10 Ways to Demonstrate Accountability in Nursing Practice

Written By: Darby Faubion BSN, RN

Are you a nurse who desires to become the best you can be? Do you look for ways to improve patient outcomes and promote nursing as a profession? Being accountable is one way all nurses can have an impact on patients, their healthcare teams, and the nursing profession. Perhaps you are wondering, “How can nurses demonstrate accountability in nursing practice?” As you continue reading, you will learn what accountability in nursing means, find 10 ways to demonstrate accountability in nursing practice and discover the consequences a lack of accountability can bring.

What Does Accountability In Nursing Practice Exactly Mean?

Accountability is defined as the acceptance of responsibility for honest and ethical conduct. Accountability in nursing practice is integral to professional practice. It is concerned with weighing the interest of patients with diverse health issues while using professional judgment, knowledge, skills, and evidence-based practices to make decisions that promote positive patient outcomes.


Why Accountability Is Important In Nursing Practice?

When nurses understand and appreciate the importance of professional accountability in nursing, that awareness is naturally carried over into every aspect of practice. Nursing accountability is essential for the delivery of safe, effective patient care. The following are four reasons explaining why all nurses should strive to practice accountability.

1. Accountability in nursing helps foster trusting relationships between patients and nurses, which can positively influence patient outcomes.

It is easy to build relationships with people dedicated to hard work and who take responsibility for their actions. When patients believe their nurses are trustworthy and dependable, characteristics of accountability in nursing practice, they are more likely to divulge sensitive information, which helps nurses develop appropriate care plans and promotes better outcomes.

2. Nurses who hold themselves accountable set themselves up for success.

Employers value nurses with high levels of integrity, which is a crucial characteristic of accountability in nursing practice. When you take personal responsibility for yourself and your actions, your employer, team members, and patients know they can depend on you. The reliability and trustworthiness that come with accountability lead to increased chances for success in your current job and future professional endeavors.

3. A culture of accountability in nursing reduces the misuse of valuable healthcare resources.

Nurses who fail to realize the value of healthcare resources often make choices that negatively impact access to much-needed resources. One way to demonstrate accountability in nursing is to use resources for their intended purpose. Taking care of equipment, administering medications as prescribed, and documenting any supplies used in patient care also demonstrate accountability to your patients and employer. When nurses choose to use resources wisely, they contribute to reducing healthcare costs, making healthcare services more affordable for all patients.

4. Nurses who practice accountability can promote a positive reputation for the facilities where they are employed.

Patients are often asked to complete patient satisfaction surveys about the care they receive in healthcare facilities. When a patient is satisfied with the care she receives, it increases the likelihood of them providing positive feedback, which has a positive impact on the reputation of the healthcare team and facility. However, have you heard the saying, "One bad apple spoils the bunch?" Regarding nursing care, that saying may be interpreted as meaning one nurse who makes poor decisions or fails to practice accountability can negatively impact the reputation of everyone on the healthcare team and the facility as a whole.

What Are The Four Core Components Of Accountability In Nursing Practice?

Accountability in nursing can be demonstrated in all aspects of patient care. There are several characteristics associated with accountability, including dependability, confidentiality, acting as a patient advocate, and ensuring best practices are followed. Accountability in nursing practice can be classified under one of four core components, as defined below.

1. Professional Accountability:

The Code of Ethics established by the American Nursing Association defines professional accountability as being answerable to oneself and others for one’s own actions. Nurses have a formal obligation of accountability placed on them by their Nurse Regulatory Board and must be willing to accept professional responsibility for the care they provide.

2. Legal Accountability:

All nurses should be mindful of their legal responsibilities related to the role of patient care. Nurses are personally accountable by law for their actions and/or omissions and have a legal obligation to provide care within their Scope of Practice. Further, legal accountability in nursing includes the responsibility of nurses to know what tasks or duties may be delegated to others and the care with which they make decisions regarding delegation.

3. Ethical Accountability:

This component of accountability in nursing practice relates to the nurse’s responsibility to provide for patients and to maintain the patient’s best interest as a priority. Ethical responsibilities in nursing include beneficence, respect, non-maleficence, fairness, and honesty.

4. Employment Accountability:

Nurses should practice accountability to their employers. While there is usually an assumption that employer and employee goals are the same, if opinions differ, nurses must choose how to respond. It is imperative that nurses understand accountability to employers should not require them to conduct themselves in a manner that is against legal or ethical guidelines for nursing practice. Likewise, employers should strive to create an atmosphere that fosters professional, legal, and ethical accountability in all nurses.


There are endless opportunities to demonstrate accountability in nursing practice. The following is a list of 10 best ways nurses can demonstrate accountability in nursing practice.

1. Work within your Scope of Practice.

The nurse’s Scope of Practice is in place to help maximize patient health outcomes and safeguard patient experiences. When nurses work outside their Scope of Practice, patients, coworkers, healthcare facilities, and society are at risk. Working within the Scope of Practice is one of the best ways to demonstrate accountability in nursing practice.

2. Accept responsibility for yourself and your actions.

You cannot make other people act responsibly, but you can accept responsibility for your own behavior and work ethic. Practicing accountability in nursing requires a willingness to acknowledge your role in situations, good or bad. When you demonstrate personal accountability, it becomes easy to build strong relationships with employers and peers, which can positively impact patient outcomes.

