Application Of Ethics And Legalities Of Medication Errors

Application The Ethics And Legalities Of Medication Error Disclosurea

Application: The Ethics and Legalities of Medication Error Disclosure American writer Nikki Giovanni once said: “Mistakes are a fact of life. It is the response to the error that counts” (Goodreads, 2012). Whenever you make an error when writing a prescription, you must consider the ethical and legal implications of your error—no matter how seemingly insignificant it might be. You may fear the possible consequences and feel pressured not to disclose the error. Regardless, you need to consider the potential implications of non-disclosure.

How you respond to the prescription error will affect you, the patient, and the health care facility where you practice. In this Assignment, you examine ethical and legal implications of disclosure and nondisclosure of personal error. 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. 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.

Paper For Above instruction

The issue of medication errors in healthcare is a significant concern, particularly regarding the ethical and legal responsibilities of healthcare professionals when such errors occur. The scenario of an advanced practice nurse (APN) making a prescribing mistake illustrates the complex decision-making process involved in disclosure versus nondisclosure. This paper explores these ethical and legal considerations, personal professional responsibilities, and strategies to prevent medication errors.

Ethical Implications of Disclosure and Nondisclosure

Ethically, healthcare providers are bound by principles such as autonomy, beneficence, non-maleficence, and justice. Disclosing medication errors aligns with respecting patient autonomy, as patients have the right to be informed about their health and any mistakes that could affect their treatment (Beauchamp & Childress, 2012). Transparency fosters trust and reinforces the therapeutic alliance. Conversely, nondisclosure may be perceived as deception, potentially damaging the patient-provider relationship and undermining trust if the error is later discovered (Gallagher et al., 2013).

Furthermore, from a beneficence perspective, disclosure allows for appropriate follow-up and management of potential adverse effects resulting from the error. Non-maleficence, the obligation to do no harm, supports honest communication that enables timely intervention if necessary. Justice involves fairness and accountability; dishonesty or concealment may violate ethical standards and lead to legal consequences.

Legal Considerations for Advanced Practice Nurses

Legal obligations vary by jurisdiction but generally require healthcare providers to disclose errors that could harm patients. Federal laws, such as the Patient Safety and Quality Improvement Act of 2005, promote transparency and safety reporting but do not explicitly mandate disclosure to individual patients (U.S. Department of Health & Human Services, 2015). However, state laws often impose specific duties on healthcare professionals.

For example, in many states, advanced practice nurses are considered licensed healthcare providers with a duty to disclose errors akin to physicians (American Nurses Association, 2019). Maryland, for instance, mandates that practitioners report and disclose medical errors that have resulted in harm (Maryland State Medical Board, 2018). Failure to disclose such errors could lead to legal actions including malpractice claims, disciplinary actions, or loss of licensure.

Personal and Institutional Responsibility

As an APN, disclosure of an error is not only a legal obligation but also an ethical one. The decision to disclose should consider the potential risks and benefits for the patient and the provider. In the scenario where the nurse believes the patient would be unaware of the mistake and that it was unintentional, the decision becomes nuanced. Nonetheless, transparency aligns with ethical standards and professional integrity.

Disclosing the error allows the healthcare provider to inform the patient, apologize if appropriate, and facilitate necessary steps such as additional monitoring or treatment modifications. Institutionally, transparency encourages a culture of safety and continuous improvement, reducing the likelihood of future errors (Kohn, Corrigan, & Donaldson, 2000).

Strategies to Minimize Medication Errors

Writing prescriptions accurately requires meticulous attention to detail. Strategies include double-checking medication names, dosages, and patient information; utilizing electronic prescribing systems with clinical decision support; and engaging in ongoing training and education about medication guidelines. Incorporating standardized protocols and checklists can reduce human error (Bates et al., 2003).

Furthermore, fostering an environment where staff feel comfortable reporting errors without fear of punishment promotes safety. Continuous quality improvement initiatives, such as root cause analysis of errors and near-misses, help identify systemic issues and implement corrective measures (Leape et al., 1995).

Personal Approach to the Scenario

In this scenario, I would advocate for disclosure of the medication error to the patient. Ethically, transparency respects the patient’s right to information and supports trust. Legally, adherence to state laws requiring disclosure would be essential, and I would document the error and my communication efforts thoroughly. I believe that honesty, combined with a willingness to address the situation proactively, best serves the patient’s interests and upholds my professional integrity.

Conclusion

Medication errors pose significant ethical and legal challenges for healthcare providers. Disclosing errors aligns with core ethical principles, promotes trust, and supports patient safety. Legally, statutes in many states mandate transparency, and failure to disclose can have serious consequences. Implementing strategies such as meticulous prescription practices and fostering a culture of safety can minimize errors. Ultimately, transparency and proactive error management are vital for providing ethical, safe, and quality care.

References

• American Nurses Association. (2019). Nursing scope and standards of practice (3rd ed.). ANA.
• Bates, D. W., et al. (2003). Effect of computerized physician order entry and clinical decision support systems on medication errors. JAMA, 289(14), 1772-1777.
• Beauchamp, T. L., & Childress, J. F. (2012). Principles of biomedical ethics (7th ed.). Oxford University Press.
• Gallagher, T. H., et al. (2013). Disclosing medical errors to patients: Don't overpromise. Journal of Legal Medicine, 34(2), 119-126.
• Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (2000). To Err is Human: Building a safer health system. National Academy Press.
• Leape, L. L., et al. (1995). The nature of adverse events in hospitalized patients: Results of the Harvard Medical Practice Study I. New England Journal of Medicine, 324(6), 377-384.
• Maryland State Medical Board. (2018). Medical error reporting laws. Maryland Department of Health.
• U.S. Department of Health & Human Services. (2015). Patient Safety and Quality Improvement Act of 2005. HHS.gov.
• Institute for Safe Medication Practices. (n.d.). Strategies to prevent medication errors. ISMP.org.
• Goodreads. (2012). Nikki Giovanni quote: Mistakes are a fact of life. Goodreads.com.