Pharmacology: Legal and Ethical Implications of Prescribing Prescription Drugs, Disclosure, and Nondisclosure

Posted on November 14, 2022 |

Pharmacology: Legal and Ethical Implications of Prescribing Prescription Drugs, Disclosure, and Nondisclosure – Review the Resources for this module and consider the legal and ethical implications of prescribing prescription drugs, disclosure, and nondisclosure…

What You Will Learn hide

1 Instructions

1.1 To Prepare

1.2 By Day 7 of Week 1

2 Solution

2.1 Introduction

2.2 Ethical and Legal Implications of the Scenario to Various Stakeholders

2.3 Strategies to Address Disclosure and Nondisclosure of Scenario 2

2.4 Process of Writing Prescription and Strategies to Minimize Medication Errors

2.5 Conclusion

3 References

4 Related Searches

5 Health Care Systems Essay Examples

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Instructions

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.

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.

My Scenario;

A friend calls and asks you to prescribe a medication for her. You have this autonomy, but you don’t have your friend’s medical history. You write the prescription anyway.

Solution

Scenario

A friend calls and asks you to prescribe a medication for her. You have this autonomy, but you don’t have your friend’s medical history. You write the prescription anyway

Introduction

Throughout the US, advanced practice registered nurses (APRNs) enjoying varying degrees of prescriptive authority over various medicines, controlled substances, and medical services. Essentially, the state demands supervision, delegation, or team- management by an outside health discipline for the NP to offer patient care.

Studies, however, indicate that states where nurses encounter the least restrictive regulations reported the highest increase in patients seen by NPs (Kuo et al., 2013). As such, states like Florida should strive to move to reduced practice and, finally, full practice.

Under the full practice, the legislation would offer all NPs authority to evaluate, diagnose, order, and interpret diagnostic tests, initiate and manage treatment, including the authority to prescribe medications. Suffice it to say that the NPs full prescriptive authority calls for a need to address the ethical and legal implications accompany it.

Consequently, this essay purposes of exploring the ethical and legal implications of a scenario where a friend calls and requests an NP to prescribe medication for her. The ethical and legal issues in the event arise from the fact that while the NP has prescriptive authority, the NP does not have her friend’s medical history but still goes ahead to write the prescription.

Ethical and Legal Implications of the Scenario to Various Stakeholders

Many nursing education students admit to having friends and family members who regularly said that they could not wait for the APRN to finish school and then have the ability to write prescriptions for them. As a new APRN, one must be aware of the ethical implications as well as professional nursing legislation that governs and regulate nursing practice in various states.

According to Raus et al. (2018), the ethical issues raised by the scenario include beneficence and fiduciary duty. To start with, the ethical principle of beneficence requires that the prescriber address the idea that a nurse’s actions promote well. Doing good is conceptualized as doing what is best for the patient, which in the current context is hampered by the prescribing nurse’s lack of the client’s past medical history.

In an ideal situation, the principal acts as the APRN’s obligation to protect their patients from harm through removal and prevention of bad situations while simultaneously promoting good ones. Like the prescriber, the pharmacist is also captured in the principle of fiduciary duty, which requires healthcare professionals to consider only the patients’ interests and not those of the practitioner’s interests in the process of delivering patient care. From time immemorial, clinicians have acknowledged the fact that the well-being and health of patients rely on the collaboration between the provider and the patient.

Furthermore, patients share the responsibility for their healthcare with the clinicians. As such, patients have the ethical obligation of bringing their healthcare and medical issues to the attention of their providers in a timely way. The patient should, therefore, share all information regarding their medical condition to the best of their ability (Nwafor & Nwafor et al., 2016). The fiduciary duty would, therefore, also impose an ethical obligation on the patient’s family to ensure that the provider-patient relationship is built on trust necessitating all the parties involved to place the patient’s welfare above any other individual’s self- interest.

The legal requirement to collaborate with the physician is essential towards the realization of full practice for NPs in Florida. Be that as it may, Scenario 2 represents a potential break-in collaborative relationship. Given this, the NP should make full disclosure of their ethical violation. It is imperative to remember by writing their friend the requested prescription, and there was no physician involved.

