Accountability Flashcards
What does the NMC code say about accountability?
2008 Code says accountable means responsible for something or to someone
The new code does not address accountability so directly except in the area of delegation
Responsibility is seen as …
Responsibility is seen as being liable to be called to account, answerable for, accountable for (Dimond 2005)
what does it mean to be accountable
Someone who is accountable is completely responsible for what they do and must be able to give a satisfactory reason for what they do
Accountable- requiring or expected to justify actions or decisions, responsible
what does it mean to be responsible
To be responsible for- to have control and authority over something or someone and the duty of taking care of it or them
Responsible- having an obligation to do something, or having control or care for someone as part of their job or role
as nurses what are we accountable for?
- Professionally accountable to our professional body NMC
- Contractually accountable to our employers
- Accountable in law for our actions as professionals- criminal law
- civil law
what is professional accountability
“Professional accountability is fundamentally concerned with weighing up the interests of patients and clients in complex situations, using professional knowledge, judgment and skills to make a decision and enabling you to account for the decision made.” (UKCC 1996)
Accountability is part of professional practice- we are called upon to use our professional knowledge experience training and skills in order to make many clinical and managerial judgements
Professional accountability includes delegation- we must make sure the person is able to do he job and the level of support and supervision is appropriate
The 2008 code stated what about professional accountability?
“ As a professional, you are personally accountable for actions and omissions in your practice and must always be able to justify your decisions.”
The Code 2015 says you must recognise and work within the limits of your competence. To achieve this, you must…
accurately assess signs of normal or worsening physical and mental health in the person receiving care
make a timely and appropriate referral to another practitioner when it is in the best interests of the
individual needing any action, care or treatment
ask for help from a suitably qualified and experienced healthcare professional to carry out any action or procedure that is beyond the limits of your competence
take account of your own personal safety as well as the safety of people in your care
complete the necessary training before carrying out a new role.
The Code 2015 says you must always offer help if an emergency arises in your practice setting or anywhere else. To achieve this…
only act in an emergency within the limits of your knowledge and competence
arrange, wherever possible, for emergency care to be accessed and provided promptly, and
take account of your own safety, the safety of others and the availability of other options for providing care.
The Code 2015 says you must act without delay if you believe that there is a risk to patient safety or public protection. To achieve this…
raise and, if necessary, escalate any concerns you may have about patient or public safety, or the level of care people are receiving in your workplace raise your concerns immediately if you are being asked to practise beyond your role, experience and training
tell someone in authority at the first reasonable opportunity if you experience problems that may prevent you working within the Code
acknowledge and act on all concerns raised to you, investigating, escalating or dealing with those concerns where it is appropriate for you to do so
do not obstruct, intimidate, victimise or in any way hinder a colleague, member of staff, person you care for or member of the public who wants to raise a concern, and
protect anyone you have management responsibility for from any harm, detriment, victimisation or unwarranted treatment after a concern is raised.
The Code 2015 says you must Raise concerns immediately if you believe a person is vulnerable or at risk and needs extra support and protection. to do this….
Take all reasonable steps to protect people who are vulnerable or at risk from harm, neglect or abuse
Share information if you believe someone may be at risk of harm, in line with the laws relating to the disclosure of information, and
Have knowledge of and keep to the relevant laws and policies about protecting and caring for vulnerable people.
The Code (2015) states the nurse must Be accountable for your decisions to delegate tasks and duties to other people- how can you achieve this
Only delegate tasks and duties that are within the other person’s scope of competence, making sure that they fully understand your instructions
make sure that everyone you delegate tasks to is adequately supervised and supported so they can
provide safe and compassionate care, and
confirm that the outcome of any task you have delegated to someone else meets the required standard.
In law we can be found to be negligent if ________________________________________
Professionally we could be found guilty of misconduct and removed from the register, even if ________________________________
In law we can be found to be negligent if a person suffers harm because we did not care for them properly
Professionally we could be found guilty of misconduct and removed from the register, even if the patient suffered no harm
what (legally) is duty of care
“You must take reasonable care to avoid acts or omissions which you can reasonably foresee would be likely to injure your neighbour. Who is your neighbour? The answer seems to be persons who are so closely and directly affected by my act that I ought to have them in contemplation as being so directly affected when I am directing my mind to the acts or omissions which are called in question”
Legal duty of care may vary according to the circumstances, we would have a legal and professional duty of care as a nurse to a patient in our charge, we may have a different duty of care to a passer by in the street
describe the bolam test
“ The test is the standard of the ordinary skilled man exercising and professing to have that special skill. A man need not possess the highest expert skill at the risk of being found negligent…. It is sufficient if he exercises the skill of an ordinary competent man exercising that particular art”
Is the care I am giving equivalent to that which would be given by a competent trained nurse in my situation. Thus we do not have to measure ourselves against expert care but by accepted practice.
however can be argued that this standard in law may change with the expectations of evidence based practice, best practice guidelines and so forth. the new code is far more directive about the quality of care that can be reasonably expected of us as professionals now
