NR 510 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part Two
Chamberlain University NR 510 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part Two– Step-By-Step Guide
This guide will demonstrate how to complete the Chamberlain University NR 510 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part Two assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.
How to Research and Prepare for NR 510 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part Two
Whether one passes or fails an academic assignment such as the Chamberlain University NR 510 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part Two depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.
After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.
How to Write the Introduction for NR 510 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part Two
The introduction for the Chamberlain University NR 510 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part Two is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.
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How to Write the Body for NR 510 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part Two
After the introduction, move into the main part of the NR 510 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part Two assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.
Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.
How to Write the Conclusion for NR 510 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part Two
After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.
How to Format the References List for NR 510 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part Two
The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.
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Sample Answer for NR 510 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part Two
Like I stated in Part 1, this can be a serious matter even if the patient is not physically harmed. Since Stephanie is the medical assistant, placing and verifying orders are not in her job description. Even as I am now as a bedside nurse, placing orders without proper verification from a MD/NP/DO would land me in some trouble if this happened.Only nursing orders, like IV pump, heating pad or basic equipment/care can be placed by the nurse at the hospital I work at.
As an NP in this situation, I do not think that the NP is held liable. If a nurse places an order and document that it was verified by the MD, but thru investigation it was found that it was not, the MD is not held liable. The same should go for the NP. The nurse would be reprimanded for doing that and the MD will not held liable or be found at fault. In school for each profession, one is taught what they can and cannot do within legal limits. Stephanie got comfortable and thought it was go to go outside of her job description that I am sure she already knows. The practice as a whole may be liable, especially if harm was done to the patient. The principle of non-maleficence (to do no harm) states that a health care professional should act in such a way that he or she does no harm, even if her or his patient or client requests this. Stephanie may have not had bad intent and was thinking she was probably helping in this situation to alleviate some of the work for the providers and NPs. Also, she probably thought she was making it more simple for the patient. However, this could cause harm to the patient as a NP or MD must assess if and why a new antibiotic must be ordered in the first place. Also, the practice is responsible and must be held liable of alerting Mrs. Smith of the situation so the he knows what he going on. This maybe the hardest part as Mrs. Smith might lose trust in the practice, place a bad review and can have the right to sue the facility even if no physical harm was done. Negligence can be seen as failure to take reasonable care or steps to prevent loss or injury to another person. Nursing negligence is when a nurse who is fully capable of caring does not care in the way a reasonably prudent nurse would, and as a result the patient suffers unnecessarily. Even though this was not directly a nursing issue, she can still sue for negligence. Mrs. Smith may do nothing at all once told if she feels strongly tied to the practice. However, it is completely up to Mrs. Smith how she wants to go about the issue. If she decides to take it that far into suing the practice, Stephanie might be at risk to lose her job as she now becomes a liability to the practice. There is many ways this situation goes depending on the outcome. (Tinnon, 2017)
To prevent that issue, maybe the medical assistant can only have access to certain parts of the program. For example, maybe when it comes to prescriptions, the medical assistant can not print out or issue it out to the patient till the NP/MD signs off and verifies it. The program should stop her from issuing it to the patient without proper verification. For example, in the hospital setting, even if the program is the same name, each profession has their own set customized for their job description. A nurse’s screen will look different from a PCA, unit secretary or a respiratory therapist. With this setup, one can only access what is felt is allowed for the specific job description. (Schub & Kornusky, 2016)
Reference:
Schub, T. B., & Kornusky, J. M. (2016). Standing Orders, Order Sets, and Protocols: Government Regulations. CINAHL Nursing Guide,
Tinnon, E (2017). Situational awareness and Nursing Code of Ethics. Nurse Educator, 43(1), 32-36.
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Sample Answer 2 for NR 510 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part Two
In this weeks reading, we learned about the legal scope of nursing practice and how to solve ethical dilemmas. Thankfully Stephanie was honest and admitted what she did. In a healthcare dilemma that is probably seen far too often, Stephanie was in the wrong for assuming the prescription was ok without consulting me. Patients can be pushy, but Stephanie could have either set Mrs. Smith up with a same-day appointment, have her come in a day or two to be seen early, or at least checked with the on-call physician or Nurse Practitioner in the practice to see if the prescription was ok. The first legal concern is a medical assistant prescribing. The role of a Medical Assistant is to escort patient, take vital signs, and write down the chief complaint in the medical record (Chapman & Blash, 2017). Prescribing is outside of her scope of practice. The ethical dilemma is reporting a hard-worker or not for trying to help you out. This may be her first offense, but she should know better, especially with ten years experience, that she was acting outside her job description. Telephone prescribing is risky due to lack of physical assessment, testing for infections, and the possibility of over-prescribing antibiotics (Ewen, Willey, Kolm, McGhan, & Drees, 2015). An antibiotic for a cough is probably useless and could potentially lead to yeast infections or lead to antibiotic-resistant infections, doing Mrs. Smith more harm than good. I am liable for this situation because my name is on the prescription, and any harm to the patient could be a negligence or malpractice suit. I should also follow up with all of my patients and their symptoms. I also need the correct coding and documentation for billing purposes. Things need to be appropriately documented. Depending on the state of practice and the ability of the physician to delegate NPs to prescribe, the practice could also be seen liable. The practice should also oversee the hiring and firing of employees as well as making sure people are in their scopes of practice. A good way to safeguard my role would be to not prescribe via telephone. Although more time consuming, physically assessing my patients and testing for illness before I prescribe medications is safer for my license and my patients.
