Medication errors are one of the major leading of death in the United States and are currently ranked fourth. The recent reports show that more than 250000 per year in the United States are as a result of the medical errors. The reports by the Center for Disease Prevention and Control has also ranked medical errors as one of the leading causes of deaths in the United States. While the United States is currently calling for the need to have increased quality in the healthcare sector, medical errors are one of the causes of low quality and patients’ dissatisfaction. The controversy has been on the ethical and legal obligation of the healthcare providers regarding medical errors. In many cases, the medical errors go undisclosed, and the outcome has been the adverse effects health outcome of the patients. While nurses have a moral obligation to disclose the medical error to the patient, the incidences of lawsuits have always scared these nurses away from disclosing such cases.
Ethical and Legal Implications for Disclosure and Nondisclosure
When the medication errors occur, the major issue that arises is whether to disclose or not to disclose the error to the patient as well as the management. The ethical consideration for disclosure of the medication error can be analyzed based on the various ethical principles. The concept of autonomy and the right to know requires that they make their own choices concerning how they receive treatment ( Bonney, 2014 ). The advanced nurses have an obligation to inform the patients of every care they receive, including when the medical error occurs. They have the moral obligation to disclose to the patients when an error has occurred. Disclosure will help the patient to seek better treatment that could help minimize the adverse harms that could result from medical error. Nondisclosure, on the other hand, could lead to serious harmful effects on the patients and can be unethical in part of the nurse.
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Similarly, the principle of beneficence and nonmaleficence requires the care providers to provide the best benefit and least harm to the patients. They are disclosing the medication error results to the patient taking the necessary step to get important treatment to offset the potential harm. Nondisclosure, on the other hand, can lead to harmful effects on the patient. At the same time, the healthcare providers have the ethical obligation to disclose the information to the patients for the need to make decisions, including the medication error ( McLennan et al., 2016 ). Every institution needs to have a detailed policy for the disclosures of the information about the medication error. The principle of veracity requires that the ethical obligation of the nurses is to provide truthful information that can help the patient improve their health outcome. Following the rising cases of medical error, California’s response to the medical error was to pass two bills by the legislature in 2000 [ SB 1875 ], and 2002 [ SB 801 ] that required the creation of medication-related errors plan within the medical facility ( Laurie, 2014 ). The care providers have the legal obligation to disclose and report the medication error to the patients and the right authority within the health care facility. Failing to disclose the medication error can result in healthcare providers facing lawsuits and litigation.
What to do as an Advanced Nurse
The best thing to do as an advanced is to disclose the medication error to the patient. The reason for the need to disclose is to help the patient take an appropriate step towards seeking the treatment that would help counteract the potential adverse harm from the error. Medication errors can be harmful and can usually lead to death, even for conditions that could have been avoided. Failing to disclose such information to the patients put their lives at risk by exposing them to the potential harm. It is, therefore, necessary to have the information disclosed to the patients to allow them to take the right initiative to seek the right treatment that will remove the effects of the medication error. At the same time, there are ethical principles that guide the nurses on what they should do in such scenarios. While the advanced nurses may be faced with ethical dilemmas, the ethical principles should always act as the guiding move towards making the right direction. Both the principles of beneficence, disclosure, and right to know, autonomy, and veracity also require the nurses to disclose the information to the patients. The best thing to do is, therefore, to disclose the information about the medical error to the patients.
Prescription Process and Strategies to Minimize Medication Error
The prescription process requires that all the prescription documents are legible. The verbal orders should be minimized, as this is one of the causes of medication error. All the drugs need to have codes for identification to avoid incidences where the wrong drug is given to the patient. With technological development, drugs should be electronically recorded.
The prevention of medication errors requires that the five rights of medication administration are followed. This requires that correct medication is prescribed for the correct patient, in the correct dosage, via the correct route, and timed correctly. Double-checking is necessary to ensure there is no error in the process of administering the drug ( Ghazal, Saleem & Amlani. 2014 ). Accurate and proper documentation is also necessary to ensure that there is always the right record for everything during the administration of the drug. Having the right medication administration policies within the institution ensures that every nurse adheres to the required prescription procedures.
References
Bonney, W., (2014). Medical errors: Moral and ethical considerations. Journal of Hospital Administration , 3 (2), 80-88.
Laurie, G., (2014). Recognizing the right not to know: conceptual, professional, and legal implications. The Journal of Law, Medicine & Ethics , 42 (1), 53-63.
Ghazal, L., Saleem, Z., & Amlani, G. (2014). A medical error: To disclose or not to disclose. J Clin Res Bioeth , 5 (174), 2.
McLennan, S. R., Diebold, M., Rich, L. E., & Elger, B. S. (2016). Nurses’ perspectives regarding the disclosure of errors to patients: a qualitative study. International journal of nursing studies , 54 , 16-22 .
