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ABSTRACT
Nursing regulations exist to protect and benefit the health, safety, and welfare of the individual. Accountability is a multifaceted concept with many interpretations. All nurses are expected to engage in professional role activities appropriate to their education, experience, and position. Ultimately, nurses are accountable to themselves, their patients, and their peers for their professional nursing actions. This article addresses regulatory statutes and other issues of importance in the perioperative setting, including ethical and legal considerations, patient advocacy, delegation of tasks to unlicensed assistive personnel, and selected expanded roles in perioperative nursing practice. AORN J 70 (Aug 1999) 241-252.
Nursing regulations exist to protect and benefit the health, safety, and welfare of patients. State and federal legislation provide dynamic components to nursing practice in all settings. Accountability is a multifaceted concept with many interpretations and can be described as the professional nurse's ability and willingness to anticipate the results of one's actions, act accordingly, and be held accountable by one's peers. To be accountable means an acceptance both of the obligation to disclose and of dealing with the consequences of the disclosure.1 Embedded in accountable clinical practice is the concept of ethics. A nursepatient relationship is based on trust; trust that the professional nurse has the knowledge, skills, and abilities of a professional and trust that all that can be done will be done, or that an explanation will be given.2 All nurses are expected to engage in professional role activities appropriate to their education and position. Ultimately, nurses are accountable to themselves, their patients, and their peers for their professional actions.
Accountability cannot be delegated-you must answer for the care you give and also for the care you ask others to complete. This has become a very sensitive issue as more unlicensed assistive personnel (UAP) replace licensed staff in an effort to manage costs.
REGULATIONS, STANDARDS, AND CODES FOR PRACTICE
In 1915, the American Nurses Association (ANA) drafted its first model nurse practice act, and by 1923, all 48 states had enacted nursing licensure laws.3 Now, plans are underway to revamp nursing regulation in the United States, from the current single-state licensure model to a multistate licensure system. The model, known as the Mutual Recognition Model, has been proposed by the National...