Medication Error Disclosure: Ethics and Legalities

Introduction

Nurses can make errors during their practice for different reasons – the lack of attention or time, tiredness, and stress. These mistakes can be small or substantial, potentially affecting patient’s health and hurting their well-being. Thus, if a nurse makes a mistake, their following actions are significant in resolving the situation. Currently, nursing code of ethics includes a discussion about patient safety and mentions disclosure as a necessary practice among healthcare professionals (ANA, 2015). Some nurses may feel discouraged from reporting accidents to their superiors and patients because of a punitive culture established in some organizations (Harrison et al., 2014). Nonetheless, it is vital for healthcare providers to remember that patients’ health is the focus of healthcare and nondisclosure of medical errors has serious ethical and legal consequences for them. Nursing profession requires specialists to protect patients’ health and make sure that their treatment is safe – they should report all errors using established systems and encourage safe practices to lower the rate of errors.

Upon choosing to pursue the career of nursing, people have to commit to the code of ethics developed for all specialists in the field. The focus of the document’s most recent version and its central ideology is holistic – patients should be respected and treated as individuals with needs, wants, and rights (ANA, 2015). Furthermore, nurses should accept that caring for people is their professional duty. Thus, they are required to support patients’ safety in relation to their health. If a nurse or other professional makes a mistake that is directly connected to the patient’s health, they should disclose this information and mitigate the outcomes not only because of personal beliefs but because of duties prescribed to this profession. As the code states, “when errors or near misses occur, nurses must follow institutional guidelines in reporting such events … and must ensure responsible disclosure of errors to patients” (ANA, 2015, p. 11). Therefore, there exists an ethical obligation to act in cases where errors occur.

Some legal outcomes to one’s failure to disclose potentially harmful information also exist in nurses’ practice. They may differ from one state to another, but they generally encourage transparency and patient protection. For instance, the New Jersey Department of Health has a particular procedure that gives healthcare providers an opportunity to report errors to the authorities. It is called the Patient Safety Reporting System, and it is designed to comply with the Patient Safety Act – it is confidential and focused on non-punitive actions (State of New Jersey Department of Health, 2018). However, if a nurse fails to disclose the problem and it leads to adverse effects or becomes known, this person can face legal charges.

Actions of an Advanced Practice Nurse

Even though the discussed error does not appear to be significant, an advanced practice nurse should report it. First, it is necessary to inform one’s superior about the mistake. This can be done through a written or oral report. Next, the patient should be notified to ensure that they does not suffer from any additional adverse outcomes to this situation. Then, a formal report should be submitted to the Patient Safety Reporting System to be considered. This program attempts to discourage punitive practices, and its primary concern is the health of individuals. It does not mean that the nurse will not face any repercussions, but it implies that the impact of the error will be considered in more detail than other factors. Finally, the nurse should participate in learning activities to make sure that similar accidents will not happen in the future.

Prescription Writing Process

Nurses may write prescriptions frequently during their day at work. Therefore, it is essential for them not to lose their concentration and attention to details during each patient’s visit. Wang et al. (2015) argue that an organization should implement a combination of initiatives to lower the rate of mistakes, including computer-based projects, education, and processes’ optimization. For example, clinics can install special software that checks prescriptions and finds possible errors in calculations and names. In addition, training classes for nurses can be organized to teach them how to write prescriptions using these programs. Finally, a reporting system should be established to create a comprehensive statistic of all errors and near misses in the facility.

Nurses should also use some techniques to write correct prescriptions. For example, they can create checklists which they will reference every time they issue a new prescription. Such documents can include a patient’s age, condition, weight, dose, time of administration, and other important aspects. By remembering to reference this checklist, a nurse can standardize the process and decrease the possibility of making a mistake.

Conclusion

The nursing profession incorporates many ethical responsibilities and requires people to assume full responsibility for their actions. Nurses should remember that patients’ health is a priority of their work. Thus, disclosure is an action inherent to all practices in this field – patients’ safety is directly connected to nurses’ activities. In order to comply with local and federal laws, as well as the ethical code of nursing, nurses should report any medication errors to their superiors, patients, and the government through standardized systems.

References

American Nurses Association (ANA). (2015). Code of ethics for nurses with interpretive statements. Web.

Harrison, R., Birks, Y., Hall, J., Bosanquet, K., Harden, M., & Iedema, R. (2014). The contribution of nurses to incident disclosure: A narrative review. International Journal of Nursing Studies, 51(2), 334-345. Web.

State of New Jersey Department of Health. (2018). Health care quality assessment: Patient Safety Reporting System (PSRS). Web.

Wang, H. F., Jin, J. F., Feng, X. Q., Huang, X., Zhu, L. L., Zhao, X. Y., & Zhou, Q. (2015). Quality improvements in decreasing medication administration errors made by nursing staff in an academic medical center hospital: A trend analysis during the journey to Joint Commission International accreditation and in the post-accreditation era. Therapeutics and Clinical Risk Management, 11, 393-406. Web.