Assignment: Ethical and Legal Implications of Prescribing Drugs

Nurse practitioners (NPs) across the nation have different levels of prescriptive authority on medical services, controlled substances, and medications. Before writing a prescription, NPs are obligated to obtain a comprehensive health history, conduct a physical exam, and in other instances, order diagnostic laboratory or radiological tests (Arcangelo et al, 2017). After deciding to prescribe a specific drug, NPs must consider factors such as variations in the mode of action, route of administration, medication costs, side effects, convenience, and interactions. In this paper, the author discusses the ethical and legal implications of prescribing drugs. Assignment: Ethical and Legal Implications of Prescribing Drugs This knowledge promotes ethical prescribing among NPs, promotes quality care, and patient safety.

Case Overview

A friend calls and asks you to prescribe a medication for her. You have this autonomy, but you don’t have your friend’s medical history. You write the prescription anyway Assignment: Ethical and Legal Implications of Prescribing Drugs.

Ethical and Legal Implications of Selected Scenario

The most important factors to consider before prescribing drugs for friends or close family members are state-specific laws on prescriptive authority, how regulations by an individual’s state board of nursing address the issue. For instance, the author’s state regulations require NPs to have a collaborative agreement with a physician, and this agreement is limited to a practice setting (Mitchel & Oliphant, 2016).  Writing prescriptions without this collaborative agreement violates the state laws and regulations and warrants disciplinary measures.

Prescriber: writing a prescription to a friend minus a comprehensive history and a specific diagnosis beyond a practice setting increase the risk of adverse reactions, subsequent lawsuits, and a revoked license.

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Pharmacist: filling a prescription without ascertaining whether a prescriber obtained a patient’s history, and performed a physical assessment increases the likelihood to lose his practice license.

Patient and Patient’s Family: prescribing drugs to friends without obtaining a history and performing a physical examination increases the risk of medication errors, adverse events, and drug-drug interactions (Arcangelo et al, 2017) Assignment: Ethical and Legal Implications of Prescribing Drugs. Patients are likely to incur additional medical costs in terms of management and can likely sue a prescriber for malpractice.

Strategies to Address Disclosure, Nondisclosure, and Decision Making

The author’s state laws and regulations require that NPs should discuss and educate patients about prescribed medications including the five rights of medication administration. In case of any prescription or medication errors, the laws further require that NPs should disclose related information to relevant stakeholders as this will guide decision making in addressing the issue Assignment: Ethical and Legal Implications of Prescribing Drugs. Although some NPs prescribe medications for friends and family, it is not a good practice since the close relationship can easily cloud an NPs judgment (Centers for Disease Control, 2016). The two most effective strategies that the author would use to guide decision making are; using a prescriptive decision-making model, and rational prescribing. The former incorporates groups with a special interest, the family, patient, and colleagues and the latter emphasizes the need to ensure that patients are prescribed the appropriate drugs based on identified clinical needs, timing, dosing, and cost.

Explain the Process of Writing Prescriptions

According to the World Health Organization, prescribers must observe the following process when writing prescriptions;

• Taking history, conducting a physical exam and ordering for diagnostic tests
• Determining the therapeutic objective of drug therapy
• Selecting the right drug (consider affordability by a patient)
• Educating patients about a drug, interactions, side effects, instructions, and warnings
• Regularly monitoring a patient. Assignment: Ethical and Legal Implications of Prescribing Drugs
• Using appropriate  prescribing tools  to  reduce prescription errors.

Finally, utilizing the state-specific laws on prescriptive authority, how regulations by an individual’s state board of nursing address the issue can help NP’s provide care within their scop of practice.

References

Arcangelo, V. P., Peterson, A. M., Wilbur, V. F., & Reinhold, J. A. (2017). Pharmacotherapeutics for advanced practice: a practical approach. Philadelphia: Wolters Kluwer

Centers for Disease Control. (2016). Prescription drug physical exam requirements. Retrieved from https://www.cdc.gov/phlp/docs/pdpe-requirements.pdf

Mitchell, A., & Oliphant, C. M. (2016). Responsibility for Ethical Prescribing. The Journal for Nurse Practitioners, 12(3), A20. Assignment: Ethical and Legal Implications of Prescribing Drugs

Assignment: Ethical and Legal Implications of Prescribing Drugs

To Prepare

By Day 7 of Week 1

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). All papers submitted must use this formatting.

Submission and Grading Information