NURS-6521C Week 1: Assignment 2 Ethical and Legal Implications of Prescribing Drugs
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.
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NURS-6521C Week 1: Assignment 2 The Ethical and Legal Implications of Drug Prescriptions
Nurse practitioners in advanced roles must provide high-quality care to patients. They have to follow ethical, legal, and professional rules while doing their job. When they prescribe drugs, they must gather important information to prevent mistakes. Errors in drug prescription can be fatal and can result in legal and ethical consequences for the prescribing nurse. However, there are legal systems and policies in place to reduce medication errors through reporting mechanisms used by hospitals. Nurses and other healthcare professionals must adhere to guidelines to ensure patient safety. The role of nurses in medication administration goes beyond just writing accurate prescriptions. It also involves understanding the potential side effects and drug interactions.
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Let’s consider a scenario: a 72-year-old man has had a massive stroke and is unresponsive. In this paper, we will explore the ethical and legal implications related to this scenario, how to handle the disclosure and nondisclosure of information, and the process of prescribing medications.
Ethical and Legal Implications
Prescribing medications involves many stakeholders, including the prescriber, pharmacist, patient, and the patient’s family. All of these parties must follow legal and ethical guidelines to avoid serious consequences, such as patient harm or even death. These stakeholders are responsible for the lives of many people and must take steps to prevent prescription errors. Healthcare professionals are accountable for any mistakes made during the prescription process. In this case, since the patient cannot provide input due to being nonresponsive, the family’s role becomes crucial. They need to provide the practitioner with essential information about the patient’s medical history and preferences. Understanding the patient’s history and educating the family can facilitate the prescription process.
For instance, in this scenario, there is a dilemma because the spouse and the daughter have different opinions about the patient’s wishes. The practitioner must educate both family members to avoid legal and ethical issues. Hence, the ethical or legal implications may start with the prescriber recommending the wrong medication, which could lead to complications or the patient’s death. Since the patient cannot express their wishes, the Nursing practitioner must be careful when making any medical prescription for the elderly patient. Failing to involve both family members in drug recommendations would be considered unethical.
Additionally, pharmacists play a crucial role in helping patients use their prescribed medications effectively. If there’s an agreement between the prescriber and the family, the next stakeholder in line is the pharmacist. They must ensure that the patient gets the maximum benefit from the prescribed drugs and provide honest information about any potential side effects or issues related to the prescribed medication.
Moreover, the family needs to reach a consensus on how to handle the situation. If they decide to attempt to revive the patient, they should demand due diligence in the prescription process. If they detect any prescription errors, they are legally obligated to report them. As for the patient, the decisions lie with the healthcare professionals and family since he is nonresponsive.
Strategies for Managing Disclosure and Nondisclosure
Healthcare professionals must handle the disclosure and nondisclosure of information carefully to improve patient safety. In this scenario, since the patient is elderly and unresponsive, errors could occur if the prescriber recommends drugs without thoroughly reviewing the patient’s medical history and current condition. Similarly, the pharmacist may neglect to provide all necessary information, including potential side effects. However, these professionals can rectify these errors by sharing information with the patient and all other stakeholders. Medication errors are not uncommon, but how disclosure or nondisclosure is handled matters significantly. For example, in Texas, HB No 1614 relates to reporting medical mistakes. This strategy can enhance the oversight of professionals making mistakes and the seriousness of these errors.
Decision-Making Strategies in this Case
Two main strategies guide decision-making: legal and ethical codes of conduct. Ethical standards require healthcare professionals not to expose clients to harm or injury. Thus, it is essential to disclose any mistakes to prevent harm that could result from nondisclosure, such as side effects. Moreover, state and federal laws demand accountability from medical professionals. Therefore, there is an obligation to disclose any errors to the patient and the institution to rectify the mistake and avoid legal consequences in some cases.
The Prescription Writing Process
The process of writing a prescription begins with examining and defining the patient’s issue. Without this initial step, it would be challenging to make a prescription. Next, specifying the therapeutic goal allows the healthcare professional to direct the prescription toward a specific objective with expected outcomes. Selecting a suitable, cost-effective, and effective drug therapy is crucial. Additionally, starting therapy with pertinent details and considering non-pharmacological treatments is wise. Prescriptions should be clear and legible. Information, warnings, and instructions are vital when writing a prescription. Notably, The National Coordinating Council on Medication Error Reporting and Prevention recommends avoiding abbreviations for instructions and drug names to prevent medication errors. The use of computers and other tools can also help eliminate mistakes.
In conclusion, providing drug prescriptions can lead to serious harm or death. Therefore, advanced nurse practitioners with prescription authority must understand the legal and ethical guidelines and implications. They should be aware that they can be legally accountable for any medication errors. It’s essential to recognize that these practitioners should not prescribe drugs to the family, and in the event of a medication error, it’s crucial for the healthcare professional to disclose the information to the relevant stakeholders, including the patient. Following institutional and evidence-based guidelines can help prevent errors.
References
Brits, H., Botha, A., Niksch, L., Venter, K., Terblanché, R., & Joubert, G. (2017). Illegible handwriting and other prescription errors on prescriptions at National District Hospital, Bloemfontein. Professional Nursing Today, 21(2), 53-56.
Segal, G., Segev, A., Brom, A., Lifshitz, Y., Wasserstrum, Y., & Zimlichman, E. (2019). Reducing drug prescription errors and adverse drug events by application of a probabilistic, machine-learning-based clinical decision support system in an inpatient setting. Journal of the American Medical Informatics Association, 26(12), 1560-1565.
Tariq, R. A., Vashisht, R., Sinha, A., & Scherbak, Y. (2018). Medication dispensing errors and prevention.
Zaghloul, A. A., Elsergany, M., & Mosallam, R. (2018). A measure of barriers toward medical disclosure among health professionals in the United Arab Emirates. Journal of Patient Safety, 14(1), 34-40.
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