Ethical And Legal  Implications Of Prescribing Drugs Assignment

Walden University Ethical And Legal  Implications Of Prescribing Drugs Assignment-Step-By-Step Guide

This guide will demonstrate how to complete the Walden University Ethical And Legal  Implications Of Prescribing Drugs Assignment assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for Ethical And Legal  Implications Of Prescribing Drugs Assignment                           

Whether one passes or fails an academic assignment such as the Walden University Ethical And Legal  Implications Of Prescribing Drugs Assignment depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for Ethical And Legal  Implications Of Prescribing Drugs Assignment                         

The introduction for the Walden University Ethical And Legal  Implications Of Prescribing Drugs Assignment is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

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How to Write the Body for Ethical And Legal  Implications Of Prescribing Drugs Assignment                         

After the introduction, move into the main part of the Ethical And Legal  Implications Of Prescribing Drugs Assignment assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for Ethical And Legal  Implications Of Prescribing Drugs Assignment                         

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for Ethical And Legal  Implications Of Prescribing Drugs Assignment                           

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Ethical And Legal Implications Of Prescribing Drugs Assignment

A Sample Answer For the Assignment: Ethical And Legal Implications Of Prescribing Drugs Assignment

Introduction

From the case study, it is clear that any practitioner, especially a nurse practitioner, should adhere to the laws and guidelines put forth by the many states as well as the numerous codes of conduct. In addition to providing comprehensive details on what the state expects from the legislation, strategies on what to do in such an instance or with regard to the subjects covered are also supplied. This essay seeks to provide details that could serve as a roadmap for what to anticipate in the scenario described while abiding by the different laws and regulations set forth by the state. (Rosenthal & Burchum, 2021).

Ethical and Legal Implications on Stakeholders

In the prescription of medication there are several stakeholders that are involved in case of any ethical or legal errors they are likely to be implicated depending on their role. As per the scenario I as the nurse practitioner (NP) will likely to be implicated the most as I am the prescriber in this case. It is expected that the prescriber has sufficient knowledge regarding prescription of medication and therefore a gross mistake as giving a dosage for an adult to a 5-year-ol is unexpected. Such mistakes can lead to severe harm to a patient and therefore the resulting legal implication will also be harsh to the prescribe (Rosenthal & Burchum, 2021).

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The pharmacist will be next in incurring the legal implications of such an error. This is due to the fact they are dispensing the medication and as they do so they are to follow expected guidelines and use the knowledge they have gained regarding dispensing medication therefore preventing such errors from impacting the patient.

They should act as a point of verification of the prescribed medication and if any errors are noted refer back to the prescriber to make the necessary adjustments instead of dispensing the medication without question. To the patient the most severe implication that will occur is to their health as the medication in the prescribed dosage is not appropriate and will negatively impact them (Rosenthal & Burchum, 2021).

Strategies to address Disclosure and Non-disclosure

The appropriate course of action in this situation will be to report the problem, but this will be complicated by the worry that doing so may result in losing one’s employment or position as a nurse practitioner (NP).The prescriber who is the NP is expected to inform the patient, the patient’s family or their legal representative of the error and correct it as soon as possible. In Tennessee medics are expected by law to follow ethical and practice guidelines when disclosing errors.

Ethical And Legal Implications Of Prescribing Drugs Assignment
Ethical And Legal Implications Of Prescribing Drugs Assignment

This involves providing accurate and complete information regarding the error and failure to do so could lead to legal and professional consequences. Each practitioner is accountable for being aware of the rules and laws that apply in the state where they practice. Due to this, in the case of a prescription error occur they should disclose it promptly in an empathetic and compassionate minor while taking measures to mitigate the harm that could occur (Clarke, 2019).

Strategies involved in Decision Making

There are several strategies that one can utilize to guide in the decision making process. Firstly it is expected in order to avoid legal implications the nurse practitioner to disclose that the error occurred so that the patient’s family are able to discuss steps they would like to undertake. Among the strategies that could be beneficial is having a colleague to double check the prescription and the dose given.

