Assignment: Ethical and Legal Implications of Prescribing Drugs

Assignment: Ethical and Legal Implications of Prescribing Drugs

A Sample Answer For the Assignment: Assignment: Ethical and Legal Implications of Prescribing Drugs

Title: Assignment: Ethical and Legal Implications of Prescribing Drugs

Assignment Ethical and Legal Implications of Prescribing Drugs

 

In the case scenario, a nurse practitioner makes an error when prescribing medication to a 5-year-old patient. Instead of dosing him appropriately, the NP prescribes a dose suitable for an adult. Several ethical issues may arise due to medication errors, including causing harm to the patient, dilemma on whether to disclose the error, erosion of trust, and effect on quality care. This paper seeks to explore ethical and legal implications in the scenario and strategies to address disclosure and nondisclosure.

Ethical and Legal Implications

The case can have legal and ethical implications for both the prescriber and the dispensing pharmacist. The NP may face various legal consequences of mistrust from the patient, civil and criminal charges, and have her license revoked due to the medication error (Sorrell, 2017). The pharmacist had the role of assessing the appropriateness, effectiveness, and safety of medication for the patient. The pharmacist may face legal actions and have the license revoked for not evaluating if the medication prescribed was appropriate and safe for the patient (Sorrell, 2017). The pharmacist may face ethical implications of failing to uphold beneficence and nonmaleficence for prescribing a high dose (Sorrell, 2017). The patient and his family can make legal charges to the hospital and prescriber if the patient develops adverse outcomes.

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When NPs face the choice between disclosing and nondisclosure of a prescription error, they should always choose to disclose.

Pennsylvania laws on disclosure of medication errors state that a medical through an appropriate designee should provide written notification to the patient affected or to an available family member with consent from the patient. This should be effected within seven days of the occurrence or discovery of a serious event (Rieders, 2005). If the patient is incapable of giving consent, the notification should be given to an adult member of the immediate family. The appropriate person to inform the patient is the attending physician or the physician with overall responsibility for managing the patient’s care (Rieders, 2005). Using a non-physician might send the wrong signal to the patient.

Assignment Ethical and Legal Implications of Prescribing Drugs
Assignment: Ethical and Legal Implications of Prescribing Drugs

In the scenario, I would use ethical principles and state laws to guide decision making.  Ethical principles propose that in every nursing case, medication safety is essential, and if an error occurs, NPs should be forthcoming (Bonney, 2014). Failing to disclose and report a medication error is unethical, illegal, and harmful to the patient (Bonney, 2014). Though difficult, I will meet with the patient and his caregiver to inform them of the medication error, apologize, and make amends. I will explain to the patient and the caregiver how the error occurred, how the harmful effects of the prescription error will be managed, and explain to the patient the measures that will be taken to prevent the error in the future. This will help in maintaining a healthy relationship with patients and promoting trust. Besides, disclosing medication errors can prevent an adverse effect on the patient.

Process of Writing Prescriptions and Strategies to Minimize Medication Errors

A prescription should contain the name and address of the prescriber, date of prescription, and name, and dose of the drug. The prescriber should include the name, address, and age of the patient. If the drug is generic, the generic name should be indicated and the total dose of the drug.

To reduce the incidence of medication errors, clinicians can adopt a culture of obtaining a thorough patient history that includes current medications and drug allergies (Chu, 2016). A comprehensive exam that entails the height and weight in pediatrics can help calculate the correct dosage to avoid overdosing. Furthermore, prescribing clinicians can adopt the use of drug software which facilitates checking of the drug dose, allergies associated with the drug, and drug interactions (Chu, 2016). The use of electronic health record (EHR) is also a strategy that can minimize medication errors and promote patient safety, mostly in pediatric patients (Chu, 2016). The EHR calculates the drug dosage based on the patient’s weight and enables the clinician to prescribe the correct dosage for a pediatric patient.

Ethical and Legal Implications of Prescribing Drugs

Across the United States, nurse practitioners have some extent of prescriptive authority over drugs, controlled substances, medical services, and medical devices (de Araújo et al., 2019). NPs and other healthcare professionals with legal authority to prescribe medication are required to observe legal and ethical guidelines to safeguard the patient from harm. However, the regulations governing prescriptive practice among NPs vary across different states. For this discussion, the ethical and legal implications of the provided case scenario will be illustrated based on the New Jersey NP’s scope of practice.

Ethical and Legal Implications

The provided case study demonstrates an ethical dilemma of whether or not to report an NP who prescribes narcotic medication to her husband. The laws and regulations regarding prescribing medication to a family member or a friend differ by state as it is forbidden in other states, whereas in some states, it is only advised against. In New Jersey, NPs are required to collaborate with physicians to enjoy prescriptive authority privileges (Ellenbogen & Segal, 2019). When prescribing controlled drugs such as narcotics, the NP is required to consult with the supervisory physician and complete must have completed education in the pharmacology of drugs listed under controlled substances. Consequently in New Jersey, prescribing controlled substances to self, family member, or friend is prohibited.