For that, no physical assessment and documentation were pausing legal consequences if a severe allergic reaction happened as a result of the prescribed medication. Additionally, there is also a possibility the prescription is also out of the NP’s certified area of practice, which would put the integrity of the NP involved into disrepute. Bird (2016) also opines that the physician practicing with the NP may not have consented to the nurse prescribing the medication to the friend.

Strategies to Address Disclosure and Nondisclosure of Scenario 2

As a prescriber, when one encounters a request for prescribing medication for a friend or members of the family, it is prudent for one to ask oneself whether one’s decision to prescribe is being guided by what will most likely benefit the patient medically.

The urge to appear helpful in the eyes of the patient (their friendship or familial ties notwithstanding) should not override professional ethics and guidelines on how to prescribe medications. An NP working in the state of Florida is required to work in cahoots with a physician as outlined in the specified area of practice through the Nurse Practice Act Section 464.003(Tony- Butler & Martin, 2019).

The second strategy, as envisaged by the current best healthcare practice, is for the nurse to avoid prescribing medication to anyone with whom they enjoy having a close personal relationship. Usually, prescribing medication for family, friends, and coworkers is not recommended due to the ever-present danger of lack of objectivity leading to possible discontinuation of care.

When personally faced with such a scenario, I would first ask myself whether writing the requested prescription is offering a repeat or new prescription in addition to considering whether my friend’s prescription request falls within my scope of practice. Most importantly, I would make full disclosure of this ethical and legal violation while avoiding a repeat of the same in the future.

Process of Writing Prescription and Strategies to Minimize Medication Errors

Pharmacies across the US filled over four billion prescriptions in 2017 alone. At the same time, healthcare experts point out that prescriptions remain the leading cause of medication errors accounting for more than 70%. As such, there need for practitioners to follow steps that ensure patient safety. Before following the correct steps of prescribing medication, the prescriber should ensure their handwriting is legible and were used that abbreviations are written correctly. To begin with, the prescriber should indicate their personal information at the top of the prescription with the clinician’s name, office address, and contacts.

Step two includes the date of the prescription, the patient’s information with name, age, date of birth, and home address. The recipe (Rx) appears the third step and covers the medication being prescribed, its dose, and dosage form followed by the signature (sig), which captures the patient’s instructions on how to take the prescribed medication at step four. Step five contains the dispensing instructions (Disp), which lets the pharmacist know the amount of medication the patient should take.

The last two steps contain the number of refills (RF) and the prescriber’s signature, respectively. Where no refill is desired, the prescriber should write zero refills. The prescriber’s signature should have the National Provider Identifier also. In order to reduce prescription errors, de Araujo et al. (2019) suggest the promotion of educational actions for prescribers and the integration of computerized alert systems into clinical practice, amongst others.

Conclusion

In conclusion, APRNs need to remember with prescriptive authority comes responsibilities, which, if abused, gives rise to ethical and legal implications that allow the affected patient or their family to seek legal redress. As such, the APRNs, whether working in states with a full practice, reduced practice, or local practice, should prudently apply prescriptive authority. Doing so is bound to improve the quality of healthcare through reduced medication errors.

References

Bird, S. (2016). The pitfalls of prescribing for family and friends. Australian Prescriber, 39(1), 11-13.
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 pharmacology, 10, 439.
Kuo, Y. F., Loresto Jr, F. L., Rounds, L. R., & Goodwin, J. S. (2013). States with the least restrictive regulations, experienced the most massive increase in patients seen by nurse practitioners. Health Affairs, 32(7), 1236-1243.
Nwafor, G. C., & Nwafor, A. O. (2016). The Healthcare Providers-Patients Relationship and State Obligations in Times of Public Health Emergency. African Journal of Legal Studies, 9(4), 268-298.
Raus, K., Mortier, E., & Eeckloo, K. (2018). The patient perspective in health care networks. BMC Medical Ethics, 19(1), 1-8.
Rudner Lugo, N. (2016). Full practice authority for advanced practice registered nurses is a gender issue. OJIN: The Online Journal of Issues in Nursing, 21(2).
Toney-Butler, T. J., & Martin, R. L. (2019). Florida Nursing Laws and Rules. In StatPearls [Internet]. StatPearls Publishing.

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