Patient Autonomy, Patient Safety And Risk

Accountability means:” being accountable for one’s own action”. The American Nursing Association (ANA) states in its code that the nurse will assume accountability for individual nursing judgments and actions. Professional nurses are accountable in several areas including accountability to the public, client, profession, employer, and self (Hood, 2010, p. 307). All professional nurses have the responsibility to work within their scope of practice to provide the best possible care to patients. Nurses’ should have a thorough knowledge about their accountability in specific areas of practice. The level of responsibility and accountability depends on professional levels. A nursing supervisor has more responsibility than a charge- nurse. A

Patients have the right to self-determination and individuals should have control over their own lives. With respect for human autonomy comes respect for patient rights. Apart of the nurses job is to promote, advocate and protect the rights, health, and safety of our patients. Patients have the right to determine their health needs, make informed decisions, and the right to information regarding their treatment and also the refusal of treatment. Nurses are obligated to know the rights of a patient and to make sure the patient understands their treatment plan. Supporting patient autonomy includes making decisions in the best interest of the patient, considering their values and recognizing differences between cultures. In the treatment

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 the task, the nurse is at fault because she delegated that procedure and she is ultimately accountable for patient outcomes.

Every health professional has a legal obligation to patients. Nurses as part of the health care team share an important role in the quality and safe delivery of patient care. They have the major responsibility for the development, implementation and continuous practice of policies and procedures of an organisation. It is therefore essential that every organization offer unwavering encouragement and resources to support their staff to perform their duty of care in every patient. On the other hand, high incidences of risk in the health care settings have created great concerns for healthcare organizations. Not only they have effects on patients, but also they project threat to the socioeconomic status. For this reason, it is expected that all health care professionals will engage with all elements of risk management to ensure quality and safe patient delivery. This paper will critically discuss three (3) episodes of care from the case study Health Care Complaints Commission [HCCC] v Jarrett [2013] Nursing and Midwifery Professional Standards Committee of New South Wales [NSWNMPSC] 3 in relation to Registered Nurse’s [RN] role as a leader in the health care team, application of clinical risk management [CRM] in health care domains, accountability in relation to clinical governance [CG], quality improvement and change management practices and the importance of continuing professional development in preparation for transition to the role of RN.

This article discusses about the process of nursing delegation. For the process of nursing delegation, it must have strong communication, empowered staff, and organizational support. The guidelines identify 5 rights of delegation, which include right task, right circumstances, right person, right direction & communication, and right supervision & evaluation. When a delegator, such as a nurse, delegates, they will remain responsible for the tasks that were delegated. Delegation of an action/task is done based on the patient’s safety and their quality of care. Following the process enables a nurse to appropriately delegate to benefit the care of the patient.

The nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation of tasks consistent with the nurse’s obligations to provide optimum patient care. (Bosek & Savage, 2007, p. 59) The nursing student realized that she wasn’t an expert in pharmacokinetics and requested the help of a pharmacist to provide quality care for her patient. (Bosek & Savage, 2007, p. 59) Delegation is a huge responsibility and should never be taken lightly. The duty of the nurse is to ensure the patient receives quality care. This means delegating responsibilities to others to ensure that care is met. If a nurse feels she is unsure of a certain area of care, that nurse is obligated to find the precise person who can provide that care. The author’s daughter (Bella) was in the hospital for a reoccurring MRSA infection. When the nurse walked in the door they were asked a question regarding infectious disease protocols and how best to handle the situation. Instead of giving an answer they thought might be correct, the nurse requested that an infectious disease doctor be called in to answer all questions concerning the patient.

Management needs to empower nurses to speak when they feel there is a safety issue

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 is defined as, "being responsible and liable for actions or failure of actions of oneself or others in the context of delegation" (NCSBN, 2009). This is in reference to the nurse's legal liability for the actions taken and patient outcomes. Accountability and responsibility are different, as 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

To begin with the person is the centre of the plan, to be consulted with and their views must always come first: It should include all aspects of their care, and every professional should work together to provide it. (Leathard 2000) Autonomy refers to an individuals’ ability to come to his or her own decisions and requires nurses to respect the choices patients make concerning their own lives (Hendrick 2000).However Gillon Argues that the principle respect for autonomy may need some restriction, otherwise we may be morally obliged to respect an autonomous course of action with unthinkable consequences.( Gillon 1986) Every human being has an intrinsic value, they all have a right to well being, to self-fulfilment and to as much control over their own lives as is consistent with others (British Association of Social Workers 2002).Professional Judgement and patient preference cannot be suspended if practice is to be safe and effective rather than routine(DOH 2005) Alex had to attend this session as it was within his Timetable, how could it have been effective?, he was unhappy and

