Regulation and Accountability for Practice
The registered nurse’s practice flows through several levels of accountability in order to ensure safe competent practice. At the base of this pyramid of accountability is the Scope and Standards of Nursing Practice, developed and vetted by ANA on behalf of the profession. The Scope and Standards create the foundation for specialty practice standards and inform the State Nurse Practice Acts, which provide a second layer of accountability. Rules and regulations promulgated by individual states, based upon each state’s nurse practice act, may restrict the RN’s practice. Further restrictions upon practice occur because of the nurse’s accountability to the institution or agency for whom she/he employed, via institutional policies and procedures. A final level of accountability for RN practice occurs via the individual nurse’s own self-determination of those aspects of practice she/he believes herself competent to perform.