ATI Content Mastery Series (CMS) Leadership Practice Test

In delegation, it’s about who does the work and who owns the results. Responsibility is the duty to carry out the task and do it safely and correctly. Accountability is the obligation to answer for the outcomes of that task. In practice, the nurse who delegates remains accountable for the patient’s overall care and for ensuring the task is appropriate, supervised, and evaluated, while the person performing the task is responsible for executing it correctly.

For example, if a nurse assigns wound care to a licensed practical nurse, the LPN is responsible for performing the wound care per protocol. The delegating nurse remains accountable for the patient’s overall plan, safety, and outcomes, and must ensure proper supervision and follow-up. Accountability cannot be fully transferred; it stays with the person who holds overall responsibility for the patient.

That’s why they’re not interchangeable: responsibility is about doing the task; accountability is about ownership of the results, and the delegation relationship keeps accountability with the delegator, even as the task is carried out by someone else.