Sample Answer for NURS 6512 Assignment 2 Ethical and Legal Implications of Prescribing Drugs IN Included After Question
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.
By Day 6 of Week 1
Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days by suggesting additional patient factors that might have interfered with the pharmacokinetic and pharmacodynamic processes of the patients they described. In addition, suggest how the personalized plan of care might change if the age of the patient were different and/or if the patient had a comorbid condition, such as renal failure, heart failure, or liver failure.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
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A Sample Answer For the Assignment: NURS 6512 Assignment 2 Ethical and Legal Implications of Prescribing Drugs IN
Title: NURS 6512 Assignment 2 Ethical and Legal Implications of Prescribing Drugs IN
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.
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.
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 Pharmacology, 10. 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 Economics, 28(10), 1220–1225. https://doi.org/10.1002/hec.3922
Phillips, S. J. (2020). 32nd Annual APRN Legislative Update. The Nurse Practitioner, 45(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
A Sample Answer 2 For the Assignment: NURS 6512 Assignment 2 Ethical and Legal Implications of Prescribing Drugs IN
Title: NURS 6512 Assignment 2 Ethical and Legal Implications of Prescribing Drugs IN
When a patient enters the health center, medication is very likely to be administered. A health history and a patient’s medical evaluation are important things to examine when administering medication. A nurse or doctor should administer the care of the condition and be informed of the standard a condition should be offered depending on a background of health and physical inspection (Rosenthal & Burchum, 2020). In this discussion, the essay focuses on Scenario 2 to clarify the ethical and legal ramifications of patient family, prescriber, pharmacist and patient to all parties concerned. The discussion continues by explaining the methods I will use to drive decision-making for an experienced clinical nurse in the selected scenario.
Selected scenario
A colleague calls and demands for drugs to be taken for her. You are self-sufficient, but do not have the medical experience of your mate. Anyway, you write the drug. The ethical, as well as legal implications of the scenario on all stakeholders such as the prescriber, pharmacist, patient, and patient’s family, discuss as follow:
Nurse Practitioner: A nurse who uses medications without performing the requisite testing, evaluation and legal consequences such as absence, as needed by the medical code of ethics, such as the Colorado “Medical Practice Act,” breaches the code and is unprofessional (Sabatino & Pruchnicki, 2017). The NP who prescribes medication for a friend without a medical background fears jeopardizing his permit since adverse reactions can turn fatal. A nurse has the ethical obligation to prescribe the best medication, but only after a medical exam and evaluation.
Pharmacist: In mediation, a pharmacy dealer who carries out a prescription does not presume that the prescriber has made an examination, nor that the practitioner is ethically and legitimately liable for the background before the order is submitted. Thus, loading the Rx with the pharmacist’s chance of losing the license while knowing his clinical background.
Patient and family: Prescribing drugs to a patient is morally and technically permissible whether a patient may not have an awareness of his or her background, evaluation and allergies. Therefore the patient and the relatives will bring court charges against the nurse and pharmacy firm should any incident take place.
Strategies to Guide Decision making
The first strategy is to call the patient before prescribing medication and to make an appropriate date for a medical evaluation to reach the condition. Medical testing and an assessment may lead to the patient’s medical condition and, therefore, to the required medication (Musellim & Borekci, 2017). In medical and personal interactions, faulty and incorrect prescribe inaccurate medications, less frequent usage for preventive treatment, loss of medical satisfactions, and escalated aggressive incidents against healthcare providers, maybe the result of a patient’s evaluation over a short duration of time. The patient assessment period could have been influenced too gradually or too rapidly.
The second strategy is to do the clinical examination before administering medication to assess the condition of the patient. Clinical trials are study experiments in which patients actively undergo experimental therapeutic techniques, techniques or measures in order to avoid, diagnose, cure or control various conditions or diseases (Rosenthal & Burchum, 2020). Some studies consider how people react to a new procedure and what side effects may be created. The third method is to implement a prescriptive decision-making process by looking at the patient’s family members and their prior fitness. The prescriptive method of educated judgment aid approaches describes a variety of strategies to enable citizens to think differently about a decision.
Process of Writing Prescriptions
There are important things that physicians should consider before writing medications. Relevant elements must also be considered. Again, it is necessary to remember that there are norms in various countries. The criteria specify that the details on medications are provided. Both medications usually tend to use a vocabulary the consumer can understand such that they can learn quickly how to take medicine. Secondly, it is important to write clearly in writing while writing the medication (Solanki & Shah, 2015). Third, it is necessary to determine the duration of usage of the medication and the days the patient is supposed to take. Additional detail used is subject to local drug laws. With the exponential advancement of technology, electronic prescribing will continue to reduce the cost-effectiveness of drug mistakes. Electronic prescribing is an efficient means of eliminating medication errors. The continuous dependency on handwriting writing is one of the factors that have made medication mistakes inevitable (Nickless & Davies, 2016). Handwritten prescriptions might be negligible. Problems like this can be overcome by technology-based prescribing, as this will help to reduce drug mistakes.
