What type of drug should you prescribe based on your patientâ€s diagnosis? How much of the drug should the patient receive? How often should the drug be administered? When should the drug not be prescribed? Are there individual patient factors that could create complications when taking the drug? Should you be prescribing drugs to this patient? How might different state regulations affect the prescribing of this drug to this patient? These are some of the questions you might consider when selecting a treatment plan for a patient.
As an advanced practice nurse prescribing drugs, you are held accountable for peopleâ€s lives every day. Patients and their families will often place trust in you because of your position. With this trust comes power and responsibility, as well as an ethical and legal obligation to â€œdo no harm.â€ It is important that you are aware of current professional, legal, and ethical standards for advanced practice nurses with prescriptive authority. Additionally, it is important to ensure that the treatment plans and administration/prescribing of drugs is in accordance with the regulations of the state in which you practice. Understanding how these regulations may affect the prescribing of certain drugs in different states may have a significant impact on your patientâ€s treatment plan. In this Assignment, you explore ethical and legal implications of scenarios and consider how to appropriately respond.
Review the Resources for this module and consider the legal and ethical implications of prescribing prescription drugs, disclosure, and nondisclosure.
Review the scenario assigned by your Instructor for this Assignment.
Search specific laws and standards for prescribing prescription drugs and for addressing medication errors for your state or region, and reflect on these as you review the scenario assigned by your Instructor.
Consider the ethical and legal implications of the scenario for all stakeholders involved, such as the prescriber, pharmacist, patient, and patientâ€s family.
Think about two strategies that you, as an advanced practice nurse, would use to guide your ethically and legally responsible decision-making in this scenario, including whether you would disclose any medication errors.
Write a 2- to 3-page paper that addresses the following:
Explain the ethical and legal implications of the scenario you selected on all stakeholders involved, such as the prescriber, pharmacist, patient, and patientâ€s family.
Describe strategies to address disclosure and nondisclosure as identified in the scenario you selected. Be sure to reference laws specific to your state.
Explain two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario, including whether you would disclose your error. Be sure to justify your explanation.
Explain the process of writing prescriptions, including strategies to minimize medication errors.
Your assignments will be assessed in the same manner. The syllabus states that the assignments should be 2-3 pages, and you MUST adhere to this. Content is very important to me, so I want you to make sure that your posts and writings for assignments are substantial and are from credible sources (i.e., textbook, publications, etc.). Sources such as drugs.com, Medscape.com, etc., can be used, but they CANNOT be the only sources you have. The latter are set up as information sites only and will not always be accurate.
In your discussions, as well as assignments, you should be focusing on the medication parts of the assignment. This is a pharmacology class, so I want you to be researching how the disease is treated, why those treatments the best for the specific disease state, what complications come from treatment, how to avert possible problems with treatment, how to deal with comorbidities during treatments, etc. This is not all inclusive, but some of the things I want you to be thinking about. This will help ensure that you will get the most out of this class and sharpen your reasoning skills as to why certain treatments are used once you are in practice. Sources nothing less than 5 years
Sample Paper Solution
The ethical and legal implications of the scenario involve various stakeholders including prescriber, pharmacist, patient, patient’s family. The ethical implications include failure of the pharmacist to disclose full information the patient and failure of the prescriber to accept responsibility of the mistake (Gorgich, Barfroshan, Ghoreishi & Yaghoobi, 2016). The patient has the responsibility of reporting the case for proper action to be taken and stop such tendencies in hospitals. The patient’s family has the responsibility of seeking justice and fairness. On the other hand, the legal implications involve the consequences that follow after the medical error has occurred. The patient’s family should report the case to the hospital administration and the legal justice system (Ferrah, Lovell & Ibrahim, 2017). The nurse has the responsibility of telling the truth of what happened to protect the interest of the patient. The patient should also be responsible for explaining the scenario to a legal justice system. The pharmacist should maintain fidelity which calls for faithfulness and truthfulness in exercising nursing duties. Therefore, all the stakeholders should be aware of the ethical and legal implications that occur after a medical error has happened.