This will aid in preventing further errors from occurring as the involved calculations can be confirmed by another knowledgeable health personnel. Another strategy would be to tell the patient of relative to read back the instructions. Through that one will be able to note the incorrectness of the information and make the necessary alterations (Sabatino et al., 2017).

Process of writing Prescriptions

Part of the diagnosis process involves the NP assessing the pinpoint issue of the patient. Review of the disease’s pathophysiology will be among the initial steps in treatment before prescribing the appropriate drug to manage the condition. The NP is charged with the responsibility of identifying possible adverse drug reactions that could occur if a patient utilizes a certain drug as well as the nature of the reactions.

Additionally, the five R’s should be considered that include right drug, right route, right dose, right time and right patient as well as being wary of medications that look or sound alike. Through taking these precautions, situations such as severe side effects and drug mistakes can be significantly avoided (Institute for Safe Medication Practices, 2017).

Conclusion

Therefore, nurse practitioners should exercise caution when writing prescriptions, making sure they follow the correct procedure and are acting within the scope of their authority as well as adhering to the various regulations and laws of the state in which they are located in to ensure they have carried out their duties in accordance with the state’s expectations (Rosenthal & Burchum, 2021).

References

Clarke, P. Case Commentaries (2019).

Institute for Safe Medication Practices. (2017). List of error-prone abbreviations, symbols, and    dose designations Links to an external site.. Retrieved from         https://www.ismp.org/recommendations/error-prone-abbreviations-list

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.

Sabatino, J. A., Pruchnicki, M. C., Sevin, A. M., Barker, E., Green, C. G., & Porter, K. (2017).    Improving prescribing practices: A pharmacist‐led educational intervention for nurse practitioner students Links to an external site. Journal of the American Association of            Nurse Practitioners, 29(5), 248–254. doi:10.1002/2327-6924.12446

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.

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.

Write a 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.

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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). All papers submitted must use this formatting.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “WK1Assgn+last name+first initial.(extension)” as the name.
  • Click the Week 1 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 1 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK1Assgn+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission.
Grading Criteria

To access your rubric:

Week 1 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 1 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 1

To participate in this Assignment:

Week 1 Assignment

Learning Resources

Required Readings (click to expand/reduce)

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.

  • Chapter 1, “Prescriptive Authority” (pp. 1–3)
  • Chapter 2, “Rational Drug Selection and Prescription Writing” (pp. 4–7)
  • Chapter 3, “Promoting Positive Outcomes of Drug Therapy” (pp. 8–12)
  • Chapter 4, “Pharmacokinetics, Pharmacodynamics, and Drug Interactions” (pp. 13–33)
  • Chapter 5, “Adverse Drug Reactions and Medication Errors” (pp. 34–42)
  • Chapter 6, “Individual Variation in Drug Response” (pp. 43–45)
 

American Geriatrics Society 2019 Beers Criteria Update Expert Panel. (2019). American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 67(4), 674–694. doi:10.1111/jgs.15767

American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults by American Geriatrics Society, in Journal of the American Geriatrics Society, Vol. 67/Issue 4. Copyright 2019 by Blackwell Publishing. Reprinted by permission of Blackwell Publishing via the Copyright Clearance Center.

This article is an update to the Beers Criteria, which includes lists of potentially inappropriate medications to be avoided in older adults as well as newly added criteria that lists select drugs that should be avoided or have their dose adjusted based on the individual’s kidney function and select drug-drug interactions documented to be associated with harms in older adults.

Drug Enforcement Administration. (n.d.-a). Code of federal regulations. Retrieved February 1, 2019, from https://www.deadiversion.usdoj.gov/21cfr/cfr/1300/1300_01.htm

This website outlines the code of federal regulations for prescription drugs.

Drug Enforcement Administration. (n.d.-b). Mid-level practitioners authorization by state. Retrieved May 13, 2019 from http://www.deadiversion.usdoj.gov/drugreg/practioners/index.html

This website outlines the schedules for controlled substances, including prescriptive authority for each schedule.