References
Musellim, B., & Borekci, S. (2017). What should be the appropriate minimal duration for patient examination and evaluation in pulmonary outpatient clinics? Annals of Thoracic Medicine, 12(3), 177–182. doi:10.4103/atm.ATM_396_16
Nickless, G., & Davies, R. (2016). How to take an accurate and detailed medication history. The Pharmaceutical Journal.
Rosenthal, L., & Burchum, J. (2020). Lehne’s Pharmacotherapeutics for Advanced Practice Nurses and Physician Assistants. Elsevier – Health Sciences Division.
Sabatino, J. A., & Pruchnicki, M. C. (2017). Improving prescribing practices: A pharmacist-led educational intervention for nurse practitioner students. Journal of the American Association of Nurse Practitioners, 29(5), 248-254. doi:10.1002/2327-6924.12446
Solanki, N. D., & Shah, C. (2015). Prescription audit in outpatient department of multispecialty hospital in western India: an observational study. International Journal of Clinical Trials, 14-19.
Rubric Detail
| Excellent | Good | Fair | Poor | ||
| 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. | Points Range: 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. |
Points Range: 20 (20%) – 22 (22%)
The response explains the ethical and legal implications of the scenario selected on all stakeholders involved. The response includes accurate explanations as to how these implications affect the prescriber, pharmacist, patient, and the patient’s family. |
Points Range: 18 (18%) – 19 (19%)
The response inaccurately or vaguely explains the ethical and legal implications of the scenario selected for all stakeholders involved. The response includes vague explanations as to how these implications affect the prescriber, pharmacist, patient, and the patient’s family. |
Points Range: 0 (0%) – 17 (17%)
The response vaguely and inaccurately explains the ethical and legal implications of the scenario selected for all stakeholders involved, or the response is missing. The response vaguely and inaccurately explains how these implications affect the prescriber, pharmacist, patient, and the patient’s family, or is missing. |
|
| Describe strategies to address disclosure and nondisclosure as identified in the scenario selected. Be sure to reference laws specific to your state. | Points Range: 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. |
Points Range: 16 (16%) – 17 (17%)
An accurate description of strategies to address disclosure and nondisclosure as identified in the scenario selected is provided. The response includes accurate reference to state laws related to the scenario. |
Points Range: 14 (14%) – 15 (15%)
A vague or inaccurate description of strategies to address disclosure and nondisclosure as identified in the scenario selected is provided. The response includes inaccurate or vague reference to state laws related to the scenario. |
Points Range: 0 (0%) – 13 (13%)
A vague and inaccurate description of strategies to address disclosure and nondisclosure as identified in the scenario selected is provided, or is missing. The response includes vague and inaccurate reference to state laws related to the scenario, or is missing. |
|
| 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. | Points Range: 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. |
Points Range: 16 (16%) – 17 (17%)
The response accurately explains at least two strategies that an advanced practice nurse would use to guide decision making in the scenario. The response accurately explains whether they would disclose the error, including an accurate justification for the explanation provided. |
Points Range: 14 (14%) – 15 (15%)
The response inaccurately or vaguely explains at least two strategies that an advanced practice nurse would use to guide decision making in the scenario, or only explains one strategy. The response inaccurately or vaguely explains whether they would disclose the error, including a justification that is vague, inaccurate, or misaligned to the explanation provided. |
Points Range: 0 (0%) – 13 (13%)
The response inaccurately and vaguely explains only one strategy that an advanced practice nurse would use to guide decision making in the scenario, or is missing. The response inaccurately and vaguely explains whether they would disclose the error, with no justification provided, or is missing. |
|
| Explain the process of writing prescriptions including strategies to minimize medication errors. | Points Range: 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. |
Points Range: 16 (16%) – 17 (17%)
The response provides an accurate explanation of the process of writing prescriptions, including some strategies to minimize medication errors. |
Points Range: 14 (14%) – 15 (15%)
The response provides an inaccurate or vague explanation of the process of writing prescriptions, including inaccurate or vague strategies to minimize medication errors. |
Points Range: 0 (0%) – 13 (13%)
The response provides an inaccurate and vague explanation of the process of writing prescriptions, including inaccurate and vague strategies to minimize medication errors, or is missing. |
|
| 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. |
Points Range: 5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity. |
Points Range: 4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. |
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. |
Points Range: 0 (0%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time. |
|
| Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation |
Points Range: 5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors |
Points Range: 4 (4%) – 4 (4%)
Contains a few (1–2) grammar, spelling, and punctuation errors |
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3–4) grammar, spelling, and punctuation errors |
Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding |
|
| Written 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. | Points Range: 5 (5%) – 5 (5%)
Uses correct APA format with no errors |
Points Range: 4 (4%) – 4 (4%)
Contains a few (1–2) APA format errors |
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3–4) APA format errors |
Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) APA format errors |
|
| Total Points: 100 | |||||