures helps to keep nurses keen and responsible for their actions in a bid to keep their licenses. 

The Texas BON is also responsible for conducting investigations into any issues brought to its attention about nurses’ practice. The information is obtained during regular collection and analysis of nurse workforce data and through notices from patients, their representatives, and other healthcare practitioners (Huynh and Haddad, 2020). The board makes determinations based on a careful evaluation of the situation and decides the type and terms of disciplinary action to be applied. The board records the actions in the National Practitioner Data Bank where it is accessible to all authorized agencies. The measures improve accountability among nurses in a bid to avoid the negative consequences of poor performance. 

Demonstration of Accountability by a Student Nurse

The alternation between academic and real-life scenarios can make student nurses unsure of their boundaries in offering safe and evidence-based patient care. However, as Griffith and Board point out, accountability in nursing means that all nurses are legally obliged to take responsibility and be answerable for their actions and mistakes, regardless of whether they were acting on their own accord or others (2018, p.607). Student nurses able to justify their actions in clinical settings demonstrate professional accountability. Accountability by student nurses supports registered clinicians in sufficiently meeting the demands of their dual roles as care providers and student supervisors (Milliken & Grace, 2017, p.523). Further, it enhances the students’ confidence in their abilities and skills to offer high-quality services. 

Student nurses can also demonstrate accountability by making ethical decisions within clinical settings. In nursing, ethical decisions are guided by sensitivity and adherence to the four principles of ethical practice, including respect for autonomy, beneficence, non-maleficence, and justice (Milliken & Grace, 2017, p.519). Integration of the student’s moral values in the provision of care and willingness to accept the consequences further enhances their accountability. Student nurses are bound to consult with their supervisors during decision-making processes as a show of accountability to them, their patients, and to the guidelines provided by the regulatory body of their profession. 

Awareness of self and the political, social, legal, and individual implications of one’s decisions and activities is another sign of accountability by student nurses. Poor decision-making among nurses may lead to the provision of substandard care (Milliken & Grace, 2017, p.517).  Careful analysis of the available options through consultation with others helps in overcoming barriers to effective decision-making experienced by student nurses. In other instances, the activities of a student nurse may be guided by intuition in the absence of empirical clinical data (Griffith & Board, 2018, p.608). Recognition of one’s cognitive skills and consultation with an expert before acting on such intuitions demonstrates accountability among student nurses in the provision of quality patient care. 

Student nurses can also demonstrate accountability by fulfilling their roles during clinical training and actively participating in all nursing activities under the oversight of their instructors. In so doing, weaknesses in the student nurses can be effectively identified (Leigh et al., 2020, p.632). The strategy ensures early implementation of interventions to overcome the challenges to avoid transference into long-term professional practice where their consequences can be detrimental. It also helps in improving independence by inculcating a sense of confidence and accountability for one’s actions. 

Demonstration of Accountability by a Registered Nurse

Registered nurses demonstrate accountability by conducting themselves professionally in the clinical setting. Professionalism is shown by competency, willingness to obey the standards of practice, and participation in continuing professional (Cusack et al., 2019, p.21). Professionalism also entails nurses’ engagement in safe clinical practices.  Professionalism fosters rapport with patients and colleagues while ensuring the provision of safe care at all times. 

Registered nurses can also demonstrate accountability by ensuring effective oversight of student nurses. Understanding the strengths, weaknesses, and needs of student nurses enables registered nurses to allocate duties and responsibilities best suited to their abilities to promote a safe care environment (McPherson & Wendler, 2020, p.513). The strategy helps to prevent detrimental outcomes through timely recognition of bad practices. The strategy motivates a focused implementation of corrective interventions to ensure the safety of the patients and improve care outcomes. 


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