coursework-banner

Assignment 2: Ethical and Legal Implications of Prescribing Drugs

Assignment 2: Ethical and Legal Implications of Prescribing Drugs

Introduction

The scenario involves a nurse practitioner being requested by a friend to prescribe medication. However, even though the practitioner does not have the friend’s complete medical history, the NP goes ahead and writes the prescription. According to Cooper & Fitzpatrick (2021), a medication prescription is not supposed to be written without complete health history and physical examination. Writing prescriptions should be done according to the medical history of the patient, including past and current medications, as well as diagnosis. It is also important for the prescriber to first perform a risk-to-benefit analysis prior to writing a prescription (Cooper & Fitzpatrick, 2021). Therefore, advanced practice nurses need to be aware of the responsibilities allied to prescribing drugs. This paper will provide an analysis of the legal and ethical implications in the provided scenario.

Ethical and Legal Implications and Relevant Stakeholders

States regulate and control prescriptive practices and depending on the state, an NP writing a prescription without performing the required tests, physical examination, and gathering medical history may be liable for unprofessional conduct, leading to legal implications like omission (Peterson, 2017). Therefore, an NP prescribing for a friend without a medical history may have some legal implications because the NP may not know the patient’s allergies and current medications; this may result in adverse reactions, which can lead to patient harm (Halli-Tierney et al., 2019). NPs also have the ethical duty to prescribe correctly, which is possible through physical examination, collecting medical history, and assessment. Moreover, prescribing to friends and family without documentation may result in legal implications in case of patient harm (Coombes et al., 2020). The patient and the family are also involved as they can take legal action if the prescription caused harm to the patient. The pharmacist is also involved in the scenario. When filling and dispensing the prescription, the pharmacist has the duty of checking the prescriptions before dispensing and filling the medication to patients in order to make sure the patient receives the correct prescription.

Click here to ORDER an A++ paper from our MASTERS and DOCTORATE WRITERS: Assignment 2: Ethical and Legal Implications of Prescribing Drugs

Strategies to Address Disclosure and Nondisclosure

Health practitioners recognize medical errors occur during practice. As a result, there are established processes to prevent and report medical errors. The state government passed HB 1614 (Quality and patient safety, n.d). legislation that requires medical practitioners to have a detailed entry of medical error incidents (Gracia et al., 2019). This strategy ensures surveillance of medical practitioners who make medical errors frequently and the intensity of the errors leading to legal actions. This strategy can be implemented to identify and take disciplinary action against practitioners who are rampant in medical errors, negligence, and other errors. The strategy also helps to identify quack practitioners (Gracia et al., 2019). The second strategy is to obligate healthcare practitioners to document medical errors and implement legal frameworks to handle court cases (Gracia et al., 2019). This strategy can improve the cautiousness among healthcare practitioners and minimize medical errors and the resulting adverse events.

Strategies for Decision Making

The response to this scenario should be guided by the principles of honesty and integrity. These principles guide an individual when it comes to adhering to the codes of conduct and professional ethics. Therefore, codes of conduct and ethics can effectively guide the response to this scenario. For example, Kantian deontology requires individuals to base their actions on the rule of law, irrespective of the consequences to both the recipient and the actor (Suri et al., 2020). Therefore, in this scenario, it is appropriate to report the incident because this is what the state law requires. Therefore, this incident should be reported as per ethical principles. It is also important for the NP to follow up with the patient to establish if any adverse event occurred after prescribing the medication without physical assessment and the required history.

The Process of Writing Prescriptions

It is important for the nurse practitioner to have the required health history, medication history, patient information, and laboratory findings before prescribing medications. This information helps the prescriber to know the type of medication and dosage of the medication, as well as the route of administration (Cooper, & Fitzpatrick, 2021). The pharmacist also needs to have an overview of this patient information in order to ensure the correct dispensing of medication.

Conclusion

Prescribing of medications should not be done without the complete patient’s health information. This is because a lack of vital information such as allergies, diagnosis, and current medications could lead to adverse effects and patient harm. As a result, can result in the violation of both legal and ethical prerequisites, resulting in legal implications on such a prescriber.

References

Coombes, I., Markwell, A., Kubler, P., Redmond, A. M., McGurk, G., & Roberts, J. A. (2020). Principles of ethical prescribing for self and others: hydroxychloroquine in the COVID-19 pandemic. Australian prescriber, 43(3), 76–77. https://doi.org/10.18773/austprescr.2020.030

Cooper, S. M., & Fitzpatrick, R. W. (2021). Implementation and evaluation of a good prescribing tip email to reduce junior doctors’ prescribing errors. Journal of Patient Safety and Risk Management, 26(5), 214-220.

Gracia, J. E., Serrano, R. B., & Garrido, J. F. (2019). Medication errors and drug knowledge gaps among critical-care nurses: a mixed multi-method study. BMC health services research, 19(1), 1-9.

