NURS 6051 Assignment: Ethical and Legal Implications of Prescribing Drugs
Sample Answer for NURS 6051 Assignment: Ethical and Legal Implications of Prescribing Drugs Included After Question
NURS 6051 Assignment 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 Links to an external site.). All papers submitted must use this formatting.
NURS 6051 Assignment Ethical and Legal Implications of Prescribing Drugs
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A Sample Answer For the Assignment: NURS 6051 Assignment: Ethical and Legal Implications of Prescribing Drugs
Title: NURS 6051 Assignment: Ethical and Legal Implications of Prescribing Drugs
When nurses prescribe medications, they are responsible for the lives of a large number of people. A simple error can be fatal, and nurses must be as precise and ethical as their profession requires. A situation in which a friend calls and requests a prescription for medication can have regrettable legal and ethical ramifications, and nurses should exercise caution. State laws should also guide all health care providers in implementing the necessary strategies to minimize medical errors. This article discusses the legal and ethical implications of the scenario, disclosure and nondisclosure, decision-making strategies, and the process of prescribing and minimizing errors.
Stakeholders’ Ethical and Legal Consequences
Prescribing medications incorrectly can have a negative impact on a number of stakeholders in the health care system. The prescriber is the first in this chain of events to make a mistake. Prescribing medications without an adequate patient history or medical record is unethical and illegal (May et al., 2020). The pharmacist is the other significant stakeholder. Pharmacists should always have an interest in the patient who is receiving medication. They should avoid compounding prescribers’ errors, and it is critical for them to verify that diagnosis occurred. The patient acts in good faith. However, patients should not use friendship to create ethical dilemmas for health care providers. As a result, the prescriber and pharmacist are the most ethically and legally culpable parties in this situation.
Strategies for Disclosure and Nondisclosure
Generally, health care professionals are aware when medical errors occur within their profession. It is critical to disclose such errors to avoid lawsuits and to protect health professionals from harsh penalties for concealing medical errors (Sorrell, 2017). Nurses and other health care providers should never be afraid of the consequences of disclosure. Nondisclosure is considered ethical misconduct because it violates the principle of integrity and has a detrimental effect on the patient-nurse relationship (Alnahdi, 2017). The primary strategy guiding disclosure and nondisclosure, as enshrined in various state laws, is reporting. The other strategy is to document all medical errors, as Texas House Bill 1614 requires (Texmed, 2016). Additionally, the state of California recommends reporting by requiring health care providers to notify patients and families in the event of a medication error, outlining the consequences for the patient. Prescription errors are more closely monitored when they are recorded and reported. As a federally mandated practice, it eliminates negligence and the possibility of quack professionals entering the health profession.
Strategies of Guiding Decision Making
Due to the profound ethical and legal implications of the scenario, a nurse should be guided by the principles of integrity and honesty. Despite the relationship with the patient requesting prescription, nurses should act within professional guidelines. Integrity and honesty also align with the deontology principles. Deontology ethics obliges health care providers to be moral and actions should be based on the rule of law regardless of their effects (Façanha & Garrafa, 2019). Since my state requires reporting of medication errors, I would disclose the error. I would make a report covering all the details to ensure that any threat can be managed professionally.
Writing Prescriptions and Minimizing Medication Errors
Always, health care practitioners should be guided by laboratory reports before prescribing any drug. The illness and its severity should be clear. Pharmacists should also use such reports and analyze other variables that can affect health outcomes such as allergic reactions. Prescription should be closely examined to ensure that it meets patient needs. Following the prescription rules is one way of minimizing medication errors. The other strategy is to accept faults when they occur and report immediately. Quick interventions minimize the chances of an error being transferred from one health care provider to another.
In conclusion, medication errors are part of the health practice. They have profound ethical and legal consequences and reporting them is highly encouraged. As the professional mandate obliges them, health care providers should avoid prescribing drugs unless guided by laboratory reports. The case of prescribing drugs to a friend manifests common mistakes that health care providers must avoid to maintain the patient-health care provider trust. If an error occurs, it should be disclosed and proper interventions applied to minimize the consequences.
