Accountability

Question 1

What are the four pillars

Answer 1

Professional
Ethical
Legal
Employer

Question 2

The first pillar of accountability- professional

Answer 2

Allows nurses to work within a framework and to follow principles of conduct
Promotes the wellbeing/welfare of patients through nursing care
The NMC is responsible for setting out the standards of conduct for nurses
Creates minimum standards of professional behaviour
Clause 1.3 states ‘ you are personally accountable for your ‘practice’ regardless of advice or direction given by other professionals

Question 3

The second pillar of accountability- ethics

Answer 3

Ethical rules may be set rules decided by society that cover everyone
Society may allow conscientious objection to some activity in healthcare
Nurses have their own moral values that guide their practice and should know when they are being compromised and need awareness of their own set of values and limitations
Based on the ethical principles of; beneficence, non-maleficence and justice (Beauchamp & Childress, 2009)

Question 4

Third pillar of accountability- legal

Answer 4

The law is a set of rules, regulations & cases that provide interpretation of the rules and regulations that apply to society
Two systems of law;
Civil- set out arrangements between two private party’s. sanctions include paying compensation I.e employer dispute or falls claim
Criminal- the system is designed to assess that the rules set by parliament are followed by everyone. Sanctions may involve fines or imprisonment to punish the perpetrators
Inexperience is no defence to negligence
The law will protect patient autonomy over professional paternalism
Nurses have a legal duty of care
You will be judged against the standard that would be expected of a competent practitioner
Employers have a statutory responsibility to ensure all staff are trained and supervised to provide care to a legal standard

Question 5

Fourth pillar of accountability-Employment

Answer 5

The employment contract sets out responsibility and rights, duties and expectations , policies and protocol, terms and conditions for the nurse and employer
Disciplinary measures can be taken by each party if employee thinks they are being treated unfairly or employer believes nurse is not behaving in a way covered by the contract - employment tribunals

Question 6

Summary of the 4 pillars

Answer 6

Useful framework as it enables professionals to assess their boundaries in relation to nursing practice
Provides clarity in limits and responsibilities and allows nurses to consider implicTions of their actions
Chief executives are responsible for the quality of our services

Question 7

RCN and accountability

Answer 7

Nurses have a duty of care
‘ all practitioners must ensure they perform competently and that they don’t work beyond their levels of competence. They must inform a senior member when they are unable to perform competently

Question 8

RCN to be accountable nurses must;

Answer 8

Have the ability to perform the activity or intervention
Accept responsibility for doing the activity
Have the authority to perform the activity through delegation and the policies and protocols of the organisation

Question 9

Hunt (1994)accountability is……

Answer 9

Accountability is the readiness or preparedness to give explanation/ justification to relevant others for ones judgement , intentions , acts and omissions when appropriately called upon to do so
Can be
Upwards- what employers expect
Lateral-self regulation in which practitioners are accountable too and judged by peers
Downwards - what the patients expect

Question 10

Walsh (1997) accountability involves…

Answer 10

Explaining and justifying actions on sound evidence this means decisions must be;
Logical and replicable and Autonomous
Whereas responsibility is seen as performing the tasks that are delegated

Question 11

NMC 2015- accountability and delegation

Answer 11

Be accountable for your decisions to delegate tasks and duties to others
Only delegate tasks that are in the persons scope of competence making sure they fully understand your instructions
Make sure everyone you delegate a task to is adequately supervised and supported
Confirm the outcome of any task delegated

Question 12

Who are students accountable too?

Answer 12

Ethically and legally accountable

Accountable to their seconding trust and to the university

Question 13

Who created the four pillars of accountability?

Answer 13

Caulfield (2005)