Ethical and Legal Implications of Prescribing Drugs

Ethical and Legal Implications of Prescribing Drugs

The case scenario presented indicates that prescription errors can have significant consequences for all stakeholders involved in the transaction. Health practitioners must consider all the possible harms that are likely to occur when they make a prescription error. The foundation of medical practitioners revolves around non-maleficence and “do not harm.” Therefore, they should disclose information to the patient as an ethical obligation and prevent any damage that could arise. By so doing, they gain the patient’s trust and create an opportunity to improve the treatment process. Nurses should therefore consider all the ethical, legal, and professional implications of prescribing drugs.

Ethical and Legal Implications

The scenario in question was a nurse practitioner giving a five-year-old the incorrect prescription dosage. Instead of delivering the correct dose, the nurse ordered an adult dose. Mitchell & Oliphant (2016) note that nurses should always make sure they understand the type of therapy their patients require before giving them a prescription. They emphasize that when calculating the dose for children, the most crucial thing to consider is the child’s weight. A specific indication of the dosage for each kilogram of a child’s body weight is required.

In this case, the prescriber is in charge of interpreting pharmaceutical information from the physician and putting it into practice by prescribing the proper prescription. In the case study, the nurse failed in her duty and faced disciplinary action, which might include being fired from his job, having his practice license revoked, or even being prosecuted. One probable consequence of the miscalculation is that the child would experience issues resulting from the overdose (Pozgar, 2019). Litigation, the loss of the nurse’s and pharmacists’ jobs, and the hospital’s reputation could all be a consequence of such an occurrence. Medication errors are the most common cause of malpractice claims against doctors.

Strategies to Address Disclosure and Nondisclosure

According to Pozgar (2019), patients want to hear an explicit declaration that a mistake occurred, what happened and the ramifications for their health, why it happened, and how future recurrences will be avoided for themselves and other patients in an error disclosure. The patients would also like to hear an apology and not a statement of regret. The strategies to address disclosure begin by stating that an error has occurred. Nurses should then describe the events using simple language that the patients will understand. By stating the nature of the error and the consequences, the nurses express their regrets before apologizing. Finally, the nurses should plan the next step to address the issue with the patient.

Strategies to Guide in Decision Making

As a practice nurse, the first line of defense would be to avoid giving the incorrect dosage right away. I would next inform the child’s parents or guardians of the error and apologize for the oversight. Kumar et al. (2018) note that failing to reveal pharmaceutical errors could result in financial losses in the form of litigation and claims from patients or their families who suffer harmful effects. Following that, I would inform the pharmacist of my mistake and request the correct dosage through the proper pediatric prescription processes. In the end, I would demonstrate repentance and submit to whatever disciplinary actions were made against me as a result of my error.

The second technique is to undertake a root-cause investigation and identify long-term corrective and preventive measures. The hospital administration is likely to designate a team to investigate the issue right away. I would work with the investigators to explain the circumstances around my error. This collaboration will assist everyone in determining the root cause of the mistake. According to Montgomery et al. (2021), workplace stress may cause nurses to make mistakes when prescribing medications. The long-term remedy in such a circumstance is to hire more nurses to lessen the workload. The hospital should also increase the number of checkpoints between prescribing nurses to ensure that the patient receives the correct dosage.

Process of Writing a Prescription

There are several factors that physicians must consider while prescribing medications. It is critical to recognize that different countries have specific standards. The standards dictate the information that must be included in the medications. Typically, all prescriptions must be written in a language that the patient can comprehend in taking the medications (Kumar et al., 2018). Second, it is critical to write the prescription in legible handwriting. Finally, specify the frequency with which the patient should take the drug and the anticipated days on which the patient should take the drug. Other information is dependent on the state’s prescription requirements.

Conclusion

It is not unusual for nurse practitioners to make mistakes in the healthcare setting. While some of these errors have severe ramifications for the practitioners’ professional practice and the health of their patients, others may not be as detrimental. Medication errors in children can have a wide range of effects on the patient, the patient’s family, the hospital, and the practitioners, as this paper has demonstrated. In such blunders, the most ethical thing to do is admit the fault and strive to mitigate the repercussions. It’s also critical to identify and eliminate the fundamental causes of prescription errors so that they don’t happen in the first place.

References

Kumar, A., Jain, S., Dangi, I., Chowdary, S., Choubitker, O., Pandey, K. K., & Pawar, R. S. (2018). Ideal Drug Prescription Writing. World Journal of Pharmacy and Pharmaceutical Sciences, 8(3), 634–654.

Mitchell, A., & Oliphant, C. M. (2016). Responsibility for Ethical Prescribing. The Journal for Nurse Practitioners, 12(3), A20.

Montgomery, A. P., Azuero, A., Baernholdt, M., Loan, L. A., Miltner, R. S., Qu, H., Raju, D., & Patrician, P. A. (2021). Nurse Burnout Predicts Self-Reported Medication Administration Errors in Acute Care Hospitals. The Journal for Healthcare Quality (JHQ), 43(1), 13–23.

Pozgar, G. D. (2019). Legal and Ethical Issues for Health Professionals. Jones & Bartlett Learning.

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

references

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 Download 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 list 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. (2021). CFR – Code of Federal Regulations Title 21Links to an external site.. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=1300
This website outlines the code of federal regulations for prescription drugs.

Drug Enforcement Administration. (n.d.). Mid-level practitioner’s authorization by stateLinks to an external site.. 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.

Institute for Safe Medication Practices. (2017). List of error-prone abbreviations, symbols, and dose designationsLinks to an external site.. 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.

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
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 the pharmacist as a collaborator.