URS 6521 Week 1 Assignment: Ethical And Legal Implications of Prescribing Drugs Essay
URS 6521 Week 1 Assignment: Ethical And Legal Implications of Prescribing Drugs Essay
According to the World Health Organization, approximately one out of ten hospitalized patients get harm that is a result of the healthcare process. Out of the cases, 50% are preventable. It is estimated that every year, there are 421 million hospitalized patients. Of these, 42.7 million adverse effects occur, and medication errors contribute to 18.3% of these cases. In the United States of America, 128,000 deaths are reported every year in hospitals due to prescription drugs. Therefore, healthcare workers must understand the ethical and legal implications of prescribing drugs to patients. This will help in preventing some of these cases.
Case Scenario
In this case scenario, as a nurse practitioner, I prescribe drugs to a five-year-old patient. In the process, I give an adult dosage instead of the appropriate pediatric dosage. Medicines can treat, cure or prevent illnesses. However, when there is an error in the medication process, either in the prescription or administration, then damages can be caused. There are laws that govern medical management right from prescription, distribution, administration, follow-up, and monitoring, as well as patient education.
Ethical and Legal Implications On Stakeholders
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In this case scenario, the nurse practitioner prescribes adult dosage for a pediatric patient. The adult dosage can have adverse effects and cause harm to the patient. This goes contrary to the ethical principle of nonmaleficence. As such, the practitioner can be charged for causing preventable medical harm to the patient. On the part of the pharmacist, there are supposed to counter-check the prescribed drug if appropriate, check the age of the patient, the name as well as the dosage, and ensure that they conform. In this case scenario, the pharmacist has shown negligence by not counterchecking the prescription and may also be liable for a charge for the same violation of the ethical principle of nonmaleficence (Vaismoradi et al., 2021). For the patient, in this case, their right to quality and appropriate medical care has been violated. Their ethical principles have also been violated by being subjected to an adult doing that might cause harm to them. The patient, therefore, has the right to press charges. The implication for the patient’s family is that they can lose trust in the nurse practitioner and the hospital for that mistake. This can make them not seek further medical intervention in the facility. Besides, they can press charges and hold the nurse practitioner, the pharmacist, and the hospital culpable of any damage caused to their child.
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Addressing Disclosure and Nondisclosure
Disclosure refers to the communication between the health care provider and the patient, their family, or their proxy acknowledging the fact that an error occurred, explaining the possible effects of the error to the patient, and how it can be addressed. According to the State of Georgia laws and regulations, a nurse shall be reported to the Georgia Board of Nursing if they commit an error that contributed to a patient’s death or harm. Furthermore, a nurse can also be reported to the board if they have committed several minor incidents that would pose a risk to the lives of patients. In this case, I would first accept that an error occurred and report the error to my superior in the hospital as well as the hospital administration (Mansour et al., 2020). Secondly, I would look for the patient, find an appropriate place accompanied by one of my superiors, sit down with the patient and their family and acknowledge the error that occurred. During that meeting, I would explain the kind of error that occurred, why it occurred, and the possible effects of that kind of error on the patient.
Strategies To Guide Decision Making
The two strategies that would guide my decision-making include understanding the rational method of decision-making, which involves the foundation of the patient care process. The second is balancing the care equation by looking at both the subjective and the objective factors (Oliveira et al., 2020). It would be better to understand the patient’s pharmacological history and the experiences they have had before. Besides, I would look at the factors that would affect the patient’s treatment process and help overcome those barriers that would hinder effective therapy. During this process, I would also look at convenience. By looking at all that, the final decision would favor the patient’s interest.
The Process of Writing Prescriptions
According to Nkera-Gutabara and Ragaven (2020), errors that arise as a result of writing prescriptions account for up to 70% of medical errors. Prescription writing is a vital part of the patient care process. The health care provider must evaluate and identify the patient’s problem, define the treatment objectives, choose the appropriate mode of treatment, initiate the treatment process, and give information regarding the treatment modality chosen. A good prescription should have the following components: date of prescription, patient identifiers, the medical regimen, and the prescriber. The patient’s identity includes full name, age, gender, address, and hospital number. The medical regimen includes the name of the drug, the dosage, the mode of administration, and the duration. Finally, the prescriber must include their name and signature.