Drug Enforcement Administration. (2006). Practitioner’s manual. Retrieved from http://www.legalsideofpain.com/uploads/pract_manual090506.pdf
This manual is a resource for practitioners who prescribe, dispense, and administer controlled substances. It provides information on general requirements, security issues, recordkeeping, prescription requirements, and addiction treatment programs.

Drug Enforcement Administration. (n.d.-c). Registration. Retrieved February 1, 2019, from https://www.deadiversion.usdoj.gov/drugreg/index.html

This website details key aspects of drug registration.

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.

This resource introduces the code of ethics for nurses and highlights critical aspects for ethical guideline development, interpretation, and application in practice.

Institute for Safe Medication Practices. (2017). List of error-prone abbreviations, symbols, and dose designations. Retrieved from https://www.ismp.org/recommendations/error-prone-abbreviations-list

This website provides a list of prescription-writing abbreviations that might lead to misinterpretation, as well as suggestions for preventing resulting errors.

Ladd, E., & Hoyt, A. (2016). Shedding light on nurse practitioner prescribing. The Journal for Nurse Practitioners, 12(3), 166–173. doi:10.1016/j.nurpra.2015.09.17

This article provides NPs with information regarding state-based laws for NP prescribing.

Sabatino, J. A., Pruchnicki, M. C., Sevin, A. M., Barker, E., Green, C. G., & Porter, K. (2017). Improving prescribing practices: A pharmacist‐led educational intervention for nurse practitioner students. Journal of the American Association ofNursePractitioners, 29(5), 248–254. doi:10.1002/2327-6924.12446

The authors of this article assess the impact of a pharmacist‐led educational intervention on family nurse practitioner (FNP) students’ prescribing skills, perception of preparedness to prescribe, and perception of pharmacist as collaborator.

Required Media (click to expand/reduce)

Introduction to Advanced Pharmacology

Meet Dr. Terry Buttaro, associate professor of practice at Simmons College of Nursing and Health Sciences as she discusses the importance of pharmacology for the advanced practice nurse. (8m)

 

 

What’s Coming Up in Module 2?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

In the next module, you will examine the impact of changes in pharmacokinetic and pharmacodynamic processes on patient drug therapy for cardiovascular disorders and the types of drugs prescribed to patients with respiratory disorders.

Looking Ahead: Week 2 Assignment

In Week 2, your Instructor will assign you a case study related to Assignment 1 by Day 1 of the week. Please make sure to review the “Course Announcements” area of the course to verify your assigned case study. Please plan ahead to ensure you have time to review your case study and Learning Resources in order to complete your Assignment on time.

Photo Credit: Getty Images/iStockphoto

Next Week

In the case scenario, a friend calls and requests me to prescribe her medication. Although I have the autonomy, I do not have the friend’s medical history. However, I still write the prescription. This paper explores the ethical and legal implications of this scenario, approaches to address disclosure and nondisclosure, and the procedure of writing prescriptions.

Ethical and Legal Implications Of The Scenario On All Stakeholders Involved

Prescribing or giving medications to family members and friends, except for an emergency is regarded as unprofessional conduct and can call for disciplinary measures. The ethical problem surrounds the fact that the relationship with a friend or relative can cloud a practitioner’s judgment (Sorrell, 2017). Based on the state, the prescriber in this scenario can face legal consequences for prescribing to their friend.

Writing a drug prescription for friends in a social setting can prompt legal action. Since the prescriber has the autonomy to prescribe, the ethical and legal consequences would center on what is best for the person prescribed and whether local ethic boards have an outlook on the matter (Sorrell, 2017). The prescribed medication may result in an adverse drug event since no assessment was conducted, which fails to uphold ethical principles of beneficence and nonmaleficence.

The ethical and legal implications of the act would not only fall on the prescriber but also the dispensing pharmacist. Ethical implications for the pharmacists would include the failure to uphold beneficence and nonmaleficence. The pharmacist ought to have reviewed the diagnosis for the patient before dispensing to ensure the medication is appropriate for the patient’s medical condition (Sorrell, 2017). Failing to review the medical information puts the patient at risk of adverse drug effects if the drug is not appropriate for the patient.  Furthermore, the patient may face legal implications for getting a prescription without being assessed and diagnosed by a healthcare provider.

