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Accountability is an essential component of professional nursing practice; accountability also is an essential component of patient safety. The American Nurses Association Code of Ethics states that the definition of accountability is "to be answerable to oneself and others for one's own actions"1. As perioperative nurses, we are accountable to our patients and their family members, our colleagues, our workplace, and our profession. Because of this, perioperative nurses should hold themselves accountable for patient advocacy, continuity of care, lifelong learning, to colleagues, the nursing profession, and their organisation.
Patient advocate
Perioperative nurses have a responsibility to act on behalf of patients during times when patients cannot advocate for themselves, particularly during surgery or other invasive procedures when they may be unable to communicate their needs or wishes. This advocacy is based on the trust that the perioperative nurse builds during the preoperative assessment. It starts with understanding and communicating the patient's cultural and treatment preferences to other team members. For example, a patient may have religious preferences that preclude the administration of blood products or the implantation of human allograft tissue. As the patient advocate, the nurse needs to help ensure that the patient has the opportunity to discuss these preferences with the surgeon and anesthesia professional before the start of the procedure. The nurse also needs to understand the patient's preferences for communication with his or her family members during and after surgery. Understanding and honouring these preferences protects the patient's right to privacy. Advocacy also includes verifying that the correct patient is present and the correct procedure is performed and that it occurs at the correct site.
Advocacy includes the nurse speaking up on behalf of the patient in situations when safety issues arise. Speaking up needs to be done in a respectful, assertive manner that promotes high-quality care from the entire team. For example, when the perioperative nurse is aware of a breach in sterile technique, he or she is accountable to speak up and bring it to the attention of the scrubbed team members regardless of who is responsible for the break in technique or what that person's position or seniority may be.
Accountability relies on both clinical expertise and effective communication skills. Excellent clinical skills allow the nurse to identify...