The prescriber, which in this case is the NP, violated all the regulations for prescribing controlled substances as required by the New Jersey state laws. For instance, she failed to consult the supervisory physician before prescribing the narcotic medication to her husband, which is also against the law. Prescribing medication to a family member undermines the professional objectivity of the prescriber in addition to compromised professional medical judgment (Phillips, 2020). Legally, the prescriber can end up losing their prescriptive authority or even the practice license. The pharmacist, on the other hand, must ensure that the prescription from the NP has met all the requirements as per the prescriptive practice protocol before dispensing the medication to the patient. Failure to do so, the pharmacist can also face legal charges.

Finally, the patient in this scenario may fail to disclose all the required information to promote the safe use of controlled substances, to her wife, who is the prescriber. Due to patient privacy and confidentiality, most couples fail to share their full medical history, especially the ones that they consider embarrassing such as addiction. Failure to disclose such information may promote the risks of adverse events and negative treatment outcomes (Squellati et al., 2022).

Disclosure and Nondisclosure

            The nurse who witnessed her colleague violating the prescriptive authority of state laws and regulations was faced with an ethical dilemma of disclosure and nondisclosure of the incident. According to the Patient Safety Act, N.J.S.A. 26:2H-12.23, healthcare professionals are required to report any form of medical malpractice including prescription malpractice, to the department head and the patient (Ellenbogen & Segal, 2019). Doing so will help prevent such issues from taking place in the future. However, failing to disclose the matter can lead to legal implications, in addition to being unethical primarily to the patient. As such, in the provided case study, it would have been necessary for the nurse to approach the prescribing nurse, and inform her about the implications associated with her actions in addition to the adverse outcomes associated with the use of narcotics. The prescribing nurse should also be advised against failing to adhere to the outlined prescriptive practice protocols to promote patient safety and positive treatment outcome. If the prescribing nurse ignores these concerns, she should then be reported to the departmental head, for legal action to be taken.

Decision Making

            As an advanced practice nurse, critical thinking is crucial in promoting appropriate decision-making in situations like the one described above. Considering the patient as the center of care is a crucial strategy that must be utilized among all healthcare professionals when deciding on whether or not to disclose a medical error (Grecu & Spector, 2019). The second strategy should be based on upholding the patients’ rights, such as the right to information concerning their health. With these two strategies, I would disclose the error to the patient, and adopt appropriate mitigating interventions to ensure the patient’s safety and prevent harm. Failing to disclose the information to the patient, is unethical, and puts the patient at risk of adverse events and negative outcomes associated with the use of controlled substances such as narcotics.

Process of Writing a Prescription

            A high level of professionalism is required in prescribing medication to promote patient safety and avoid medication errors. The prescriber must meet all the information requirements when writing the prescription. The following steps are crucial when writing a prescription. The first step is collecting patient information, including demographics and diagnosis (de Araújo et al., 2019). The second step is providing your information as the prescriber. The third step is to identify the drug name, form, strength and frequency to be administered. It is also important to write the exact quantity of the drug that has been prescribed. The fourth step is giving the direction of use and the number of refills. Finally, the prescriber must append his or her signature.

Assignment: Ethical and Legal Implications of Prescribing Drugs Conclusion

With the increasing prescriptive privileges among nurses, it is crucial to consider legal and ethical guidelines to promote patient safety. Consequently, each state has specific regulations governing prescriptive practice among RNs. Violation of such regulation is unethical to the patient and can also lead to legal implications for the prescriber, just like in the discussed case study.

 

 

Assignment: Ethical and Legal Implications of Prescribing Drugs References

de Araújo, B. C., de Melo, R. C., de Bortoli, M. C., Bonfim, J. R. de A., & Toma, T. S. (2019). How to Prevent or Reduce Prescribing Errors: An Evidence Brief for Policy. Frontiers in Pharmacology10. https://doi.org/10.3389/fphar.2019.00439

Ellenbogen, M. I., & Segal, J. B. (2019). Differences in Opioid Prescribing Among Generalist Physicians, Nurse Practitioners, and Physician Assistants. Pain Medicine. https://doi.org/10.1093/pm/pnz005

Grecu, A. M., & Spector, L. C. (2019). Nurse practitioners’ independent prescriptive authority and opioids abuse. Health Economics28(10), 1220–1225. https://doi.org/10.1002/hec.3922

Phillips, S. J. (2020). 32nd Annual APRN Legislative Update. The Nurse Practitioner45(1), 28–55. https://doi.org/10.1097/01.npr.0000615560.11798.5f

Squellati, R., McCants, K. M., Hadden, T. A., & Mitchell, C. V. (2022, January 1). 9 – Health policy for NPs: health literacy, cultural competence, and communication (D. Seibert, B. Malone, & P. DeLeon, Eds.). ScienceDirect; Academic Press. https://www.sciencedirect.com/science/article/pii/B9780323999939000068

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Please read through the following information on writing a Discussion question response and participation posts.

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Important information on Writing a Discussion Question

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  • Do not include quotes—instead summarize and paraphrase the information
  • Follow APA-7th edition
  • Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

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