References
Alnahdi, S. A. (2017). The ethical obligation for disclosure of medical error in the intensive care unit. Duquesne University. https://dsc.duq.edu/cgi/viewcontent.cgi?article=1118&context=etd
Façanha, T. R. D. S., & Garrafa, V. (2019). Patient safety and deontological codes in the context of Beauchamp and Childress. Revista Bioética, 27(3), 401-409. https://doi.org/10.1590/1983-80422019273323
May, T., Holloway, K., Buhociu, M., & Hills, R. (2020). Not what the doctor ordered: Motivations for nonmedical prescription drug use among people who use illegal drugs. International Journal of Drug Policy, 82, 102823. https://doi.org/10.1016/j.drugpo.2020.102823
Sorrell, J. M. (2017). Ethics: ethical issues with medical errors: shaping a culture of safety in healthcare. OJIN: The Online Journal of Issues in Nursing, 22(2). doi: 10.3912/OJIN.Vol22No02EthCol01
Texmed. (2016). Ending the blame game – Texas medical association. https://www.texmed.org/Template.aspx?id=4332
A Sample Answer 2 For the Assignment: NURS 6051 Assignment: Ethical and Legal Implications of Prescribing Drugs
Title: NURS 6051 Assignment: Ethical and Legal Implications of Prescribing Drugs
Across the United States, nurse practitioners have some extent of prescriptive authority over drugs, controlled substances, medical services, and medical devices (de Araújo et al., 2019). NPs and other healthcare professionals with legal authority to prescribe medication are required to observe legal and ethical guidelines to safeguard the patient from harm. However, the regulations governing prescriptive practice among NPs vary across different states. For this discussion, the ethical and legal implications of the provided case scenario will be illustrated based on the New Jersey NP’s scope of practice.
Ethical and Legal Implications
The provided case study demonstrates an ethical dilemma of whether or not to report an NP who prescribes narcotic medication to her husband. The laws and regulations regarding prescribing medication to a family member or a friend differ by state as it is forbidden in other states, whereas in some states, it is only advised against. In New Jersey, NPs are required to collaborate with physicians to enjoy prescriptive authority privileges (Ellenbogen & Segal, 2019). When prescribing controlled drugs such as narcotics, the NP is required to consult with the supervisory physician and complete must have completed education in the pharmacology of drugs listed under controlled substances. Consequently in New Jersey, prescribing controlled substances to self, family member, or friend is prohibited.
The prescriber, which in this case is the NP, violated all the regulations for prescribing controlled substances as required by the New Jersey state laws. For instance, she failed to consult the supervisory physician before prescribing the narcotic medication to her husband, which is also against the law. Prescribing medication to a family member undermines the professional objectivity of the prescriber in addition to compromised professional medical judgment (Phillips, 2020). Legally, the prescriber can end up losing their prescriptive authority or even the practice license. The pharmacist, on the other hand, must ensure that the prescription from the NP has met all the requirements as per the prescriptive practice protocol before dispensing the medication to the patient. Failure to do so, the pharmacist can also face legal charges.
Finally, the patient in this scenario may fail to disclose all the required information to promote the safe use of controlled substances, to her wife, who is the prescriber. Due to patient privacy and confidentiality, most couples fail to share their full medical history, especially the ones that they consider embarrassing such as addiction. Failure to disclose such information may promote the risks of adverse events and negative treatment outcomes (Squellati et al., 2022).
Disclosure and Nondisclosure
The nurse who witnessed her colleague violating the prescriptive authority of state laws and regulations was faced with an ethical dilemma of disclosure and nondisclosure of the incident. According to the Patient Safety Act, N.J.S.A. 26:2H-12.23, healthcare professionals are required to report any form of medical malpractice including prescription malpractice, to the department head and the patient (Ellenbogen & Segal, 2019). Doing so will help prevent such issues from taking place in the future. However, failing to disclose the matter can lead to legal implications, in addition to being unethical primarily to the patient. As such, in the provided case study, it would have been necessary for the nurse to approach the prescribing nurse, and inform her about the implications associated with her actions in addition to the adverse outcomes associated with the use of narcotics. The prescribing nurse should also be advised against failing to adhere to the outlined prescriptive practice protocols to promote patient safety and positive treatment outcome. If the prescribing nurse ignores these concerns, she should then be reported to the departmental head, for legal action to be taken.
