Ethical Implications Of Disclosure

Nurses should be encouraged to question the doctors if a wrong drug is prescribed. They should also restrain from taking verbal orders. Written signed orders should be mandated.

Each year, roughly 1.5 million adverse drug events (ADEs) occur in acute and long-term care settings across America (Institute of Medicine [IOM], 2006). An ADE is succinctly defined as actual or potential patient harm resulting from a medication error. To expound further, while ADEs may result from oversights related to prescribing or dispensing, 26-32% of all erroneous drug interventions occur during the nursing administration and monitoring phases (Anderson & Townsend, 2010). These mollifiable mishaps not only create a formidable financial burden for health care systems, they also carry the potential of imposing irreversible physiological impairment to patients and their families. In an effort to ameliorate cost inflation, undue detriment, and the potential for litigation, a multifactorial approach must be taken to improve patient outcomes. Key components in allaying drug-related errors from a nursing perspective include: implementing safety and quality measures, understanding the roles and responsibilities of the nurse, embracing technological safeguards, incorporating interdisciplinary collaborative efforts, and continued emphasis upon quality control.

The topics that will be discussed in this paper will be the ethical decisions that have to be made by Dr. F and the RN in regards to disclosing information to Dr. J. Also, according to the NANDA nursing diagnosis for ethical consideration, Dr. F and the RN also have to consider if Mrs. Z has some knowledge deficits in regards to her prognosis and if due to her culture, she feels powerlessness towards her diagnosis. Ethical theories are important to justifying and relating situations in nursing. In this paper, there will be discussions relating ethical theories to nursing, as well as, ethical decision making models that will relate to the delivery of healthcare.

Remley and Herlihy (2016) defines confidentiality as an ethical concept which refers to the counselor 's obligation to respect the client 's privacy and in session discussion will be protected from disclosure without their consent (p.108). The receptionist never disclosed what was being discussed in wife A session; however, her inadvertent breach of confidentiality occurred the moment she divulged the fact that wife A is a patient at a mental health facility. An important premise to understanding the ethical principle of confidentiality is base that a counselor respects the client 's right to privacy (Remley & Herlihy, 2016; Quigley, 2007). Premise one states the "counselor honor the rights of clients to decide who knows what information about them and in what circumstances" (p.110).

The full disclosure principle states that any future event that may or will occur, and thatwill have a material economic impact on the financial position of the business, should be disclosed to probable and potential readers of the statements. Such disclosures are most frequently made by footnotes. For example, a hotel should report the building of a new wing, or the future acquisition of another property. A restaurant facing a lawsuit from a customer who was injured by tripping over a frayed carpet edge should disclose the contingency of the lawsuit. Similarly, if accounting practices of the current financial statements were changed and differ from those previously reported, the changes should

Sule stated that, “The Patient Bill of Right adopted by American Hospitals Association states that ‘a patient possesses the right to be informed of the medical consequences of his or her actions and decisions and refuse treatment to the extent permitted by the law’. However, this is true only if the patient is in position to understand the consequences of his treatment. Incompetent, senile patients neither have the correct judgment regarding which treatment is appropriate for them, nor are they in a state of understanding the implications of their treatment. In such case, their willingness to grant or deny consent cannot dictate the course of treatment.” Problem with the Act is being able to find that the patient component enough to make such a call. Another issue that Sule stated was on confidentiality and autonomy. According to Sule, “This is another ethical issue erupting from the conflict of patient's rights and professional ethics in nursing job and profession. The Patient Bill of Right makes it mandatory for the medical practitioners to reveal the form and extent of the ailment along with the course of treatment to be undertaken by the practitioners. However, this law of autonomy clashes with the nursing ethic that the professional should maintain high degree of confidentiality regarding the patient's health and treatment.” This can cause conflicting issues in the NP’s

When I say this, however, most people would picture the nurse giving the wrong medication due to lack of focus on the tasks at hand. While this could happen, I have noticed during my time at hospitals that the doctor orders are still hand written for the most part. Consequently, they can be very hard to be read legibly much less correctly translated into proper medication dosages. The first suggestion I would give to an organization would be that they required all orders to be submitted securely, by the doctors, to the pharmacy be electronic means.

As a result medication errors are costly and seem to be relative to the staffing of nurses. Given that nurses make up such a large segment of the staff population, it is important to identify with the factors behind these medication errors.

Within this assignment it is intended to present an example of a prescribing situation that arose in practice, to ensure prescribing issues are illustrated. The rationale for the decisions reached will also be discussed. A brief overview of the nurse prescribing initiative and how it developed will be addressed. The importance of ethical principles, accountability and legal issues that surround nurse prescribing will be demonstrated. As a patient will be addressed in the example, a pseudonym will be used.

Everyone is entitled to confidentiality unless they give permission for someone else to see their information or they can no longer make decisions on their own (for example, if they are confused or comatose). A federal law, Health Insurance Portability and Accountability Act applies to most health care physicians and its guideline, known as the Privacy Rule. The Privacy Rule sets specific rules regarding privacy, access, and disclosure of information. For example, HIPAA specifies the following:

Nurses are constantly challenged by changes which occur in their practice environment and are under the influence of internal or external factors. Due to the increased complexity of the health system, nowadays nurses are faced with ethical and legal decisions and often come across dilemmas regarding patient care. From this perspective a good question to be raised would be whether or not nurses have the necessary background, knowledge and skills to make appropriate legal and ethical decisions. Even though most nursing programs cover the ethical and moral issues in health care, it is questionable if new nurses have the depth of knowledge and understanding of these issues and apply them in their practice

A physician could make mistakes in prescribing, the pharmacy could send the wrong medication, but who actually gave it to the patient is accountable for the consequences. For this reason, it’s our responsibility to implement change in our practice based on the evidence in order to ensure safe patient care.

Nurses are subject to a plethora of legal, ethical, and professional duties which can be very challenging on a day to day basis. Some of these duties include respecting a patient 's confidentiality and autonomy, and to recognize the duty of care that is owed to all patients. As nurses our duties are always professional; however there are legal implications if these duties are breached. We also must consider when it is okay as nurses to breach these duties and therefore ethical issues arise. As nurses one of our main priorities is to advocate for our patients, without our own personal feelings on the matter taking over.

Confidentiality is central to trust between doctors, medical team and patients. Patients have a right to expect that information about them will be held in confidence. The birth of the Hippocratic Oath in the fourth century started the responsibility of physicians to preserve the privacy and confidentiality of their patients. One of the provisions of the Oath lays the ethical foundation for the physician’s duty of confidentiality even beyond the circumstances of medical care. The Florence Nightingale Pledge, which was composed in 1893, was a modification of the “Hippocratic Oath,” a statement of the ethics and principles of the nursing profession. Included in the pledge is to hold in confidence

Medication error is one of the biggest problems in the healthcare field. Patients are dying due to wrong drug or dosage. Medication error is any preventable incident that leads to inappropriate medication use or harms the patient while the medication is in the control of the health care professional,or patient (U.S. Food and Drug Administration, 2015). It is estimated about 44,000 inpatients die each year in the United States due to medication errors which were indeed preventable (Mahmood, Chaudhury, Gaumont & Rust, 2012). There are many factors that contribute to medication error. However, the most common that factors are human factors, right patient information, miscommunication of abbreviations, wrong dosage. Healthcare providers do not intend to make medication errors, but they happen anyways. Therefore, nursing should play a tremendous role to reduce medication error