NURS 6521 Advanced Pharmacology, module 1, week 1, Assignment: Ethical and Legal Implications of Prescribing Drugs
NURS 6521 Advanced Pharmacology
Discussion: Pharmacokinetics and Pharmacodynamics
As an advanced practice nurse assisting physicians in the diagnosis and treatment of disorders, it is important to not only understand the impact of disorders on the body, but also the impact of drug treatments on the body. The relationships between drugs and the body can be described by pharmacokinetics and pharmacodynamics.
Pharmacokinetics describes what the body does to the drug through absorption, distribution, metabolism, and excretion, whereas pharmacodynamics describes what the drug does to the body.
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When selecting drugs and determining dosages for patients, it is essential to consider individual patient factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes. These patient factors include genetics, gender, ethnicity, age, behavior (i.e., diet, nutrition, smoking, alcohol, illicit drug abuse), and/or pathophysiological changes due to disease.
For this Discussion, you reflect on a case from your past clinical experiences and consider how a patient’s pharmacokinetic and pharmacodynamic processes may alter his or her response to a drug.
To Prepare
Review the Resources for this module and consider the principles of pharmacokinetics and pharmacodynamics.
Reflect on your experiences, observations, and/or clinical practices from the last 5 years and think about how pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug.
Consider factors that might have influenced the patient’s pharmacokinetic and pharmacodynamic processes, such as genetics (including pharmacogenetics), gender, ethnicity, age, behavior, and/or possible pathophysiological changes due to disease.
Think about a personalized plan of care based on these influencing factors and patient history in your case study.
By Day 3 of Week 1
Post a description of the patient case from your experiences, observations, and/or clinical practice from the last 5 years. Then, describe factors that might have influenced pharmacokinetic and pharmacodynamic processes of the patient you identified. Finally, explain details of the personalized plan of care that you would develop based on influencing factors and patient history in your case. Be specific and provide examples.
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Solution
Ethical and Legal Implications of Prescribing Drugs
Advanced nurses and other medical practitioners are responsible for providing quality care to patients. However, these practitioners should adhere to legal, professional, and ethical guidelines while performing their duties. In this case, the practitioner should comply with the ethical and legal standards as set by the state of Georgia while prescribing medicine to the patient. This paper will address the ethical and legal issues associated with the selected case study, measures for dealing with both disclosure and nondisclosure, strategies for influencing the practitioner’s decision, and the procedure of prescribing medications.
The Ethical and Legal Issues associated with the Selected Case
Both ethical guidelines and legal policies are applicable in the selected scenario. In this case, the medical practitioner has been authorized by a fried to prescribe medication for her. However, the client does not provide the practitioner with her medical history, which should act as a guide during the prescription. The state’s legal and ethical guidelines are against such actions since they are likely to expose patients to harm.
Georgia’s Prescription Drug Monitoring Program (PDMP) was enforced to govern the prescription of drugs primarily to reduce cases of drug abuse, thus enhancing the safety of the citizens. The newly enacted PDMP requires the pharmacist to record their prescriptions within 24 hours. This deadline was reduced from a period between 7 and 10 days (Rodriguez, 2017). This move will prevent individuals from purchasing the same drug from multiple pharmacies. The new law also emphasizes accountability. Physicians are required to check the system before prescribing drugs to the patients (Rodriguez, 2017). Thus, prescribing medication without a patient’s medical history would imply that the prescriber has acted against this policy. Furthermore, the action would compromise the patient’s physical and emotional health due to the ineffectiveness of the prescribed medication. According to Harrison et al (2016), the patient’s well-being is significantly affected by clinical errors. Additionally, the action would compromise the well-being of the patient’s family since the health status of their loved one will expose them to psychological torture.
The Georgia State Board of Pharmacy also requires the medical practitioner to adhere to the set ethical standards while prescribing drugs to the patients. Particularly, the board requires pharmacists to review the patient’s records before prescribing any medication (Pozgar, 2015). Additionally, the dispensing pharmacist is required to discuss with the client all issues pertaining to the drug such as possible side effects or any potential allergic reactions (Pozgar, 2015). Therefore, prescribing medication to the friend without her medical history would imply that both the prescriber and pharmacist have acted against this ethical standard. Also, the action would have a negative impact on the patient since the administered medication is likely to have some allergic reactions, thus deteriorating her health status further. The patient’s family will also be affected psychologically by the deteriorating health status of their loved one.
Approaches for Handling both Disclosure and Non-Disclosure
Healthcare practitioners should handle both disclosure and non-disclosure in the most effective manner to enhance the level of patient safety (Sorrell, 2017). In this scenario, mistakes are likely to arise if the practitioner prescribes drugs without reviewing the patient’s medical history. First, the prescriber can correct the error by informing the patient about it and possible harm. For instance, the ethical standards of conduct set by the State of Georgia require the prescriber or pharmacist to inform the client about various issues associated with the administered drug (Rodriguez, 2017). Thus, an error regarding drug allergic reaction or potential side effects can be corrected by informing the client about it. Disclosing about the error will, in turn, enhance the level of patient’s safety (Moffatt-Bruce et al., 2016). D On the other hand, the prescriber can address a non-disclosure by correcting the error without informing the patient about it. Taking this action will protect patient’s loyalty and trust towards the practitioner. For instance, the ethical standards of conduct set by the State of Georgia require the prescriber to review the patient’s records before prescribing any medication (Pozgar, 2015). Thus, any error in the prescription can be corrected by reviewing the health records of the client before administering any medication.
Strategies influencing Decision
As an advanced practice nurse, my decision making, in this case, is influenced by two strategies. In particular, the decision will be influenced by both ethical and legal guidelines. The set ethical standards require medical practitioners not to expose clients to any form of harm. Thus, I would disclose the error to the patient to prevent her from any harm that is likely to arise following a mistake in prescription. Additionally, the State’s law emphasizes accountability. Therefore, I would disclose the error and correct the mistake since I would be held accountable for my action.
The Procedure for Prescribing Medication
Healthcare practitioners are mandated to prescribing drugs to patients. They should ensure minimum medication errors occur during the process. This goal can be achieved by adhering to the set ethical and legal standards regarding drug prescription. Physicians can minimize errors by adhering to the legal requirement of reviewing the medical history of the patient before any prescription. Additionally, errors can be reduced by complying with an ethical standard that requires practitioners to prevent patients from any form of harm.
The State of Georgia requires advanced nurses to adhere to the set ethical guidelines and legal policies during drug prescription. These standards were primarily set to minimize the cases of medical errors that are likely to occur during prescription. The nurses should be prepared to address both disclosure and non-disclosure medical errors to ensure the patient’s safety.
References
Harrison, R., Lawton, R., Perlo, J., Gardner, P., Armitage, G., & Shapiro, J. (2015). Emotion and coping in the aftermath of medical error: a cross-country exploration. Journal of patient safety, 11(1), 28-35.
Moffatt-Bruce, S. D., Ferdinand, F. D., & Fann, J. I. (2016). Patient safety: disclosure of medical errors and risk mitigation. The Annals of thoracic surgery, 102(2), 358-362.
Pozgar, G, D. (2015). Legal and Ethical Essentials of Health Care Administration (2nd Edition). Massachusetts: Jones & Bartlett Learning.
Rodriguez, J. (2017). New Law Aims To Combat Prescription Drug Abuse. Retrieved from https://www.gpbnews.org/post/new-law-aims-combat-prescription-drug-abuse
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 Vol. 22, No. 2.