nr510 week 4 discussion (dq1+dq2) latest 2018 january
Week 4 discussion
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Organizational Change
and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part One
You are a family nurse practitioner employed in a busy
primary care office. The providers in the group include one physician and three
nurse practitioners. The back office staff includes eight medical assistants
who assist with patient care as well as filing, answering calls from patients,
processing laboratory results and taking prescription renewal requests from patients
and pharmacies. Stephanie, a medical assistant, has worked in the practice for
10 years and is very proficient at her job. She knows almost every patient in
the practice, and has an excellent rapport with all of the providers.
Mrs. Smith was seen today in the office for an annual
physical. Her last appointment was a year ago for the same reason. During this
visit, Mrs. Smith brought an empty bottle of amoxicillin with her and asked if
she could have a refill. You noted the patient’s name on the label, and the
date on the bottle was 1 week ago. You also noted your name printed on the
label as the prescriber. The patient admitted that she called last week
concerned about her cough and spoke to Stephanie. You do not recall having
discussed this patient with Stephanie nor do the other providers in the
practice.
Discussion Question:
What is your next logically sound course of action? Provide
evidence to support your response.
DQ2 Organizational
Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study
Part Two
Upon further investigation, you learn that Stephanie spoke
with the patient and called the medication into the patient’s pharmacy without
consulting with a provider. Stephanie claimed that the patient was insistent
about needing a prescription. Because Mrs. Smith was coming into the office the
following week for an appointment, she didn’t think you would mind if the
patient received the prescription early.
Discussion Question:
What
are the ethical-legal concerns associated with this situation? What is your
liability in this situation, if any? What is the practice’s liability in this
situation? What quality improvement strategies might you implement as an APN in
this practice to safeguard your role and assure patient safety? Provide evidence
to support your response
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