Feb 23, 2024 Ethical And Legal Implications Of Prescribing Drugs Assignment
Ethical And Legal Implications Of Prescribing Drugs Assignment
A Sample Answer For the Assignment: Ethical And Legal Implications Of Prescribing Drugs Assignment
Introduction
From the case study, it is clear that any practitioner, especially a nurse practitioner, should adhere to the laws and guidelines put forth by the many states as well as the numerous codes of conduct. In addition to providing comprehensive details on what the state expects from the legislation, strategies on what to do in such an instance or with regard to the subjects covered are also supplied. This essay seeks to provide details that could serve as a roadmap for what to anticipate in the scenario described while abiding by the different laws and regulations set forth by the state. (Rosenthal & Burchum, 2021).
Ethical and Legal Implications on Stakeholders
In the prescription of medication there are several stakeholders that are involved in case of any ethical or legal errors they are likely to be implicated depending on their role. As per the scenario I as the nurse practitioner (NP) will likely to be implicated the most as I am the prescriber in this case. It is expected that the prescriber has sufficient knowledge regarding prescription of medication and therefore a gross mistake as giving a dosage for an adult to a 5-year-ol is unexpected. Such mistakes can lead to severe harm to a patient and therefore the resulting legal implication will also be harsh to the prescribe (Rosenthal & Burchum, 2021).
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The pharmacist will be next in incurring the legal implications of such an error. This is due to the fact they are dispensing the medication and as they do so they are to follow expected guidelines and use the knowledge they have gained regarding dispensing medication therefore preventing such errors from impacting the patient.
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They should act as a point of verification of the prescribed medication and if any errors are noted refer back to the prescriber to make the necessary adjustments instead of dispensing the medication without question. To the patient the most severe implication that will occur is to their health as the medication in the prescribed dosage is not appropriate and will negatively impact them (Rosenthal & Burchum, 2021).
Strategies to address Disclosure and Non-disclosure
The appropriate course of action in this situation will be to report the problem, but this will be complicated by the worry that doing so may result in losing one’s employment or position as a nurse practitioner (NP).The prescriber who is the NP is expected to inform the patient, the patient’s family or their legal representative of the error and correct it as soon as possible. In Tennessee medics are expected by law to follow ethical and practice guidelines when disclosing errors.
Ethical And Legal Implications Of Prescribing Drugs Assignment
This involves providing accurate and complete information regarding the error and failure to do so could lead to legal and professional consequences. Each practitioner is accountable for being aware of the rules and laws that apply in the state where they practice. Due to this, in the case of a prescription error occur they should disclose it promptly in an empathetic and compassionate minor while taking measures to mitigate the harm that could occur (Clarke, 2019).
Strategies involved in Decision Making
There are several strategies that one can utilize to guide in the decision making process. Firstly it is expected in order to avoid legal implications the nurse practitioner to disclose that the error occurred so that the patient’s family are able to discuss steps they would like to undertake. Among the strategies that could be beneficial is having a colleague to double check the prescription and the dose given.
This will aid in preventing further errors from occurring as the involved calculations can be confirmed by another knowledgeable health personnel. Another strategy would be to tell the patient of relative to read back the instructions. Through that one will be able to note the incorrectness of the information and make the necessary alterations (Sabatino et al., 2017).
Process of writing Prescriptions
Part of the diagnosis process involves the NP assessing the pinpoint issue of the patient. Review of the disease’s pathophysiology will be among the initial steps in treatment before prescribing the appropriate drug to manage the condition. The NP is charged with the responsibility of identifying possible adverse drug reactions that could occur if a patient utilizes a certain drug as well as the nature of the reactions.
Additionally, the five R’s should be considered that include right drug, right route, right dose, right time and right patient as well as being wary of medications that look or sound alike. Through taking these precautions, situations such as severe side effects and drug mistakes can be significantly avoided (Institute for Safe Medication Practices, 2017).
Conclusion
Therefore, nurse practitioners should exercise caution when writing prescriptions, making sure they follow the correct procedure and are acting within the scope of their authority as well as adhering to the various regulations and laws of the state in which they are located in to ensure they have carried out their duties in accordance with the state’s expectations (Rosenthal & Burchum, 2021).
References
Clarke, P. Case Commentaries (2019).
Institute for Safe Medication Practices. (2017). List of error-prone abbreviations, symbols, and dose designations Links to an external site.. Retrieved from https://www.ismp.org/recommendations/error-prone-abbreviations-list
Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.
Sabatino, J. A., Pruchnicki, M. C., Sevin, A. M., Barker, E., Green, C. G., & Porter, K. (2017). Improving prescribing practices: A pharmacist‐led educational intervention for nurse practitioner students Links to an external site. Journal of the American Association of Nurse Practitioners, 29(5), 248–254. doi:10.1002/2327-6924.12446
What type of drug should you prescribe based on your patient’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 people’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 “do no harm.” 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 patient’s treatment plan. In this Assignment, you explore ethical and legal implications of scenarios and consider how to appropriately respond.
