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?
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 on a daily basis. 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. In this Discussion, you explore ethical and legal implications of scenarios and consider how to appropriately respond.
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.
Review Chapter 1 of the Arcangelo and Peterson text, as well as articles from the American Nurses Association, Ladd and Hoyt (2016), the Drug Enforcement Administration, and Sabatino et al (2017).
Select one of the four scenarios listed above.
Consider the ethical and legal implications of the scenario for all stakeholders involved such as the prescriber, pharmacist, patient, and the 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.
With these thoughts in mind:
Post an explanation of the ethical and legal implications of the scenario you selected on all stakeholders involved such as the prescriber, pharmacist, patient, and the patient’s family. Describe two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario.
Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.
Chapter 1, “Issues for the Practitioner in Drug Therapy” (pp. 3–14)
This chapter introduces issues relating to drug therapy such as adverse drug events and medication adherence. It also explores drug safety, the practitioner’s role and responsibilities in prescribing, and prescription writing.
Chapter 59, “The Economics of Pharmacotherapeutics” (pp. 1009-1018)
This chapter analyzes the costs of drug therapy to health care systems and society and explores practice guideline compliance and current issues in medical care.
Chapter 60, “Integrative Approaches to Pharmacotherapy—A Look at Complex Cases” (pp. 1021-1036)
This chapter examines issues in individual patient cases. It explores concepts relating to evaluation, drug selection, patient education, and alternative treatment options.
Due to the importance of ethical and legal considerations in advanced practice nursing, several resources have been provided for your reference.
Sabatino, J.A., Pruchnicki, M.C., Sevin, A.M., Barker, E., & Green, C.G. (2017). Improving prescribing practices: A pharmacist‐led educational intervention for nurse practitioner students.
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.
Note: Retrieved from the Walden Library databases.
American Nurses Association. (2001). Code of ethics for nurses with interpretive statements. Nursing World. Retrieved from http://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses/Code-of-Ethics-For-Nurses.html
This article outlines ethical standards in the nursing profession and identifies nine provisions of care that must be adhered to by all nurses.
Ladd, E., and Hoyt, A. (2016).Shedding Light on Nurse Practitioner Prescribing. The Journal For Nurse Practitioners. 12(3). 166-173.
This article provides NP’s with information regarding state based laws for NP prescribing.
Note: Retrieved from the Walden Library databases.
Drug Enforcement Administration. (n.d.). Mid-level practitioners authorization by state. Retrieved from August 23, 2012, http://www.deadiversion.usdoj.gov/drugreg/practioners/index.html
This website outlines the schedules for controlled substances, including prescriptive authority for each schedule.
Drug Enforcement Administration. (2006.). Practitioner’s manual. Retrieved from http://www.deadiversion.usdoj.gov/pubs/manuals/pract/index.html
This manual is a resource for practitioners who prescribe, dispense, and administer controlled substances. It provides information on general requirements, security issues, recordkeeping, prescription requirements, and addiction treatment programs.
Institute for Safe Medication Practices. (2012). ISMP's list of error-prone abbreviations, symbols, and dose designations. Retrieved from http://www.ismp.org/Tools/errorproneabbreviations.pdf
This website provides a list of prescription writing abbreviations that might lead to misinterpretation, as well as suggestions for preventing resulting errors.
Drug Enforcement Administration. (n.d.). Code of federal regulations. Retrieved August 23, 2012, from http://www.deadiversion.usdoj.gov/21cfr/cfr/1300/1300_01.htm
Drug Enforcement Administration. (n.d.). Registration. Retrieved August 23, 2012, from http://www.deadiversion.