Strategies to Address Disclosure and Nondisclosure As Identified In the Scenario

Disclosure of medical error refers to the communication between a health provider and a client, family member, or a client’s proxy whereby the provider admits that a medical error occurred. North Carolina has a statute that protects reports made by a health provider making an apology for an adverse treatment outcome. The statute on disclosure, states that health providers should offer to implement remedial or corrective treatment interventions, as well as voluntary acts to assist the affected patient (North Carolina Medical Board, 2017).

However, the North Carolina statute does not protect any confessions of fault or a provider’s acknowledgment of responsibility. In the case that the medication has an adverse event on the prescriber’s friend or the prescriber realizes they prescribed the wrong medication, the prescribing clinician should inform the patient (Eniola & Gambino, 2019). The clinician should explain how the error occurred and the actions to be taken to correct the error and its effects.

Strategies That You, As an Advanced Practice Nurse, Would Use To Guide Your Decision Making In This Scenario

In this scenario, my decisions would be based on the North Carolina laws and ethical principles. I would reveal the medication error to the patient by explaining how it occurred as stated by the state law to avoid legal action and implications such as having my APN license revoked (Eniola & Gambino, 2019). In addition, I would employ beneficence and nonmaleficence in making decisions to promote ethical practice. Beneficence is the moral duty to promote good, while nonmaleficence is the duty to cause no harm.

In this regard, I would take the duty to do good and prevent harm on the patient by informing them of the error and taking prompt interventions to mitigate potential harm from the medication error (Sorrell, 2017). Besides, I would explain to the patient the steps that the provider and the hospital are implementing to prevent errors in the future. This would help maintain the client’s trust in the clinician and the hospital.

Process of Writing Prescriptions and Strategies to Minimize Medication Errors

The prescribing clinician should first fill in the patient’s data, including name, age, sex, and medical diagnosis. The next step is to write the prescribed medication, including the name, dose, frequency, and route of administration (de Araújo et al., 2019). Besides, the clinician should indicate the frequency of refills, particularly for patients with chronic illness. The last step should be to write the clinician’s name, address, National Provider Identifier number, and DEA number.

Medication errors can be reduced by taking a detailed history of the patient’s drug allergies and current medications (de Araújo et al., 2019). Organizations can adopt technology systems such as the E-prescribing software, which generates prescriptions electronically and send them directly to the pharmacy. The software minimizes errors cause by illegible paper prescriptions.   Drug interaction checkers can also be used to help evaluate potential drug interactions, thus reducing adverse drug outcomes.

Conclusion

The prescribing clinician and dispensing pharmacist face ethical implications for not upholding beneficence and nonmaleficence by prescribing medication without a patient assessment and medical diagnosis.  The North Carolina statute states that the clinician should inform the client of the medical error and the corrective treatments to be implemented. Medication errors can be avoided by taking a patient history of drug allergies, current treatments, and using IT systems.

References

de Araújo, B. C., de Melo, R. C., de Bortoli, M. C., Bonfim, J. R. D. A., & Toma, T. S. (2019). How to prevent or reduce prescribing errors: an evidence brief for policy. Frontiers in pharmacology10, 439. https://doi.org/10.3389/fphar.2019.00439

Eniola, K., & Gambino, C. (2019). Taking the Fear Out of Error Disclosure. Family practice management26(6), 36-36.

North Carolina Medical Board. (2017). Position Statements North Carolina Medical Boardhttps://www.ncmedboard.org/images/uploads/other

Sorrell, J. M. (2017). Ethics: Ethical issues with medical errors: Shaping a culture of safety in healthcare. OJIN: The Online Journal of Issues in Nursing22(2). de Araújo, B. C., de Melo, R. C., de Bortoli, M. C., Bonfim, J. R. D. A., & Toma, T. S. (2019). How to prevent or reduce prescribing errors: an evidence brief for policy. Frontiers in pharmacology10, 439. https://doi.org/10.3389/fphar.2019.00439

Rubric Detail

Select Grid View or List View to change the rubric’s layout.
Content
Name: NURS_6521_Week1_Assignment_Rubric

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List View

Excellent Good Fair Poor

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.

