NURS 6521 Ethical and Legal Implications of Prescribing Drugs Essay

NURS 6521 Ethical and Legal Implications of Prescribing Drugs Essay

NURS 6521 Ethical and Legal Implications of Prescribing Drugs Essay

Ethical and Legal Implications of Prescribing Drugs

An elderly man who had experienced a major stroke that left him unable to speak or move his body was hospitalized in the intensive care unit (ICU) in the case study that was supplied for this assignment. It was decided that the patient would need mechanical ventilation. The patient’s wife instinctively understands what the patient would have desired despite the absence of advanced healthcare directives, which is substantially different from the perspective of her adult daughter. The couple’s daughter is convinced that her father would want to be supported if there was any chance that things would get better, but the wife is reasonably clear that her husband may not want to live this way. The purpose of this paper is to elucidate the ethical and legal ramifications of the aforementioned scenario and identify strategies to address both disclosure and nondisclosure.

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Ethical and Legal Implications

The patient had grave effects as a result of the prescription mistake, including a massive stroke that left him unconscious, according to the scenario provided. There are various ethical and legal implications to this case. For instance, the prescriber may obstruct the patient’s ability to make decisions for themselves (Ozeke et al., 2019). Additional ethical ramifications include the ideas of non-maleficence and beneficence, as well as transparency and the right to knowledge. Other possible legal ramifications include a malpractice claim or the prescription provider losing their license to practice medicine. Contrarily, it is the pharmacist’s responsibility to review the prescription twice and inform the prescriber of any medical mistakes so that the necessary corrections may be made.

The pharmacist in the aforementioned circumstance might therefore face legal implications, such as losing the right to practice medicine. The patient has suffered the greatest damage as a result of the medication error. He is unconscious, hence his right to knowledge and self-determination has been denied. However, his family members may advocate for the patient by filing a lawsuit or reporting the medication error to higher authorities (Samundeeswari, 2018). Nevertheless, they are unable to act on the patient’s behalf since there are no prior instructions.

Disclosure and Non-disclosure

            Looking at the case scenario provided, the patient and his family expect and desire prompt and complete disclosure of the circumstances that resulted in an unexpected outcome, including knowledge of what occurred, what is being done to prevent it from happening again, an admission of responsibility, and a show of sympathy. To oversee and detect issues about healthcare provision, hospitals in Massachusetts are legally required to disclose “serious reportable events” (SREs) to the Department of Public Health under the purview of the Health and Human Services. For instance, 940 Code. Mass. Regs, § 3.16(3)  states that failure to comply with existing legislation, rules, regulations, or laws intended to safeguard the public’s health, safety, or welfare constitutes a violation of M.G.L. c. 93A, § 2(940 CMR 3.00: General Regulation | Mass.gov, n.d.). One may argue that because the purpose of this new law is to safeguard the health, safety, and welfare of the general public, failing to reveal a medical error is a violation of c. 93A. The provider must look into the healthcare organization’s policy and guidelines for disclosing prescription mistakes before taking any remedial action, and they must talk with the supervisor about how to accomplish so (Ozeke et al., 2019).

Decision Making

            My immediate superior has to be informed of the error before I can proceed with alerting the patient’s relatives. This honors the patient’s right to autonomy as well as their desire to gain information. This decision was based on the policies and processes for reporting prescription errors established by the healthcare institution (Robertson & Long, 2018). Therefore, my supervisor will help me decide the appropriate course of action to take and any possible legal implications that may be related to the error. The patient will be made aware of this information since he is unconscious, and the proper course of action will be taken after notifying his family (Melnyk et al., 2021).

Writing Prescriptions

The act of prescribing medications necessitates a significant level of proficiency and erudition to ensure the well-being of patients and prevent errors in medication administration. To issue a valid prescription, the prescriber must adhere to all pertinent regulations and guidelines. The initial step in composing a prescription involves obtaining pertinent patient information, such as diagnosis and demographics, as emphasized by de Arajo et al. (2019). The subsequent phase entails the provision of personal information by the prescriber. The third step entails the determination of the name, dosage, frequency, and route of drug administration. It is imperative to document the precise dosage and quantity of the prescribed medication. The fourth stage indicates the utilization and quantity of refills. Ultimately, the individual responsible for prescribing medication must affix their signature to the physical document. Automated provider order input is recommended for prescribers to reduce prescription errors.

Conclusion

Because nurses are gaining an increasing amount of prescriptive powers, legal and ethical criteria must be taken into consideration to guarantee the safety of patients. As a direct consequence of this, prescriptive practice among registered nurses is controlled by specific legislation in every state. Non-compliance with these regulations can be considered unethical concerning the patient and may result in legal consequences for the prescriber. This is analogous to the case study that has been discussed above.