Decision Making
As an advanced practice nurse, critical thinking is crucial in promoting appropriate decision-making in situations like the one described above. Considering the patient as the center of care is a crucial strategy that must be utilized among all healthcare professionals when deciding on whether or not to disclose a medical error (Grecu & Spector, 2019). The second strategy should be based on upholding the patients’ rights, such as the right to information concerning their health. With these two strategies, I would disclose the error to the patient, and adopt appropriate mitigating interventions to ensure the patient’s safety and prevent harm. Failing to disclose the information to the patient, is unethical, and puts the patient at risk of adverse events and negative outcomes associated with the use of controlled substances such as narcotics.
Process of Writing a Prescription
A high level of professionalism is required in prescribing medication to promote patient safety and avoid medication errors. The prescriber must meet all the information requirements when writing the prescription. The following steps are crucial when writing a prescription. The first step is collecting patient information, including demographics and diagnosis (de Araújo et al., 2019). The second step is providing your information as the prescriber. The third step is to identify the drug name, form, strength and frequency to be administered. It is also important to write the exact quantity of the drug that has been prescribed. The fourth step is giving the direction of use and the number of refills. Finally, the prescriber must append his or her signature.
Conclusion
With the increasing prescriptive privileges among nurses, it is crucial to consider legal and ethical guidelines to promote patient safety. Consequently, each state has specific regulations governing prescriptive practice among RNs. Violation of such regulation is unethical to the patient and can also lead to legal implications for the prescriber, just like in the discussed case study.
References
de Araújo, B. C., de Melo, R. C., de Bortoli, M. C., Bonfim, J. R. de A., & Toma, T. S. (2019). How to Prevent or Reduce Prescribing Errors: An Evidence Brief for Policy. Frontiers in Pharmacology, 10. https://doi.org/10.3389/fphar.2019.00439
Ellenbogen, M. I., & Segal, J. B. (2019). Differences in Opioid Prescribing Among Generalist Physicians, Nurse Practitioners, and Physician Assistants. Pain Medicine. https://doi.org/10.1093/pm/pnz005
Grecu, A. M., & Spector, L. C. (2019). Nurse practitioners’ independent prescriptive authority and opioids abuse. Health Economics, 28(10), 1220–1225. https://doi.org/10.1002/hec.3922
Phillips, S. J. (2020). 32nd Annual APRN Legislative Update. The Nurse Practitioner, 45(1), 28–55. https://doi.org/10.1097/01.npr.0000615560.11798.5f
Squellati, R., McCants, K. M., Hadden, T. A., & Mitchell, C. V. (2022, January 1). 9 – Health policy for NPs: health literacy, cultural competence, and communication (D. Seibert, B. Malone, & P. DeLeon, Eds.). ScienceDirect; Academic Press. https://www.sciencedirect.com/science/article/pii/B9780323999939000068
A Sample Answer 3 For the Assignment: NURS 6051 Assignment: Ethical and Legal Implications of Prescribing Drugs
Title: NURS 6051 Assignment: Ethical and Legal Implications of Prescribing Drugs
When a patient enters the health center, medication is very likely to be administered. A health history and a patient’s medical evaluation are important things to examine when administering medication. A nurse or doctor should administer the care of the condition and be informed of the standard a condition should be offered depending on a background of health and physical inspection (Rosenthal & Burchum, 2020). In this discussion, the essay focuses on Scenario 2 to clarify the ethical and legal ramifications of patient family, prescriber, pharmacist and patient to all parties concerned. The discussion continues by explaining the methods I will use to drive decision-making for an experienced clinical nurse in the selected scenario.
