NURS 6512 Ethical and Legal Implications of Prescribing Drugs

NURS 6512 Ethical and Legal Implications of Prescribing Drugs

Sample Answer for NURS 6512 Ethical and Legal Implications of Prescribing Drugs Included After Question

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. NURS 6521 week 1 Assignment: Ethical and Legal Implications of Prescribing Drugs
• 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.

Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The School of Nursing Writing Template with Instructions provided at the Walden Writing Center offers an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “WK1Assgn+last name+first initial.(extension)” as the name.
• Click the Week 1 Assignment Rubric to review the Grading Criteria for the Assignment.
• Click the Week 1 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK1Assgn+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission. NURS 6521 week 1 Assignment: Ethical and Legal Implications of Prescribing Drugs

A Sample Answer For the Assignment: NURS 6512 Ethical and Legal Implications of Prescribing Drugs

Title: NURS 6512 Ethical and Legal Implications of Prescribing Drugs

Drug administration error causes some of the fatal medical accidents that could result in a patient’s death. Policies and legal frameworks exist to reduce the occurrence of such incidences, and other medical errors, through a reporting system. The case scenario involves prescribing medication to a child using the elderly patients’ standards. NURS 6521 week 1 Assignment: Ethical and Legal Implications of Prescribing Drugs Several people are often affected and implicated in the chain of the wrong subscription, and it is the patient that is profoundly affected.

Ethical and legal implications for all involved stakeholders

The prescriber occupies the first position in the chain of events involving the administration of medication prescribed according to the standard of an elderly patient. The mistake begins with the prescriber. The error is ethically and legally unjustified. First, the prescriber is fully aware that the patient is a child. Prescribing drugs for a child according to the standard elderly patient places the child at risk of overdoes and exposes the patient to a legal suit. The pharmacist is also liable for compounding the prescriber’s mistake. The pharmacists should have an interest in the patient receiving the medications. It is fundamental to ask and confirm the demographic features of the patient, such as age before prescribing drugs. The patient and the patient’s family have not worked against any ethical or legal principle. Patients trust their physicians and take medications believing the physician to be accurate. They are not professionals. Therefore, the prescriber and the pharmacists are ethical and legally guilty of the wrong prescription NURS 6521 week 1 Assignment: Ethical and Legal Implications of Prescribing Drugs.

Strategies to Address Disclosure and Nondisclosure

Medical practitioners recognize the occurrence of medical errors within the profession. The health institutions, states, and federal governments have established procedures to prevent medical errors and reporting and response channels. The state of Texas did not have an elaborate disclosure system until June 20, 2003, when the state government enacted into law legislation HB 1614 (Quality and patient safety, n.d). The enactment is unique to the needs of Texas despite having subtle similarities with other level legislations. The essential component of the law is the requirement that practitioners at the mental hospitals, hospitals, ambulatory surgical centers enter a detailed entry of medical errors.

The benefits of the strategy are its ability to increase surveillance on practitioners making frequent errors, and the intensity of the mistakes to take legal actions. It could be adopted to detect and punish practitioners responsible for rampant negligence and other mistakes. The strategy could also reveal quack practitioners who have entered the profession without prerequisite qualifications, under-training, or quasi practitioners. The health care sector needs to emphasize the recording of medical errors and the implementation of legal frameworks to deal with cases at the court levels and to underscore the seriousness with which medical errors are treated. The strategy would improve the practitioner’s attention and minimize deaths and other drug reactions detrimental to the patient’s health.

Strategies for Decision Making In This Scenario and Disclose of Error

The principles of integrity and honesty govern the response to the situation. The two principles determine how one relates to professional ethics and the codes of conduct. Therefore, using professional codes and professional ethics are the two key strategies to respond to the scenario. For instance, ethical principles such as Kantian deontology defines ethics or morality as action based on the rule of law regardless of the consequences to the actor and recipient of the work (Barrow  & Khandhar, 2019). In this case, state law requires reporting the scenario. I would file a report of the medical error per the ethical principles. The code of conduct defines how the doctor should relate to the patient. For instance, implementing the code of doing well under all circumstances, responding to the scenario would require entering a report and fast-tracking the child to ensure the threat is managed NURS 6521 week 1 Assignment: Ethical and Legal Implications of Prescribing Drugs.

