Readings
Arcangelo, V. P., & Peterson, A. M. (Eds.). (2013). Pharmacotherapeutics for advanced practice: A practical approach (3rd ed.). Ambler, PA: Lippincott Williams & Wilkins.
Chapter 1, “Issues for the Practitioner in Drug Therapy” (pp. 2–14)
This chapter introduces issues relating to drug therapy such as adverse drug events and medication adherence. It also explores drug safety, the practitioner’s role and responsibilities in prescribing, and prescription writing.
Chapter 59, “The Economics of Pharmacotherapeutics” (pp. 918–927)
This chapter analyzes the costs of drug therapy to health care systems and society and explores practice guideline compliance and current issues in medical care.
Chapter 60, “Integrative Approaches to Pharmacotherapy—A Look at Complex Cases” (pp. 928–939)
This chapter examines issues in individual patient cases. It explores concepts relating to evaluation, drug selection, patient education, and alternative treatment options.
Due to the importance of ethical and legal considerations in advanced practice nursing, several resources have been provided for your reference.
Crigger, N., & Holcomb, L. (2008). Improving nurse practitioner practice through rational prescribing. The Journal for Nurse Practitioners, 4(2), 120–125.
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.
American Nurses Association. (2001). Code of ethics for nurses with interpretive statements. Nursing World. Retrieved from
https://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 from
https://www.americannursetoday.com/assets/0/434/436/440/6276/6334/6350/6356/8b8dac76-6061-4521-8b43-d0928ef8de07.pdf
Drug Enforcement Administration. (n.d.). Mid-level practitioners authorization by state. Retrieved from August 23, 2012, https://www.deadiversion.usdoj.gov/drugreg/practioners/index.html
Drug Enforcement Administration. (2006.). Practitioner’s manual. Retrieved from
https://www.deadiversion.usdoj.gov/pubs/manuals/pract/index.html
Drugs.com. (2012). Retrieved from https://www.drugs.com/
Institute for Safe Medication Practices. (2012). ISMP’s list of error-prone abbreviations, symbols, and dose designations. Retrieved from https://www.ismp.org/Tools/errorproneabbreviations.pdf
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Scenario 1:
As a nurse practitioner, you prescribe medications for your patients. You make an error when prescribing medication to a 5-year-old patient. Rather than dosing him appropriately, you prescribe a dose suitable for an adult.
Scenario 2:
A friend calls and asks you to prescribe a medication for her. You have this autonomy, but you don’t have your friend’s medical history. You write the prescription anyway.
Scenario 3:
You see another nurse practitioner writing a prescription for her husband who is not a patient of the nurse practitioner. The prescription is for a narcotic. You can’t decide whether or not to report the incident.
Scenario 4:
During your lunch break at the hospital, you read a journal article on pharmacoeconomics. You think of a couple of patients who have recently mentioned their financial difficulties. You wonder if some of the expensive drugs you have prescribed are sufficiently managing the patients’ health conditions and improving their quality of life.
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To prepare:
Review Chapter 1 of the Arcangelo and Peterson text, as well as articles from the American Nurses Association, Anderson and Townsend, the Drug Enforcement Administration, and Philipsend and Soeken.
1))Select one of the four scenarios listed above.
2))Consider the ethical and legal implications of the scenario for all stakeholders involved such as the prescriber, pharmacist, patient, and the patient’s family.
3))Think about two strategies that you, as an advanced practice nurse, would use to guide your ethically and legally responsible decision-making in this scenario.
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Post an explanation of the ethical and legal implications of the scenario you selected on all stakeholders involved such as the prescriber, pharmacist, patient, and the patient’s family. Describe two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario.
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