Points Range: 23 (23%) – 25 (25%)

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.

Points Range: 20 (20%) – 22 (22%)

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.

Points Range: 18 (18%) – 19 (19%)

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.

Points Range: 0 (0%) – 17 (17%)

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

Points Range: 18 (18%) – 20 (20%)

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.

Points Range: 16 (16%) – 17 (17%)

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.

Points Range: 14 (14%) – 15 (15%)

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.

Points Range: 0 (0%) – 13 (13%)

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.
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.

Points Range: 18 (18%) – 20 (20%)

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.

Points Range: 16 (16%) – 17 (17%)

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.

Points Range: 14 (14%) – 15 (15%)

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.

Points Range: 0 (0%) – 13 (13%)

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

Points Range: 18 (18%) – 20 (20%)

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

Points Range: 16 (16%) – 17 (17%)

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

Points Range: 14 (14%) – 15 (15%)

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

Points Range: 0 (0%) – 13 (13%)

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.
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.

Points Range: 5 (5%) – 5 (5%)

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

Points Range: 4 (4%) – 4 (4%)

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

Points Range: 3.5 (3.5%) – 3.5 (3.5%)

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

Points Range: 0 (0%) – 3 (3%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.
Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation

Points Range: 5 (5%) – 5 (5%)

Uses correct grammar, spelling, and punctuation with no errors

Points Range: 4 (4%) – 4 (4%)

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

Points Range: 3.5 (3.5%) – 3.5 (3.5%)

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

Points Range: 0 (0%) – 3 (3%)

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding
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.
Points Range: 5 (5%) – 5 (5%)
Uses correct APA format with no errors

Points Range: 4 (4%) – 4 (4%)
Contains a few (1–2) APA format errors

Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3–4) APA format errors

Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) APA format errors
Total Points: 100
Name: NURS_6521_Week1_Assignment_Rubric

You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

APA Format and Writing Quality

Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.

LopesWrite Policy

For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

In the case scenario, a friend calls and requests me to prescribe her medication. Although I have the autonomy, I do not have the friend’s medical history. However, I still write the prescription. This paper explores the ethical and legal implications of this scenario, approaches to address disclosure and nondisclosure, and the procedure of writing prescriptions.

Ethical and Legal Implications Of The Scenario On All Stakeholders Involved

Prescribing or giving medications to family members and friends, except for an emergency is regarded as unprofessional conduct and can call for disciplinary measures. The ethical problem surrounds the fact that the relationship with a friend or relative can cloud a practitioner’s judgment (Sorrell, 2017). Based on the state, the prescriber in this scenario can face legal consequences for prescribing to their friend. Writing a drug prescription for friends in a social setting can prompt legal action.

Since the prescriber has the autonomy to prescribe, the ethical and legal consequences would center on what is best for the person prescribed and whether local ethic boards have an outlook on the matter (Sorrell, 2017). The prescribed medication may result in an adverse drug event since no assessment was conducted, which fails to uphold ethical principles of beneficence and nonmaleficence.

The ethical and legal implications of the act would not only fall on the prescriber but also the dispensing pharmacist. Ethical implications for the pharmacists would include the failure to uphold beneficence and nonmaleficence. The pharmacist ought to have reviewed the diagnosis for the patient before dispensing to ensure the medication is appropriate for the patient’s medical condition (Sorrell, 2017). Failing to review the medical information puts the patient at risk of adverse drug effects if the drug is not appropriate for the patient.  Furthermore, the patient may face legal implications for getting a prescription without being assessed and diagnosed by a healthcare provider.

Strategies to Address Disclosure and Nondisclosure As Identified In the Scenario

Disclosure of medical error refers to the communication between a health provider and a client, family member, or a client’s proxy whereby the provider admits that a medical error occurred. North Carolina has a statute that protects reports made by a health provider making an apology for an adverse treatment outcome. The statute on disclosure, states that health providers should offer to implement remedial or corrective treatment interventions, as well as voluntary acts to assist the affected patient (North Carolina Medical Board, 2017).

