Ethical and Legal Implications and Prevention of Medication Errors

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 are 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 the ethical and legal implications of scenarios and consider how to appropriately respond.

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. (please see attached)
  • 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 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.

 

Answer

Ethical and Legal Implications and Prevention of Medication Errors

The presented scenario involves AC, a 72-year-old male patient who has had a massive stroke and is admitted to the ICU, where he is unresponsive and on a ventilator. His wife believes he would prefer not to live in his current condition, whereas his daughter believes he would prefer to be kept alive if recovery was possible. This paper will address the ethical and legal implications of prescribing prescription drugs, disclosure and nondisclosure, and how to minimize prescription errors.

The prescriber has ethical and legal implications in determining the best course of action for the patient. This includes taking into account the patient’s and their family’s wishes and the available medical evidence and weighing the potential risks and benefits of any treatment. In this case, the prescriber must decide whether to provide the patient with life-sustaining treatment, including medications (Vaismoradi et al., 2021). The ethical and legal implications for the pharmacist entail ensuring that any medication they dispense is appropriate for the patient’s condition. The pharmacist must ensure that the medication is safe and effective and used according to the prescriber’s instructions.

Furthermore, the pharmacist must ensure that all medications are dispensed under state regulations and laws (Vaismoradi et al., 2021). The patient and their family must make decisions about their care based on their wishes and values, which have ethical and legal implications. This includes deciding whether to pursue life-sustaining treatment, such as medications, or to prioritize comfort care. Furthermore, the patient’s family must ensure that the patient’s wishes are respected and carried out. Finally, the patient’s care team must ensure the best possible care for the patient. This includes ensuring patients receive the best available treatment options and respecting and following their wishes.

Strategies for Addressing Disclosure and Nondisclosure According to the Laws of State

AC’s healthcare team should follow the laws and regulations of the state where he is located to address the issue of disclosure and nondisclosure in the case scenario. According to the Florida Advance Directives Act (FADA), healthcare providers must inform patients and their surrogates about their right to accept or refuse medical treatment (Florida Advance Directives, 2020). This includes informing AC and his family about the advantages, disadvantages, and alternatives to his treatment. The healthcare team should also explain advance directives and review AC’s treatment’s possible outcomes.

In addition, the healthcare team should follow the Florida Uniform Health Care Decisions Act (FUHCDA). This act requires healthcare providers to make healthcare decisions based on the patient’s wishes or, if the patient cannot make decisions, on the decision of a surrogate (House & Ogilvie, 2020). In the case of AC, his healthcare team should make decisions that reflect both his wife’s and his daughter’s wishes. If the two surrogates’ wishes cannot be reconciled, the healthcare provider should document the disagreement and decide to reflect the patient’s intent best. When making treatment decisions for AC, the healthcare team should also consider the principles of beneficence and non-maleficence (House & Ogilvie, 2020). This includes striking a balance between preserving life and minimizing unnecessary suffering.

Decision-Making Strategies for Advanced Practice Nurses Involving Error

In this scenario, the first strategy for guiding decision-making would be to assess the patient’s and family’s goals and values. When making healthcare decisions, advanced practice nurses must consider the patient’s and family’s wishes (Molina-Mula & Gallo-Estrada, 2020). As a result, a thorough discussion of the patient’s and family’s goals and values is required to ensure that the decisions are to their wishes.

The second strategy for guiding decision-making in this scenario would be considering the patient’s clinical status. AC’s neurological evaluation revealed no significant improvement; his CT scan revealed severe brain damage from the stroke. A comprehensive assessment of the patient’s clinical status is required to determine the potential benefits of additional treatment, such as medication (Toney-Butler & Unison-Pace, 2022). Factors such as age, comorbidities, medication history, and organ dysfunction would need to be considered to determine the appropriateness of any medication.

Transparency and honesty with the patient and family are critical in the event of an error. As an advanced practice nurse, you must accept responsibility for any mistakes and take the necessary steps to correct the situation. It is critical to disclose any errors to the patient and family so that they can understand the situation and participate in decision-making.

Minimizing Medication Errors in Prescription Writing.

Prescription writing is a complex process that includes several steps to ensure accuracy and patient safety. Before issuing a prescription, the healthcare provider must assess the patient’s condition, review the patient’s medical history, and discuss the medication’s benefits and risks (Tariq & Scherbak, 2022). It is critical to include all relevant information when writing the prescription, such as the dosage, route of administration, frequency, and duration of use. Using simple language and avoiding abbreviations and slang terms is critical. It is also important to look for potential drug interactions or contraindications with the patient’s current medications.

Electronic prescription systems, double-checking prescriptions, correctly labeling medications, and providing patient education are all strategies for reducing medication errors (Rodziewicz et al., 2022). Electronic prescription systems enable healthcare providers to enter prescriptions directly into the patient’s electronic health record, reducing errors by eliminating manual transcription. By comparing the written prescription to the patient’s medical record, double-checking prescriptions helps to ensure accuracy. Correct medication labeling aids in ensuring that the correct medication is administered to the correct patient. Finally, providing patient education on medication use helps ensure that the patient understands how to take the medication safely.

Conclusion

In conclusion, medication errors can have serious consequences for patient safety and health outcomes. When making treatment decisions, healthcare providers must consider ethical and legal implications, disclosure and nondisclosure, and the patient’s and family’s wishes. Strategies such as using electronic prescription systems, double-checking prescriptions, correctly labeling medications, and providing patient education must be implemented to reduce the risk of medication errors. This can aid in ensuring that patients receive the safest and most effective medication treatment possible.

 

References

Florida Advance Directives. (2019). Statutes & Constitution: View Statutes: Online Sunshine. State.fl.us. http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0700-0799/0765/0765.html

House, S. A., & Ogilvie, W. A. (2020). Advance directives. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459133/

Molina-Mula, J., & Gallo-Estrada, J. (2020). Impact of nurse-patient relationship on quality of care and patient autonomy in decision-making. International Journal of Environmental Research and Public Health, 17(3), 835. https://doi.org/10.3390/ijerph17030835

Rodziewicz, T. L., Hipskind, J. E., & Houseman, B. (2022, May 1). Medical error reduction and prevention. National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK499956/

Tariq, R. A., & Scherbak, Y. (2022). Medication dispensing errors and prevention. National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK519065/

Toney-Butler, T. J., & Unison-Pace, W. J. (2022, August 30). Nursing admission assessment and examination. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK493211/

Vaismoradi, M., Jordan, S., Logan, P. A., Amaniyan, S., & Glarcher, M. (2021). A systematic review of the legal considerations surrounding medicines management. Medicina, 57(1), 65. https://doi.org/10.3390/medicina57010065

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