Medications errors occur when a nurse practitioner prescribes, administer, or dispense a drug inappropriately. Of importance is the harm that such mistakes can cause to the patient which includes a possibility of fatalities. The patient may suffer adverse reactions from the drug, reduced patient experience and life quality, adverse drug-to-drug interactions, suboptimal adherence and lack of efficacy (Anderson & Townsend, 2010). The result is a significant consequence of the health provision and economy as the victims increase hospital use, and become admitted on preventable medication-related grounds. The most significant problem that includes the vice is the administration of drugs in wrong doses during the primary care. The errors can be caused by factors relating to both the professional and the client. Other contributors are connected to medicines (naming and labeling), work environment, tasks, technological advancement, and primary-secondary care interface.
However, regardless of these many factors, the buck stops at the healthcare practitioner as they hold the key to the decisions of treatment. When the mistakes of medication occur, it is the responsibility of the health practitioner to choose whether to disclose or not disclose to the patient or family what happened. Before the decision of disclosure or nondisclosure is made, the practitioner has to think of the legal and ethical implications of such errors. Some principles govern the medical practice, and the medical professional should be aware of such. The first moral imperative of “do no harm” is a fundamental aspect that has been governing the practice since Hippocratic era (ANA, 2001). The present expression of the ethical obligation to nonmaleficence is not restricted to only deliberate harm. It also prohibits the damage caused by the intent of healing just as the malicious one. However, the principle only deals with half the solution to the medication error as it drives the prevention. What it lacks is the solution to the occurrence of harm.
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The other principle is the one of beneficence which refers to the moral obligations of the physician to act for the benefit of the patient (Crigger & Holcomb, 2008). As to err is human, the disclosure of the medication errors means the professional is truthful and helps the patient to build trust with the health care system and the provider. Despite the revelation being a difficult thing to do, it is the ethically accepted act. The Texas statutory laws require that the practitioner reports any adverse effect that results in a significant complication which is divergent from the underlying condition (Byrne, 2011). Medication error is one of the events that should be disclosed. Hence disclosure is essential as it would lead to the prevention of adverse consequences or the rectification of the error.
When caught up in a similar situation, I would consider the legal implications of medication errors. I would first notify the patient and family about the incident. I would then inform the rest of the care team to handle any immediate adverse patient outcomes and reduce the probability of future occurrence (Philipsen & Soeken, 2011). Documentation would then follow to report to the hospital safety committee. While the non-disclosure would make me think I would escape any personal victimization if no complication occurs, the adverse effects would make me punished. A thorough analysis suggests it would lead to lawsuits, possible complications to the patients, and distrust to the healthcare organization. This makes me only left with just the disclosure choice however tricky.
Writing a prescription is essential for the elimination of medication errors due to the information contained therein. The first step is to write the name, address and the telephone number of the prescriber to act as contact person from the pharmacist including the date of prescription. Including the strength of the drug should also be observed (DEA, 2006). This is where most errors come from especially in the abbreviations and decimals. It is advisable to avoid abbreviations in administration routes and write words in full for the metric measurements. The specific direction of dosage should be stated and avoiding phrases like “as directed.” The indication should be specified.
Conclusion
In conclusion, medication errors can be prevented by following some procedures and requirements. Some occurrences can occur regardless of how careful the practitioner tries to carry out the prescription. The failure is not an issue as no one is perfect, but what the professional does after it occurs. The best thing to do to avoid the legal and ethical issues is to disclose the incident.
References
American Nurses Association. (2001). Code of ethics for nurses with interpretive statements. Nursing World. Retrieved 7 March 2018 from http://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses/Code-of-Ethics-For-Nurses.html
Anderson, P., & Townsend, T. (2010). Medication errors: Don’t let them happen to you. American Nurse Today, 5(3), 23–28. Retrieved 7 March 2018 from https://americannursetoday.com/medication-errors-dont-let-them-happen-to-you/
Byrne, W. (2011). U.S. nurse practitioner prescribing law: A state-by-state summary. Medscape Nurses
Crigger, N., & Holcomb, L. (2008). Improving nurse practitioner practice through rational prescribing. The Journal for Nurse Practitioners, 4(2), 120–125.
Drug Enforcement Administration. (2006.). Practitioner’s manual. Retrieved 7 March 2018 from http://www.deadiversion.usdoj.gov/pubs/manuals/pract/index.html
Philipsen, N. C., & Soeken, D. (2011). Preparing to blow the whistle: A survival guide for nurses. The Journal for Nurse Practitioners, 7(9), 740–746.
