Professional Accountability and Patient Safety

This essay discusses the adverse effects of illegal activities in healthcare, such as breaching chaperone undertakings and providing false entries and departures. It explores the case of a nurse who breached her chaperone undertaking and the legal consequences she faced. The essay also highlights the importance of professional accountability and patient safety in nursing practice.

Running head: PROFESSIONAL ACCOUNTABILITY AND PATIENT SAFETY
Professional Accountability and Patient Safety
Name of the student:
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1Professional Accountability and Patient Safety
Introduction:
Breaching and illegal activities in the healthcare setting can lead to legal consequences such as,
fine, suspension and imprisonment. The aim of this essay is to evaluate the adverse effect of
illegal activities such as providing false entry and departure, absence during the shift timing or
absence if attentiveness if present. The patient in the case study are the female patient, which are
under consultation of a medical practitioner. The nurse had undertaken to act as a chaperone with
the medical practitioner under the medical board of Australia. On 23rd of September 2016, she
was referred to tribunal by the NMBA (Nursing and Midwifery Board of Australia ) in the case
of breaching the undertaking chaperone. She herself admitted that, she had been breaching the
chaperone undertaking from quite a long time. She admitted that, she had provided misleading
log about the chaperone to the Australian Health Practitioner Regulation Agency. She has also
provided wrong information regarding the entry and departure. The tribunal considered this as an
illegal behaviour and suspended her for 2 months and imposed a fine of $2000 (NMBA 2019).
Along with that, tribunal also imposed to undertake further education on the legal and ethics
obligation in nursing on her (AHPRA 2019).
Adverse action of the registered nurse:
In this case study, Ms Moyle had commenced with Medical Board of Australia that she
will act as a chaperone for a doctor at his consultation with the female patients. During the
period, she admitted on her own that she breached the chaperone undertaking that was
committed by her. She had also admitted that she was involved in the conduct of falsification of
departure and entries.

2Professional Accountability and Patient Safety
Due to the false entries and grave departure, she was not able to attend the consultant meeting
between the female patient and medical practitioner. Hence, she was not able to understand the
pain and worries of the patient. She also admitted that she mislead the AHPRA (Australian
Health Practitioner Regulation Agency) logs and the communication procedure. Due to such
unethical action, her registration was suspended for 2 months by the tribunal. Along with that, a
fine of $2000 and condition of getting education on the legal and ethics obligations in nursing
was also imposed on her (NMBA 2019).
Ms Moyle had breached the chaperone undertaking. She remain absent or if present, does
not attend the consultation between the general practitioner and the female patient. As she was
assigned to act as a chaperone for the general practitioner, it is her duty to assist the general
practitioner during the consultant, but she was not doing her work and misleading the logs of
AHPRA (Australian Health Practitioner Regulation Agency ). Instead of assisting the general
practitioner, she was breaching the chaperone undertaking by providing false logs, which was
objectionable and unethical (Griffith and Tengnah, 2017). Hence she needs to learn the legal and
ethics obligation in nursing, which was imposed on her along with fine and suspension by
Australian Health Practitioner Regulation Agency (AHPRA 2019).
In the health care setting it is required to be attentive in order to get the effective
treatment. To provide the patient care, the registered nurse standard of practice formulated by
NMBA (Nursing and Midwifery Board of Australia) should be considered. According to NMBA
(2019), (Nursing and Midwifery Board of Australia), standard 1- nursed should engage
themselves in professional and therapeutic relationship with the patient. This standard will be
fulfilled if the nurse will attend the patient. However in this case, Ms Moyle was not attentive