The Process of Writing Prescriptions

The practitioner and the pharmacist should consider the laboratory reports and consideration of the patient’s demographic features before prescribing drugs. Analyses of these variables inform the dosage and type of drug the prescriber gives to the patient. Also, there is a need for reexamining the prescription to ensure it meets the patient’s needs. The practitioner should accept faults in cases they lack knowledge or experience on the prescription. Doing so would limit drug errors resulting from ego.

References

Barrow, J. M., & Khandhar, P. B. (2019). Deontology. In StatPearls [Internet]. StatPearls Publishing.

Quality and Patient Safety. (n.d). Public and Private Policy Medical Errors and Patient Safety. Retrieved from http://www.qups.org/med_errors.php?c=individual_state&s=44&t=all

A Sample Answer 2 For the Assignment: NURS 6512 Ethical and Legal Implications of Prescribing Drugs

Title: NURS 6512 Ethical and Legal Implications of Prescribing Drugs

The promotion of safety and quality in the prescription of medications is imperative in nursing practice. Advanced registered nurses make treatment decisions based on best practices available and utilize interprofessional collaboration to optimize treatment outcomes. Therefore, this paper explores the ethics of prescribing a new drug, which has not been approved to a 7-year-old child for asthma.

Ethical and Legal Implications

The prescription of unapproved drug to the 7-year-old child is associated with significant ethical and legal implications to the nurses’ role in practice. First, the new drug has not been tested or approved for its efficiency and effectiveness in asthma treatment. The drug has also not been used in children under the age of 12 years. As a result, it raises the concerns related to the safety of the drug(Woo et al., 2019). The drug predisposes the 7-year-old to harm because of the lack of information about its safety in children below 12 years.

The prescription of the new drug to the 7-year-old violates the nurses’ code of ethics and standards of practice. Advanced registered nurses have the professional and legal responsibility of promoting safety, quality, and efficiency in their practice. They make decisions based on best available evidence, practice guidelines, and protection of the patient’s rights in the treatment process. The professional standards of practice require them to make decisions that minimize harm while optimizing treatment benefits(Grace & Uveges, 2022). The new drug has never been tested or studied to determine its safety and efficacy profile. Therefore, prescribing the drug will violate the stated codes of practice and ethics in nursing.

Strategies to Address Disclosure and Non-Disclosure

Disclosure and non-disclosure influence the actions that nurses implement in their practice. disclosure entails the provider informing the patient and their significant others about the events that have happened to them in the care process. Advanced practice nurses have the professional obligation to inform their patients about any health interventions implemented to promote their health and recovery. The code of ethics by the American Nurses Association requires that nurses should promote and advocate the patients’ rights, safety, health, and wellbeing(Passini et al., 2023). Non-disclosure entails not informing the patients about any events that have happened to them in the care process.

The state of California requires that healthcare providers to disclose any information that influences health and outcomes to the patients. The disclosure includes providing information about any error that has been made in the delivery of the care. The patient then makes the decision to either share the information with other people or not. The disclosure will also extend to the hospital’s management for the implementation of interventions that will minimize error occurrence in the future. Disclosure of information would promote patient’s autonomy, beneficence, and non-maleficence in the treatment process(Fairchild, 2021). Non-disclosure will translate into nurse’s lack of professional responsibility and negligence, which violates provision 3 of the American Code of Ethics for nurses.

Strategies to Guide Decision Making

One of the strategies that I will adopt to guide my decision-making is interprofessional collaboration. I will involve the other healthcare providers in assessing if we should prescribe the new drug to the 7-year-old. Interprofessional collaboration will ensure the collective examination of the potential alternatives that we may consider to optimize outcomes in the treatment process. Collaboration will also enable the team to examine any evidence that supports the use of the new drug in the treatment and potential risks if any(Donnelly et al., 2021). Therefore, interprofessional collaboration will ensure the adoption of an ethical and most relevant solution in the scenario.

