The Ethics and Legalities of Medication Errors Disclosure
Instructions: Consider the following scenario:
You are working as an advanced practice nurse at a community health clinic. You make an error when prescribing a drug to a patient. You do not think the patient would know that you made the error, and it certainly was not intentional.
To prepare:
• Consider the ethical implications of disclosure and nondisclosure.
• Research federal and state laws for advanced practice nurses. Reflect on the legal implications of disclosure and nondisclosure for you and the health clinic.
• Consider what you would do as the advanced practice nurse in this scenario including whether or not you would disclose your error.
• Review the Institute for Safe Medication Practices website in the Learning Resources. Consider the process of writing prescriptions. Think about strategies to avoid medication errors.
To complete:
Write a 2- to 3- page paper that addresses the following:
• Explain the ethical and legal implications of disclosure and nondisclosure. Be sure to reference laws specific to your state. (Mississippi)
• Describe what you would do as the advanced practice nurse in this scenario including whether or not you would disclose your error. Provide your rationale.
• Explain the process of writing prescriptions including strategies to minimize medication errors.
Solution.
The Ethics and Legalities of Medication Errors Disclosure
Nurses are human just like any other person who are prone to making an error. In day-to-day activities nurses are can encounter errors in their line of work. An advanced nurse who is entitled to prescribing drugs can make a prescription error. What do we do about this as nurses? Most nurse’s report tend to turn to a physician for help. After committing an error on medication grounds, the step taken by a nurse are imperative. Nurses have an obligation to ensure total safety of the client of the patients by responding accordingly to the error made. This paper will explain the ethics and legalities behind medication error disclosure to a patient based on the following scenario: As an advanced nurse working in a clinic, you make a mistake of prescribing medication wrongly to a patient, but you do not want to create an awareness to the patient about the error. This paper will help nursing practitioners on how to conduct themselves when hit with such ethical issues and dilemmas.
Disclosure and Non-Disclosure
Douglas et al., 2004, outline by saying that it is ethically the right thing to do in disclosing an error to a patient. According to the federal laws of Mississippi, Private policy formed the Information and Policy healthcare that addressed the issues with patient’s safety in 2005. These rules state that patients are entitled to be briefed of their medication concerns. As a nurse practitioner, one is required by this federal legislation to disclose any harmful errors he/she committed towards the medication procedures to the patient.Staes like Mississipi and District of Columbia have come with rules and regulation to protect the nurses from malpractice suit in case of disclosure of medication errors.
Nurses are to acknowledge they indeed made a mistake and apologize accordingly (Mastroianni, Mello, Sommer, Hardy, & Gallagher, 2010).The ethics and legalities behind these errors require that nurses explain why the error occurred, how the errors can be abated, and provide necessary steps on how the error can be avoided in future.Nurses have to seek legal protection in case of disclosure of any medication error they ought to have made (Philipsen & Soeken, 2011). By adhering to the steps mentioned above, patients will respect your decision to admit to a mistake, and they will have the concern when you try to fix the problem you created. The critical part in the field of healthcare is the procedure on how the error is being handled in a health setting.
Advanced Practice Nurse
A large number of patients recently have less interactional time with the nurse practitioners because of the higher demands for nurses in Mississippi. The tendency to commit a prescription error is high since an NP has to serve a large number of patients at a go. The less time spent by the NPs on patients can result in errors as they are in a hurry to offer a prescription to cater for all the patients. The time constraint stimulates to wrong or irrational medication and prescription. According to federal laws, nurses are solely and individually accounted for the health status of the community and the existing dangers to safety and health of the society. Nurses are also responsible for educating the public on the current issues on health in the community. Also, they are they are responsible for identifying circumstances and conditions that can cause any form of illness in the community. They are the cup-bearers in encouraging healthy lifestyles and being role models to the young generations to come. As NPs, they are also required to participate in health promotional activities in the community and foster legislation efforts to defend the fundamental national health objectives (American Nurses Association, 2001).
Writing prescription
Writing a prescription require certain parameters that need to be adhered to minimize on medication errors that are present during the process. To begin with the problem or illness present in the patient should be matching with the role of the drug. In this part, the drug should be the best in treating the disease.Age differences are also important in prescribing drugs to avoid the side effects some drugs have on adults and children (Gallagher, Ryan, Byrne, Kennedy, & O’Mahony, 2008). Also, the medication administered should create adverse side effects on the patient. Secondly, the dosage should be correct respective how high or low the treatment requires. Alos to minimize the medication errors, an NP should consider on the current medication that the patient is undergoing. Also, one will need to check the compatibility of the drugs that the patient is taking and the one administered (Velo & Minuz, 2009).
Nurses should also consider the following parameters to ensure minimal medication errors. First, the storage must be known to establish the state of the drug if it is either safe or not. The medication of the drug must not adversely affect the lifestyle of the patient. This factor raises questions; the patient should also accept to take the drug. Before a patient receives the drug, he or she must be acutely aware of the side effects and how he will react to the side effects. Economically, the cost of the drug matters when it comes to patients of the middle class.Lastly, the nurse has to provide a plan for the patient, or the nurse can ask if the patient has a plan in taking the medications of the required program.
Conclusion
Medication errors are prone
to happen in the course of a nursing career. At times, it is not intentional.
There laws that a nurse can follow to protect him/her from malpractice suits.
With the great demand for nurses in the society, a few nurses serve a large
number of patients which can lead to making errors while prescribing medications
for patients.Disclosing an error is the right thing to do and ensure
rectification to help the client recover successfully. Apologies and explanations
to the patient create trust between the nurse and the patient.
References
American Nurses Association. (2001, June 5). Code of Ethics for Nurses with Interpretive Statements. Retrieved from Nursing World: http://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses/Code-of-Ethics.pdf
Douglas, S. P., Crook, E. D., Stellini, M., Levine, D., Wiese, W., & Douglas, S. (2004). Medical Errors and the Trainee: Ethical Concerns. The American Journal of the Medical Sciences, 327(1), 33-37.
Gallagher, P., Ryan, C., Byrne, S., Kennedy, J., & O’Mahony, D. (2008). STOPP (Screening Tool of Older Person’s Prescriptions) and START (Screening Tool to Alert Doctors to Right Treatment). Consensus Validation. International Journal of Clinical Pharmacology and Therapeutics, 46(2), 72-83.
Mastroianni, A. C., Mello, M. M., Sommer, S., Hardy, M., & Gallagher, T. H. (2010). The Flaws in State ‘Apology’and ‘Disclosure’Laws Dilute their Intended Impact on Malpractice Suits. Health Affairs, 29(9), 1611-1619.
Philipsen, N. C., & Soeken, D. (2011). Preparing to Blow the Whistle: A Survival Guide for Nurses. The Journal for Nurse Practitioners, 7(9), 740–746.
Velo, G., & Minuz, P. (2009). Medication Errors: Prescribing Faults and Prescription Errors. British Journal of Clinical Pharmacology, 67(6), 624-628.
