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Posted: May 15th, 2023
ETHICAL AND LEGAL IMPLICATIONS OF PRESCRIBING DRUGS
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. (Illinois 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.
• Introduction and conclusion.
SCENARIO
AC is a 72-year-old male who is admitted to your ICU after suffering a massive stroke that has left him unresponsive and unable to communicate. He is currently on a ventilator. It was discovered that the stroke was the result of a medication error. His wife of 48 years is available along with their one adult daughter. The wife informs you that they don’t have any advanced directives, but she is “pretty sure her husband would not want to live like this.” However, their daughter is adamant her dad would want to be kept alive in case there is any chance to come out of this.
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GRADING RUBRICS
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. = 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.
Describe strategies to address disclosure and nondisclosure as identified in the scenario selected. Be sure to reference laws specific to your state. = 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.
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. = 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.
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Explain the process of writing prescriptions including strategies to minimize medication errors. = The response provides an accurate, detailed, and thorough explanation of the process of writing prescriptions, including detailed strategies to minimize medication errors.
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. = Paragraphs and sentences follow writing standards for flow, continuity, and clarity.
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Written Expression and Formatting - English writing standards: Correct grammar, mechanics, and proper punctuation. = Uses correct grammar, spelling, and punctuation with no errors.
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. = Uses correct APA format with no errors. use and cite at least 4 sources for written assignments throughout the quarter.
REQUIRED READING AND REFERENCING
• Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.
o Chapter 1, “Prescriptive Authority” (pp. 1–3)
o Chapter 2, “Rational Drug Selection and Prescription Writing” (pp. 4–7)
o Chapter 3, “Promoting Positive Outcomes of Drug Therapy” (pp. 8–12)
o Chapter 4, “Pharmacokinetics, Pharmacodynamics, and Drug Interactions” (pp. 13–33)
o Chapter 5, “Adverse Drug Reactions and Medication Errors” (pp. 34–42)
o Chapter 6, “Individual Variation in Drug Response” (pp. 43–45)
• American Geriatrics Society 2019 Beers Criteria Update Expert Panel. (2019). American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society Download Journal of the American Geriatrics Society, 67(4), 674–694. doi:10.1111/jgs.15767
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American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults by American Geriatrics Society, in Journal of the American Geriatrics Society, Vol. 67/Issue 4. Copyright 2019 by Blackwell Publishing. Reprinted by permission of Blackwell Publishing via the Copyright Clearance Center.
This article is an update to the Beers Criteria, which includes lists of potentially inappropriate medications to be avoided in older adults as well as newly added criteria that lists select drugs that should be avoided or have their dose adjusted based on the individual's kidney function and select drug-drug interactions documented to be associated with harms in older adults.
• Drug Enforcement Administration. (2021). CFR - Code of Federal Regulations Title 21Links to an external site.. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=1300
This website outlines the code of federal regulations for prescription drugs.
• Drug Enforcement Administration. (n.d.). Mid-level practitioners authorization by stateLinks to an external site.. Retrieved May 13, 2019 from http://www.deadiversion.usdoj.gov/drugreg/practioners/index.html
This website outlines the schedules for controlled substances, including prescriptive authority for each schedule.
• Institute for Safe Medication Practices. (2017). List of error-prone abbreviations, symbols, and dose designationsLinks to an external site.. Retrieved from https://www.ismp.org/recommendations/error-prone-abbreviations-list
This website provides a list of prescription-writing abbreviations that might lead to misinterpretation, as well as suggestions for preventing resulting errors.
• Sabatino, J. A., Pruchnicki, M. C., Sevin, A. M., Barker, E., Green, C. G., & Porter, K. (2017). Improving prescribing practices: A pharmacist‐led educational intervention for nurse practitioner studentsLinks to an external site.. Journal of the American Association of Nurse Practitioners, 29(5), 248–254. doi:10.1002/2327-6924.12446
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The authors of this article assess the impact of a pharmacist‐led educational intervention on family nurse practitioner (FNP) students’ prescribing skills, perception of preparedness to prescribe, and perception of pharmacist as collaborator.
References
https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=1300
http://www.deadiversion.usdoj.gov/drugreg/practioners/index.html
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https://www.ismp.org/recommendations/error-prone-abbreviations-list
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Ethical and Legal Implications of Prescribing Drugs
Prescribing drugs is a critical aspect of healthcare, and it is essential for healthcare providers to understand the ethical and legal implications of their actions. This paper will discuss a scenario involving a medication error that led to a massive stroke in a 72-year-old male patient. The ethical and legal implications of this scenario on all stakeholders, including the prescriber, pharmacist, patient, and patient's family, will be examined. Strategies to address disclosure and nondisclosure, as well as decision-making strategies for advanced practice nurses, will be discussed. Finally, the process of writing prescriptions and strategies to minimize medication errors will be explored.
Ethical and Legal Implications
The medication error in this scenario has significant ethical and legal implications for all stakeholders involved. The prescriber and pharmacist have a duty to provide safe and effective care, which includes ensuring that medications are prescribed and dispensed correctly (Rosenthal & Burchum, 2021). In this case, the medication error may have resulted from negligence or a lack of knowledge, which could lead to legal consequences such as malpractice lawsuits. The patient and his family are also affected by the error, as they must deal with the emotional and financial burden of the patient's condition.
Strategies to Address Disclosure and Nondisclosure
In Illinois, healthcare providers have a legal obligation to disclose medical errors to patients and their families (Illinois Medical Patient Rights Act, 410 ILCS 50/3.2). In this scenario, the healthcare team should disclose the medication error to the patient's wife and daughter, explaining the cause of the stroke and the potential consequences. This disclosure should be accompanied by an apology and a discussion of the steps being taken to prevent similar errors in the future.
Decision-Making Strategies for Advanced Practice Nurses
As an advanced practice nurse, two strategies to guide decision-making in this scenario include using ethical principles and seeking guidance from professional organizations. First, applying ethical principles such as beneficence, nonmaleficence, and respect for autonomy can help determine the best course of action (Rosenthal & Burchum, 2021). In this case, disclosing the error aligns with these principles by promoting transparency and respecting the patient's and family's right to know. Second, consulting guidelines from professional organizations, such as the American Nurses Association, can provide additional insight into the appropriate response to medication errors.
Process of Writing Prescriptions and Minimizing Medication Errors
The process of writing prescriptions involves several steps, including selecting the appropriate drug, determining the correct dosage, and providing clear instructions for use (Rosenthal & Burchum, 2021). To minimize medication errors, healthcare providers should:
Use standardized abbreviations and avoid error-prone abbreviations (Institute for Safe Medication Practices, 2017).
Double-check calculations and dosages, especially for high-risk medications.
Utilize electronic prescribing systems to reduce the risk of misinterpretation due to illegible handwriting.
Collaborate with pharmacists to ensure appropriate drug selection and dosing (Sabatino et al., 2017).
Conclusion
Understanding the ethical and legal implications of prescribing drugs is crucial for healthcare providers to ensure patient safety and maintain trust. In the presented scenario, disclosing the medication error and implementing strategies to prevent future errors are essential steps in addressing the situation. Advanced practice nurses can use ethical principles and professional guidelines to guide their decision-making in such cases. By following best practices in prescription writing and collaborating with pharmacists, healthcare providers can minimize the risk of medication errors and improve patient outcomes.
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