Selected scenario
A colleague calls and demands for drugs to be taken for her. You are self-sufficient, but do not have the medical experience of your mate. Anyway, you write the drug. The ethical, as well as legal implications of the scenario on all stakeholders such as the prescriber, pharmacist, patient, and patient’s family, discuss as follow:
Nurse Practitioner: A nurse who uses medications without performing the requisite testing, evaluation and legal consequences such as absence, as needed by the medical code of ethics, such as the Colorado “Medical Practice Act,” breaches the code and is unprofessional (Sabatino & Pruchnicki, 2017). The NP who prescribes medication for a friend without a medical background fears jeopardizing his permit since adverse reactions can turn fatal. A nurse has the ethical obligation to prescribe the best medication, but only after a medical exam and evaluation.
Pharmacist: In mediation, a pharmacy dealer who carries out a prescription does not presume that the prescriber has made an examination, nor that the practitioner is ethically and legitimately liable for the background before the order is submitted. Thus, loading the Rx with the pharmacist’s chance of losing the license while knowing his clinical background.
Patient and family: Prescribing drugs to a patient is morally and technically permissible whether a patient may not have an awareness of his or her background, evaluation and allergies. Therefore the patient and the relatives will bring court charges against the nurse and pharmacy firm should any incident take place.
Strategies to Guide Decision making
The first strategy is to call the patient before prescribing medication and to make an appropriate date for a medical evaluation to reach the condition. Medical testing and an assessment may lead to the patient’s medical condition and, therefore, to the required medication (Musellim & Borekci, 2017). In medical and personal interactions, faulty and incorrect prescribe inaccurate medications, less frequent usage for preventive treatment, loss of medical satisfactions, and escalated aggressive incidents against healthcare providers, maybe the result of a patient’s evaluation over a short duration of time. The patient assessment period could have been influenced too gradually or too rapidly.
The second strategy is to do the clinical examination before administering medication to assess the condition of the patient. Clinical trials are study experiments in which patients actively undergo experimental therapeutic techniques, techniques or measures in order to avoid, diagnose, cure or control various conditions or diseases (Rosenthal & Burchum, 2020). Some studies consider how people react to a new procedure and what side effects may be created. The third method is to implement a prescriptive decision-making process by looking at the patient’s family members and their prior fitness. The prescriptive method of educated judgment aid approaches describes a variety of strategies to enable citizens to think differently about a decision.
Process of Writing Prescriptions
There are important things that physicians should consider before writing medications. Relevant elements must also be considered. Again, it is necessary to remember that there are norms in various countries. The criteria specify that the details on medications are provided. Both medications usually tend to use a vocabulary the consumer can understand such that they can learn quickly how to take medicine. Secondly, it is important to write clearly in writing while writing the medication (Solanki & Shah, 2015). Third, it is necessary to determine the duration of usage of the medication and the days the patient is supposed to take. Additional detail used is subject to local drug laws. With the exponential advancement of technology, electronic prescribing will continue to reduce the cost-effectiveness of drug mistakes. Electronic prescribing is an efficient means of eliminating medication errors. The continuous dependency on handwriting writing is one of the factors that have made medication mistakes inevitable (Nickless & Davies, 2016). Handwritten prescriptions might be negligible. Problems like this can be overcome by technology-based prescribing, as this will help to reduce drug mistakes.
References
Musellim, B., & Borekci, S. (2017). What should be the appropriate minimal duration for patient examination and evaluation in pulmonary outpatient clinics? Annals of Thoracic Medicine, 12(3), 177–182. doi:10.4103/atm.ATM_396_16
Nickless, G., & Davies, R. (2016). How to take an accurate and detailed medication history. The Pharmaceutical Journal.
Rosenthal, L., & Burchum, J. (2020). Lehne’s Pharmacotherapeutics for Advanced Practice Nurses and Physician Assistants. Elsevier – Health Sciences Division.
