SCENARIO: As a nurse practitioner, you prescribe medications for your patients. You make an error when prescribing medication to a 5-year-old patient. Rather than dosing him appropriately, you prescribe a dose suitable for an adult.
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
Full Answer Section
- Patient's family: The patient's family has the right to be informed of the patient's care and to make decisions on the patient's behalf.
Ethical Implications:
The NP's medication error has the potential to cause serious harm to the patient. The NP has a duty to disclose the error to the patient and their family so that they can make informed decisions about the patient's care. The NP also has a duty to take steps to prevent future medication errors.
Legal Implications:
The NP's medication error may be considered medical malpractice. Medical malpractice is a legal term used to describe negligence on the part of a healthcare professional. Negligence occurs when a healthcare professional fails to meet the standard of care that is expected of a reasonably competent healthcare professional in the same situation.
If the patient is harmed as a result of the NP's medication error, the patient or their family may file a medical malpractice lawsuit against the NP. The NP may also be subject to disciplinary action from their licensing board.
Disclosure and Nondisclosure
In most states, healthcare professionals are required to disclose medication errors to their patients. The purpose of disclosure is to give patients the information they need to make informed decisions about their care.
However, there are some exceptions to the disclosure requirement. For example, disclosure may not be required if the prescriber believes that disclosure would cause the patient to suffer serious emotional distress.
Strategies to Address Disclosure and Nondisclosure
If the NP decides to disclose the medication error to the patient and their family, they should do so in a timely and honest manner. The NP should explain the error to the patient and their family in a way that they can understand. The NP should also answer any questions that the patient and their family may have.
If the NP decides not to disclose the medication error to the patient and their family, they should document their decision in the patient's medical record. The NP should also take steps to prevent future medication errors.
Strategies to Guide Decision Making
When making a decision about whether or not to disclose a medication error, the NP should consider the following factors:
- The severity of the error
- The likelihood of harm to the patient
- The patient's age and understanding
- The patient's emotional state
- The patient's preferences
The NP should also consult with their colleagues and supervisors to get input on their decision.
Writing Prescriptions
The following strategies can help to minimize medication errors when writing prescriptions:
- Double-check the patient's age, weight, and medical history.
- Use generic names for medications whenever possible.
- Write the dose and frequency of the medication clearly.
- Avoid using abbreviations.
- Provide instructions for the patient on how to take the medication.
- Have the pharmacist review the prescription for accuracy and completeness.
Conclusion
Medication errors can have serious consequences for patients. It is important for healthcare professionals to take steps to prevent medication errors and to disclose any errors that do occur in a timely and honest manner.
Additional Considerations
In addition to the ethical and legal implications discussed above, the NP should also consider the following when making a decision about whether or not to disclose the medication error to the patient and their family:
- The relationship between the NP and the patient
- The NP's trust in the patient and their family
- The NP's concerns about the patient's safety
- The NP's concerns about the patient's ability to cope with the disclosure
The NP should also be aware of the potential for disciplinary action from their licensing board. In some cases, the NP may be required to report the medication error to their licensing board.
Ultimately, the decision of whether or not to disclose a medication error is a difficult one. The NP should weigh all of the relevant factors before making a decision.