Introduction
Errors in health care are now drawing considerable attention, although they are not a new occurrence. Nurses are taught techniques to reduce their likelihood of making errors, yet they do make mistakes. An advanced practice nurse (APN) has a significant obligation and responsibility. With the passage of the Affordable Care Act, moral, ethical, and legal issues for APNs delivering care have expanded significantly.
In the American Nurses Association Code of Ethics, ethical requirements for nurse practitioners are outlined (American Nurses Association [ANA], n.d.). Ethical standards are primarily determined by the particular opinions of each nurse. Since ethics is not an exact science, state laws outline how to handle certain circumstances in medical errors. The purpose of this research is to examine the ethical and legal ramifications of disclosing a prescription error to a patient who is unaware of the mistake.
Ethical Implications of Disclosure and Non-Disclosure
APN has an ethical commitment to provide patients with the knowledge necessary for making informed decisions. The patient’s bill of rights mandates full disclosure of medical mistakes (Ghezeljeh et al., 2021). As such, disclosure is necessary to assist the patient in making choices about their treatment, thus honoring their autonomy and reducing the risk of damage. Every institution must have transparent and comprehensive protocols for disclosing information concerning medical mistakes. As a result, the APN should follow the principles of disclosure and right-to-know.
The concept of truthfulness demands healthcare professionals present patients with complete, accurate, and impartial information in a way that facilitates comprehension. The truth regarding medical blunders helps establish credibility for patients’ care. The APN’s thorough communication with the patient should aid in creating a feeling of mutual respect and trust between the nurse and the patient.
However, the ethical ideals of beneficence (doing good) and non-maleficence (preventing harm) are violated when the knowledge is not given during the non-disclosure (Slaná & Slaný, 2021). Beneficence and non-maleficence are ethical notions that regulate the compassionate nursing practice, and caring presupposes that nurses work for the patients’ mutual benefit (Slaná & Slaný, 2021). As such, APNs have an ethical duty to tell patients about their continuing treatment plan, including the occurrence of a medical mistake.
Legal Implications of Disclosure and Non-Disclosure
Disclosure of medical mistakes may be related to an increased risk of patient lawsuits over incidents that the patient would not have otherwise recognized and that did not result in real damage. Some patients may not file lawsuits because they are ignorant of the medical error. 33 However, other studies have found that patients’ likelihood of filing a lawsuit does not increase when a mistake is acknowledged (Ozeke et al., 2019; Tigard, 2019).
For example, the practitioner may not be sued, particularly if the disclosure is timely and the physician apologizes and advises the patient that actions are being taken to prevent the error from occurring again.
Additionally, the likelihood of being sued is reduced when an expedient settlement or compensation is made to cover any extra expenses. In contrast, patients are more inclined to file a lawsuit if they judge their practitioner as unscrupulous or delaying disclosure (Ozeke et al., 2019). Even if a patient sues for a fully reported mistake that actually does no damage to the patient, further facts indicate that the complaint is often not feasible (Ozeke et al., 2019).
For instance, remarks, writings, or benign actions conveying compassion or a general feeling of benevolence over the pain, anguish, or death of a person implicated in an accident are inadmissible in civil cases under California law (Evid. Code, § 1160.) (Gawley, 2022). Therefore, the best course of action seems to be the prompt exposure of any medical mistakes.
As an Advanced Practice Nurse
As a nursing practitioner, I am obligated to report any medication mistakes. There is a considerable probability that nurses make a mistake; thus, they should have a plan in place for when this occurs. The strategy is to admit the mistake, secure the patient’s safety, and seek to correct the fault. According to Ozeke et al. (2019), disclosure may prevent patients from finding another nurse, enhance patient satisfaction, loyalty, and positive emotional reaction to a mistake, and reduce the chance of patients seeking legal counsel.
Therefore, when given the choice between disclosing and not disclosing a prescription error, I will always choose disclosure. Furthermore, according to Saghafi et al. (2019), nurses and healthcare providers should be honest and explain to the patient how a mistake happened if a problem arises. In essence, nurses should explain how the harmful impacts of the mistake will be reduced and what measures will be taken to prevent future recurrence.
Process of Writing Prescriptions
There are six processes involved in writing prescriptions. The World Health Organization suggests a multi-step approach to prescription that might aid practitioners in better emphasizing the treatment’s objective (Tariq et al., 2022). The criteria were established in 2007 and are still in place today. They include:
- Evaluating the patient’s condition.
- Identifying the therapeutic objective of pharmacological treatment.
- Deciding the proper medication.
- Offering patients with information, warnings, and instructions.
- Regularly monitoring the patient is the fifth step.
- When prescribing, consider the cost of medications.
The use of a suitable technology such as prescriptionsoftware and computerized pharmaceutical references reducesmedication errors. Together, these phases and continual self-directed learning provide an APN-appropriate, methodical approach to prescription.
Strategies to Avoid Medication Errors
To reach the ultimate goal of a quality healthcare system, which guarantees the integrity and efficiency of services, it is necessary to implement rules and procedures that foster trust-based, secure settings. As such, facilitating multidisciplinary cooperation in order to report medical mistakes transparently, as well as patient and family involvement in the disclosure of medical errors, may facilitate this (“Error data,” 2023).
In addition, the healthcare facility should provide its employees with emotional support and legal protection to motivate them to disclose incidents on their own. A focus on the professional code of ethics and training may also help people understand and agree with the moral foundation of patient safety.
Conclusion
In conclusion, exposure to medical blunders is challenging, and a lot of factors impact a healthcare provider’s readiness to discuss their errors. Disclosure and non-disclosure of medical mistakes have ethical and legal consequences. However, disclosing medical mistakes is the most effective strategy.
To reach the ultimate goal of the healthcare system, which is to ensure the quality and safety of services, established standards and procedures for constructing a supportive environment based on mutual trust are necessary to prevent future prescription errors. As a result, APNs must act responsibly and truthfully when prescribing medications, as they share the same responsibility with patients and healthcare facilities.
References
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Saghafi, A., Bahramnezhad, F., Poormollamirza, A., Dadgari, A., & Navab, E. (2019). Examining the ethical challenges in managing elder abuse: A systematic review. Journal of Medical Ethics and History of Medicine, 12(7), 1-19. Web.
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