The second strategy that I will use to guide my decision making is relying on the set organizational policies and guidelines. Health organizations have policies that guide nurses in making decisions. The guidelines limit the nurses’ involvement in activities that predispose patients to unintended harm. Relying on them will ensure that I make an informed decision about the issue(Grace & Uveges, 2022). I will disclose the error. As noted above, disclosure is crucial to promote the adoption of interventions that will minimize any harm. Disclosure will also ensure accountability and professional responsibility as an advanced practice nurse.

Process of Writing Prescriptions and Strategies to Minimize Medication Errors

Writing prescriptions should follow developed guidelines to minimize medication errors. One of the processes in writing prescriptions is writing clearly and accurately the patient’s data such as name, age, gender, and diagnosis. Information about the medication name should also be written clearly and accurately to avoid confusion. The prescriber should avoid abbreviations and illegible writing. The dosage information should be concise with clear and specific directions. The therapeutic duration of the drug should also be specific alongside the drug’s therapeutic intervention. Any supplemental instructions such as medication refill or warnings should also be included. The strategies that can be adopted to minimize medication errors include provider training and education about best practices, use of health technologies, double checking and encouraging open reporting of medication errors(Royce et al., 2019; Sutton et al., 2020).

Conclusion

The promotion of safety and quality in prescribing medications is important. I will disclose the medication error. The issue has significant and ethical implications to nursing practice. Advanced registered nurses should adopt best practices that minimize errors in their practice.

References

Donnelly, S., Ó Coimín, D., O’Donnell, D., Ní Shé, É., Davies, C., Christophers, L., Mc Donald, S., & Kroll, T. (2021). Assisted decision-making and interprofessional collaboration in the care of older people: A qualitative study exploring perceptions of barriers and facilitators in the acute hospital setting. Journal of Interprofessional Care, 35(6), 852–862. https://doi.org/10.1080/13561820.2020.1863342

Fairchild, A. (2021). The ethical conflict of truth, hope, and the experience of suffering: A discussion of non-disclosure of terminal illness and clinical placebos. Clinical Ethics, 16(2), 130–136. https://doi.org/10.1177/1477750920959556

Grace, P. J., & Uveges, M. K. (2022). Nursing Ethics and Professional Responsibility in Advanced Practice. Jones & Bartlett Learning.

Passini, L., Bouedec, S. L., Dassieu, G., Reynaud, A., Jung, C., Keller, M.-L., Lefebvre, A., Katty, T., Baleyte, J.-M., Layese, R., Audureau, E., &Caeymaex, L. (2023). Error disclosure in neonatal intensive care: A multicentre, prospective, observational study. BMJ Quality & Safety. https://doi.org/10.1136/bmjqs-2022-015247

Royce, C. S., Hayes, M. M., &Schwartzstein, R. M. (2019). Teaching Critical Thinking: A Case for Instruction in Cognitive Biases to Reduce Diagnostic Errors and Improve Patient Safety. Academic Medicine, 94(2), 187. https://doi.org/10.1097/ACM.0000000000002518

Sutton, R. T., Pincock, D., Baumgart, D. C., Sadowski, D. C., Fedorak, R. N., & Kroeker, K. I. (2020). An overview of clinical decision support systems: Benefits, risks, and strategies for success. Npj Digital Medicine, 3(1), Article 1. https://doi.org/10.1038/s41746-020-0221-y

Woo, B. F. Y., Zhou, W., Lim, T. W., & Tam, W. W. S. (2019). Practice patterns and role perception of advanced practice nurses: A nationwide cross-sectional study. Journal of Nursing Management, 27(5), 992–1004. https://doi.org/10.1111/jonm.12759

A Sample Answer For the Assignment: NURS 6512 Ethical and Legal Implications of Prescribing Drugs

Title: NURS 6512 Ethical and Legal Implications of Prescribing Drugs

NURS 6512 Ethical and Legal Implications of Prescribing Drugs

Ethical and Legal Implications of Prescribing Drugs 

The patient in this case scenario is an elderly 85-year-old lady with significant cognitive decline at her end-of-life phase. She has renal failure, and heart failure, and has been on prophylactic anticoagulants. She is currently in immense pain and can barely tolerate procedures. The purpose of this paper is to explore the ethical and legal implications of prescribing drugs in this scenario. The aspects that will be addressed include the ethical and legal implications on all stakeholders, strategies to address disclosure and nondisclosure, the prescription writing process, and the minimization of medical errors.  