Strategies for Disclosure and Nondisclosure
Disclosure of errors is necessary to reassure the honesty of a healthcare provider to a nurse. Nurses should not fear the repercussions of disclosure, but they should first be concerned about the welfare of a patient (Ferrah, Lovell & Ibrahim, 2017). Additionally, disclosure is important and it reduces the possibility of a lawsuit. Nurses who honestly agree that they were involved in a medical error will not be punished harshly as a nurse who is trying to hide it (Gorgich, Barfroshan, Ghoreishi & Yaghoobi, 2016). On the other hand, nondisclosure is an ethical issue that will put to question the trust and integrity of patients-nurses relationships. The reason why nondisclosure is not ethical is that the patient should be informed to start preparing mentally, physically and psychologically on the outcomes of the error.
A lawsuit in California involves a wrong medical prescription. The victim claims that the medication was meant for long-term use whereas he required a short-term drug. The man has filed a lawsuit seeking compensation for medical expenses and damages (Medication Errors, 2017). He argues that he suffered motor and neurological problems after taking the wrong drug.
Strategies for Decision-making
Decision-making strategies involve disclosing an error to protect the welfare of a patient and enhance their trust. It involves acknowledging to a fellow nurse or nurse leader that a mistake has occurred (Gorgich, Barfroshan, Ghoreishi & Yaghoobi, 2016). Once the mistake is identified, it becomes easy to find a solution. Nurses should not be afraid to acknowledge their mistakes since it forms the basis for learning. However, failure to disclose the mistake can harm the patient since they will take the wrong medication. The ‘do no harm’ principle is essential and thus the welfare of the patient should be prioritized.
The second strategy involves consulting from other experienced professionals. The process of consulting is used when something is not clear. A nurse should not fear to ask a question since it can save a life (Zaghloul, Rahman, El-Enein & Younes, 2016). For example, it could involve confirming from the nurse who prescribed the medication on what they meant. Consultations can also be made when the prescribed medication is not illegible. It could be important to ask a patient to wait or step aside as consultations continue rather than providing the wrong medication. A nurse can also consult the guide available for references (Ferrah, Lovell & Ibrahim, 2017). The guide shows the amounts, dosing, interaction and the condition to be treated by all kinds of medications.
Strategies for Writing Prescriptions
The process of writing prescriptions is crucial since it plays a role in reducing medication errors. The writing process can be summarized into four major parts. The first step while writing a prescription is to write down the name of the patient plus another identifier such as date of birth (Ferrah, Lovell & Ibrahim, 2017). It should also include the route to be used in taking the medication, strength, amount and frequency of the medication. It is also important to state the number of refills that the patient should have for a specified period of time (Sukumaran, 2017). The physician should also indicate their identity including NPI numbers. The various identifiers will be essential in reducing the wrong medical prescription.
The process of minimizing medical errors include double-checking the details of the medication required. Double-checking involves checking the type of medication, the amount and type of condition of a patient (Zaghloul, Rahman, El-Enein & Younes, 2016). A name alert strategy should be used to minimize the medical errors by checking for names such as Johnston and Johnson. It is important to confirm the amount of dosage provided. A pharmacist is always advised to check the use of zeros and abbreviations. For example, 0.25mg should not be confused with 25mg since it has adverse effects on patients. A pharmacist should also use a guide for reference purposes to avoid confusing generic names, dosing, nursing considerations, and drug-to-drug interaction (Sukumaran, 2017). A nurse should also follow the five rights including confirming the appropriate route, timing, patient, dosage and accurate prescription.
Ferrah, N., Lovell, J. J., & Ibrahim, J. E. (2017). A systematic review of the prevalence of medication errors resulting in hospitalization and death of nursing home residents. Journal of the American Geriatrics Society, 65(2), 433-442.
Gorgich, E. A. C., Barfroshan, S., Ghoreishi, G., & Yaghoobi, M. (2016). Investigating the causes of medication errors and strategies to prevention of them from nurses and nursing student viewpoint. Global Journal of Health Science, 8(8), 220.
Medication Errors (2017). California man sues for medical negligence after a medication error. Retrieved from; http://www.kastnerlaw.com/blog/2017/01/california-man-sues-for-medical-negligence-after-medication-error.html
Sukumaran, S. (2017). Physician challenges in medical error disclosure–a case study in undergraduate medical student education. Global Bioethics Enquiry, 35.
Zaghloul, A. A., Rahman, S. A., El-Enein, A., & Younes, N. (2016). Obligation towards medical errors disclosure at a tertiary care hospital in Dubai, UAE. International Journal of Risk & Safety in Medicine, 28(2), 93-99.
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