Scenario: A Nurse Practitioner Prescribes Medications ✓ Solved

Scenarioas A Nurse Practitioner You Prescribe Medications For Your P

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. Write a 2 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. No plagiarism No copying No US English grammar errors APA format

Sample Paper For Above instruction

Introduction

Medication prescribing errors in clinical practice pose significant ethical and legal challenges for healthcare providers, especially nurse practitioners (NPs) responsible for vital patient care decisions. The scenario involving the prescription of an adult medication dose to a 5-year-old highlights critical aspects of patient safety, professional accountability, and legal considerations. Addressing these issues requires understanding the ramifications on all stakeholders, implementing effective disclosure strategies, and adhering to state-specific laws governing medical malpractice and patient safety.

Ethical and Legal Implications

The primary ethical principles involved include non-maleficence, beneficence, autonomy, and justice. Prescribing an incorrect medication dose potentially harms the pediatric patient by risking overdose manifestations such as toxicity, adverse reactions, or even death. This breach of non-maleficence can undermine trust in the healthcare system and compromise professional integrity.

Legally, such errors may constitute malpractice or negligence, especially if adverse outcomes result. Prescribers have a duty of care to provide accurate, evidence-based treatment tailored to patient-specific needs, including age and weight considerations in pediatrics. State laws often require adherence to professional standards, and failure to do so can lead to disciplinary actions, fines, or loss of licensure. For instance, many states mandate reporting medication errors and implementing corrective actions to prevent recurrence (American Medical Association, 2020).

Stakeholders affected include:

• Patient: faces potential harm, physical discomfort, or long-term health consequences.
• Patient’s Family: experiences emotional distress, loss of trust, and concern over safety.
• Prescriber (NP): responsible for ethical accountability, possible legal action, and professional reputation.
• Pharmacist: may inadvertently dispense the incorrect dose if not double-checked, emphasizing the importance of cross-verification.

Disclosing such errors aligns with ethical obligations and promotes transparency, but it also risks legal repercussions. Balancing honesty with legal protection requires strategic communication and adherence to laws.

Strategies for Addressing Disclosure and Nondisclosure

Effective communication strategies involve honesty, empathy, and clear explanations. Open disclosure protocols recommend informing the patient’s family promptly, explaining the nature of the error, potential risks, and remedial steps taken (Wu et al., 2021). This transparency fosters trust and supports ethical standards of accountability.

In some jurisdictions, laws encourage or mandate disclosure of errors, emphasizing a culture of safety and learning. However, concerns about legal liability might discourage full disclosure. Strategies such as consulting legal counsel prior to disclosure or utilizing apology laws—where an apology does not equate to admission of liability—can help mitigate legal risks (Liu et al., 2019).

State-specific laws, like those in California, promote disclosure through mandatory reporting policies, promoting a transparent healthcare environment (California Medical Board, 2022). Healthcare providers should also document the incident thoroughly, indicating steps taken to mitigate harm and prevent future errors.

Guiding Decision-Making as an Advanced Practice Nurse

Two strategies that guide ethical decision-making in medication errors include using the ethics of fidelity and honesty and applying clinical decision support systems (CDSS). Fidelity emphasizes the duty to the patient to provide safe and competent care; honesty involves transparency about errors and corrective actions (Beauchamp & Childress, 2019).

In this scenario, I would advocate for full disclosure of the medication error to the patient’s family, maintaining transparency while explaining the incident, risks involved, and corrective measures. Disclosing errors supports ethical principles, can reduce the risk of legal repercussions, and fosters trust. According to the American Nurses Association (2015), honesty in disclosing errors is essential to ethical nursing practice.

Secondly, employing CDSS can significantly reduce medication errors. These computerized systems assist clinicians by providing real-time alerts for potential drug interactions, dosage calculations based on weight, and evidence-based prescribing guidelines (Kawamoto et al., 2018). Integrating such technology into clinical practice enhances safety by minimizing human error and ensuring appropriate dosing, especially in pediatrics.

Furthermore, ongoing education and training in pediatric pharmacology and medication safety are vital. Incorporating regular updates on best practices and legal considerations into continuing education courses ensures that practitioners remain vigilant and informed (Genius et al., 2020).

Minimizing Medication Errors in the Prescription Process

The process of writing prescriptions involves several critical steps: verifying patient identity, reviewing allergies and current medications, calculating accurate doses, and entering prescriptions into an electronic health record (EHR). Strategies to minimize errors include standardizing order sets, implementing barcode verification, and double-checking calculations—particularly for pediatric patients who require weight-based dosing.

Electronic prescribing systems with integrated clinical support reduce manual errors and provide alerts for potential contraindications or incorrect dosages (Kaushal et al., 2019). Incorporating checklists and maintaining open communication with pharmacists also serve as safety nets to catch discrepancies before medication administration.

Continuous education on medication safety, especially regarding pediatric dosing, further enhances prescriber accuracy. Practitioners should also foster a culture of safety where team members are encouraged to question dubious prescriptions and verify high-risk orders (Runciman et al., 2018).

Conclusion

Medication prescribing errors, particularly in pediatric populations, have serious ethical and legal implications. Addressing these challenges requires transparent communication, adherence to legal standards, and implementation of safety-enhancing strategies. As an advanced practice nurse, applying ethical principles and technological tools to guide decision-making and error prevention promotes patient safety, professional integrity, and legal compliance.

References

• American Medical Association. (2020). AMA Guides to Professional Conduct & Ethics. AMA Press.
• American Nurses Association. (2015). Code of Ethics for Nurses with Interpretive Statements. ANA Publishing.
• Beauchamp, T. L., & Childress, J. F. (2019). Principles of Biomedical Ethics. Oxford University Press.
• California Medical Board. (2022). Disclosure of Medical Errors Policy. California Department of Public Health.
• Genius, K., et al. (2020). Pediatric Medication Safety: Education and Practice. Journal of Pediatric Nursing, 55, 101-108.
• Kawamoto, K., et al. (2018). Advanced Decision Support in Prescribing. BMJ Quality & Safety, 27(3), 186-193.
• Kaushal, R., et al. (2019). Strategies for Reducing Medication Errors. Journal of Patient Safety, 15(2), 110-116.
• Liu, Y., et al. (2019). Legal Aspects of Error Disclosure in Healthcare. Journal of Medical Law, 33(1), 45-62.
• Runciman, W., et al. (2018). Culture of Safety in Clinical Settings. BMJ Quality & Safety, 27(9), 660-668.
• Wu, A. W., et al. (2021). Disclosure of Medical Errors: Ethical and Practical Aspects. Mayo Clinic Proceedings, 96(5), 1329-1335.