The Problem of Medication Prescription Errors
While it is largely evident that in nearly all situations that involve the impact of the human factor, the occurrence of mistakes is inevitable. However, the significance of such mistakes varies greatly in the context of each particular situation. Moreover, it could be suggested that the health care system in the area of concern in which the emergence of mistakes has a drastic influence since healthcare professionals are responsible for their patient’s health condition and quality of life in general. The examples are numerous; however, for this paper, it is decided to focus on medication prescription errors. The healthcare worker’s decision to disclose or not to disclose a prescription error has a complex set of ethical and legal implications. Therefore, this paper aims to investigate these implications concerning Florida-specific laws to develop strategies to minimize the probability of the occurrence of medication prescription errors.
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Ethical Implications of Disclosure and Nondisclosure As it is apparent from the introduction, the problem is largely divided into two principal aspects, which are ethical implications and legal implications of disclosure/nondisclosure of a prescription error. This section is dedicated to the discussion of ethical implications as they are numerous, and they are highly important. In general, the decision about disclosing the fact of the medication prescription error affects both nurses and patients. Therefore, the two parties are involved, and it is important to discuss the implications for both of them. However, it is also possible to notice that the major part of the responsibility is on healthcare professionals. For any healthcare worker, the occurrence of medication prescription error appears to be a significant problem due to several reasons. First of all, such a situation puts the health of a patient at considerable risk because the misinterpretation of the information in the prescription or a wrongly prescribed medication could seriously harm the health of a patient and also might lead to lethal consequences (Ragucci, Kern, & Shrader, 2016). Secondly, the decision not to disclose such an error is against the general ethical code of relationships between a customer and a provider of services. In this particular situation, a patient is a customer, who has the full right to know every significant detail about the services, which are provided to him or her. However, if a healthcare worker decides to disclose the error, he or she puts his professional credibility (as well as the credibility of the whole organization in which he or she works) at stake. Thus, it is apparent that the nurse in such situations is the primary responsible party. Patients do not share such responsibility as they can only choose to report or not to report on the nurse who made an error. Accordingly, ethical implications are immense for healthcare professionals. The discussion of the practical importance of this assumption will be provided in the third section of this paper. Legal Implications of Disclosure and Nondisclosure It is evident that, aside from ethical implications, legal considerations also play a highly significant role in situations of medication prescription errors. As is stated by Delcher, Wagenaar, Goldberger, Cook, and Maldonado-Molina (2015), the lack of legal control over the sphere of prescription drugs leads to considerably problematic consequences. The authors illustrate this assumption by studying the situation in Florida state in the context of oxycodone-caused mortality. Specifically, as it is mentioned, “from 2007 to 2010, the rate per 100,000 population of oxycodone-caused deaths increased by 118.3%” (Delcher et al., 2015, p. 63). However, after the implementation of a statewide Prescription Drug Monitoring Program (PDMP), the rates dropped abruptly, as Delcher et al. state as the result of their research. However, the attempts to control prescription drugs efficiently are implemented over the past two decades at least. Marcoux and Vogenberg (2015) mention that “To Err is Human,” a 1999 report by the Institute of Medicine (IOM), was the landmark in the history of legal control over the sphere of medication prescription. This report was the driving factor for federal-level policies and regulations to be implemented (Marcoux & Vogenberg, 2015). It is also observed by the authors that Florida is one of the states in which medication errors and safety requirements are included in the continuing education programs for nurses. Thus, it could be concluded that legal implications are also evidently present in the state of Florida. Discussion of the Medication Prescription Error Scenario According to the scenario, which is proposed as part of the assignment for this paper, I am put in the situation in which I am working as an advanced practice nurse at a community health clinic, and I have to decide on the disclosure or nondisclosure of an unintentional error that was made in the medication prescription for a patient. Considering ethical and legal implications that were discussed previously, I should state that it is very likely that I would disclose the error, especially if was something significant in terms of imposed risk for the patient’s health. My career might be aggravated by this fact, but the potential to harm the health of the patient outweighs such considerations.
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Strategies to Minimize the Probability of Medication Prescription Errors Finally, it is of high significance to discuss strategies for the minimization of the risk of medication prescription errors. It could be suggested that the experience of the state of Florida should be employed, developed, and improved. For example, the inclusion of evidence-based guidelines for nurses who enroll in continuing education programs would significantly impact the positive change in the current situation. Considering the process of writing prescriptions, it is possible to mention two methods. Firstly, it is essential to make sure that the patient understood the dosage and regime of consuming the prescribed drug. Another highly efficient strategy is to use the list of error-prone abbreviations, which will minimize the risk of the prescription’s misinterpretation by the patient (“List of error-prone abbreviations,” 2017). However, the vast majority of the responsibility for the decision to disclose a prescription error depends on the personal moral and ethical code of every particular healthcare worker. Therefore, each healthcare professional should review his or her ethical standards about the problem of prescription error disclosure or nondisclosure. Conclusion In conclusion, it should be emphasized that the problem of medication prescription errors is of high significance since it is widespread among contemporary advanced practice nurses. It is also evident that such mistakes are harmful primarily to patients, but the nurses and clinical staff are impacted by it as well. Overall, it is possible to observe that there are numerous strategies for the improvement of the situation. In the recent decade, various attempts were made by the government on federal and state levels to decrease the negative effects of medication prescription errors. Several strategies, as well as legal implications, were discussed in the paper. However, the most important aspect is, arguably, the maintaining of personal ethical standards by healthcare workers. References Delcher, C., Wagenaar, A. C., Goldberger, B. A., Cook, R. L., & Maldonado-Molina, M. M. (2015). Abrupt decline in oxycodone-caused mortality after implementation of Florida’s Prescription Drug Monitoring Program. Drug and Alcohol Dependence, 150, 63-68. List of error-prone abbreviations. (2017). Web. Marcoux, R. M., & Vogenberg, F. R. (2015). Professional roles evolve with changing landscape of legal risk. Pharmacy and Therapeutics, 40(9), 579-582. Ragucci, K. R., Kern, D. H., & Shrader, S. P. (2016). Evaluation of interprofessional team disclosure of a medical error to a simulated patient. American Journal of Pharmaceutical Education, 80(8), 1-6.
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