Nurses are undoubtedly one of the most trusted professionals worldwide. Patients, family members, and doctors entrust nurses to provide the utmost quality care to sick individuals. Top priorities of all nurses are advocacy for their patients: including advocating for their physical health, holistic welfare, and utmost importantly, their safety. Patient safety will always be the top priority when providing patient care. The nurse’s responsibility during every patient encounter is to ensure that each patient under her care, receives no harm. As a direct result of the previous statement, it is crucial that every nurse knows their rights to refuse unsafe patient assignments, the process to refuse unsafe patient assignments, and the legal or ethical ramifications that could present themselves if proper judgement is not used. By understanding these rules, nurses not only achieve the responsibility of advocating for patient safety but also safeguard their careers and license.

Care within the hospital has become very complex and challenging as nurses are being faced with taking critical decisions associated with care of seriously

Nursing is an all encompassing profession in which practitioners are not only proficient in technical medical functionality, they also have the obligation to remain compassionate and respectful of patients and as such are expected to adhere to pre established codes of ethics. Of these ethics, autonomy is of extreme importance as it offers patients a sense of personal authority during a time where they may feel as if their lives, or at the very least their health, is no longer under their control. Autonomy in the context of nursing allocates the patient and often their family with the final word on the course of treatment. The concept of patient autonomy is a highly variable subject in all fields of health care. It is a universal concept that varies widely in its meaning and interpretation. Autonomy in its simplest form can be defined as a state of independence or self governing (Atkins, 2006). Patient autonomy can also be defined as the ability to make once own decisions, based on one’s sound judgment. It is defined by the American Nurses Association (ANA, 2011) as the "agreement to respect another 's right to self determine a course of action; support of independent decision making." This seemingly straight forward ethical concept is rife with difficulties when one considers potential disagreements that may arise even when informed consent is provided, particularly among children or vulnerable people. Relevant research and

A professional nurse is one who puts the needs and importance of patient care above all others. While striving for professionalism, nurses need compassion, patience, empathy, strong moral and ethics, accountability and the commitment to always act in the best interest of their patients. Nurses are held accountable for providing quality, safe, and effective nursing care (Hood, 2014). A professional nurse has the responsibility to continually improve and implement nursing standards while maintaining integrity by involving themselves in various tasks. Regular involvement in reading professional literature and sharing of evidence- based research with other healthcare personal helps increase knowledge and skills. This nursing ability can be used to encourage the actions of others in the healthcare team resulting in improved patient care. Nurses should encourage each other to become involved in hospital committees, provide an environment to encourage the discussions of ethical dilemmas, promote professional growth of nurses to voice their concerns and share viewpoints to address issues. “A professional nurse should expect to commit to a life of continuous learning growth and development”. (Hood, 2014, pp. 29). Nurses choose this profession to help others. As professional nurses we must maintain our ethics, values, characteristics, and commitment to drive our profession forward (CCN, 2015). Nurses must be autonomous, accountable, and be able to delegate to unlicensed assistive personnel. Being autonomous as a nurse means having control over their practice (Hood, 2014). It allows a nurse to take risks while being held accountable for ones’ actions (Hood, 2014).

Patient safety which is the amount to which patients are free from unintentional injury has established a great deal of media attention during the past few years. Regulatory and professional agencies have specified that patient safety education should be given to healthcare workers to improve health results. The primary purpose of this essay was to gain a better understanding of the present status of patient safety consciousness among those that work in the health care setting... Risk Management Issue

Autonomy applies to the profession of nursing because the patient should always be allowed to make decisions regarding their care while being treated with respect and dignity; however, autonomy can serve as a limiting agent when the patient decides to refuse care that would be of benefit to them. Autonomy is a sensitive issue because it allows the patient to choose to die and all health care can do from that point is allow the patient to do so comfortably. With healthcare always being one step ahead, it allows a surrogate to serve as a voice piece for that patient when they are unable to make decisions. However, that surrogate can end up making decisions they think is best for the patient ignoring the patients’ will. The responsibility of the nurse and interdisciplinary team is to inform and educate the patient and patient’s surrogate on all aspects of care to include medical diagnosis, treatment, and care plan so that the patient and