Assignment: Ethical and Legal Implications of Prescribing Drugs

  
Assignment: Ethical and Legal Implications of Prescribing Drugs
At least 3 citations and references.
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.
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 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.
RUBRIC AND READINGS
   

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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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

16 (16%) – 17 (17%)
The response provides   an accurate explanation of the process of writing prescriptions, including   some strategies to minimize medication errors.

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.

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.

5 (5%) – 5 (5%)
Paragraphs and   sentences follow writing standards for flow, continuity, and clarity.

4 (4%) – 4 (4%)
Paragraphs and   sentences follow writing standards for flow, continuity, and clarity 80% of   the time.

3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and   sentences follow writing standards for flow, continuity, and clarity 60%–79%   of the time.

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

5 (5%) – 5 (5%)
Uses correct   grammar, spelling, and punctuation with no errors

4 (4%) – 4 (4%)
Contains a few (1–2)   grammar, spelling, and punctuation errors

3.5 (3.5%) – 3.5 (3.5%)
Contains several   (3–4) grammar, spelling, and punctuation errors

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.

5 (5%) – 5 (5%)
Uses correct APA   format with no errors

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

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

0 (0%) – 3 (3%)
Contains many (≥ 5)   APA format errors
READINGS
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). 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.
 

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