However, the North Carolina statute does not protect any confessions of fault or a provider’s acknowledgment of responsibility. In the case that the medication has an adverse event on the prescriber’s friend or the prescriber realizes they prescribed the wrong medication, the prescribing clinician should inform the patient (Eniola & Gambino, 2019). The clinician should explain how the error occurred and the actions to be taken to correct the error and its effects.

Strategies That You, As an Advanced Practice Nurse, Would Use To Guide Your Decision Making In This Scenario

In this scenario, my decisions would be based on the North Carolina laws and ethical principles. I would reveal the medication error to the patient by explaining how it occurred as stated by the state law to avoid legal action and implications such as having my APN license revoked (Eniola & Gambino, 2019). In addition, I would employ beneficence and nonmaleficence in making decisions to promote ethical practice. Beneficence is the moral duty to promote good, while nonmaleficence is the duty to cause no harm.

In this regard, I would take the duty to do good and prevent harm on the patient by informing them of the error and taking prompt interventions to mitigate potential harm from the medication error (Sorrell, 2017). Besides, I would explain to the patient the steps that the provider and the hospital are implementing to prevent errors in the future. This would help maintain the client’s trust in the clinician and the hospital.

Process of Writing Prescriptions and Strategies to Minimize Medication Errors

The prescribing clinician should first fill in the patient’s data, including name, age, sex, and medical diagnosis. The next step is to write the prescribed medication, including the name, dose, frequency, and route of administration (de Araújo et al., 2019). Besides, the clinician should indicate the frequency of refills, particularly for patients with chronic illness. The last step should be to write the clinician’s name, address, National Provider Identifier number, and DEA number.

Medication errors can be reduced by taking a detailed history of the patient’s drug allergies and current medications (de Araújo et al., 2019). Organizations can adopt technology systems such as the E-prescribing software, which generates prescriptions electronically and send them directly to the pharmacy. The software minimizes errors cause by illegible paper prescriptions.   Drug interaction checkers can also be used to help evaluate potential drug interactions, thus reducing adverse drug outcomes.

Conclusion

The prescribing clinician and dispensing pharmacist face ethical implications for not upholding beneficence and nonmaleficence by prescribing medication without a patient assessment and medical diagnosis.  The North Carolina statute states that the clinician should inform the client of the medical error and the corrective treatments to be implemented. Medication errors can be avoided by taking a patient history of drug allergies, current treatments, and using IT systems.

References

de Araújo, B. C., de Melo, R. C., de Bortoli, M. C., Bonfim, J. R. D. A., & Toma, T. S. (2019). How to prevent or reduce prescribing errors: an evidence brief for policy. Frontiers in pharmacology10, 439. https://doi.org/10.3389/fphar.2019.00439

Eniola, K., & Gambino, C. (2019). Taking the Fear Out of Error Disclosure. Family practice management26(6), 36-36.

North Carolina Medical Board. (2017). Position Statements North Carolina Medical Boardhttps://www.ncmedboard.org/images/uploads/other

Sorrell, J. M. (2017). Ethics: Ethical issues with medical errors: Shaping a culture of safety in healthcare. OJIN: The Online Journal of Issues in Nursing22(2). de Araújo, B. C., de Melo, R. C., de Bortoli, M. C., Bonfim, J. R. D. A., & Toma, T. S. (2019). How to prevent or reduce prescribing errors: an evidence brief for policy. Frontiers in pharmacology10, 439. https://doi.org/10.3389/fphar.2019.00439

In the United States, advanced practice nurse practitioners have varying degrees of prescriptive authority, over certain medications and medical devices. They must thus display a comprehensive understanding of the legal implications associated with prescribing drugs, in addition to their ethical obligations (Billstein-Leber et al., 2018). Clinical practice ethical guidelines recommend all clinicians with prescriptive privileges, ensure that their patients are protected from harm.

