Write a 2- to 3-page paper, APA Format, 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 ( Florida).
- 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.
You will also examine the ethical and legal implications of prescribing drugs, as well as advanced practice nurse strategies in guiding prescription drug decision-making.
- 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?
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Case Scenario Analysis
Ethical and Legal Implications
Healthcare providers are guided by a legal framework that controls the practices of the professionals even when they enjoy autonomy. In the case scenario, a friend calls for a medication prescription even when the autonomous prescriber has less or no medical history of the patient. In this scenario, various legal and ethical implications may concern the patient and the prescribing healthcare provider. The healthcare provider may highly prescribe a risky medication that may have adverse effects. The healthcare provider prescribing the medications to the patient without the patient’s history may contradict the ethical principle of non-maleficence since this may be an unsafe and ineffective prescription. The same principle applies to a pharmacist who provides OTC medications without assessing the patient and without official instructions and documentation from the physician. According to Markel (2016), it is unlawful to prescribe medications without proper documentation from the physician showing affirming the prescribed medications. It is thus unethical and illegal for a provider to prescribe medications without physical assessment of the patient and proper documentation of the patient’s health condition and official prescription form. The medications may lead to adverse health effects that may result in litigation against the prescriber and the pharmacists for prescribing harmful or wrong medications.
Strategies to address disclosure and nondisclosure
Disclosure is an important aspect of communicating to the patient on the possibility of any harm during the healthcare process. Prescription of medications attracts numerous health risks and harms to patients. For the case scenario, the physician may prescribe ineffective or harmful medications, and thus it is ethical to communicate to the patient. According to Russel (2018), disclosure to the patient and their families improves trust, indicating that the healthcare providers care much about the patient’s health. In the event of adversity resulting from an error in prescription, the patient can be allowed to report the progress and in case of adversity to the healthcare provider. The patient may maintain positive communication with the healthcare provider in monitoring the progress of the treatment. Additionally, on establishing adverse effects of the medication, the healthcare provider can communicate with the patient’s guardian or caregiver for error rectification through the phone. The federal law allows disclosure through phones, emails, fax, and others while maintaining confidentiality and privacy standards. According to the Florida law on medication disclosure, the patient and the healthcare provider should be in person, with proper medical record documentation. In case of adverse effects, the friend can only be disclosed through a formal physical encounter for assessment and proper documentation by the responsible or accountable healthcare provider. I would therefore adhere to the Florida law on disclosure.
Strategies Guiding Decision Making
Various strategies guide disclosure or nondisclosure of a patient’s medication error to the patient. One of the strategies is to consider whether harmful effects result from the prescribed medications or not. If there are adverse effects, it is important to inform the patient and assure them of quality care to rectify the error. This would avoid litigations and negative publicity by the patients or their families concerning the impactful error. Harmful errors attract legal suits and thus should be disclosed. “Nonharmful” errors are less recognized, and thus, healthcare providers are not inclined to disclose the errors (Chamberlain et al., 2016). The other strategy is considering the laws of the state. In some states, medication errors should be reported and disclosed once realized. This includes both harmful and “harmless” errors. As an advanced nurse practitioner, I would disclose to the patient when there are harmful results of the errors in avoiding confusing the patient. Changing the prescription would be the most effective strategy when the prescription is harmless. This would avoid unnecessary tension for the patient and their families.
Writing prescriptions involves the process of documenting the prescriptions for the patients. Writing prescriptions is procedural, including various steps. The prescriber should first evaluate the patient and define their problems through clinical assessment of the patient’s history. The prescriber should then select the appropriate drug therapy and initiate the appropriate details, considering the non-pharmacologic therapies. The next step is to give information about the therapy, instructions, and probably warnings on using the medications. After providing instructions and warnings, the prescriber should ensure close monitoring in considering the continuation or discontinuation of the drug. Different strategies can be used to reduce medication errors. Patient education plays a very important role in improving medication adherence and reducing errors resulting from poor following of the instructions (Lee et al., 2017). Other effective methods include using prescription checklists, improved coordinated care among health providers, and effective information technology systems.
Chamberlain, C. J., Koniaris, L. G., Wu, A. W., & Pawlik, T. M. (2016). Disclosure of “nonharmful” medical errors and other events: duty to disclose. Archives of Surgery, 147(3), 282-286. https://jamanetwork.com/journals/jamasurgery/fullarticle/1107400
Lee, Y. M., Yu, H. Y., You, M. A., & Son, Y. J. (2017). Impact of health literacy on medication adherence in older people with chronic diseases. Collegian, 24(1), 11-18.
Markel, E. (2016, December 3). Legal Considerations: Prescribing Medications for Friends and Family. thrive. https://thriveap.com/blog/legal-considerations-prescribing-medications-friends-and-family
Russell, D. (2018). Disclosure and apology: Nursing and risk management working together. Nursing Management, 49(6), 17-19.