To Prepare
· 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 patient’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 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 patient’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.
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references.
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By Day 7 of Week 1
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 patient’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.
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The College of Nursing Writing Template with Instructions provided at the Walden Writing Center offers an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
Please save your Assignment using the naming convention “WK1Assgn+last name+first initial.(extension)” as the name.
Click the Week 1 Assignment Rubric to review the Grading Criteria for the Assignment.
Click the Week 1 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK1Assgn+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.
Grading Criteria
To access your rubric:
Week 1 Assignment Rubric
Check Your Assignment Draft for Authenticity
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Submit your Week 1 Assignment draft and review the originality report.
Submit Your Assignment by Day 7 of Week 1
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Week 1 Assignment
Learning Resources
Required Readings (click to expand/reduce)
Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.
Chapter 1, “Prescriptive Authority” (pp. 1–3)
Chapter 2, “Rational Drug Selection and Prescription Writing” (pp. 4–7)
Chapter 3, “Promoting Positive Outcomes of Drug Therapy” (pp. 8–12)
Chapter 4, “Pharmacokinetics, Pharmacodynamics, and Drug Interactions” (pp. 13–33)
Chapter 5, “Adverse Drug Reactions and Medication Errors” (pp. 34–42)
Chapter 6, “Individual Variation in Drug Response” (pp. 43–45)
American Geriatrics Society 2019 Beers Criteria Update Expert Panel. (2019). American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 67(4), 674–694. doi:10.1111/jgs.15767
American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults by American Geriatrics Society, in Journal of the American Geriatrics Society, Vol. 67/Issue 4. Copyright 2019 by Blackwell Publishing. Reprinted by permission of Blackwell Publishing via the Copyright Clearance Center.
This article is an update to the Beers Criteria, which includes lists of potentially inappropriate medications to be avoided in older adults as well as newly added criteria that lists select drugs that should be avoided or have their dose adjusted based on the individual’s kidney function and select drug-drug interactions documented to be associated with harms in older adults.
Drug Enforcement Administration. (n.d.-a). Code of federal regulations. Retrieved February 1, 2019, from https://www.deadiversion.usdoj.gov/21cfr/cfr/1300/1300_01.htm
This website outlines the code of federal regulations for prescription drugs.
Drug Enforcement Administration. (n.d.-b). Mid-level practitioners authorization by state. Retrieved May 13, 2019 from http://www.deadiversion.usdoj.gov/drugreg/practioners/index.html
This website outlines the schedules for controlled substances, including prescriptive authority for each schedule.
Drug Enforcement Administration. (2006). Practitioner’s manual. Retrieved from http://www.legalsideofpain.com/uploads/pract_manual090506.pdfThis manual is a resource for practitioners who prescribe, dispense, and administer controlled substances. It provides information on general requirements, security issues, recordkeeping, prescription requirements, and addiction treatment programs.
Drug Enforcement Administration. (n.d.-c). Registration. Retrieved February 1, 2019, from https://www.deadiversion.usdoj.gov/drugreg/index.html
This website details key aspects of drug registration.
Fowler, M. D. M., & American Nurses Association. (2015). Guide to the Code of Ethics for Nurses with Interpretive Statements: Development, Interpretation, and Application (2nd ed.). Silver Spring, Maryland: American Nurses Association.
This resource introduces the code of ethics for nurses and highlights critical aspects for ethical guideline development, interpretation, and application in practice.
Institute for Safe Medication Practices. (2017). List of error-prone abbreviations, symbols, and dose designations. Retrieved from https://www.ismp.org/recommendations/error-prone-abbreviations-list
This website provides a list of prescription-writing abbreviations that might lead to misinterpretation, as well as suggestions for preventing resulting errors.
Ladd, E., & Hoyt, A. (2016). Shedding light on nurse practitioner prescribing. The Journal for Nurse Practitioners, 12(3), 166–173. doi:10.1016/j.nurpra.2015.09.17
This article provides NPs with information regarding state-based laws for NP prescribing.
Sabatino, J. A., Pruchnicki, M. C., Sevin, A. M., Barker, E., Green, C. G., & Porter, K. (2017). Improving prescribing practices: A pharmacist‐led educational intervention for nurse practitioner students. Journal of the American Association ofNursePractitioners, 29(5), 248–254. doi:10.1002/2327-6924.12446
The authors of this article assess the impact of a pharmacist‐led educational intervention on family nurse practitioner (FNP) students’ prescribing skills, perception of preparedness to prescribe, and perception of pharmacist as collaborator.
Required Media (click to expand/reduce)
Introduction to Advanced Pharmacology
Meet Dr. Terry Buttaro, associate professor of practice at Simmons College of Nursing and Health Sciences as she discusses the importance of pharmacology for the advanced practice nurse. (8m)
What’s Coming Up in Module 2?
Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images
In the next module, you will examine the impact of changes in pharmacokinetic and pharmacodynamic processes on patient drug therapy for cardiovascular disorders and the types of drugs prescribed to patients with respiratory disorders.
Looking Ahead: Week 2 Assignment
In Week 2, your Instructor will assign you a case study related to Assignment 1 by Day 1 of the week. Please make sure to review the “Course Announcements” area of the course to verify your assigned case study. Please plan ahead to ensure you have time to review your case study and Learning Resources in order to complete your Assignment on time.
Photo Credit: Getty Images/iStockphoto
Next Week
To go to the next week:Module 2
In the case scenario, a friend calls and requests me to prescribe her medication. Although I have the autonomy, I do not have the friend’s medical history. However, I still write the prescription. This paper explores the ethical and legal implications of this scenario, approaches to address disclosure and nondisclosure, and the procedure of writing prescriptions.
Ethical and Legal Implications Of The Scenario On All Stakeholders Involved
Prescribing or giving medications to family members and friends, except for an emergency is regarded as unprofessional conduct and can call for disciplinary measures. The ethical problem surrounds the fact that the relationship with a friend or relative can cloud a practitioner’s judgment (Sorrell, 2017). Based on the state, the prescriber in this scenario can face legal consequences for prescribing to their friend.
Writing a drug prescription for friends in a social setting can prompt legal action. Since the prescriber has the autonomy to prescribe, the ethical and legal consequences would center on what is best for the person prescribed and whether local ethic boards have an outlook on the matter (Sorrell, 2017). The prescribed medication may result in an adverse drug event since no assessment was conducted, which fails to uphold ethical principles of beneficence and nonmaleficence.
The ethical and legal implications of the act would not only fall on the prescriber but also the dispensing pharmacist. Ethical implications for the pharmacists would include the failure to uphold beneficence and nonmaleficence. The pharmacist ought to have reviewed the diagnosis for the patient before dispensing to ensure the medication is appropriate for the patient’s medical condition (Sorrell, 2017). Failing to review the medical information puts the patient at risk of adverse drug effects if the drug is not appropriate for the patient. Furthermore, the patient may face legal implications for getting a prescription without being assessed and diagnosed by a healthcare provider.
Strategies to Address Disclosure and Nondisclosure As Identified In the Scenario
Disclosure of medical error refers to the communication between a health provider and a client, family member, or a client’s proxy whereby the provider admits that a medical error occurred. North Carolina has a statute that protects reports made by a health provider making an apology for an adverse treatment outcome. The statute on disclosure, states that health providers should offer to implement remedial or corrective treatment interventions, as well as voluntary acts to assist the affected patient (North Carolina Medical Board, 2017).
However, the North Carolina statute does not protect any confessions of fault or a provider’s acknowledgment of responsibility. In the case that the medication has an adverse event on the prescriber’s friend or the prescriber realizes they prescribed the wrong medication, the prescribing clinician should inform the patient (Eniola & Gambino, 2019). The clinician should explain how the error occurred and the actions to be taken to correct the error and its effects.
Strategies That You, As an Advanced Practice Nurse, Would Use To Guide Your Decision Making In This Scenario
In this scenario, my decisions would be based on the North Carolina laws and ethical principles. I would reveal the medication error to the patient by explaining how it occurred as stated by the state law to avoid legal action and implications such as having my APN license revoked (Eniola & Gambino, 2019). In addition, I would employ beneficence and nonmaleficence in making decisions to promote ethical practice. Beneficence is the moral duty to promote good, while nonmaleficence is the duty to cause no harm.
In this regard, I would take the duty to do good and prevent harm on the patient by informing them of the error and taking prompt interventions to mitigate potential harm from the medication error (Sorrell, 2017). Besides, I would explain to the patient the steps that the provider and the hospital are implementing to prevent errors in the future. This would help maintain the client’s trust in the clinician and the hospital.
Process of Writing Prescriptions and Strategies to Minimize Medication Errors
The prescribing clinician should first fill in the patient’s data, including name, age, sex, and medical diagnosis. The next step is to write the prescribed medication, including the name, dose, frequency, and route of administration (de Araújo et al., 2019). Besides, the clinician should indicate the frequency of refills, particularly for patients with chronic illness. The last step should be to write the clinician’s name, address, National Provider Identifier number, and DEA number.
Medication errors can be reduced by taking a detailed history of the patient’s drug allergies and current medications (de Araújo et al., 2019). Organizations can adopt technology systems such as the E-prescribing software, which generates prescriptions electronically and send them directly to the pharmacy. The software minimizes errors cause by illegible paper prescriptions. Drug interaction checkers can also be used to help evaluate potential drug interactions, thus reduci
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