Assignment: Ethical and Legal Implications of Prescribing Drugs

Assignment: Ethical and Legal Implications of Prescribing Drugs
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.
SCENARIO-For the Assignment, please use the following scenario:
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.
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.-copied and pasted above
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.
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.
Explain 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: 23 (23%) – 25 (25%)
The response accurately and thoroughly explains in detail the ethical and legal implications of the scenario selected on all stakeholders involved.
The response includes accurate, clear, and detailed explanations as to how these implications affect the prescriber, pharmacist, patient, and the patient’s family.
Describe strategies to address disclosure and nondisclosure as identified in the scenario selected. Be sure to reference laws specific to your state: 18 (18%) – 20 (20%)
An accurate, detailed, and clear description of strategies to address disclosure and nondisclosure as identified in the scenario selected is provided.
The response includes specific, detailed, and accurate reference to state laws related to the scenario.
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: 18 (18%) – 20 (20%)
The response accurately and thoroughly explains in detail at least two strategies that an advanced practice nurse would use to guide decision making in the scenario.
The response accurately and completely explains whether they would disclose the error, including an accurate, detailed, and clear justification for the explanation provided.
Explain the process of writing prescriptions including strategies to minimize medication errors.
18 (18%) – 20 (20%)
The response provides an accurate, detailed, and thorough explanation of the process of writing prescriptions, including detailed strategies to minimize medication errors.
Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
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Solution
Ethical and Legal Implications of Prescribing Drugs
Prescription writing is a significant task by a health professional during patient management. Lack of attention during the writing of a prescription can result in prescription errors which subsequently can adversely affect the well-being of a patient. Prescription errors usually occur as a result of hastiness and careless attitudes exhibited by some health professionals when writing prescriptions (Dyasanoor & Urooge, 2016).
The prescriber and the pharmacist are ethically and legally responsible for preventing prescription error because almost all interactions between a patient and a health professional end with prescription writing. When dosage calculations are made in error, medication errors occur. Another worker should always check your dosage calculations. Doses must be measured out with complete accuracy. In the scenario, the pharmacist should have checked the prescriber’s dosage calculations. Conn et al. (2021) indicate that pharmacists are responsible for supporting safe prescribing by guiding prescribers, identifying errors, and delivering education.
Communication with parents and children might lead to errors. This is pertinent during drugs reconciliation when parents/ carers at times provide incomplete or inaccurate information. . Errors might arise when prescribers alter a medication’s solution strength of a drug without notifying parents or when prescribers orally notify patient’s family of updated doses without passing the information to the child’s general practitioner (Conn et al., 2021).
Strategies to address disclosure and nondisclosure
Responding to and disclosing medication errors are a portion of the professional obligations for which the nurse is liable. If a medication error arises, it must be reported, whether the error was made by a professional nurse or a nursing student. The nurse should follow health care institution procedures and policies for disclosing and documenting the error closely and carefully (Lilley et al., 2019).
In my state (Pennsylvania), the Medical Care Availability and Reduction of Error Act (Mcare) mandates disclosure of all serious events. Health professionals should verbally disclose serious events to the family or patient must occur within twenty-four hours of the event while written confirmation must take place within seventy-two hours. The serious event determination should be electronically reported to the Pennsylvania Patient Safety Authority (Painter et al., 2018).
Strategies to guide decision making
Professional values of honesty and integrity will guide my decision making in the scenario. As an advanced practice nurse, I would disclose the error to the child’s family and the health care institution because it is my ethical and legal obligation to provide full disclosure to patients and my organization when errors occur in patients’ care.
I will also give factual information and proactively apologize and accept responsibility for the error as this can help avoid litigation As indicated by Lilley et al. (2019) when a medication error occurs, the nurse must complete all appropriate forms, entailing an incident report as per the I procedures and policies of the health care institution. , and offer appropriate documentation. The medication error should be documented, nevertheless, by offering only truthful information about the medication error. Documentation should be objective, thorough, and accurate
The process of writing prescriptions, and strategies to minimize medication errors
When writing a prescription, the major elements that must be present to compose a complete prescription include prescriber name, contact information and license number; patient name and date of birth; prescriber DEA number if applicable; name of the medication; patient allergies; medication strengths, m indication for medication; dose of medication and frequency, medication strength; number of refills, and number of capsules or tablets to dispense. (Rosenthal & Burchum, 2020).
Electronic prescribing is a strategy to minimize medication errors. According to Rosenthal and Burchum (2020), using an electronic medical record permits the provider to select a specific, patient-selected pharmacy. After entry of correct medication information, the prescription is automatically sent to the selected pharmacy. This is beneficial because information is directly transmitted, making errors less likely. Encouraging patient care by a multidisciplinary team, with the participation of a pharmacist is another strategy to minimize medication errors. Working as a multidisciplinary team minimizes prescribing errors, particularly when the pharmacist is in the team.
References
Conn, R., Fox, A., Carrington, A., Dornan, T., & Lloyd, M. (2021). Prescribing errors in children: why they happen and how to prevent them. The Pharmaceutical Journal, 306, 7946. DOI:10.1211/PJ.2021.1.42997
Dyasanoor, S., & Urooge, A. (2016). Insight Into Quality of Prescription Writing –An Institutional Study. Journal of Clinical and Diagnostic Research, 10(3), ZC61–ZC64. doi: 10.7860/JCDR/2016/18011.7472
Lilley, L. L., Collins, S. R., & Snyder, J. (2019). Pharmacology and the Nursing Process E-Book. Elsevier.
Painter, L. M., Kidwell, K. M., Kidwell, R. P., Janov, C., Voinchet, R. G., Simmons, R. L., & Wu, A. W. (2018). Do Written Disclosures of Serious Events Increase Risk of Malpractice Claims? One Health Care System’s Experience. Journal of Patient Safety, 14(2), 87-94. doi: 10.1097/PTS.0000000000000178
Rosenthal, L., & Burchum, J. (2020). Lehne’s Pharmacotherapeutics for Advanced Practice Nurses and Physician Assistants. Elsevier.