Standards assure safe and effective care that is based on current evidence. Standards define good practice and set out expectations for practice.

Standards are often referred to as many other things, among them:

  • protocols
  • guidelines
  • guidance
  • best practice statements
  • benchmarks.

Standards and guidance present in the following ways:

standards and guidance for nurses

Accountability and delegation

The principles of accountability and delegation are relevant to all members of the nursing team.

Accountability

Accountability in terms of the NMC Code (2018), means being held to account for your actions and being able to explain how you used your professional judgement to make decisions, including decisions to delegate aspects of care. Under the Code you remain accountable for the decisions made by the people you delegate to.

You are expected to perform as competently and safely. You must also inform a more senior member of staff, or the nurse in charge of the shift, when you are unable to perform competently and/or safely.

Delegation

Delegation is the process by which the delegator allocates clinical or non-clinical treatment of care to a competent person. The delegator is accountable for the decision to delegate and remains accountable for the delegated task.

Registered nurses are responsible for managing the nursing care and are accountable for the appropriate delegation and supervision of care provided by others in the team.

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Nursing Workforce Standards

The RCN Nursing Workforce Standards are a set of 14 standards that are grouped into three key themes:

  • Responsibility and accountability
  • Clinical leadership and safety 
  • Health, safety and wellbeing

They set out what we expect from employers to ensure delivery of safe and effective care. These standards apply across all areas of nursing and all sectors within the UK.

Read more.

As a registered nurse, it is expected that you will know and understand your responsibilities to ensure that:

  • regulatory standards and legal policies/protocols are adhered to
  • guidance, best practice and benchmarks inform your practice decisions and interventions.

It is important that you consider how you will react in a situation where you, your team or the situation causes you to question the standard or guidance that exists.

Do not be tempted to take a risk that could harm you, your team, your organisation, and most importantly, your patient.

Reflection

Document

Reflect on a situation where you have had a difficulty or challenged a decision. 

How did you use your clinical judgement?

How was the decision informed by knowledge and understanding?

How did standards and guidance influence the decision?

Did the final decision feel right? 

Reflect on your intuition/instincts - do these influence your clinical judgement?

Raising concerns

We have developed a guide to make it easier for you to assess whether a situation you’ve witnessed or experienced should be raised as a concern, and to support you through the process of reporting it.

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Duty of candour

It is entirely possible that you will make mistakes. If you do make a mistake, report it to your preceptor or the nurse in charge. It might be difficult, but putting patient safety and honesty first is vital.

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