Accountability in Nursing and Midwifery

by Tilley, Stephen; Watson, Roger

• ISBN13: 9780632064694
• ISBN10: 0632064692
• Edition: 2nd
• Format: Paperback
• Copyright: 2004-07-23
• Publisher: Wiley-Blackwell

Summary

The second edition of Accountability in Nursing and Midwifery addresses current issues and key concerns in accountability, focusing on accountability in the four main branches of nursing (adult, child, learning disabilities and mental health), as well as in midwifery, community nursing, and nursing management. In an increasingly litigious society, the ethical and legal implications of accountability are growing and it is important that nurses understand the implications for everyday practice.

Author Biography

Stephen Tilley is a Senior Lecturer in Nursing Studies at the University of Edinburgh.

Roger Watson is a Professor of Nursing in the School of Nursing, Social Work and Applied Health Studies at the University of Hull.

Table of Contents

Contributors	xi
Preface	xiii
1 Introduction	1	(8)
Roger Watson and Stephen Tilley
Historical perspective	1	(1)
An accountant looks at nursing	1	(1)
Accountability and clinical governance	2	(1)
Accountability and the law	2	(1)
A policy perspective	3	(1)
An NHS trust perspective	3	(1)
A manager speaks	4	(1)
Caring for children	4	(1)
Learning disabilities	5	(1)
Midwifery	5	(1)
Community nursing	6	(1)
Mental health nursing	7	(1)
Research	8	(1)
Conclusion	8	(1)
2 The Development of Nursing as an Accountable Profession	9	(12)
Susan McGann
Introduction	9	(1)
Historical perspective	9	(1)
The British Nurses' Association	10	(1)
Mrs Bedford Fenwick	10	(2)
Professional registration	12	(1)
Matrons' Council of Great Britain and Ireland	12	(2)
Political perspective	14	(1)
Early registration bill	15	(1)
The war	16	(2)
Registration Act 1919	18	(1)
Conclusions	19	(2)
3 Accountability and Clinical Governance in Nursing: a Critical Overview of the Topic	21	(17)
Kerry Jacobs
Introduction	21	(5)
Accountability	26	(4)
Accountability and reform	30	(2)
Clinical governance	32	(4)
Conclusion	36	(2)
4 Accountability and Clinical Governance	38	(9)
Roger Watson
Introduction	38	(1)
Clinical governance	39	(1)
Why do we have clinical governance?	39	(3)
Poor care	42	(1)
Short cuts	43	(1)
Trust	44	(1)
Conclusion	45	(2)
5 The Legal Accountability of the Nurse	47	(17)
John Tingle
Introduction	47	(2)
The concept of accountability and the new NHS	47	(1)
Accountability is not irrelevant	48	(1)
Labels can obscure meanings	48	(1)
Ideas behind the label	48	(1)
This chapter	48	(1)
Legal accountability	49	(6)
Interests, rights and duties: the role of the law	49	(1)
The Ms B. case	49	(1)
Dispute resolution, compensation and punishment	50	(1)
Establishing nursing negligence	50	(1)
Vicarious liability	51	(1)
The aim of the law: compensation	51	(1)
Clinical negligence law today: all change?	51	(1)
Regulation, deterrence and education: the role of the law	52	(2)
Evidence-based healthcare and the courts	54	(1)
The scandals of recent years	54	(1)
The law affects all aspects of nursing	55	(1)
The various forms of accountability	55	(8)
Accountable to whom?	56	(1)
Accountability and sanctions	57	(1)
The allocation and management of healthcare resources: the nurse's role	58	(1)
A conflict of accountability	58	(1)
The role of the law: legal accountability	59	(1)
Cases of resource and negligence	59	(4)
Conclusion	63	(1)
6 Accountability and Clinical Governance: a Policy Perspective	64	(13)
Tracey Heath
Introduction	64	(1)
Background: the NHS pre-1997	64	(2)
The Labour Government's challenge	66	(4)
Practising within an era of increasing accountability	68	(1)
Towards a modern and dependable NHS: the Labour Government's response	68	(2)
Accountability and clinical governance	70	(4)
Organisational accountability	70	(4)
Reflections on the broader policy context	74	(2)
Conclusion	76	(1)
7 Accountability in NHS Trusts	77	(10)
Stephen Knight and Tony Hostick
Introduction	77	(1)
Clinical governance	77	(9)
Responsibilities of trusts	78	(4)
Professional self-regulation	82	(2)
A systematic approach to decision making	84	(1)
Implications for practice	84	(2)
Conclusion	86	(1)
8 Accountability and Clinical Governance in Nursing: a Manager's Perspective	87	(12)
Linda Pollock
