ETHICAL AND LEGAL IMPLICATIONS OF PRESCRIBING DRUGS ESSAY

ETHICAL AND LEGAL IMPLICATIONS OF PRESCRIBING DRUGS ESSAY

ETHICAL AND LEGAL IMPLICATIONS OF PRESCRIBING DRUGS ESSAY

Ethical and Legal Implications of Prescribing Drugs

Ethical and Legal Implications of Prescribing Drugs
Disclosure of medical errors (MEs) is considered a fundamental part of patients’ care. The case provides a scenario where an NP makes an error when prescribing medication to a 5-year-old. The NP prescribes the wrong dose to the child, which should be prescribed to an adult. The purpose of this paper is to explore the associated legal and ethical implications in the case and discuss disclosure and nondisclosure.

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Ethical and Legal Implications of the Scenario
The ME may result in ethical implications for the NP and pharmacist. The ethical principles involved are beneficence (duty to do good) and nonmaleficence (duty to prevent harm). The NP prescribed a wrong dose that may harm the patient from severe adverse events rather than treating the patient’s condition, failing to uphold beneficence and nonmaleficence (Varkey, 2021). The NP risks facing legal action for prescribing a dose that may cause adverse effects to the patient. The pharmacist has a role in ensuring the drug and dose prescribed are appropriate for a patient’s diagnosis and age. Thus, ethical consequences may arise for the pharmacist for failing to cross-check if the dose was appropriate for the child before dispensing. The pharmacist may face lawsuits for dispensing an incorrect dose, especially if the patient experiences adverse drug effects.
Strategies to Address Disclosure and Nondisclosure
Disclosure of MEs is endorsed and governed by ethical and professional guidelines and legislation. Most patients also desire the acknowledgment of MEs by providers, even if those errors are minor or insignificant. Buletsa et al. (2018) explain that detailed disclosure of minimal-harm or near-miss errors strengthens the patient-provider relationship, creates an open atmosphere of dialogue, and fosters patient participation in making medical decisions. Under Florida law (Fla. Stat. § 456.0575), every licensed health care practitioner must inform each patient, or the patient’s proxy, in person about adverse incidents that cause adverse harm to the patient.
Strategies to Use as an Advanced Practice Nurse to Guide Decision-Making
As an APN, I would follow the organization’s policy on disclosing MEs and review the state’s law on disclosure. I would follow the steps outlined in our organization’s policy on disclosing MEs. Besides, I would follow our state’s law on disclosure. The FL law would require that I disclose the ME to the child’s caregiver in person and document it in the medical record. When disclosing the ME, I would provide the caregiver with correct information about adverse outcomes related to the error (Mansour et al., 2020). Furthermore, I would follow the “Five A’s” of disclosure: Acknowledgment, Apology, All the facts, Assurance, and Appropriate compensation.
Process of Writing Prescriptions and Strategies to Minimize Medication Errors
When writing a prescription, the clinician should include the following information about them: Full name; Address, Telephone, and Contact number; Consultation Time and Date; Educational qualifications; Registration number. The details that should be written by the prescriber related to the patient include: Full name, age, weight, sex, address, and telephone number (Imran et al., 2020). In addition, the prescriber should write the following information About the drug: Full name in Generic, Full name in Capital letters, Strength, Dosage, and dosing instructions. MEs can be minimized by using technology like E-Prescribing, which enables the prescriber to electronically send an accurate, error-free, and understandable prescription directly to the pharmacy from the point of care. Clinicians can also reduce MEs by taking a thorough medication history for the patient to identify current and past medications and drug allergies.
Conclusion
The NP and pharmacists failed to uphold beneficence and nonmaleficence for prescribing and dispensing the wrong dose to a patient. They risk facing litigations if adverse drug events occur. Immediate disclosure of all MEs is the best approach to address disclosure. As an NP, I would address disclosure by following the organization’s policy and state law on disclosing MEs to patients.

References
Buletsa, S., Drozd, O., Yunin, O., & Mohilevskyi, L. (2018). Medical error: civil and legal aspect. Georgian Med News, 276, 161-166.
Imran, M., Doshi, C., & Kharadi, D. (2020). Time to teach basic and regulatory aspects of art of prescription writing for better doctor-patient safety and keeping communication accessible and straight. Daru: Journal of Faculty of Pharmacy, Tehran University of Medical Sciences, 28(1), 25–32. https://doi.org/10.1007/s40199-018-00236-1
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, 1-8. https://doi.org/10.1186/s12910-020-00513-2
Varkey, B. (2021). Principles of Clinical Ethics and Their Application to Practice. Medical Principles and Practice: international journal of the Kuwait University, Health Science Centre, 30(1), 17–28. https://doi.org/10.1159/000509119

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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.

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 decisdecision-makinghis 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.

Scenario: As a nurse practitioner, you prescribe medications for your patients. You make an error when prescribing medication to a 5-year-old patient. Rather than dosing him appropriately, you prescribe a dose suitable for an adult.

Course resources: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=1300

https://www.deadiversion.usdoj.gov/drugreg/practioners/index.html

https://www.ismp.org/recommendations/error-prone-abbreviations-list

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