Pharm Assignment Week 1

Introduction

As the scope of practice of nurse practitioners continue to widen, new ethical challenges within clinical settings emerge. Among the emerging roles of nurse practitioners (NPs) is the prescription of medications.  Therefore, NPs need to ensure that they have the appropriate skills and competency to handle ethical and legal issues that come with the prescribing of medication (Rosenthal & Burchum, 2017). This paper will explore the legal and ethical implications associated with the prescription of medications. Specifically, the paper will respond to a scenario where a medication error occurred during the prescription of medication to a 5-year-old patient. The patient was dosed a dose appropriate for an adult. Pharm Assignment Week 1

Ethical and Legal Implications and Involved Stakeholders

According to Kadivar et al (2017), medication errors may occur at any treatment phase, including prescribing. In the current scenario, the medication error has ethical implications for the NP, patient, and the patient’s family as well. Legally, the nurse is obligated to disclose the medication error to the patient’s family and the healthcare organization. The NP was entrusted with the patient by the family and the prescription error was unanticipated. The ethical principles of beneficence and non-maleficence obligate nurses to provide the best care to patients, without causing harm (Kadivar et al., 2017). These ethical principles were violated when a medication error occurred. Moreover, the principle of fidelity obligates nurses to be faithful to their patients. Therefore, the nurse should disclose the medication error to the patient’s family to uphold this ethical principle.

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Legally, the nurse is supposed to report the medication error using the appropriate channels. The family of the patient is also supported by the law to sue the nurse in case the patient experiences any harm. The organization is also obligated to perform the root cause analysis of the event. In the US, various states have different prescription privileges, and thus the legal consequences of the medication errors differ according to the states. Pharm Assignment Week 1

Strategies to Address Disclosure and Nondisclosure

The first strategy the nurse should do in the presented scenario is to contact the family of the patient immediately after discovering the medication error. This would ensure that the family does not continue administering the wrong dose to the patient. The NP should instruct the family to ensure the patient goes back to the clinic for monitoring and to be administered with the proper prescription. The second strategy is for the nurse to disclose the medication error through proper reporting (Kadivar et al., 2017). This will enable the organization to conduct the root cause analysis of the error and consequently implement the appropriate corrective actions. The nurse should also support the family of the patient when handling the complications and inconveniences likely to occur due to the medication error (Kadivar et al., 2017). By using these two strategies, the NP would be acting with the ethical and legal boundaries.

Strategies to Guide Prescription Drug Decision-Making

To lower the possibility of prescription errors, the nurse should utilize appropriate tools like electronic drug references and prescribing software. Factors that may guide prescription drug decision-making include the health problem of the patient, the therapeutic goal of the medication, selection of the suitable medication, the side effects associated with the medication, and the cost of the medication (Davari et al., 2018). The nurse should provide the patient and their families with the required information and instructions about the medication. The nurse should utilize reliable and valid practice guidelines regarding the prescription of medications to decrease the negative effects of various factors likely to influence the effective prescription of medications (Fowler & American Nurses Association, 2015).

The Process of Writing Prescriptions to Avoid Medication Errors

Having accurate and correct patient data is the first step towards ensuring medication safety because the information guides selection of the proper medication, dose, frequency, and route. Patient-specific identifiers should be used to make sure that the correct patient receives the correct medication (Davari et al., 2018). The second step involves verifying allergies and reactions, while the third step includes highlighting critical diagnoses and health conditions. Standardization of weight and height measurements is also important to ensure the administration of the appropriate dose. Moreover, an NP should use established guidelines regarding the correct dose, precautions, and contraindications. High-alert medications should be identified to ensure close monitoring of patients receiving “high-alert” medications (Rosenthal & Burchum, 2017). Pharm Assignment Week 1

Conclusion

Advanced practice nurses have prescriptive authority depending on the state. In the providing scenario, the first step would be to identify if independent prescribing is allowed for APNs in the specific state. The nurse should ensure that the medication error is disclosed to the family of the patient, and reported to the healthcare organization.

References

Davari, M., Khorasani, E., & Tigabu, B. M. (2018). Factors Influencing Prescribing Decisions of Physicians: A Review. Ethiopian Journal of health sciences, 28(6), 795–804. https://doi.org/10.4314/ejhs.v28i6.15.

Fowler, M. D. M., & American Nurses Association. (2015). Guide to the Code of Ethics for Nurses with Interpretive Statements: Development, Interpretation, and Application (2nd ed.). Silver Spring, Maryland: American Nurses Association.

Kadivar, M., Manookian, A., Asghari, F., Niknafs, N., Okazi, A., & Zarvani, A. (2017). Ethical and legal aspects of patient safety: a clinical case report. Journal of medical ethics and the history of medicine, 10, 15.

Rosenthal, L., & Burchum, J. (2017). Lehne’s Pharmacotherapeutics for Advanced Practice Nurses and Physician Assistants-E-Book. Elsevier Health Sciences. Pharm Assignment Week 1