The provided case study however demonstrates a situation where a nurse practitioner prescribed an adult dose of a drug to a 5-year-old. The purpose of this paper is to elaborate on the ethical and legal implications associated with this scenario, and effective mitigating strategies to prevent such occurrences in the future.

Ethical and Legal Implications

In this scenario, the medication error displayed poses substantial ethical implications for the prescriber, pharmacist, patients, and the patient’s family. The nurse practitioner as the prescriber is required to uphold ethical principles governing patient safety. It was thus an act of unprofessionalism to make such a mistake of giving a child an adult dose, knowing very well the harm that the drug could cause.

Ethically, the nurse is required to ensure beneficence in the process of care provision, which was violated by the incidence of medication error (Tigard, 2019). Consequently, clinicians are required to uphold justice in practice, which required the nurse to follow the necessary process required to address the medication error, rather than neglecting the patient. With this act, the nurse exposes the patient to the possibility of a legal lawsuit.

The pharmacist on the other hand is required to counter-check the prescription once received. In case of a medical error, the pharmacist must contact the prescriber and discuss the identified error before taking the necessary actions required to address the issue (Robertson & Long, 2018). However, if the pharmacist fails to identify the medical error, then he or she will also bear the ethical and legal burden associated with posing harm to the patient due to the medication error made by the nurse practitioner.

The patient, on the other hand, is a minor, who will suffer substantial harm from a drug overdose. The parents, who bear the legal responsibility of taking part in making healthcare decisions for their child, can sue both the prescriber and the pharmacist for the medication error (Varkey, 2021). Consequently, the patient’s parents have a legal right to information concerning the medication prescribed to their child, and how to take it, which should have been provided by the pharmacist.

Strategies to Address Disclosure and Nondisclosure

Disclosing medication error is an ethical act thus must be exhibited by all authorized prescribers in case they are faced with such a situation. In South Carolina, provisions for medication errors reporting are organized according to the South Carolina Code of Regulations. Medication errors are recognized in this state as one of the most crucial treatment-caused risks to the patient. As such, the South Carolina Department of Disabilities and Special Needs demands clinicians to report every medication error that may occur in the course of care provision (

Strategies for Appropriate Decision Making

When faced with such a situation as an advanced practice nurse, I will always decide on disclosing the information to the patient. Medication safety is a crucial aspect in safeguarding patients from harm during the care delivery process. As such, in case of an error, the nurse needs to come forward to avoid legal penalties associated with non-disclosure(Varkey,2021). I will utilize two main strategies to decide on how to disclose the matter to the patient.

First, I will explain to the patient how the medication error occurred to regain trust essential for a healthy patient-provider relationship. I will then expound on how the harmful impact of the error can be ameliorated and provide appropriate steps which will be taken to ensure that such an error will never happen again. This will help regain the patient’s confidence in the care plan hence promoting positive care outcomes.

Writing Prescriptions to Minimize Medication Errors

The process of writing a prescription mainly involves six steps. First, the prescriber must evaluate the patient’s problem, then specify the therapeutic objective (Mullen et al., 2018). After which the prescriber will select the most effective drug therapy, and initiate the therapy, with appropriate consideration of the dosage, frequency, and duration of drug use. The prescriber will then give information and instructions to the patient and evaluate therapy regularly.

To minimize incidences of medication errors, the prescriber must consider several factors before prescribing any medication. Such factors include whether the medication is the best choice in the management of the patient’s condition, whether there are any contraindications, whether the dosage is correct, whether the patient is allergic to any of the drug components, and appropriate storage for the drug among others.

Conclusion

Several ethical considerations have been outlined to promote appropriate prescriptive practices upholding patient safety and preventing harm. As such, in case of medication error like in the provided case study, the nurse is required to disclose the matter to the patient and implement appropriate strategies to address the issue.

