Put simply, ‘accountability’ is about taking responsibility for your actions, always ensuring you are competent to do the activity you’ve been asked to perform, and always putting patients’/clients’ interests first.

What it means in practice is that whatever you do in your work as a health care assistant, you should be able to justify it as a sensible course of action. This means that whatever you do:

  • you should know why you’re doing it
  • you should have been properly trained and assessed as being competent to do it
  • you should be doing it as part of an agreed plan of care for the patient/client.

Even though you’ll always be working under the supervision of a registered member of staff who’s accountable for the overall care given by the team, you’re still accountable for what you do as part of the team.

You’re accountable to your patients/clients, to whom you owe what is called a ‘duty of care’. In health care, there will be times when your actions could cause harm to a patient/client if not carried out in a careful and competent way. There are also times when your failure to do something that a health care assistant would normally be expected to do – what is called an ‘omission’ – could also cause a patient/client harm. Health care assistants are legally accountable to patients/clients for any errors they make, or any acts they fail to take, that cause them harm, and patients/clients are entitled to pursue the case through the civil law. In very extreme cases, where a patient/client has died or suffered serious harm due to an error or omission, the case might be pursued through the criminal courts.

You’re also accountable to your employer, who must set out in your contract of employment the duties you’ll be expected to perform. You then become accountable to the employer for safely and effectively carrying out those duties, and failure to do so can result in disciplinary action. Your employer has accountability to you as well, however, and the RCN has suggested that employers must support you to carry out your duties safely and effectively by:

  • making your duties clear and ensuring you have the right training to carry them out safely and effectively
  • making the boundaries of your role very clear
  • providing agreed protocols to guide care delivery
  • ensuring you have adequate support and supervision in your role
  • offering you opportunities to develop in your role
  • making issues around delegation clear.

Accountability also means complying with the code of conduct for health care workers that applies to you in your country and any codes your organisation has in place – ask your manager or supervisor to advise you on what codes apply to you, then study them to make sure you comply.

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