3Professional Accountability and Patient Safety
towards the female patient and hence is not able to engage in a therapeutic relationship with the
patent.
According to standard 5 of NMBA (Nursing and Midwifery Board of Australia),
registered nurse should comprehensively conduct the assessment. However in this case study,
she remains absent during the consultation session and assessment session. Hence she was not
able to justify the nursing standard formulated by the Nursing and Midwifery Board of Australia
(NMBA 2019).
System based approach that contributed to the adverse outcome:
Systemic based approach in the healthcare setting helps in providing better patient care
approach to the patient but failing of these approach can also lead to error in the information or
assessing of the data. It is the approach under which all the nurse, physician and all other health
care staff works. As the systemic based approach helps in assessing the data regarding all the
information of the healthcare setting, hence it should be error free and monitored regularly to
avoid any misinformation or if detected, it should be corrected immediately. Healthcare staff
taking negative advantage these for their own benefit should be suspended (AHPRA 2019).
In this case, Ms Moyle had used the log of AHPRA (Australian Health Practitioner
Regulation Agency), for her own benefit. She had been breaching the log of AHPRA and
provided false entries and departure in the log. She had admitted that, she had been doing this
repeatedly since quiet a long time and no one was able catch the falsification. From her statement
it can be stated that, there is a systemic gap in the log system due to which no one is able to
detect the false entries and departure of Ms Moyle, even though she had been doing this
repeatedly (NMBA 2019).

4Professional Accountability and Patient Safety
Such cases regarding the falsification of log has been reported frequently in the
healthcare setting. It is caused due to the error in system based approach that is used to maintain
the log system in the healthcare setting. Hence to avoid such cases of falsification, the system use
for maintaining the log should be improvised. Along with that the log system is monitored
regularly to avoid such falsification regarding the entry and departure (Griffith and Tengnah,
2017)
Apart from that, if the systemic based approach will be maintained regularly and
appropriately, the nurse will be able to assess more perfectly and hence will be able to design the
patient centre care (Archer et al., 2018).
According to NMBA (2019), assessing colleagues is an important part during the
assessment of the patient. In ensures that the highest standard of nursing practice is achieved in
the profession. During the assessing process, the nurse should be honest, fair without being
biased and constructive, and should not patient’s life at harm by conducting incorrect and
inadequate assessment (Dunphy et al., 2015).
Nurse should remain attentive during the assessment process to understand all the
complication and worries of the patient. If the nurse failed to do so, it can hamper the patient
health as well as can lead to ethical and legal obligations such as, fine, suspension and in extreme
cases it can also lead to imprisonment.
Action that should be taken to prevent the adverse outcome of the patient:
In this case study, Ms Moyle has breached the chaperone undertaking that has been
committed by her. She has committed that she will assist the general practitioner during the
consultation between the patient and the doctor. However she did not attended remain absence
during the period and also provide false entries to the log of AHPRA (Australian Health

5Professional Accountability and Patient Safety
Practitioner Regulation Agency). Due to that, the patient centred care is not provided to the
patient which is hampering the health of the patient as well as also violated the ethical rules,
standard and guidelines of the Nursing and Midwifery Board of Australia.
According to NMBA (2019), there are 4 key ethical principles of nursing which are, Non-
Maleficence, beneficence, autonomy and justice. According to these principles, the patient
should get benefit from the care or treatment, biasness will be avoided during the patient
treatment and each and every patient should get fair treatment. In addition to that, autonomy of
the patient should be maintained during the treatment in order to ensure privacy and respect of
the patient. Non- maleficence is also considered during the patient care treatment. If the nurse
will violate this rule it will negatively impact the health of the patient. In order to reduce the
negative adverse impact in patient health, nurse will be educated with the standard an guidelines
formulated by the NMBA (Nursing and Midwifery Board of Australia 2019).
According to the Nursing and Midwifery Board of Australia (2019), standard 1- nurses
should think critically and should analyse the nursing practice. Nurse should be educated about
the importance of the nursing practice and should be encouraged to critically and in the analysis
of the nursing practice. According to standard 2- nurse should engages in professional and
therapeutic relationship with the patient. Hence to prevent the adverse outcome the nurse should
be encouraged to engage in therapeutic relationship with the patient. To engage in such
relationship nurse should be attentive during the assessment and consultation. According to the
standard 3- should maintain the capability of the practice. In order to provide the best patient
care treatment and to avoid the adverse outcome, nurse should maintain their capacity and use it
to their fullest in the nursing practice. According to standard 4- nurse should comprehensively
conducted the assessment. Nurse should be educated and the awareness regarding the importance