Introduction	87	(1)
Background context	87	(1)
Clinical governance as a concept	88	(3)
The meaning of clinical governance	88	(1)
Our interpretation of clinical governance	89	(2)
Has clinical governance made a difference?	91	(5)
Clinical governance and its impact at board level	91	(1)
Clinical governance structures as a vehicle for change	92	(1)
Clinical governance and people governance	93	(2)
Clinical governance and its impact on nursing	95	(1)
Clinical governance and cultural change	96	(3)
Sharing good practice	97	(1)
Evidence-based practice - the reality	98	(1)
9 Working with Children: Accountability and Paediatric Nursing	99	(18)
Gosia Brykczyñska
Introduction	99	(1)
Definition of paediatric nursing	100	(1)
Ability	101	(2)
Obligations	103	(1)
Involving parents	104	(2)
Autonomy of children	106	(1)
Authority	107	(1)
Free will and choice	108	(1)
Power and political action	109	(2)
Responsibility	111	(1)
Responsibilities for treatment	111	(2)
Consequences of responsibility	113	(1)
Responsibility of parents and children	114	(2)
Conclusion	116	(1)
10 Accountability and Clinical Governance in Learning Disability Nursing	117	(15)
Bob Gates, Mick Wolverson and Jane Wray
Introduction	117	(1)
Clinical governance in learning disability nursing and guidelines for practice	118	(5)
Consent	120	(1)
Interdisciplinary working	120	(1)
Evidence-based practice	121	(1)
Advocacy	121	(1)
Autonomy	121	(1)
Relationships	122	(1)
Confidentiality	122	(1)
Risk assessment and management	122	(1)
The challenges of effectively implementing clinical governance in services for people with learning disabilities	123	(4)
Fragmented partnership working	125	(1)
User and carer involvement	125	(1)
The spectrum of need	126	(1)
Quality of life	126	(1)
Solutions to the barriers associated with implementing clinical governance in learning disability services	127	(4)
Conclusion	131	(1)
11 Where does the Buck Stop? Accountability in Midwifery	132	(11)
Rosemary Mander
Introduction	132	(1)
What is meant by accountability?	133	(1)
To whom is the midwife accountable?	134	(5)
Institutional accountability	135	(1)
Accountability to the woman	136	(1)
Personal accountability	136	(1)
Professional accountability	137	(1)
Hierarchy of accountability	138	(1)
Accountability and autonomy	139	(1)
What are the prerequisites for accountable midwifery practice?	140	(1)
What are the implications of the midwife being accountable?	141	(1)
Conclusion	141	(2)
12 Accountability in Community Nursing	143	(14)
Sarah Baggaley with Alison Bryans
Introduction	143	(1)
Organisational and policy issues affecting the accountability of community nursing	143	(2)
Current issues in community nursing	145	(2)
Resource allocation and skill mix	145	(1)
Delegation and skill mix	145	(2)
Legal and professional issues in community nursing	147	(1)
Clinical governance	148	(2)
Clinical effectiveness and evidence-based practice	149	(1)
Role developments	150	(2)
Nurse prescribing	152	(1)
Primary healthcare and public health nursing	153	(3)
Conclusion	156	(1)
13 Clinical Governance, Accountability and Mental Health Nursing: an Emergent Story	157	(13)
Stephen Tilley
Introduction	157	(1)
Review of themes from Tilley (1995)	158	(6)
The centrality of the topic	158	(2)
Accounts	160	(1)
Accounting	161	(1)
Accountability	162	(2)
Accountability and clinical governance	164	(3)
The role of the mental health nurse in clinical governance	167	(3)
14 Accountability in Nursing Research	170	(20)
Alison Tierney and Roger Watson
Introduction	170	(1)
Research as a responsibility of an accountable profession	170	(1)
Accountability in nursing research	171	(2)
Nurse researchers as nurses	172	(1)
The importance of accountability in research	172	(1)
To whom are nurse researchers accountable?	173	(14)
Accountability to the sponsor	174	(2)
Accountability to research ethics committees	176	(2)
Accountability to research participants	178	(4)
Accountability to research 'gatekeepers'	182	(3)
Accountability to (and of) the profession	185	(1)
Accountability to the wider public	186	(1)
Tensions of multiple accountability	187	(2)
Conclusion	189	(1)
Appendix Code of Professional Conduct	190	(8)
(Reproduced with permission of the Nursing and Midwifery Council)
References	198	(18)
Index	216