NURS 6521 Advanced Pharmacology Assignment
Module 1 Week 1 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.
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.
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.
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SAMPLE ANSWER :
Advanced Pharmacology Assignment: Ethical and Legal Implications of Prescribing Drugs
The case scenario depicts a situation where I make an error as an NP when prescribing medication to a 5-year-old male patient. Instead of dosing the patient appropriately, I prescribe a dose suitable for an adult. This paper seeks to explore the ethical and legal implications in this scenario, approaches to address disclosure and nondisclosure, and the procedure of writing prescriptions.
Ethical and Legal Implications of the Scenario You Selected On All Stakeholders
Several ethical issues may surface due to medication errors such as harm to patients, dilemma to disclose the error, erosion of trust, and impact on quality care. The case scenario has ethical and legal implications for the NP and the pharmacist. In this case, ethical implications that face the NP include failing to uphold ethical principles of nonmaleficence and beneficence (Sorrell, 2017). Prescribing an adult dose to a child puts him at risk of toxicity due to overdose and adverse drug effects. The NP fails to uphold nonmaleficence and beneficence since the dose is likely to harm the patient failing to promote the best outcome for the child (Sorrell, 2017). Furthermore, the NP is at risk of legal implications and faces legal charges or consequences such as license revocation because of overdosing the patient.
The pharmacist’s role was to evaluate the prescribed drug’s correctness, effectiveness, and safety based on the diagnosis and age. Consequently, the pharmacist can face legal implications for failing to double-check the prescribed dose and ensure it is correct and safe for the child (Sorrell, 2017). This can result in legal charges as well as revocation of the practicing license. Similar to the NP, the pharmacist may face ethical consequences for failing to uphold nonmaleficence and beneficence since he did not ensure that the dose was safe for the patient before dispensing (Sorrell, 2017). Furthermore, the healthcare facility may face legal charges if the child develops adverse side effects or drug reactions due to inappropriate dosing.
Strategies to Address Disclosure and Nondisclosure
NPs face a dilemma on whether to disclose a medication error or not due to the legal consequences involved. In 2004, the NJ Legislature enacted the Patient Safety Act (PSA). The legislation instituted a legal duty to immediately disclose medical errors to patients affected by them (NJDHSS, 2017). Under the legislation, a patient must be notified of the error no later than the end of the episode of care. If the error is discovered after the end of the episode of care, the patient should be informed promptly when they are victims of a life-threatening preventable adverse event (NJDHSS, 2017). In addition to compelling providers to report adverse events to the victims of medical malpractice, the PSA also requires the health providers to report the medical errors to the Department of Health and Human Services.
Strategies I Would Use To Guide Decision Making In This Scenario
As an APN, I would decide whether to disclose the error guided by the state laws and ethical principles. I would go through the state laws on disclosure and follow the legislation that states that the provider must immediately disclose to the patient. According to ethical principles, medication safety is crucial, and if an error occurs, the nurse should take the necessary measures (Sorrell, 2017). Failing to disclose and report an error is considered illegal and unethical since it can cause harm to the patient. In this scenario, I would arrange a meeting with the patient and the parent and notify them of the prescription error and how it happened. I would apologize to the patient professionally to maintain a healthy relationship and trust. In addition, I would explain to the parent the potential effects of the error and how it will be managed to prevent adverse effects.
Process of Writing Prescriptions and Strategies to Minimize Medication Errors
When writing a prescription, the prescriber should indicate their name and address, date of prescription, and the drug’s name and dose. In addition, the prescriber should indicate the name, age, and address of the patient (de Araújo et al., 2019). Medication errors can be reduced by having the clinician take a detailed patient history, including current medications and known drug allergies, to prevent drug interactions and adverse drug reactions (de Araújo et al., 2019). Besides, facilities should adopt the use of E-prescribing software, which allows clinicians to electronically generate and directly send a prescription to a pharmacy (McLeod et al., 2019). Using the software reduces dosage errors, increases patient safety, eases the medication workflow, and increases patient satisfaction. Besides, they can use a computerized drug prescription system, which provides knowledge on effective medication, and matches patients with the correct drugs based on their diagnosis and age.
Conclusion
Ethical implications facing the NP include failing to uphold nonmaleficence and beneficence, which puts the patient at risk of harm. The pharmacist can face legal consequences for failing to double-check the prescribed dose before dispensing it to the patient. The Patient Safety Act in NJ requires providers to disclose medical errors to the affected patients immediately. Medication errors can be minimized by obtaining I formation on current medications and drug allergies and using prescribing software.
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
McLeod, M., Karampatakis, G. D., Heyligen, L., McGinley, A., & Franklin, B. D. (2019). The impact of implementing a hospital electronic prescribing and administration system on clinical pharmacists’ activities-a mixed methods study. BMC Health Services Research, 19(1), 1-12. https://doi.org/10.1186/s12913-019-3986-4
New Jersey Department of Health and Senior Services. (2017). Mandatory Patient Safety Reporting Requirements for Licensed Health Care Facilities. The Official Web Site for The State of New Jersey. https://www.nj.gov/health/healthcarequality/documents/ps/final_directions/
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). https://doi.org/10.3912/OJIN.Vol22No02EthCol01