Disclosure of medication errors can improve patient safety, increase transparency, and foster trust. Nondisclosure, however, can result in legal liabilities and negatively impact a healthcare provider’s reputation. Having a clear medication error reporting and disclosure policy is crucial to balance patient safety and legal considerations (Flanigan, 2017). This paper aims to explore the ethical and legal implications of disclosure and nondisclosure, the rationale for disclosure and the prescription writing process and strategies.
Ethical and Legal Implications of Disclosure and Nondisclosure
The ethical and legal implications of disclosing or not disclosing a medication error in New York can be complex and far-reaching (Goguen, 2018). From an ethical perspective, informed consent requires healthcare providers to provide patients with accurate and complete information about their medical care, including any medication errors (Gülnar et al., 2020). This allows patients to make informed decisions about their care and helps to build trust between patients and providers.
From a legal perspective, disclosing a medication error can have significant implications for healthcare providers. In New York, the medical malpractice statute of limitations requires that a lawsuit be filed within two and a half years of the date of the alleged malpractice (Goguen, 2018). Suppose a healthcare provider fails to disclose a medication error. In that case, this may prevent the patient from being able to file a lawsuit within the Statute of limitations and could be seen as a failure to meet their legal and ethical obligations (Gülnar et al., 2020).
Additionally, healthcare providers in New York have a duty to report adverse events, including medication errors, to the New York State Department of Health. Failure to report an adverse event could result in penalties and sanctions, including fines and license revocation (Goguen, 2018). On the other hand, not disclosing a medication error could also have serious consequences for the patient. If the error is not disclosed, the patient may not receive the necessary treatment or follow-up care to address any negative effects of the error. This could result in further harm to the patient and could be seen as a failure to meet the healthcare provider’s ethical obligation to act in the patient’s best interests.
Rationale
As an advanced practice nurse, patient safety and trust are paramount. An error in prescribing a drug, no matter how minor, can have significant consequences and erode the patient’s trust in the healthcare system and the practitioner. Therefore, disclosing the error is the right course of action to maintain the trust and credibility of the healthcare provider. In disclosing the error, it is important to use clear and concise language, avoid medical jargon, and be empathetic toward the patient (Goguen, 2018). The disclosure should also be done in a timely manner, ensuring that the patient has sufficient time to understand the situation and make informed decisions about their care.
Additionally, documenting the error in the patient’s medical record is crucial. This documentation can serve as a reference for future healthcare providers and protects the nurse from potential legal implications (Flanigan, 2017). It is also important to follow up with the patient to ensure they receive appropriate care and monitor for any adverse effects.
The rationale for disclosing an error in prescribing a drug to a patient is rooted in ethics, patient safety, and trust building. Transparency and honesty are key ethical principles in healthcare, and disclosing an error demonstrates a commitment to these values (Flanigan, 2017). It shows the patient that the nurse is accountable for their actions and takes responsibility for ensuring the quality of care. Additionally, the disclosure allows for open and honest communication, helping to build trust between the patient and the healthcare provider.
The disclosure also serves a practical purpose. The patient has a right to know about the error and how it may affect their health. By disclosing the error, the nurse can provide the patient with important information and answer any questions they may have. This can also help the patient make informed decisions about their care and avoid potential adverse consequences.
There is also evidence to support the benefits of disclosing errors in healthcare. Studies have shown that disclosure can improve patient satisfaction, medical malpractice claims, and patient safety by reducing the likelihood of repeat errors. Additionally, disclosure can improve healthcare provider resilience and reduce emotional distress by promoting a culture of transparency and accountability.
However, it is important to note that disclosure should not be made in a manner that may cause harm to the patient. The disclosure should be made in a respectful and empathetic way and uses clear language, avoiding medical jargon. The timing of the disclosure should also be carefully considered, and the nurse should be prepared to offer a plan for corrective action if necessary.
Prescription Writing Process
The process of prescribing medication involves several steps. The first step is to assess the patient’s medical history, symptoms, and current condition to determine the best course of treatment. Based on the patient’s assessment, the healthcare provider will choose a medication that is appropriate for the patient’s condition. The healthcare provider will then determine the appropriate medication dosage for the patient, considering factors such as the patient’s age, weight, and medical history. After determining the appropriate dosage, the healthcare provider will choose the most appropriate route of administration for the medication, such as oral, topical, or intravenous (Flanigan, 2017). The next step is to determine the duration of treatment. The healthcare provider will determine how long the patient should take the medication, considering the patient’s condition and response to treatment. Another critical step is to write the prescription. The healthcare provider will write the prescription, including the name of the medication, the dosage, the route of administration, the frequency of administration, and the duration of treatment. After writing the prescription, the healthcare provider will review the prescription with the patient and provide counselling on how to take the medication, potential side effects, and what to do if the patient experiences any adverse reactions.
Strategies to minimize medication errors in the prescription writing process include the use of standard abbreviations and terminology. Healthcare providers should use standard abbreviations and terminology when writing prescriptions. Another strategy is to use computerized prescription systems. Electronic prescription systems can help reduce errors by automatically checking for potential drug interactions and allergies and verifying the dose and frequency of dosing (Roumeliotis et al., 2019). Another strategy is communication with the pharmacist. Healthcare providers should communicate with the pharmacist to ensure that the prescription is clear and accurate and to discuss any concerns about the medication or its use. Patient education is also crucial as part of strategies to prevent medication errors. Patients should be informed about the prescribed medication, including its purpose, how to take it, and potential side effects. This helps to ensure that the medication is used correctly and can minimize the risk of medication errors.
Overall, disclosure and nondisclosure of medication errors have legal and ethical implications. The paper demonstrates that healthcare organizations need to have clear medication error reporting mechanisms. Adherence to all the best practices is crucial to prevent medication errors.
References
Flanigan, J. (2017). Rethinking prescription requirements. Oxford Scholarship Online. https://doi.org/10.1093/oso/9780190684549.003.0003
Goguen, D. (2018, April 15). New York medical malpractice laws & Statute of limitations. www.alllaw.com. https://www.alllaw.com/articles/nolo/medical-malpractice/laws-new-york.html#:~:text
Gülnar, E., Özveren, H., & Özden, D. (2020). The relationship between moral sensitivity and medical errors attitude in nursing students. Journal of Forensic and Legal Medicine, 73, 101981. https://doi.org/10.1016/j.jflm.2020.101981
Roumeliotis, N., Sniderman, J., Adams-Webber, T., Addo, N., Anand, V., Rochon, P., Taddio, A., & Parshuram, C. (2019). Effect of electronic prescribing strategies on medication error and harm in hospital: A systematic review and meta-analysis. Journal of General Internal Medicine, 34(10), 2210–2223. https://doi.org/10.1007/s11606-019-05236-8
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