Shared governance is an organizational model defined as “. a structure within the professional nursing process that leads to positive outcomes for nurses, patients and organizations” (Church, Baker, & Berry, 2008, p. 36). The two main assumptions of shared governance models are: 1) the redistribution of decision-making power from managers to staff [nurses], and 2) nurses have an interest in participating in the decision-making process (Anthony, 2004). The scope of practice is in place to ensure patient care and maximize health outcomes. When nurses practice outside their area of practice, responsibility to themselves, the patient or family, peers, the institution or society is at risk. Knowledge of the AFN ensures accountability. Cox and Beeson (2018) describe accountability as “. the willingness to take responsibility for results and behaviour” (p.
25). If nurses are accountable for their actions, they have promised to take this step, which leads them to learn from their mistakes and successes. People don`t hold others accountable, it`s the individual`s job to be held accountable. Nurses are accountable to their employers by following their rules and regulations and fulfilling their professional obligations. Because nurses must be responsible for the laws set out in the NPA, they must ensure that the organization`s policies do not conflict with NPA regulations. Nurses risk breaking regulations if they do not regularly check the NPA. Nurses are also responsible for monitoring unauthorized personnel and will be held accountable. Nurses can improve accountability to their employers by taking an active role in organization-wide committees focused on improving care. To meet the growing health needs of patients living longer with chronic diseases and complex disease processes, we must be professionally responsible for expanding our clinical capabilities and consistently implementing evidence-based practice outcomes to guide our care interventions. Continuing clinical competence requires active participation to acquire and maintain the skills required to provide exceptional care to our patient population. Be present in the moment at every professional training session, without personal distractions.
This focused interaction allows us to clarify key issues that may impact patient safety and outcomes. Mentor and support your colleagues as they learn to perform new tasks to build confidence and verify that their practice meets organizational standards. Nurses practice and act according to a learned code of ethics that they implicitly follow when making judgments about care. Nurses practice according to the principles of fidelity (fidelity, honesty), respect for dignity, work and autonomy of patients when they act. Nurses are responsible for making judgments about care. When nurses take responsibility for their patients, they fulfill their commitment to practice with compassion and respect for patients. The ANA (2010a) states: “The moral standard of the profession is that nurses must adhere to themselves and their colleagues in order to be held accountable for their practice” (p. 46). Some of the key areas of responsibility for professional care include: Caregivers need to be aware of the high risk of alcohol and illicit substance dependence for themselves. If nurses observe impaired practices or unsafe patient care by a colleague and believe misconduct (e.g., medication diversion), nurses must be willing to report this unethical behaviour. Reporting such behaviour to the authorities is called whistleblowing. Whistleblowing is defined as “the disclosure of illegal, immoral or illegitimate practices under the control of their employers by current or former members of the organization to individuals or organizations that may be able to take action” (Near & Miceli, 1985, p.
4). Protecting patients from harm is one of the guiding principles of the nursing profession. Nurses and their patients must ensure that they pay attention to and report altered practices. More information on whistleblowing is available on the ANA website. Nurses play an important role in shaping the nursing profession by formulating their own policies and laws. Nurses work together to define the scope of the profession, standards of care, licensing, entry into practice, and more. Many organizations, both federal and private, have created programs to improve the quality of health care, including in the United States. Agency for Healthcare Research and Quality, The Joint Commission, National Patient Safety Goals und das Institute for Healthcare Improvement.
The Institute of Medicine (IOM) and the Quality and Safety Education for Nurses Institute (QSEN) are two organizations focused on safety in nursing education. Scientific evidence shows the gap in quality of care, and these organizations (and others) work from different angles inside and outside the health care system to reduce the frequency of unsafe and low-quality care. According to the American Nurses Association (ANA) Code of Ethics, “Responsibility means being accountable to yourself and others for your actions.” Accountability in nursing requires nurses to follow an ethical code of conduct based on the “principles of loyalty and respect for the dignity, worth and self-determination of patients.” Conclusion: Emergency caregivers need to manage their responsibilities in difficult situations on a regular basis, after being treated according to patterns of four main themes in most situations. Nevertheless, all of these factors have been influenced by nursing workload, a pervasive factor that has always been considered by emergency room nurses when making decisions. Accountability can be observed in all aspects of nursing practice, such as: Responsibility to peers is also referred to as shared responsibility. Shared responsibility occurs when team members support each other, work together to ensure a safe work environment, and serve as role models to demonstrate a culture of respect. When caregivers need to talk about a concern, they need to do so in a constructive and caring way. Communication with team members should be consistent without causing embarrassment or annoyance. When team members constantly share feedback with each other, it reinforces the desire for a supportive and cohesive team. The goal is to create an environment in which proposals for change are expected and become the norm. Building a culture of trust, respect and support leads to a healthy work environment and safe, high-quality patient care (Battié & Steelman, 2014). As described earlier, autonomy emphasizes nurses making independent decisions about care based on their knowledge, judgment and experience.
Autonomy is linked to accountability, because nurses who make independent decisions, or any other decision, are responsible for their actions.