The term bookkeeper normally refers to a sort of clerk who keeps the books and maintains transaction histories for a company. An accountant can also complete such tasks, but may also focus on reporting, analysis and possibly offer advice of the business transactions. Sometimes a bookkeeper can work in tandem with an accountant, but there should always be a strong relationship and degree of trust between the accountant and business owner.
Small business owners may not need to hire full time professionals, but they should always consult someone from the beginning. An accountant may not be necessary depending on the industry and size, but the more complex the organization, the more important it is to ensure the books are handled by an experienced CPA. If full time is not necessary, a CPA can consult with the business and touch base periodically to make sure the books are being maintained properly. Otherwise, errors may only be caught at the end of the year. If books are set up properly from the start, this is a great measurement tool for growth.