6Professional Accountability and Patient Safety
of correct assessment should be created among them. According to standard 5– nurses should
develop nursing care plan after considering the patient’s medical situation. Hence to reduce the
adverse effect nurse should be educated about the importance of the patient care plan. Hence if
the nurse will understand the importance of cate plan in the apartment of the patient, they will
remain more attentive during the assessment of the patient and hence the cases about the false
entries and departure and reduced work time will decrease gradually. According to standard 6-
patient should be provided with safe and appropriate environment. Hence is can only be possible
if the nurse will remain active during the treatment of the patient. If not done, it can lead to
adverse effect such as risk of fall in elderly and disable patient will increase. According to
standard 7- outcome of the patient care will be evaluated and to do so they must do proper
assessment of the patient situation and based on that patient care planning will be formulated.
Apart from creating the awareness regarding the guidelines and standards that has been
formulated by the Nursing and Midwifery Board of Australia, nurse should also be educated
about the legal and ethical consequences of the such illegal action. They should be aware that if a
nurse will be found to be indulged in such unethical behaviour they can get suspended, have to
pay fine or should get imprisoned also (AHPRA, 2019).
Conclusion:
From the above essay it can be concluded that, misbehaviour or misconduct the nursing
practice can give rise to ethical and legal obligation. In the above essay, case of Ms Moyle is
discussed and how she had breached the log of AHPRA (Australian Health Practitioner
Regulation Agency) by providing false entries and departure. She had violated the rule several
times and due to this unethical behaviour has been suspended from the nursing practice for 2

7Professional Accountability and Patient Safety
months and fine of $2000 was imposed on her. Falsifying of the entries and departure not only
violates the conduct of the nurse, but will also hamper the quality of the patient care. If the nurse
will not remain attentive and active during the assessment she will not be able to formulate the
care plan and hence patient care will be hampered. Such illegal activities occur due to the lack of
proper education regarding the rules and guidelines of NMBA (nursing and midwifery board of
Australia) and the legal and ethical consequences of indulging in such illegal behaviour. Along
with that error in the systemic based approach such as the system that maintains the log of the
healthcare is also responsible for such misconduct. Hence in order to avoid such illegal
behaviour in the health care setting, nurses should be educated with the registered standard of
nurse such as, engaging in therapeutic relationship with the patient, developing a care plan and
comprehensively conducting the assessment. In addition, awareness regarding the legal and
ethical consequences of such behaviour should also be created among the nurses.

8Professional Accountability and Patient Safety
References
AHPRA, 2019. Australian Health Practitioner Regulation Agency - Guidelines for advertising
regulated health services. [online] Ahpra.gov.au. Available at:
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guidelines.aspx [Accessed 14 Apr. 2019].
Archer, J., Stevenson, L., Coulter, A. and Breen, A.M., 2018, November. Connecting patient
experience, leadership, and the importance of involvement, information, and empathy in the care
process. In Healthcare management forum (Vol. 31, No. 6, pp. 252-255). Sage CA: Los Angeles,
CA: SAGE Publications.
Dunphy, L.M., Winland-Brown, J., Porter, B. and Thomas, D., 2015. Primary care: Art and
science of advanced practice nursing. FA Davis.
Griffith, R. and Tengnah, C., 2017. Law and professional issues in nursing. Learning Matters.
NMBA, 2019 Nursing and Midwifery Board of Australia - Registered nurse standards for
practice. [online] Nursingmidwiferyboard.gov.au. Available at:
https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/professional-
standards/registered-nurse-standards-for-practice.aspx [Accessed 14 Apr. 2019].
NMBA, 2019. Nursing and Midwifery Board of Australia - Tribunal suspends nurse for failing
to provide chaperoning for doctor. [online] Nursingmidwiferyboard.gov.au. Available at:
https://www.nursingmidwiferyboard.gov.au/News/2019-02-15-chaperone-doctor.aspx [Accessed
14 Apr. 2019].