Ethical and Legal Implications of Prescribing Drugs Sample Paper

Ethical and Legal Implications of Prescribing Drugs Sample Paper

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Ethical Implications of The Scenario

The ethical ramifications of this scenario are substantial. The autonomy of the patient will probably be jeopardized since she lacks the ability to arrive at an informed decision concerning her care. The most crucial factor is the patient’s autonomy and self-determination (McWhirter et al., 2020)Ethical and Legal Implications of Prescribing Drugs Sample Paper. MA’s cognitive deterioration has proceeded to the extent that she is no longer capable of making her own choices regarding treatment. If she can still communicate, her choices should be respected; if she cannot, it is up to her caregivers to make essential choices on her behalf.

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MA’s INR monitoring requires a judgment on how long she should continue. An ethical standpoint requires that the patient’s preferred interests be considered. Maintaining an eye on the INR may not be in MA’s greatest interest in this situation. Her doctor has already remarked that she is nearing the final stage of her life, and considering her other health issues, the INR is not going to play a substantial part in her treatment. Furthermore, she is going to find the periodic blood tests to be excruciatingly uncomfortable and unpleasant.

The physician’s beneficent responsibility may be challenged since it is still being determined if further treatment is necessary. The chemist’s role is to make sure that the patient adheres to the prescription as directed and to contact the doctor if any problems emerge.

Strategies To Address Disclosure and Nondisclosure

As indicated in the scenario, MA is an 85-year-old woman with significant cognitive degeneration and a variety of health issues, including kidney failure and CHF. Despite a warning from her doctor that she is on the verge of death, she remains taking blood thinners due to having had a valve replaced two decades ago. Consequently, the patient lacks the ability to endure blood draws for INR tests due to the acute agony she experiences when her fingers get picked up. To arrive at this decision, the doctor treating the patient and family members have to be contacted, and the risks and advantages of keeping track of the INR must be weighed (Narouze et al., 2018). Before deciding on how to monitor the INR, it is imperative to check the end-of-life care guidelines of the state. Ethical and Legal Implications of Prescribing Drugs Sample Paper

Strategies For Decision-Making in This Scenario

When making judgments concerning patient care, individual aspirations, and needs, in addition to the clinical situation, have to be taken into account. MA, an 85-year-old woman, is on the edge of death due to significant cognitive decline. Her treatment is presently centered on maintaining her as at ease as possible due to a valve replacement.

Considering her terminal situation, her INR does not necessarily require regular monitoring. This choice can be reached using both best-interest care and patient-centered care. In patient-centered care, the interests and wants of individuals are prioritized (Tinetti et al., 2019).

If the aforementioned scenario takes place, blood thinners will no longer be helpful to MA. Continued usage of blood thinners could possibly end in bleeding. Taking these factors into account, it can be essential to stop blood thinners.

The Process of Writing Prescriptions

In order to prevent medication errors, it is essential to keep a few standards in mind when administering medications. Prior to deciding on the best course of action, it is significant to learn current medications of a patient, and their medical history. This needs knowledge of the patient’s present prescription regimen and the allergies or additional medical problems they might be experiencing (Kondo et al., 2020). As a component of this procedure, a system for monitoring adverse effects and drug interactions have to be established. Using a computerized prescribing system will minimize the chance of medication errors. Because these technologies can reduce the likelihood of drug-related mistakes, automated refill orders may be beneficial.

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References

Kondo, M. C., Oyekanmi, K. O., Gibson, A., South, E. C., Bocarro, J., & Hipp, J. A. (2020). Nature prescriptions for health: A review of evidence and research opportunities. International journal of environmental research and public health, 17(12), 4213. https://doi.org/10.3390/ijerph17124213

McWhirter, R., Eckstein, L., Chalmers, D., Critchley, C., Nielsen, J., Otlowski, M., & Nicol, D. (2020). A scenario-based methodology for analyzing the ethical, legal, and social issues in genomic data sharing. Journal of Empirical Research on Human Research Ethics, 15(4), 355-364. https://doi.org/10.1177/1556264620920460

Narouze, S., Benzon, H. T., Provenzano, D., Buvanendran, A., De Andres, J., Deer, T., … & Huntoon, M. A. (2018). Interventional spine and pain procedures in patients on antiplatelet and anticoagulant medications: guidelines from the American Society of regional anesthesia and pain medicine, the European Society of regional anaesthesia and pain therapy, the American Academy of pain medicine, the International neuromodulation Society, the North American neuromodulation Society, and the world Institute of pain. Regional Anesthesia & Pain Medicine, 43(3), 225-262. DOI: 10.1097/AAP.0000000000000700

Tinetti, M., Dindo, L., Smith, C. D., Blaum, C., Costello, D., Ouellet, G., … & Naik, A. (2019). Challenges and strategies in patients’ health priorities-aligned decision-making for older adults with multiple chronic conditions. PloS one, 14(6), e0218249. https://doi.org/10.1371/journal.pone.0218249 Ethical and Legal Implications of Prescribing Drugs Sample Paper

  NURS 6521N PHARMACOLOGY WEEK 1 ASSIGNMENT 2 INSTRUCTIONS

 TOPIC: ETHICAL AND LEGAL IMPLICATIONS OF PRESCRIBING DRUGS

 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.

 REQUIRED READING;

• Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants(2nd ed.) St. Louis, MO: Elsevier.
  • Chapter 1, “Prescriptive Authority” (pp. 1–3)
  • Chapter 2, “Rational Drug Selection and Prescription Writing” (pp. 4–7)
  • Chapter 3, “Promoting Positive Outcomes of Drug Therapy” (pp. 8–12)
  • Chapter 4, “Pharmacokinetics, Pharmacodynamics, and Drug Interactions” (pp. 13–33)
  • Chapter 5, “Adverse Drug Reactions and Medication Errors” (pp. 34–42)
  • Chapter 6, “Individual Variation in Drug Response” (pp. 43–45)
• 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 SocietyDownload Journal of the American Geriatrics Society, 67(4), 674–694. doi:10.1111/jgs.15767 Ethical and Legal Implications of Prescribing Drugs Sample Paper

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. (2021). CFR – Code of Federal Regulations Title 21Links to an external site.. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=1300

This website outlines the code of federal regulations for prescription drugs.

• Drug Enforcement Administration. (n.d.). Mid-level practitioners authorization by stateLinks to an external site.. 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.

• Institute for Safe Medication Practices. (2017). List of error-prone abbreviations, symbols, and dose designationsLinks to an external site.. 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.

• 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 studentsLinks to an external site.. Journal of the American Association of Nurse Practitioners, 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.

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. Ethical and Legal Implications of Prescribing Drugs Sample Paper

Assignment Scenario:

MA is an 85-year-old female living in a long-term care facility. She has significant cognitive decline, and her physician has even said that death is near with her other health issues, including renal failure and CHF. She was on blood thinners for years due to a valve replacement 20 years ago. She cries in agony with each fingerpick and can barely tolerate the lab draws to check her INR if needed.

Is continual monitoring of the INR needed, given her terminal status?

Some questions/rubric requirements pertain to your job experience and state laws.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary/conclusion, and references

Students,

Please be mindful of Walden University’s Incomplete policy. You are enrolled in a didactic course. To pass the course, you must complete ALL assignments/discussion posts. If these requirements are not met by the end of the quarter, you will not pass the system and cannot move forward to your next class.

INSTRUCTIONS:

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. Ethical and Legal Implications of Prescribing Drugs Sample Paper