KRS 314.021 (2) holds nurses individually responsible and accountable for rendering safe, effective nursing care to clients and for judgments exercised and actions taken in the course of providing care.
Acts, which are within the permissible scope of practice for a given licensure level, may be performed only by those licensees who personally possess the educational preparation and current clinical competency to perform those acts safely and competently. A nurse/licensee who doubts his/her personal competency to perform a requested act has an affirmative obligation to refuse to perform the act, and to inform his/her supervisor and the provider prescribing the act, if applicable, of his/her decision not to perform the act.
If a nurse accepts an assignment that the nurse believes is unsafe or for which the nurse is not educationally prepared, then the nurse also assumes the potential liability, which may occur as a result of the assignment. Others may equally or concurrently be responsible, accountable, and liable for a licensee’s actions.
The responsibilities which any nurse can safely accept are determined by the variables in each nursing practice setting. These variables include:
1. The nurse's own qualifications including: a) basic prelicensure educational preparation; b) knowledge and skills subsequently acquired through continuing education and practice; and c) current clinical competence.
2. The "standard of care" which would be provided in similar circumstances by reasonable and prudent nurses who have similar training and experience.
3. The complexity and frequency of nursing care needed by a given client population.
4. The proximity of clients to personnel.
5. The qualifications and number of staff.
6. The accessible resources.
7. The established policies, procedures, standards of practice, and channels of communication that lend support to the types of nursing services offered.
Nurses are responsible for having adequate educational preparation and experience to safely perform any act they perform as required by KRS 314.021 (2). Nurses should maintain documented evidence of completion of continuing education and/or other training, and of demonstrated clinical competency in the performance of nursing acts.
Nurse’s practice should be consistent with the Kentucky Nursing Laws, established standards of practice, and be evidence-based.