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Accountability And Responsibility (Nursing)

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Accountability and Responsibility

The National Council of State Boards in Nursing defines delegation as "transferring to a competent individual the authority to perform a selected nursing task in a selected situation" (National Council of State Boards of Nursing, Resources section, 4). When delegating, the registered nurse (RN) assigns nursing tasks to unlicensed assistive personnel (UAP) while still remaining accountable for the patient and the task that was assigned. Delegating is a management strategy that is used to provide more efficient care to patients. Authorizing other individuals to take on nursing responsibilities allows the nurse to complete other tasks that need tended to. However, delegation is done at the nurses' discretion and is a personal choice. Nurses must make careful decisions regarding delegation, taking into account the skill and training of the UAP, the difficulty and risk of the task, and the patient's condition. The expected outcomes, a time frame for completion, and any limitations should be explained to the UAP at the time that the task was delegated.

Accountability and responsibility are two important parts of delegation. Accountability is defined as, "being responsible and answerable for actions or inactions of self or others in the context of delegation" (National Council of State Boards of Nursing, Resources section, 4). This refers to the nurse's legal liability for her actions and patient outcomes. Responsibility is defined as the "reliability, dependability, and the obligation to accomplish work. Responsibility also includes each person's obligation to perform at an acceptable level, the level that the person has been educated" (Kelly-Heidenthal, 2003, p. 268). Accountability and responsibility differ, because responsibility belongs to the person doing the task and accountability belongs to the person who assigned the task. The nurse is both accountable for the task being completed and is also responsible for evaluating the task or the results of the task. Therefore, within every delegated procedure, both the nurse and the UAP hold responsibility, yet only the nurse is accountable. If a procedure is done wrong or the patient is harmed by



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