1. Implementing evidence into practice requires nurses to identify, critically appraise and synthesize research.  this may require a comprehensive literature review.  Please respond to the following questions:
   1. In your own words, discuss what “evidence” means to you.
   2. What are “journal articles” and “Peer Review”?
   3. In your own words, describe in detail what a literature review is and how it is useful when making clinical decisions?
   4. Discuss in detail the major purposes of doing a literature review.
   5. Discuss the various criteria that a good literature review will have.
   6. What does the acronym IMRaD stand for?

Ethical and Legal Implications of Prescribing Drugs

​One of the key roles that an advanced practice nurse assumes is prescribing medications. However, one is required to be prudent as well as deliberate in the decision making to avoid potential prescribing errors. This has been emphasized by Rosenthal and Burchum (2018) that the ability to prescribe medication cannot only be considered as a privilege, but also a burden. This is given to the fact that one is required to take into consideration the ethical and legal implications of prescribing. In light of this, this paper seeks to explore legal as well as ethical implications of prescribing in respects to the scenario assigned, strategies to address disclosure and non-disclosure in respect to the scenario, strategies that can be used to guide decision-making as well as the process of writing prescriptions and minimizing medication errors.

Ethical and Legal Implications

​The scenario assigned involves a 5-year old patient who was prescribed a dose suitable for an adult rather than that an appropriate dose for his age. The legal implications of this scenario on the prescriber include civil action, criminal charges as well as a discipline by the medical board.According to Westrick and Jacob (2016), a nurse practitioner can be sued for medical malpractice if the negligence resulted in the injury of the patients. Gross negligence is therefore required to be proven for the practitioner to be charged at the court. Another legal implication from the above scenario isaction from the regulatory board. In such a scenario the board is obligated to investigate the scenario and take action such aseducation if it is established that education can remedy the situation. However, this action is only taken if the board findsthat minimal standards of care were not met in the occurrence of the errors.  In case the event was egregious, the board may suspend or revoke the practitioner’s license. Ethical implications of the above scenario include the erosion of the trust by the patients as well as possible harm or injury to the patients.

Strategies to Address Disclosure and Nondisclosure

Despite the fact that the practitioner strives to offer the highest quality care, unintended consequences still occur. In light of this, one of the strategies to address disclosure and non-disclosure in the scenario above is complying with the State law on disclosing medication error. Nurse practitioners have a legal obligation of reporting medication errors in IllinoisState. For instance, in Illinois, Adverse Health Care Event Reporting Law (410 ILCS 522/10) was passed in 2005 tofacilitate reporting of medication errors such as the wrong dose (Illinois General Assembly, 2020). However, this law is not used to punish the errors reported. The other approach isthe use of ethical imperative to disclose in which Joint Commission Standard RI.2.90 necessitates patients as well as their families not only to be informed about the outcomes of care and treatment but also the unintended outcomes (Kass & Rose, 2016). This standard can, therefore, helps in disclosing the errors to the patient and families in this context in a timely manner.

Strategies an Advanced Practice Nurse would use to GuideDecision Making

​One of the strategies I would adopt to guide decision making in the scenario above is the use of ethical principles beneficence and Nonmaleficence. These principles typically denote that healthcare practitioners should do what is best for their patients and do no harm. This would help in making the right decision and understanding the projected risk and benefits that comes with disclosure. This has been emphasized by Shaikh and Cohen (2020) that disclosure of medication error is profound in enhancing patient safety as relevant actions can be taken to prevent or minimize adverse events.The other strategy that I would use is consulting the physicians or other nurse practitioners on how to handle theabove scenario. This can ensure the best interest, which in this case is patient safety are taken into consideration. Notifying the rest of the team would further help in better handling of any negative outcome and reduce mismanagement from occurring.

​Despite the fact that practitioners are frequently faced with the dilemma of whether to disclose or not disclose medication errors, Shaikh and Cohen (2020) recommend that practitioners should always opt for disclosure. This is given that disclosure can help in reducing harm to the patients and enhance safety. In regard to the above scenario, I would disclose the medication error to the parents of the patients to ensure any harm that might have occurred is addressed as well as prevent further adverse events.

Process of Writing Prescriptions and Strategies of Minimizing Medication Errors

​In writing prescriptions, Rosenthal and Burchum (2018) recommend that key elements should be included. These elements include the prescriber’s name, license number, contact, DEA number, name of the patient and age, medication name, strength and frequency as well as the number of refills. Some of the strategies that can be used to minimize medication errors include the use of technology such as CPOE, which has been found to reduce medication errors by 50 percent, use of barcode system as well as medication reconciliation (Rosenthal & Burchum, 2018).

Conclusion

​From the above discussion, it has been established that medication error is one of the key errors that occur in healthcare. However, it has been deduced that healthcare providers have a legal obligation to disclose medication errors. This is primarily for the purpose of enhancing patients’safety.

• State your PICOT question.
• Indicate in parentheses after each segment, what part of PICOT the preceding words represent.
• For example: In patients recently discharged from the hospital following care for heart failure (P), do hand-off calls by the nurse to the primary care provider using the SBAR format (situation, background, assessment, recommendation) (I) compared to no calls (C) decrease readmission rates (O) over a one year period (T).