Ethical and Legal Implications of Prescribing Drugs Assignment Paper

Introduction

When a patient visits a healthcare system, there are high chances of prescribing for medication. A nurse or physician should prescribe according to the patient’s diagnosis and know the quality that a patient should receive based on health history and physical examination (Mitchell & Oliphant, 2016). This paper seeks to delve into the scenario to consider ethical and legal implications for involved individuals. The discussion will also incorporate a description of strategies that address disclosure and non-disclosure and approaches that I would use as an APRN to lead decision-making in the selected situation. Finally, the prescription writing process, including ways of minimizing medication errors, will be discussed Ethical and Legal Implications of Prescribing Drugs Assignment Paper.

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Legal Implications

Prescriber 

The APRN must be conscious of prescribing rights. Each state regulates prescription authority. All APRNs are responsible for prescribing within the statutes of a state (Arcangelo et al., 2017). They are also liable to state regulations, along with individual hospital and practice site laws.

Pharmacist 

It is the pharmacist’s responsibility to read and interpret prescriptions, fill orders, and educate patients, as appropriate. The pharmacist should understand and comply with the prescription correctly. The pharmacist may recommend a therapeutic interchange to facilitate cost-effectiveness. A therapeutic interchange is described as “dispensing prescribed medications are chemically different but deemed therapeutically similar to the prescribed medication” (Arcangelo et al., 2017) Ethical and Legal Implications of Prescribing Drugs Assignment Paper.

Patient

As per the nursing code of ethics, 5.2, “Moral respect affords moral worth and dignity to all human beings regardless of their personal attributes or life situation” (“American Nurses Association,” 2017). Although several patients may not be able to afford expensive medicines, they all worthy of quality healthcare. An option would be to prescribe generic medications. Thorough inspections are performed by the Food and Drug Administration to ensure manufacturing companies comply with policies on manufacturing activities (U.S. Food and Drug Administration, 2020) Ethical and Legal Implications of Prescribing Drugs Assignment Paper.

Patient families

Patient families are sometimes overwhelmed with giving or paying for their loved one’s medicines. Some patients take multiple medications. On certain occasions, medicines are over-prescribed. The World Health Organization invented the word “rational prescribing” to counter unreasonable prescribing of medicines.

Strategies to Address Disclosure and Nondisclosure

Physicians and nurses should consider patient autonomy when taking into consideration whether to disclose a non-harmful error. The disclosure of medical error is legally and ethically appropriate. In Georgia, there are two statewide medical-error reporting programs, namely: a grant-funded project through the AHRQ and the Partnership for Health and Accountability through the Georgia State Association (Slavitt & Slavitt, 2016). However, there is no law directing reporting of patient-safety in this state Ethical and Legal Implications of Prescribing Drugs Assignment Paper.

Strategies for Decision Making

When selecting a patient’s medication, the prescriber should conduct a risk-benefit analysis that considers the patient physical exam, allergies, and history (Arcangelo et al., 2017). The prescriber should understand the diagnosis and treatment when choosing correct medications.

A good practitioner must be able to prepare for unplanned outcomes (Arcangelo et al., 2017. Assessing the patient both physically and economically, is essential in efforts to predict unexpected situations like non-compliance.

Prescription Writing Process and Strategies for Minimizing Medication Errors

The following is the criterion used is in prescribing medications.

  1. Noting down the doctor’s information
  2. Noting down the patient’s information including name, medical history, and health condition
  3. Indicating the date of prescription
  4. Conducting the actual prescription, done using the Rx initials
  5. Inscription happens, where the information of the prescribed drugs is provided
  6. Subscription takes place for compound medication
  7. Signature happens, where the practitioner clarifies how the medication should be taken
  8. Refill-data is given. It shows the number of doses to be taken by the patient after the current prescription.
  9. Lastly, the practitioner appends his signature

The strategies to minimize medical errors include:

  1. Increasing handover conversation from one practitioner to another to reduce the loss of information
  2. Making health records and information practical
  3. Avoiding diagnostic errors ((“Strategies to Reduce Medication Errors: Working to Improve Medication Safety”, 2017) Ethical and Legal Implications of Prescribing Drugs Assignment Paper

Summary

This discussion has looked into the scenario and described the ethical and legal implications of different stakeholders. It has also provided strategies to address disclosure and disclosure, and the approaches that I would use an APRN to aid in making decisions. The final part of my discussion described the prescription process and the strategies to reduce medication errors.

References

American Nurses Association. (2017). Code of ethics for nurses with interpretive statements. Retrieved from http://nursingworld.org/DocumentVault/Ethics-1/Code-of-Ethics-for-Nurses.html

Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (2017). Pharmacotherapeutics for advanced practice: A practical approach. Ambler.

Slavitt, A., & Slavitt, D. A. A. (2016). 8515 Georgia Ave., Suite 400 Silver Spring, MD 20910 www. nursingworld. org.

Generic Drug Facts. U.S. Food and Drug Administration. (2020). Retrieved 5 June 2020, from https://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/GenericDrugs/ucm167991.htm.

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

Assignment: Ethical and Legal Implications of Prescribing Drugs Write a 2 -page paper that addresses the following: • Explain the ethical and legal implications of the scenario on all stakeholders involved, including the prescriber, pharmacist, patient, and patient’s family. • Describe strategies to address disclosure and nondisclosure. Be sure to reference laws specific to Georgia state. • Explain two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario. 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. Assigned scenario During your lunch break at the hospital, you read a journal article on pharmacoeconomic Ethical and Legal Implications of Prescribing Drugs Assignment Paper.

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You think of a couple of patients who have recently mentioned their financial difficulties. You wonder if some of the expensive drugs you have prescribed are sufficiently managing the patients’ health conditions and improving their quality of life. Reading/Resources Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier. • Chapter 1, “Prescriptive Authority” (pp. 1–3) • Chapter 2, “Rational Drug Selection and Prescription Writing” (pp. 5–9) • Chapter 3, “Promoting Positive Outcomes of Drug Therapy” (pp. 11–16) • Chapter 4, “Pharmacokinetics, Pharmacodynamics, and Drug Interactions” (pp. 17–40) • Chapter 5, “Adverse Drug Reactions and Medical Errors” (pp. 41–49) • Chapter 6, “Individual Variation in Drug Response” (pp. 51–56) 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) Ethical and Legal Implications of Prescribing Drugs Assignment Paper.

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. This website provides a list of prescription-writing abbreviations that might lead to misinterpretation, as well as suggestions for preventing resulting errors Ethical and Legal Implications of Prescribing Drugs Assignment Paper