References

Billstein-Leber, M., Carrillo, C. J. D., Cassano, A. T., Moline, K., & Robertson, J. J. (2018). ASHP guidelines on preventing medication errors in hospitals. American Journal of Health-System Pharmacy75(19), 1493-1517. https://doi.org/10.2146/ajhp170811

Mullen, R. J., Duhig, J., Russell, A., Scarazzini, L., Lievano, F., & Wolf, M. S. (2018). Bestpractices for the design and development of prescription medication information: A systematic review. Patient education and counseling101(8), 1351-1367. https://doi.org/10.1016/j.pec.2018.03.012

Robertson, J. J., & Long, B. (2018). Suffering in silence: medical error and its impact on health care providers. The Journal of emergency medicine54(4), 402-409. https://doi.org/10.1016/j.jemermed.2017.12.001

Tigard, D. W. (2019). Taking the blame: appropriate responses to medical error. Journal of Medical Ethics45(2), 101-105. http://dx.doi.org/10.1136/medethics-2017-104687

Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice30(1), 17-28. https://doi.org/10.1159/000509119

The instructions say “Be sure to reference laws specific to the state of South Carolina

Name: NURS_6521_Week11_Assignment_Rubric

 Excellent Good Fair Poor
Explain the circumstances under which children should be prescribed drugs for off-label use. Be specific and provide examples. Points Range: 36 (36%) – 40 (40%)

The response accurately and thoroughly explains in detail the circumstances under which children should be prescribed drugs for off-label use.

The response includes accurate and specific examples that fully support the explanation provided.

Points Range: 32 (32%) – 35 (35%)

The response accurately explains the circumstances under which children should be prescribed drugs for off-label use.

The response includes accurate examples that support the explanation provided.

Points Range: 28 (28%) – 31 (31%)

The response inaccurately or vaguely explains the circumstances under which children should be prescribed drugs for off-label use.

The response includes inaccurate or vague examples that may or may not support the explanation provided.

Points Range: 0 (0%) – 27 (27%)

The response inaccurately and vaguely explains the circumstances under which children should be prescribed drugs for off-label use, or is missing.

The response includes inaccurate and vague examples that do not support the explanation provided, or is missing.

Explain strategies to making off-label use and dosage of drugs safer for children from infancy to adolescence and descriptions and names of off-label drugs that require extra care and attention when used in pediatrics. Be specific. Points Range: 41 (41%) – 45 (45%)

The response accurately and clearly describes in detail strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence.

The response includes accurate, complete, and detailed descriptions and names of off-label drugs that require extra care and attention when used in pediatrics.

Points Range: 36 (36%) – 40 (40%)

The response accurately describes strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence.

The response includes accurate descriptions and names of off-label drugs that require extra care and attention when used in pediatrics.

Points Range: 32 (32%) – 35 (35%)

The response inaccurately or vaguely describes strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence.

The response includes inaccurate or vague descriptions and names of off-label drugs that require extra care and attention when used in pediatrics.

Points Range: 0 (0%) – 31 (31%)

The response inaccurately and vaguely describes strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence, or is missing.

The response includes inaccurate and vague or incomplete descriptions and names of off-label drugs that require extra care and attention when used in pediatrics, or is missing.

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.
Points Range: 5 (5%) – 5 (5%)

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

Points Range: 4 (4%) – 4 (4%)

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

Points Range: 3.5 (3.5%) – 3.5 (3.5%)

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

Points Range: 0 (0%) – 3 (3%)

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

Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation
Points Range: 5 (5%) – 5 (5%)

Uses correct grammar, spelling, and punctuation with no errors

Points Range: 4 (4%) – 4 (4%)

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

Points Range: 3.5 (3.5%) – 3.5 (3.5%)

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

Points Range: 0 (0%) – 3 (3%)

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

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. Points Range: 5 (5%) – 5 (5%)

Uses correct APA format with no errors

Points Range: 4 (4%) – 4 (4%)

Contains a few (1–2) APA format errors

Points Range: 3.5 (3.5%) – 3.5 (3.5%)

Contains several (3–4) APA format errors

Points Range: 0 (0%) – 3 (3%)

Contains many (≥ 5) APA format errors

Total Points: 100  
      

Name: NURS_6521_Week11_Assignment_Rubric

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