Sabatino, J. A., & Pruchnicki, M. C. (2017). Improving prescribing practices: A pharmacist-led educational intervention for nurse practitioner students. Journal of the American Association of Nurse Practitioners, 29(5), 248-254. doi:10.1002/2327-6924.12446
Solanki, N. D., & Shah, C. (2015). Prescription audit in outpatient department of multispecialty hospital in western India: an observational study. International Journal of Clinical Trials, 14-19.
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Performance Category 100% or highest level of performance
Demonstrates achievement of scholarly inquiry for professional and academic topics.
Presentation of information was exceptional and included all of the following elements:
Provides evidence of scholarly inquiry relevant to required TD topic(s).
Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
Presentation of information was good, but was superficial in places and included all of the following elements:
Provides evidence of scholarly inquiry relevant to required TD topic(s).
Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
Presentation of information was minimally demonstrated in all of the following elements:
Provides evidence of scholarly inquiry relevant to required TD topic(s).
Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
Presentation of information is unsatisfactory in one of the following elements:
Provides evidence of scholarly inquiry relevant to required TD topic(s).
Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
Presentation of information is unsatisfactory in two of the following elements:
Provides evidence of scholarly inquiry relevant to required TD topic(s).
Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information.
Presentation of information is unsatisfactory in three or more of the following elements
Provides evidence of scholarly inquiry relevant to required TD topic(s).
Presents specific information from scholarly sources to develop a comprehensive presentation of facts.
Uses at least one outside scholarly reference that is relevant, less than 5 years old (use of older references requires instructor permission) and reliable for the required topic.*
Uses in-text citation and full reference at end of posting when presenting another person’s thoughts as quotes or paraphrase of information
Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations
Presentation of information was exceptional and included all of the following elements:
Applies principles, knowledge and information from scholarly resources to the required topic.
Applies facts, principles or concepts learned from scholarly resources to a professional experience.
Application of information is comprehensive and specific to the required topic.
Presentation of information was good, but was superficial in places and included all of the following elements:
Applies principles, knowledge and information from scholarly resources to the required topic.
Applies facts, principles or concepts learned from scholarly resources to a professional experience.
Application of information is comprehensive and specific to the required topic.
Presentation of information was minimally demonstrated in the all of the following elements:
Applies principles, knowledge and information from scholarly resources to the required topic.
Applies facts, principles or concepts learned from scholarly resources to a professional experience.
Application of information is comprehensive and specific to the required topic.
Presentation of information is unsatisfactory in one of the following elements:
Applies principles, knowledge and information from scholarly resources to the required topic.
Applies facts, principles or concepts learned from and scholarly resources to a professional experience.
Application of information is comprehensive and specific to the required topic.
Presentation of information is unsatisfactory in two of the following elements:
Applies principles, knowledge and information from scholarly resources to the required topic.
Applies facts, principles or concepts learned from scholarly resources to a professional experience.
Application of information is comprehensive and specific to the required topic.
Presentation of information is unsatisfactory in three of the following elements
Applies principles, knowledge and information and scholarly resources to the required topic.
Applies facts, principles or concepts learned scholarly resources to a professional experience.
Application of information is comprehensive and specific to the required topic.
Initial post should be a minimum of 300 words (references do not count toward word count)
The peer and instructor responses must be a minimum of 150 words each (references do not count toward word count)
Responses are substantive and relate to the topic.
Demonstrated all of the following:
Initial post must be a minimum of 300 words.
The peer and instructor responses must be a minimum of 150 words each.
Responses are substantive
Responses are related to the topic of discussion.
Demonstrated 3 of the following:
Initial post must be a minimum of 300 words.
The peer and instructor responses must be a minimum of 150 words each.
Responses are substantive
Responses are related to the topic of discussion.
Demonstrated 2 of the following:
Initial post must be a minimum of 300 words.
The peer and instructor responses must be a minimum of 150 words each.
Responses are substantive
Responses are related to the topic of discussion.
Demonstrated 1 or less of the following:
Initial post must be a minimum of 300 words.
The peer and instructor responses must be a minimum of 150 words each.
Responses are substantive
Responses are related to the topic of discussion.
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