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Mistakes are an inevitable part of an individual’s life due to the imperfections of human nature. However, it is also apparent that the value of a mistake significantly differs depending on the circumstance where an error occurred and the position of a person who made it. Further, it could be hardly doubted that errors in the sphere of the healthcare system are valued as being considerably more severe than the majority of other cases because a health practitioner is responsible for the well-being of his or her patients to a vast extent.
Mistakes in medication prescriptions could be considered as one of the most evident examples of the importance of advanced practice nurses’ high competency. This paper aims to study the ethical and legal implications of medication error disclosure and non-disclosure based on the proposed scenario.
Ethical and Legal Challenges of Drug Prescription Errors
First of all, it is necessary to observe the scenario which is proposed for this assignment to put further reasoning in the proper context. According to this scenario, I am working as an advanced practice nurse in a community health clinic. Eventually, I make a mistake when prescribing medication to a patient. This error was not intentional, and the patient is not likely to find out about the mistake. However, I am put into the situation of an ethical dilemma, which also has specific legal implications.
The primary question which should be answered in the proposed situation is whether I should disclose my mistake or hide it. From the perspective of healthcare ethics, it is more than obvious that the non-disclosure of a prescription error will be unethical primarily toward the patient. His or her health, well-being, and recovery are the most critical concerns for an advanced practice nurse, and thus the patient should know if the prescribed drug or its dose is suitable for the treatment (Arcangelo and Wilbur 7). The decision not to disclose the error is also in discrepancy with the moral code of a health practitioner.
However, it is essential to observe that the disclosure of the prescription error, being the right decision from the perspective of healthcare ethics, is followed by specific legal implications. The primary pressure is put on the advanced practice nurse who made a mistake. As it is stated in the “New Jersey Board of Nursing Law,” an advanced practice nurse “may prescribe medications and devices in all other medically appropriate settings” (24).
The process of prescribing is elaborately described in the mentioned act, including rules and regulations for by “standing orders or joint protocols” (“New Jersey Board of Nursing Law” 24). However, it is also stated in the document that the violation of any provision of the act is subject to a penalty from 200 to 500 dollars (“New Jersey Board of Nursing Law” 19). Additionally, the disclosure of a prescription error is harmful to the clinic where an advanced practice nurse is working.
The rationale behind the Decision and Strategies for Improvement
Since ethical and legal implications were discussed, it is appropriate to determine my decision in the described scenario and explain the rationale behind it. I assume that I would disclose my error to the patient and the clinical manager. First of all, I consider the responsibility for the patient’s health and proper treatment to be the critical driving factor in the decision. In other words, the ethical aspect of the issue is more important in such situations than legal implications. By admitting my mistake, I will guarantee that I would be more accurate in prescribing medication in further practice.
Further, it is essential to discuss strategies for the improvement of drug prescription. Firstly, Institute for Safe Medication Practices (ISMP) provides an opportunity for confidential and voluntary reporting of medication mistakes to gather data on this issue (“Reporting a Medication or Vaccine Error or Hazard to ISMP”). This procedure helps to contribute to the investigation and analysis of factors that cause various prescription errors.
The person’s personal information is not disclosed to any third party, which makes it a great opportunity to act ethically even if one decides not to reveal his or her error to a patient or clinical staff. Secondly, there is “ISMP’s List of Error-Prone Abbreviations, Symbols, and Dose Designations,” which can be used to avoid common mistakes when prescribing a particular drug (1). Thirdly, it is possible to mention that the implementation of disclosure training programs for advanced practice nurses can be a significantly efficient tool for the improvement of the situation (Ragucci et al. 6).
Finally, the observation of the conducted analysis should be made. It should be emphasized that the problem of prescription mistakes is of high importance since it is widespread among advanced practice nurses. It is also evident that such errors are harmful primarily to patients, but the nurses and clinical staff are impacted by it as well. In conclusion, it is possible to observe that there numerous strategies for the improvement of the situation. In my opinion, one should act primarily in favor of high ethical standards.
Arcangelo, Virginia P., and Veronica F. Wilbur “Issues for the Practitioner in Drug Therapy.” Pharmacotherapeutics for Advanced Practice: A Practical Approach. 4th ed., edited by Virginia P. Arcangelo et al., Lippincott Williams & Wilkins, 2017, pp. 3-14.
“New Jersey Board of Nursing Law.” New Jersey Consumer Affairs. 2015. Web.
“Reporting a Medication or Vaccine Error or Hazard to ISMP.” ISMP. Web.
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Ragucci, Kelly R., et al. “Evaluation of Interprofessional Team Disclosure of a Medical Error to a Simulated Patient.” American Journal of Pharmaceutical Education, vol. 80, no. 8, 2016, pp. 1-6. Web.