Organizational accountability is a foundational competency for nurse leaders responsible for driving quality, safety, and ethical practice across healthcare systems. This e-learning module, Accountability in Action: Leading for Quality and Safety, explores how nurse leaders extend their influence beyond individual patient care to shape organizational outcomes, culture, and performance. Learners will examine strategies for fostering transparency, just culture, and shared responsibility while aligning leadership actions with institutional values and fiscal stewardship. The course emphasizes ethical decision-making, executive presence, and systems thinking to support high-quality, cost-effective, patient-centered care. Designed for nurse leaders at all levels, this module strengthens the skills needed to lead accountability and continuous improvement within complex healthcare environments. Vanderbilt University School of Nursing is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s (ANCC) Commission on Accreditation. To earn continuing education credit, participants must complete both the Nurse Leader pre-assessment and post-assessment. Upon successful completion, learners will be awarded 0.75 ANCC contact hours.