Feb 23, 2024 NURS 6521 Discussion: Ethical and Legal Implications of Prescribing Drugs
NURS 6521 Discussion Ethical and Legal Implications of Prescribing Drugs
A sample Answer For the Assignment: NURS 6521 Discussion: Ethical and Legal Implications of Prescribing Drugs
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).
Struggling to Meet Your Deadline?
Get your assignment on NURS 6521 Discussion: Ethical and Legal Implications of Prescribing Drugs done on time by medical experts. Don’t wait – ORDER NOW!
Meet my deadline
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.
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.
Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS NURS 6521 Discussion Ethical and Legal Implications of Prescribing Drugs:
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.
NURS 6521 Discussion Ethical and Legal Implications of Prescribing Drugs
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
The case study shows significant issues for the healthcare providers in the setting. First, the medical assistant is a fault in failing to report the vitals to the nurse practitioner. Legal actions can be taken against her should the patient experience complications related to severe hypotension. The nurse practitioner could also be held responsible for neglect.
The nurse practitioner has failed to monitor her clients closely, which places them at a risk of safety issues. The medical director has also failed in his duty of ensuring the employees work as expected. He has failed to instill the staff the desired culture of safety, quality, and efficiency. As a result, the practice can be closed and license revoked should the issues persist.
One of the strategies I would implement to prevent further episodes of potential dangerous outcomes is setting, communicating, and reinforcing new rules that guide staff behavior. I will also seek to understand the needs of the staff and determine potential strategies to address them. I will advocate for culture of patient safety and align the organizational systems and processes with it (Lee et al., 2019). This culture will prevent future occurrence of similar events.
One of the leadership qualities I would apply to effect positive changes in the practice is leading by example. I will adopt best leadership practices such as open communication, teamwork, and shared decision-making in the organization. I will also embrace strategies that drive excellence in the practice such as involving the staff in exploring issues and using them to come up with continuous improvement strategies (Marx, 2019). I will also organize for training opportunities regularly for the staff to be updated with the current trends in healthcare and implications to their practice.
References
Lee, S. E., Scott, L. D., Dahinten, V. S., Vincent, C., Lopez, K. D., & Park, C. G. (2019). Safety Culture, Patient Safety, and Quality of Care Outcomes: A Literature Review. Western Journal of Nursing Research, 41(2), 279–304. https://doi.org/10.1177/0193945917747416
Marx, D. (2019). Patient Safety and the Just Culture. Obstetrics and Gynecology Clinics, 46(2), 239–245. https://doi.org/10.1016/j.ogc.2019.01.003
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?
Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS NURS 6521 Discussion: Ethical and Legal Implications of Prescribing Drugs:
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 on a daily basis. 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. In this Discussion, you explore ethical and legal implications of scenarios and consider how to appropriately respond.
Scenario 1: Discussion: Ethical and Legal Implications of Prescribing Drugs
As a nurse practitioner, you prescribe medications for your patients. You make an error when prescribing medication to a 5-year-old patient. Rather than dosing him appropriately, you prescribe a dose suitable for an adult.
Scenario 2: Discussion: Ethical and Legal Implications of Prescribing Drugs
A friend calls and asks you to prescribe a medication for her. You have this autonomy, but you don’t have your friend’s medical history. You write the prescription anyway.
Scenario 3: Discussion: Ethical and Legal Implications of Prescribing Drugs
You see another nurse practitioner writing a prescription for her husband who is not a patient of the nurse practitioner. The prescription is for a narcotic. You can’t decide whether or not to report the incident.
Scenario 4: Discussion: Ethical and Legal Implications of Prescribing Drugs
During your lunch break at the hospital, you read a journal article on pharmacoeconomics. You think of a couple of patients who have recently mentioned their financial difficulties. You wonder if some of the expensive drugs you have prescribed are sufficiently managing the patients’ health conditions and improving their quality of life.
To prepare FOR Discussion: Ethical and Legal Implications of Prescribing Drugs:
Review Chapter 1 of the Arcangelo and Peterson text, as well as articles from the American Nurses Association, Ladd and Hoyt (2016), the Drug Enforcement Administration, and Sabatino et al (2017).
Select one of the four scenarios listed above.
Consider the ethical and legal implications of the scenario for all stakeholders involved such as the prescriber, pharmacist, patient, and the 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.
With these thoughts in mind:
By Day 3
Post an explanation of the ethical and legal implications of the scenario you selected on all stakeholders involved such as the prescriber, pharmacist, patient, and the patient’s family. Describe two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario.
By Day 6
Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who selected a different scenario than you did, in one or more of the following ways:
Suggest additional ethical and legal implications for all stakeholders in your colleagues’ scenarios.
Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional research.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
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 reducing adverse drug outcomes.
Conclusion
The prescribing clinician and dispensing pharmacist face ethical implications for not upholding beneficence and nonmaleficence by prescribing medication without a patient assessment and medical diagnosis. The North Carolina statute states that the clinician should inform the client of the medical error and the corrective treatments to be implemented. Medication errors can be avoided by taking a patient history of drug allergies, current treatments, and using IT systems.
References
de Araújo, B. C., de Melo, R. C., de Bortoli, M. C., Bonfim, J. R. D. A., & Toma, T. S. (2019). How to prevent or reduce prescribing errors: an evidence brief for policy. Frontiers in pharmacology, 10, 439. https://doi.org/10.3389/fphar.2019.00439
Eniola, K., & Gambino, C. (2019). Taking the Fear Out of Error Disclosure. Family practice management, 26(6), 36-36.
North Carolina Medical Board. (2017). Position Statements North Carolina Medical Board. https://www.ncmedboard.org/images/uploads/other
Sorrell, J. M. (2017). Ethics: Ethical issues with medical errors: Shaping a culture of safety in healthcare. OJIN: The Online Journal of Issues in Nursing, 22(2). de Araújo, B. C., de Melo, R. C., de Bortoli, M. C., Bonfim, J. R. D. A., & Toma, T. S. (2019). How to prevent or reduce prescribing errors: an evidence brief for policy. Frontiers in pharmacology, 10, 439. https://doi.org/10.3389/fphar.2019.00439
Rubric
Select Grid View or List View to change the rubric’s layout.
NURS 6521 Discussion: Ethical and Legal Implications of Prescribing Drugs Content
Name: NURS_6521_Week2_Discussion_Rubric
Grid View
List View
Outstanding Performance
Excellent Performance
Competent Performance
Proficient Performance
Room for Improvement
Main Posting:Response to the discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.
Points Range: 44 (44%) – 44 (44%)
Thoroughly responds to the discussion question(s)
is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.
supported by at least 3 current, credible sources
Points Range: 40 (40%) – 43 (43%)
Responds to the discussion question(s)
is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.
75% of post has exceptional depth and breadth
supported by at least 3 credible references
Points Range: 35 (35%) – 39 (39%)
Responds to most of the discussion question(s)
is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.
50% of post has exceptional depth and breadth
supported by at least 3 credible references
Points Range: 31 (31%) – 34 (34%)
Responds to some of the discussion question(s)
one to two criteria are not addressed or are superficially addressed
is somewhat lacking reflection and critical analysis and synthesis
somewhat represents knowledge gained from the course readings for the module.
post is cited with fewer than 2 credible references
Points Range: 0 (0%) – 30 (30%)
Does not respond to the discussion question(s)
lacks depth or superficially addresses criteria
lacks reflection and critical analysis and synthesis
does not represent knowledge gained from the course readings for the module.
<
Order a similar assignment, and have writers from our team of experts write it for you, guaranteeing you an A
