Summary
Nurses must attend to the requirements of their patients. Legal, ethical, moral, and practical criteria are met in fulfilling this obligation. As a result of the trust placed in nursing staff to deliver the utmost medical care possible, this is warranted. In particular, prescription activities with a high risk of harm due to the nurse’s prescription mistakes bear the above statement. Whoever is to blame for an error must assume responsibility for it, and nursing staff is typically held jointly accountable, resulting in fines, penalties, and even criminal charges. The prescription errors might have a detrimental impact on a nurse’s career path. There is a lot of uncertainty among nurses on the appropriateness of disclosing medication mistakes. In addition to adopting a systematic prescription procedure to minimize errors, healthcare providers have an ethical and legal duty to disclose such errors to the impacted patients or their families.
Ethical Implications of Disclosure and Nondisclosure
Healthcare providers are ethically obligated to inform patients and their families if they or their loved ones have been victims of a medical error. Healthcare practitioners would put their interests ahead of patient-centered ethics if the mistake were not disclosed (Vatani et al., 2020). However, they are often hesitant to share this information because they fear hurting their professional ties with the patients. For the patient’s well-being, disclosing a medical mistake is always the right thing to do.
Healthcare practitioners should think about the ethical ramifications of revealing or not disclosing medical mistakes. As a result of errors, ethical concerns occur since the patient may be injured. Also, the errors may affect the quality of patient treatment while eroding trust with patients, family members, and other stakeholders involved. Medication mistakes have a ripple effect that extends beyond the patient and their family to include the prescriber, the nurse, and the organization. Prescriptive mistakes have several ethical implications, including malpractice, distrust, strained professional relations, and even damage or death for the patient. Medical errors may devastate patients physically, emotionally, and spiritually. The emotional toll, the financial burden, or the general decline in well-being may harm family members (Vatani et al., 2020). Possible outcomes are litigation, license revocation, personal guilt, ethical issues, or disciplinary action against the practitioner.
Legal Implications of Disclosure and Nondisclosure
The federal government mandates that healthcare organizations and providers disclose any medication mistakes. The California Code of Regulations and the Department of Health Services include provisions relating to medical mistake reporting. California’s Department of Public Health should be notified of hospital medical error reports (CDPH, n.d.). Due to this fact, the nurse should inform the patient, their family, and the Department of Public Health about the issue. Civil proceedings, medical board sanctions, and criminal charges are among the legal ramifications that healthcare practitioners face due to medical mistakes. Practitioners may be torn between disclosing an error and just brushing it under the rug due to the obvious legal implications of medical mistakes.
The California Patient Privacy Act restricts access to the file of patients who have applied for medical care to everyone except the patient and the medical staff of this medical organization. According to this legal act, disclosing information about patients’ health status to third parties is prohibited. It is forbidden to provide information about causes of the patient’s request for medical help, the results of examinations, and the diagnosis to persons not related to the patient’s treatment. Thus, this non-disclosure law ensures the security and reliability of the processing, storage and transmission of medical information.
What I Would Do in A Medical Error Scenario
As an advanced practice nurse, I would disclose the medical mistake. Medical mistakes are seldom disclosed to patients, but research shows that prescribing practitioners should do so (Oliveira et al., 2021). That is why disclosing medical errors might be justified to the patient or family on ethical grounds. In addition, transparency has been found to lessen the chance of a lawsuit. It is also worth noting that certain jurisdictions mandate reporting medical mistakes of this nature. Disclosure is also critical since it helps prevent medication mistakes from causing harm. Due to this fact, healthcare institutions are safer since they may learn from their mistakes.
Accordingly, all medical mistakes must be disclosed. An advanced practice nurse should talk to a colleague about the concern to gain a perspective on dealing with it. For the most part, patients desire to know when a medical error has occurred and complete information on the mistake’s nature, why it transpired, and how future occurrences may be averted. The fact that I opt to disclose the error shows that my self-interests came after the patient’s, and I thus honor a patient-centered ethic. It takes moral courage to do the correct thing when medical mistakes are made because keeping patients in the dark regarding medical errors impair their ability to make decisions regarding their care. Patients suffer harm instead of benefits, and the trust essential for the practitioner-patient relationship is compromised; above all, the lawsuit is significantly increased.
Process of Writing Prescriptions
Writing prescriptions in healthcare is crucial since it may substantially impact the extent of medical mistakes, therefore requiring a thorough approach. The first stage in the prescription procedure is to assess and precisely define the patient’s condition. This step is critical because it helps practitioners avoid writing prescriptions for drugs they do not need to. Because no specific therapy may be necessary, evaluating and defining a patient’s condition is crucial. A clear understanding of the situation helps avoid negative consequences and impacts. The second phase entails identifying a treatment objective. As a result of this phase, the prescription issued will have a defined purpose and expected results. The third stage entails picking the proper medication to utilize. To address frequent disorders, practitioners should develop a prescription medication formula for themselves. It may be necessary to consider an additional benefit the medicine provides to the patient.
Additionally, the fourth stage entails initiating medicine with the correct information and taking non-pharmacological treatments into account. Prescribers must write prescriptions in straightforward language and comprehensibly. The fifth and last stage is to provide relevant information, instructions and cautions if any are required. Providers must inform patients about the treatment’s purpose, expected results, and adverse effects. The final stage entails routine therapy evaluations (Mekory et al., 2017). The goal of this stage is to substantiate a drug’s efficacy while also minimizing any negative consequences.
Strategies To Minimize Medication Errors
Implementing some strategies can minimize medication mistakes. Computers and other prescription tools such as treatment guidelines are among the systems. These strategies are critical, partly because of the fast evolution of pharmacotherapeutics. A different approach is documenting and analyzing medical mistakes. When an error is discovered, it should be utilized as a learning opportunity so that no further errors are repeated (Oliveira et al., 2021). Reducing pharmaceutical mistakes can be made easier using a bar-coding system. Reducing pharmaceutical mistakes requires education as well. Educational initiatives should focus on staff development and organizational structures to decrease medication mistakes (Billstein et al., 2018). One of the essential skills that nurses should master is educating patients and other health care providers.
References
Billstein-Leber, M., Carrillo, C. J. D., Cassano, A. T., Moline, K., & Robertson, J. J. (2018). ASHP guidelines on preventing medication errors in hospitals. American Journal of Health-System Pharmacy, 75(19), 1493-1517.
CDPH. (n.d.). Health in All Policies: A Collaborative Approach. Cdph.
De Oliveira Jr, G. S., Castro-Alves, L. J., Kendall, M. C., & McCarthy, R. (2021). Effectiveness of pharmacist intervention to reduce medication errors and health-care resources utilization after transitions of care: a meta-analysis of randomized controlled trials. Journal of patient safety, 17(5), 375-380.
Mekory, T. M., Bahat, H., Bar-Oz, B., Tal, O., Berkovitch, M., & Kozer, E. (2017). The proportion of errors in medical prescriptions and their executions among hospitalized children before and during accreditation. International Journal for Quality in Health Care, 29(3), 366-370.
Vatani, A., Tavajohi, A., & Piri Amirhajiloo, F. (2020). The Necessity of Disclosure of Medical Errors: Basics, Systems and Obstacles. Scientific Journal of Forensic Medicine, 26(2), 121-129.