References

940 CMR 3.00: General regulation | Mass.gov. (n.d.). Www.mass.gov. Retrieved June 2, 2023, from https://www.mass.gov/regulations/940-CMR-300-general-regulation

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

Melnyk, B. M., Tan, A., Hsieh, A. P., Gawlik, K., Arslanian-Engoren, C., Braun, L. T., Dunbar, S., Dunbar-Jacob, J., Lewis, L. M., Millan, A., Orsolini, L., Robbins, L. B., Russell, C. L., Tucker, S., & Wilbur, J. (2021). Critical Care Nurses’ Physical and Mental Health, Worksite Wellness Support, and Medical Errors. American Journal of Critical Care, 30(3), 176–184. https://doi.org/10.4037/ajcc2021301

Ozeke, O., Ozeke, V., Coskun, O., &Budakoglu, I. I. (2019). Second victims in health care: current perspectives. Advances in Medical Education and Practice, Volume 10, 593–603. https://doi.org/10.2147/amep.s185912

Robertson, J. J., & Long, B. (2018). Suffering in Silence: Medical Error and its Impact on Health Care Providers. The Journal of Emergency Medicine, 54(4), 402–409. https://doi.org/10.1016/j.jemermed.2017.12.001

Samundeeswari, A. (2018). Nurses’ Knowledge on Prevention of Medication Error. Journal of Medical Science and Clinical Research, 6(3). https://doi.org/10.18535/jmscr/v6i3.45

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Ethical and Legal Implications of Prescribing Drugs

What type of drug should you prescribe based on your patient’s diagnosis? How much of the drug should the patient receive? How often should the drug be administered? When should the drug not be prescribed? Are there individual patient factors that could create complications when taking the drug? Should you be prescribing drugs to this patient? How might different state regulations affect the prescribing of this drug to this patient?

These are some of the questions you might consider when selecting a treatment plan for a patient.

As an advanced practice nurse prescribing drugs, you are held accountable for people’s lives every day. Patients and their families will often place trust in you because of your position. With this trust comes power and responsibility, as well as an ethical and legal obligation to “do no harm.” It is important that you are aware of current professional, legal, and ethical standards for advanced practice nurses with prescriptive authority. Additionally, it is important to ensure that the treatment plans and administration/prescribing of drugs is in accordance with the regulations of the state in which you practice. Understanding how these regulations may affect the prescribing of certain drugs in different states may have a significant impact on your patient’s treatment plan. In this Assignment, you explore ethical and legal implications of scenarios and consider how to appropriately respond.

Resources

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

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.

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 College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The College 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

Links to an external site.). All papers submitted must use this formatting.

submission information

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.

To submit your completed assignment, save your Assignment as WK1Assgn2_LastName_Firstinitial

Then, click on Start Assignment near the top of the page.

Next, click on Upload File and select Submit Assignment for review.

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Rubric

NURS_6521_Week1_Assignment_Rubric

NURS_6521_Week1_Assignment_Rubric

Criteria Ratings Pts

This criterion is linked to a Learning Outcome 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.

25 to >22.25 pts

Excellent

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.

22.25 to >19.75 pts
Good

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.19.75 to >17.25 pts

Fair

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.17.25 to >0 pts

Poor

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.

25 pts

This criterion is linked to a Learning Outcome Describe strategies to address disclosure and nondisclosure as identified in the scenario selected. Be sure to reference laws specific to your state.
20 to >17.8 pts

Excellent

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.

17.8 to >15.8 pts

Good

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.

15.8 to >13.8 pts

Fair

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.

13.8 to >0 pts

Poor

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.

20 pts

This criterion is linked to a Learning Outcome 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.

20 to >17.8 pts

Excellent

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.

17.8 to >15.8 pts
Good

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.

15.8 to >13.8 pts
Fair

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.

13.8 to >0 pts

Poor

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.

20 pts

This criterion is linked to a Learning Outcome Explain the process of writing prescriptions including strategies to minimize medication errors.

20 to >17.8 pts

Excellent

The response provides an accurate, detailed, and thorough explanation of the process of writing prescriptions, including detailed strategies to minimize medication errors.

17.8 to >15.8 pts
Good

The response provides an accurate explanation of the process of writing prescriptions, including some strategies to minimize medication errors.

15.8 to >13.8 pts

Fair

The response provides an inaccurate or vague explanation of the process of writing prescriptions, including inaccurate or vague strategies to minimize medication errors.

13.8 to >0 pts

Poor

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.

20 pts

This criterion is linked to a Learning Outcome 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.

5 to >4.45 pts

Excellent

Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

4.45 to >3.95 pts

Good

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

3.95 to >3.45 pts

Fair

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.

3.45 to >0 pts

Poor

Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.

5 pts

This criterion is linked to a Learning Outcome Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation

5 to >4.45 pts

Excellent

Uses correct grammar, spelling, and punctuation with no errors

4.45 to >3.95 pts

Good

Contains a few (1–2) grammar, spelling, and punctuation errors

3.95 to >3.45 pts

Fair

Contains several (3–4) grammar, spelling, and punctuation errors

3.45 to >0 pts

Poor

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding

5 pts

This criterion is linked to a Learning Outcome 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.

5 to >4.45 pts

Excellent

Uses correct APA format with no errors

4.45 to >3.95 pts
Good

Contains a few (1–2) APA format errors

3.95 to >3.45 pts

Fair

Contains several (3–4) APA format errors

3.45 to >0 pts

Poor

Contains many (≥ 5) APA format errors

5 pts

Total Points: 100