Medication errors are the medical errors related to prescription of drugs and other medications. Despite many interventions aimed at reducing their incidence in diverse settings, medication errors are still a burden to health care. However, the majority of adverse events related to medication errors can be prevented in case of timely disclosure (Kalra, Kalra, & Baniak, 2013). Professional registered nurses are likely to identify a mistake and thus prevent it.
Nevertheless, if an error is revealed after it was made, a nurse faces both ethical and legal aspects related to disclosure and nondisclosure. This essay reviews ethical and legal implications of disclosure and nondisclosure according to South Carolina legislature, addresses the case scenario from the position of the advanced practice nurse, and explains the process of writing prescriptions identifying strategies that contribute to minimization of medication errors.
Ethical and Legal Implications of Disclosure and Nondisclosure
The nurse practitioners in case of identifying a medication error face a dilemma of disclosing or not disclosing their finding. This dilemma has both ethical and legal implications. While ethical implications are related to the Code of Ethics for Nurses, legal ones are guided by state legislature that can differ depending on the state. Thus, the Code states that nurses should demonstrate professional responsibility in promoting a culture of safety (American Nurses Association, 2001).
Therefore, disclosure of a medication error is an ethical decision. It is not only important to disclose medication errors but also provide explanations of their causes, ways to reduce their harmful effect, and suggest steps that should be taken to prevent similar errors in further practice.
As for legal implications, they involve statutes and administrative rules of every state. For example, in South Carolina, the major provisions for medical errors reporting are organized according to the South Carolina Code of Regulations (“South Carolina. Public and private policy,” n.d.). Recognizing medication errors as one of the most significant treatment-caused risks to individuals, the South Carolina Department of Disabilities and Special Needs demands reporting of every medication error that follows a certain procedure. Thus, a person who reveals the medication error is responsible for its reporting. It is necessary to notify supervisory/administrative staff as soon as possible.
Depending on the severity of the error, the decision about calling the prescriber is made. The type of report also depends on the severity level. Both reactive and proactive analyses are conducted to reduce medication errors. Moreover, the Drug Enforcement Administration (n.d.) contributes to prevention of medication, providing mid-level practitioners’ authorization to administer certain groups of medications. On the whole, the legal system contributes to ensuring patient safety (Guillod, 2013).
Reacting to the Scenario and Its Rationale
As the advanced practice nurse, I am expected to disclose a medication error as soon as it is revealed. It is a duty of a person who notices an error to report it because nondisclosure can lead to serious consequences.
Even in case of a non-intentional error, disclosure should be made. The ethical code of nurses obliges them to act in order to ensure patient safety. Consequently, a medication error should be disclosed to contribute to safety because a medication administered by mistake can result in undesirable adverse effects. Regular reporting with the following analysis of the mistakes and development of preventive strategies are likely to decrease the incidence of medication errors.
Process of Writing Prescriptions
There are some strategies to consider in the process of writing prescriptions. First of all, it is important to evaluate if the drug can be effective for a specific patient’s problem. Also, it is necessary to ensure there are no contradictions to administering this drug in case of every patient. One of the crucial steps is to check the dosage as well as patient’s allergies. Moreover, an advanced practice nurse should be able to correlate other medications that a patient is using with the new drug to check their interaction and evaluate adverse effects thus preventing possible complications. These are some of the logical steps that reduce the risk of medication errors.
Nevertheless, one more risk for medication mistake that is also preventable is misinterpretation of error-prone abbreviations, symbols, and dose designations (Institute for Safe Medication Practices, 2012). To avoid harmful medication errors that appear due to this factor, nurses and physicians are taught to use symbols and abbreviations that cannot be misinterpreted. For example, the abbreviation from “unit” used in clinical practice is “U,” which can be mistakenly taken as numbers “0” or “4”. Thus, it is better to use a full word to avoid misunderstanding.
On the whole, the issue of medication errors is related to both ethical and legal aspects. The ethical one is regulated by the code of ethics for nurses and is universal for all facilities throughout the country. At the same time, while legal implications differ depending on the state, they demand reporting on medication errors revealed in healthcare facilities. The disclosure procedure is provided in state regulations where the peculiarities of reporting are included. Disclosure of medication errors has a potential to reduce their incidence in diverse healthcare settings and empower the interventions for error prevention.
American Nurses Association. (2001). Code of ethics for nurses with interpretive statements. Nursing World. Web.
Drug Enforcement Administration. (n.d.). Mid-level practitioners authorization by state. Web.
Guillod, O. (2013). Medical error disclosure and patient safety: Legal aspects. Journal of Public Health Research, 2(3), 182-185. Web.
Institute for Safe Medication Practices. (2012). ISMP’s list of error-prone abbreviations, symbols, and dose designations. Web.
Kalra, J., Kalra, N., & Baniak, N. (2013). Medical error, disclosure and patient safety: A global view of quality care. Clinical Biochemistry, 46(13-14), 1161-1169. Web.
South Carolina. Public and private policy. Medical errors and patient safety. (n.d.). Quality and Patient Safety. Web.