Accountability / Responsibility

CONSIDERING: ACCOUNTABILITY, RESPONSIBILITY AND PROCESS

Any decision to delegate nursing and midwifery tasks and duties using this framework is underpinned by seven elements that should be applied to each decision. They are:

  1. Accountability
  2. Responsibility
  3. Process which comprises the right:
    1. Task
    2. Circumstance
    3. Person
    4. Direction
    5. Support and evaluation

  • Accountability

    Accountability in the context of nursing and midwifery delegation means that a registered nurse or midwife is answerable for choices, decisions and actions measured against a specified standard or standards.

    For those who are delegating nursing and/ or midwifery tasks and duties this includes accountability to consider and adhere to:

    • Professional Standards
    • Employment Standards
    • the delegation decision making process

     

    and for confirming

    • the safety, quality and experience of outcome against the described standard.

     

    For those individuals who are accepting the delegated task or duty (delegatee), being accountable for their own actions includes adherence to:

    • the described professional standards
    • employment standards
    • acting within organisational policies and procedures
  • Responsibility

    symbolResponsibility in the context of delegation of nursing and midwifery tasks and duties means that a registered nurse or midwife should be prepared and able to give an account of his or her actions for any decision to delegate. Delegators and delegatees have responsibilities to support a framework for decision making to delegate nursing and/or midwifery tasks and duties. They include that:

    The delegator has:

    • authority to delegate the task
    • competence relating to the task*
    • undertaken an assessment of need prior to decision making and obtained any required consent
    • undertaken a risk assessment as to whether or not the task is delegable in the particular circumstance
    • provided clear direction to the delegatee checking competence and understanding to carry out the task
    • provided the necessary level of supervision for the delegatee
    • ensured a process is in place to enable regular and ongoing review and evaluation of the outcome of the delegated task in the context of the ongoing assessment of clients changing needs.

     

    The delegatee:

    • confirms acceptance of the task
    • communicates the outcome (written and/or verbal)
    • understands the factors that inform the delegation decision making process
    • communicates or reports relevant changes to the delegator which may impact on safety or the outcome, taking into consideration the delegation decision making factors
    • maintains his/her own competence
    • works to the terms of his/her employment
    • works to the organisational policies and standards including raising and escalating concerns
    • adheres to relevant codes of practice.