3. Follow policies and procedures as established by your employer.

Nurses demonstrate accountability to employers by following policies and procedures. It is vital for nurses to understand that policies and procedures are not meant to replace legal limitations in nursing practice as set forth in the Nurse Practice Act. Any nurse with questions about a policy or procedure’s legality or legal limits should verify any facility policies they believe conflict with Nurse Practice Act regulations.

4. Accept correction or instruction from supervisors when needed.

Everyone likes to be complimented or told they are doing a good job. It is not always easy, though, to accept correction. Being accountable in nursing means being willing to listen to team leaders or managers and learning from them. While no one has a right to demean you or make you feel embarrassed, supervisors who approach you with your and your patients' best interest in mind and who treat you with respect will appreciate any effort from you to improve.

5. Stay up to date with professional nursing standards.

Any nurse can work a 12-hour shift and go home. Nurses who genuinely care about patients and their careers understand the importance of accountability in nursing practice. A vital step in practicing nursing accountability is to be aware of changes related to professional nursing practices. A few ways nurses can stay up to date are joining a nursing association, reading nursing journals or magazines, joining social media platforms, subscribing to podcasts, taking continuing education courses, and attending nursing conventions.

6. Use evidence-based practices when providing patient care.

Evidence-based practice (EBP) is described as the judicious and conscientious use of current best evidence combined with clinical expertise and patient values to guide health care decisions. Evidence-based practices use scientific research necessary to make crucial decisions for patient care. Using evidence-based practices, nurses can understand the effectiveness or potential risks associated with patient care. Using EBP is an excellent way to demonstrate accountability in nursing practice. To effectively apply evidence-based practices, nurses are encouraged to formulate care-relevant questions, identify knowledge gaps, research literature when needed, and involve the patient in clinical decision-making when appropriate.

7. Implement accountability safeguards.

All nurses should strive to implement accountability safeguards within their professional roles. Accountability safeguards include utilizing quality improvement, peer review, and research to help ensure safe, high-quality patient care.

8. Complete tasks assigned to you before leaving work.

We all have days that seem to run out of hours before our work is finished. When you are tired or stressed, you may be tempted to clock out at the end of your shift and let someone else take up the slack from your unfinished work. Can you imagine what would happen if one nurse on each shift did this each day? Eventually, it could lead to significant problems. Accountability in nursing practice means acknowledging that everyone has a job to do and not shirking your responsibilities onto someone else. Granted, some employers may have rules restricting overtime, but before you leave a job undone, talk to your supervisor and ask how they want the situation handled.

9. Set personal and professional goals.

When you set goals and follow through with them, you create a habit of personal accountability. The more goal-oriented you become, the greater the level of accountability you will demonstrate. Those habits will become more natural with time, and you will experience the benefits in both your personal and professional life.

10. Provide safe, quality care to all patients.

Nurses are accountable to patients by fulfilling obligations set forth in the Code of Ethics and Scope and Standards of Practice. These documents outline the requirement of nurses to provide exemplary care to all patients in need of healthcare services.

4 Consequences Of Lack Of Accountability In Nursing Practice

A lack of accountability in nursing practice can have significant, far-reaching consequences. Nurses should strive to demonstrate accountability in all aspects of practice. The following are examples of consequences of lack of accountability in nursing.

1. Increased risk to patient safety:

In 2020, more than 750,000 cases of nursing error occurred in the U.S. Of those cases, nearly 90,000 resulted in patient death or serious injury. Nurses who practice professional accountability strive to provide safe, high-quality care to patients, reducing risks to patient safety.

2. Increased healthcare costs:

Nurses who practice irresponsibly contribute to the high cost of healthcare. These costs may be the result of lawsuits against the nurse or healthcare facility, or expenses related to an increased need for patient care directly related to nursing errors.

3. Poor nurse-patient and interprofessional relationships:

Patients want to be cared for by nurses who are professionally responsible. Healthcare providers want to work with peers who take their jobs seriously, and they can count on when they need a hand. Accountability in nursing means being dependable, and when nurses are not, relationships become strained.

4. Loss of job and/or nursing license:

Employers and the nursing profession demand accountability from all nurses. Unfortunately, when nurses lack accountability in professional practice, it can result in the loss of jobs or the loss of their nursing license.

Useful Resources To Improve Accountability In Nursing Practice

Nurses can implement measures to help improve accountability in nursing practice. There are several resources to give you ideas of how to improve personal and professional accountability. The following are a few examples of YouTube videos, podcasts, and books focused on accountability in nursing.

YouTube Videos

Let’s Talk About Accountability- Caring with Confidence: The Code in Action
Nursing Responsibility and Accountability


Accountability, Responsibility, and Developing a Questioning Attitude (Nursing in America)
How to Demonstrate Accountability in Nursing (Listen Notes)


Accountability in Nursing: Six Strategies to Build and Maintain a Culture of Commitment
Vital Notes for Nurses: Accountability

My Final Thoughts

I strongly believe all nurses should ask themselves and their peers, “How can nurses demonstrate accountability in nursing practice?” By asking yourself and others what you can do to be accountable, you show a genuine desire to promote positive patient outcomes and build better teams. Implementing the 10 ways to demonstrate accountability in nursing practice featured in this article will help show your dedication to patients, their loved ones, your peers, and nursing.

Darby Faubion BSN, RN
Darby Faubion is a nurse and Allied Health educator with over twenty years of experience. She has assisted in developing curriculum for nursing programs and has instructed students at both community college and university levels. Because of her love of nursing education, Darby became a test-taking strategist and NCLEX prep coach and assists nursing graduates across the United States who are preparing to take the National Council Licensure Examination (NCLEX).