Provision 4
Nurses have authority over nursing practice and are responsible and accountable for their practice consistent with their obligations to promote health, prevent illness, and provide optimal care.
4.1 Responsibility and Accountability for Nursing Practice
Nurses are responsible for delivering competent, compassionate, person-centered care within their scope of practice. Responsibility and accountability in nursing practice are inseparable concepts. Ethical responsibilities are grounded in the profession’s values and goals. Nurses are accountable for fulfilling their ethical responsibilities. This includes choices to take or not take action. Systems and technologies that assist in clinical practice are adjunct to, not replacements for, the nurse’s knowledge and skill. Therefore, nurses are accountable for their practice even in instances of system or technology failure. Nurses are always accountable for their judgments, decisions, and actions; however, in some circumstances, responsibility may be borne by both the nurse and the institution, organization, or public entity. Nurses’ acceptance or rejection of specific role demands and assignments cannot be arbitrary but should be factually based on their education, knowledge, competence, and experience, as well as their assessment of the level of risk for patient safety.
Nurses ought to bring forward for discussion and review difficult issues related to patient care and/or institutional constraints upon ethical practice. The nurse acts to promote inclusion of appropriate individuals in all ethical deliberation. When patient care issues and institutional constraints are beyond nurses’ ability to remedy, they access resources such as ethics services, nursing organizations, and relevant literature as aids. Nurses have a responsibility to combat the dissemination of health misinformation and disinformation.
Nurses should be aware of regulatory documents relevant to their practice setting and region. Regulatory documents include nurse practice acts, standards of care, and state and federal laws. Nurses should seek advice when these regulations conflict or seem to conflict with patient or community interests. Nurses remain accountable for the outcomes of their decisions whether the impact is on patients, colleagues, and/or institutional operations. Nurses are also responsible and accountable for maintaining professional standards, engaging in professional development activities, and contributing to quality patient care endeavors such as staffing plans, institutional credentialing, and quality improvement.