Conclusion
Medical errors can occur during the process of prescribing drugs. However, most of these errors can be prevented to avoid significant harm to the patient and help improve the quality of health care provided. There are laws that govern the process of health care service provision. Patients’ rights must be protected and the ethical principles upheld all the time. Disclosure is important when an error occurs and the correct procedure and process should be followed when doing this. Healthcare providers are advised to be very keen when providing services to patients to prevent preventable medical errors.
References
Mansour, R., Ammar, K., Al-Tabba, A., Arawi, T., Mansour, A., & Al-Hussaini, M. (2020). Disclosure of medical errors: physicians’ knowledge, attitudes and practices (KAP) in an oncology center. BMC Medical Ethics, 21(1), 74. https://doi.org/10.1186/s12910-020-00513-2
Nkera-Gutabara, J. G., & Ragaven, L. B. (2020). Adherence to prescription-writing guidelines for outpatients in Southern Gauteng district hospitals. African Journal of Primary Health Care & Family Medicine, 12(1), e1–e11. https://doi.org/10.4102/phcfm.v12i1.2263
Oliveira, I. V., Nascimento, Y. de A., & Ramalho-de-Oliveira, D. (2020). The decision-making process in Comprehensive medication management services: From the understanding to the development of a theoretical model. Pharmacy (Basel, Switzerland), 8(4), 180. https://doi.org/10.3390/pharmacy8040180
Vaismoradi, M., Jordan, S., Logan, P. A., Amaniyan, S., & Glarcher, M. (2021). A systematic review of the legal considerations surrounding medicines management. Medicina (Kaunas, Lithuania), 57(1), 65. https://doi.org/10.3390/medicina57010065
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• Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.
o Chapter 1, “Prescriptive Authority” (pp. 1–3)
o Chapter 2, “Rational Drug Selection and Prescription Writing” (pp. 4–7)
o Chapter 3, “Promoting Positive Outcomes of Drug Therapy” (pp. 8–12)
o Chapter 4, “Pharmacokinetics, Pharmacodynamics, and Drug Interactions” (pp. 13–33)
o Chapter 5, “Adverse Drug Reactions and Medication Errors” (pp. 34–42)
o Chapter 6, “Individual Variation in Drug Response” (pp. 43–45)
o
• 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 Download 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. (2021). CFR – Code of Federal Regulations Title 21Links to an external site.. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=1300
This website outlines the code of federal regulations for prescription drugs.
• Drug Enforcement Administration. (n.d.). Mid-level practitioners authorization by stateLinks to an external site.. 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.
• Institute for Safe Medication Practices. (2017). List of error-prone abbreviations, symbols, and dose designationsLinks to an external site.. 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.
• 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 studentsLinks to an external site.. Journal of the American Association of Nurse Practitioners, 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.
• Speed Pharmacology. (2016). Pharmacology – Adrenergic receptors & agonistsLinks to an external site. (MADE EASY) [Video]. https://www.youtube.com/watch?v=KtmV-yMDYPI&t=372s
Note: This media program is approximately 18 minutes.
• Speed Pharmacology. (2017). Drugs for Hyperlipidemia (Made Easy)Links to an external site. [Video]. https://www.youtube.com/watch?v=Of1Aewx-zRM&t=24s
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URS_6521_Week1_Assignment_Rubric
| NURS_6521_Week1_Assignment_Rubric | ||||||
| Criteria | Ratings | Pts | ||||
| This criterion is linked to a Learning OutcomeExplain 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. |
|
25 pts | ||||
| This criterion is linked to a Learning OutcomeDescribe strategies to address disclosure and nondisclosure as identified in the scenario selected. Be sure to reference laws specific to your state. |
|
20 pts | ||||
| This criterion is linked to a Learning OutcomeExplain 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. |
|
20 pts | ||||
| This criterion is linked to a Learning OutcomeExplain the process of writing prescriptions including strategies to minimize medication errors. |
|
20 pts | ||||
| This criterion is linked to a Learning OutcomeWritten 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. |
|
5 pts | ||||
| This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation |
|
5 pts | ||||
| This criterion is linked to a Learning OutcomeWritten Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list. |
|
5 pts | ||||
| Total Points: 100 | ||||||
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