Speakers - WNRC2026

Abstract

Ethical competency supports the integrity of nursing practice. The conceptual design of the chain of custody is under-studied, yet it is of paramount importance to promote patient safety, compliance with standards of care, and the prevention of errors. The chain of custody is a sequential and holistic approach with a sequence of events that must be followed from admission to discharge. As nurses understand their roles within the chain of custody, moral distress, burnout, and anxiety are reduced. The chain of custody affirms role-based ethics in which responsibilities are defined by one’s role.

To illustrate role-based responsibilities within the chain of custody, the presenters developed a Responsibility/Accountability/Evaluation model. The concepts of the model draw from a multi-disciplinary approach to clarify ethical uncertainty and emotional bias. The model reflects a practical application process. Use of the model can aid in identifying responsibility and accountability while avoiding passing blame, thereby facilitating collaborative communication and conflict resolution.

Objectives:

1. Discern how the ethical concept of the chain of custody functions in nursing and how to restore it when it is broken.
2. Identify the critical processes perioperative nurses have within the chain of custody.
3. Develop a Responsibility/Accountability/Evaluation model to aid in clarifying roles in the chain of custody.

Conclusion:

The Responsibility/Accountability/Evaluation model reaches administrative, strategic, and interpersonal levels of ethical competency within the processes of nursing. Ethical competency enhances role-awareness and clarity of task and collaboration within the chain of custody.