Ethical and Legal Implications for All Stakeholders 

The prescriber is ethically and legally obligated to prescribe medications that are safe and effective in attaining the therapeutic objective. This may necessitate the prescription of restricted medications such as opioids since the patient is in agony for adequate end-of-life care. The pharmacist is obligated to dispense the correct medication in appropriate doses. Both the prescriber and pharmacist should take responsibility and accountability for any medical errors. The patient and their families should disclose any information that may contribute to adverse outcomes such as comorbidities and current medications. The patient should also follow recommendations for the best therapeutic outcomes and seek clarification for any concerns about their management. 

 Strategies to Address Disclosure and Nondisclosure 

Disclosure and nondisclosure of medical errors are complex issues within the healthcare setting. Strategies for effective disclosure include avoidance of blame and speculation, sincere apology, reassurance of mitigation of resultant effects, strategies to prevent a recurrence, and training of healthcare professionals (Kalra et al., 2019). In Canada, policies dictate that healthcare professionals are obligated to fully disclose harmful, near-harm, and near-miss incidents to patients (Advice to the profession: Disclosure of harm. CPSO, n.d.). This will allow for the adoption of measures to mitigate resultant adverse outcomes, prevent future recurrence, and promote patient autonomy in making informed decisions. 

Strategies to Guide Decision-Making 

The patient in this scenario has significant cognitive decline which may necessitate the use of advanced directives, the patient’s family, and care teams in decision-making regarding treatment interventions. The decisions will be guided by the ethical principles of beneficence, nonmaleficence, autonomy, and justice (Varkey, 2020). The benefits and harms of each intervention should be weighed to avoid any harm to the patient. There should not be any coercion to therapeutic interventions. In case of medical errors, integrity should be upheld by promptly informing the patient and their family which prioritizes the patient’s interest.  

 Prescription Writing Process and Strategies to Minimize Medication Errors 

Prescription writing errors significantly contribute to medical errors with implications on quality of care, patient safety, legal, and economic sequelae. The prescription writing process follows a set standard that includes certain elements in prescriptions. These include the date of prescription, patient identifiers such as name, age, and gender, prescriber identifiers such as name, registration number, and contacts, and treatment description that meets the therapeutic objective (Nkera-Gutabara et al., 2020). The treatment should include the full drug name, dose, frequency, and duration of the regimen. Generic names, use of standard abbreviations, and legibility should be ensured to minimize medication errors (Nkera-Gutabara et al., 2020). The patient should also be educated on appropriate and correct drug use. 

Conclusion  

Drug prescription is an integral component of patient care that sometimes result in unexpected medical errors. These errors can have implications on patient safety, quality of care, and legal issues. In the event of harmful, near-harm, and near-miss incidents, healthcare professionals are legally and ethically obligated to disclose such events to patients and their families. This provides room for mitigation measures against resultant adverse outcomes, prevention of recurrence, and promotion of informed decisions by the patient. 

References 

Advice to the profession: Disclosure of harm. CPSO. (n.d.). Retrieved December 13, 2022, from https://www.cpso.on.ca/Physicians/Policies-Guidance/Policies/Disclosure-of-Harm/Advice-to-the-Profession-Disclosure-of-Harm#:~:text=Physicians%20have%20a%20legal%20duty,valid%20consent%20for%20subsequent%20treatment.  

Kalra, J. (J., Campos-Baniak, M. G., Saxena, A., & Rafid-Hamed, Z. (2019). Medical error disclosure – A Canadian perspective in improving quality of health care. Advances in Intelligent Systems and Computing, 26–34. https://doi.org/10.1007/978-3-030-20451-8_3  

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). https://doi.org/10.4102/phcfm.v12i1.2263  

Varkey, B. (2020). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17–28. https://doi.org/10.1159/000509119