Halli-Tierney, A. D., Scarbrough, C., & Carroll, D. (2019). Polypharmacy: evaluating risks and deprescribing. American family physician, 100(1), 32-38.

Peterson M. E. (2017). Barriers to Practice and the Impact on Health Care: A Nurse Practitioner Focus. Journal of the advanced practitioner in oncology, 8(1), 74–81.

Ethical and Legal Implications of Prescribing Drugs

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

Resources

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.

WEEKLY RESOURCES

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.
  • 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.

By Day 7 of Week 1

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.

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

Rubric

NURS_6521_Week1_Assignment_Rubric
NURS_6521_Week1_Assignment_Rubric
Criteria Ratings Pts

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.

25 to >22.25 pts

Excellent
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.

22.25 to >19.75 pts

Good
The response explains the ethical and legal implications of the scenario selected on all stakeholders involved. … The response includes accurate explanations as to how these implications affect the prescriber, pharmacist, patient, and the patient’s family.

19.75 to >17.25 pts

Fair
The response inaccurately or vaguely explains the ethical and legal implications of the scenario selected for all stakeholders involved. … The response includes vague explanations as to how these implications affect the prescriber, pharmacist, patient, and the patient’s family.

17.25 to >0 pts

Poor
The response vaguely and inaccurately explains the ethical and legal implications of the scenario selected for all stakeholders involved, or the response is missing. … The response vaguely and inaccurately explains how these implications affect the prescriber, pharmacist, patient, and the patient’s family, or is missing.
25 pts

Describe strategies to address disclosure and nondisclosure as identified in the scenario selected. Be sure to reference laws specific to your state.

20 to >17.8 pts

Excellent
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.

17.8 to >15.8 pts

Good
An accurate description of strategies to address disclosure and nondisclosure as identified in the scenario selected is provided. … The response includes accurate reference to state laws related to the scenario.

15.8 to >13.8 pts

Fair
A vague or inaccurate description of strategies to address disclosure and nondisclosure as identified in the scenario selected is provided. … The response includes inaccurate or vague reference to state laws related to the scenario.

13.8 to >0 pts

Poor
A vague and inaccurate description of strategies to address disclosure and nondisclosure as identified in the scenario selected is provided, or is missing. … The response includes vague and inaccurate reference to state laws related to the scenario, or is missing.
20 pts

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.

20 to >17.8 pts

Excellent
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.

17.8 to >15.8 pts

Good
The response accurately explains at least two strategies that an advanced practice nurse would use to guide decision making in the scenario. … The response accurately explains whether they would disclose the error, including an accurate justification for the explanation provided.

15.8 to >13.8 pts

Fair
The response inaccurately or vaguely explains at least two strategies that an advanced practice nurse would use to guide decision making in the scenario, or only explains one strategy. … The response inaccurately or vaguely explains whether they would disclose the error, including a justification that is vague, inaccurate, or misaligned to the explanation provided.

13.8 to >0 pts

Poor
The response inaccurately and vaguely explains only one strategy that an advanced practice nurse would use to guide decision making in the scenario, or is missing. … The response inaccurately and vaguely explains whether they would disclose the error, with no justification provided, or is missing.
20 pts

Explain the process of writing prescriptions including strategies to minimize medication errors.

20 to >17.8 pts

Excellent
The response provides an accurate, detailed, and thorough explanation of the process of writing prescriptions, including detailed strategies to minimize medication errors.

17.8 to >15.8 pts

Good
The response provides an accurate explanation of the process of writing prescriptions, including some strategies to minimize medication errors.

15.8 to >13.8 pts

Fair
The response provides an inaccurate or vague explanation of the process of writing prescriptions, including inaccurate or vague strategies to minimize medication errors.

13.8 to >0 pts

Poor
The response provides an inaccurate and vague explanation of the process of writing prescriptions, including inaccurate and vague strategies to minimize medication errors, or is missing.
20 pts

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.

5 to >4.45 pts

Excellent
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

4.45 to >3.95 pts

Good
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

3.95 to >3.45 pts

Fair
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.

3.45 to >0 pts

Poor
Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.
5 pts

Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation

5 to >4.45 pts

Excellent
Uses correct grammar, spelling, and punctuation with no errors

4.45 to >3.95 pts

Good
Contains a few (1–2) grammar, spelling, and punctuation errors

3.95 to >3.45 pts

Fair
Contains several (3–4) grammar, spelling, and punctuation errors

3.45 to >0 pts

Poor
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding
5 pts

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.

5 to >4.45 pts

Excellent
Uses correct APA format with no errors

4.45 to >3.95 pts

Good
Contains a few (1–2) APA format errors

3.95 to >3.45 pts

Fair
Contains several (3–4) APA format errors

3.45 to >0 pts

Poor
Contains many (≥ 5) APA format errors
5 pts
Total Points: 100