Chapman, S. A., & Blash, L. K. (2017). New roles for medical assistants in innovative primary care practices. Health Services Research, 5(2), 383-406. doi:10.1111/1475-6773.12602
Ewen, E., Willey, V. J., Kolm, P., McGhan, W. F., & Drees, M. (2015). Antibiotic prescribing by telephone in primary care. Pharmacoepidemiology And Drug Safety, 24(2), 113-120. doi:10.1002/pds.3686
Sample Answer 3 for NR 510 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part Two
You brought forth great information and ideas regarding this hot topic we are discussing. I agree, Stephanie not only put the patient at risk, but the NP, MD and practice as a whole with her actions. I think most of us agree that she probably thought she was helping both the patient and the NP, however quite the opposite took place. She is very lucky that the patient did not have an adverse reaction to he medication, and for all we know this “persistent” patient may have told Stephanie that this particular antibiotic worked well for her in the past. None the less, Stephanie should not have taken things into her own hands, and should always consult the licensed prescriber that she is phoning medications in under first, under any and all circumstances, no matter how trivial they may seem to her. As I mentioned in a previous post, I myself was a medical assistant for many years prior to becoming a nurse. I had a great relationship with the physicians I worked with, and they trusted me with many things, including phoning in medications for them. We had a great system down, I would help sort through the messages, placing the most important ones on top (such as ill patients asking for medication), and the MD would write what he wanted done, such as patient needs to be seen, or the name of the medications he wished to be phoned in. The MD would always sign his name/initials on the message as well, as a means of authorization. I would then phone the patients that he wanted to be seen so that they can come in for a visit, then I would phone in any authorized prescriptions. We typically performed these tasks between patients in effort to keep both the in person patients waiting to be seen, and the high influx of phone calls, running as smooth as possible. We were always busy, but we had a good system in place, and trust me- we had many “persistent” patients who wanted to have their way or got mad at us if they didn’t get their way as far as medications being phoned in. No matter how busy or behind we were, I never took matters into my own hands without first speaking with the MD. So, if Stephanie attempts to say she was trying to not bother the NP or was trying to save time, this is still no excuse for going outside of her scope of practice. In addition, this cough that the patient has could be viral as many are, or simply not an infection at all. What if it is a side effect from one of her existing medications, or due to a heart issue? These are the considerations that would be taking place with a licensed practitioner, which is ultimately for them to decide what is in the best interest of the patient, the prescriber and the practice.
Sample Answer 4 for NR 510 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part Two
It has almost been two decades since a new class of anti microbial has been developed to treat systemic infections (Velez, 2016). I believe the only way to prevent resistant bacterias from spreading is to treat antibiotics as controlled substances. There is no reason to have refills on antibiotics unless a person has chronic infections where the benefits outweigh the risk for a long term treatment of a low dose antibiotic. Superinfections are increasing, during these times, I believe it would be appropriate to make antibiotic prescriptions no refills. I also believe Schedule III under the controlled substances should be amended.
“Schedule III: These medications have a lower potential for abuse than substances in Schedules I or II, but abuse may lead to moderate or low physical dependence or high psychological dependence. Refill restrictions for Schedule III are the same as for Schedule IV—you may refill up to five times within six months. (GoodRx, nd.)”.
Schedule III should include can lead to development of antibiotic resistant bacteria if misused. We are in a time where antibiotics are being over prescribed and 50% of time it is unnecessary. This is the same case for the epidemic in narcotic overdoses. Antibiotics are overprescribed and we need to have stronger policy to restrict refills.
Reference:
GoodRx. What Are Controlled Substances? 9 Dec. 2016, www.goodrx.com/blog/what-are-controlled-substances/.
Velez, R., Selway, J., & Richmond, E. (2016). Legal Considerations For Antimicrobial Prescription. Journal Of Legal Nurse Consulting, 27(3), 49-52.
Sample Answer 5 for NR 510 Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part Two
The medical assistant’s actions raise several ethical-legal concerns because she broke several laws. She is not authorized to write prescriptions under her scope of practice. Medical assistants are to work directly under the primary care provider (Chapman & Blash, 2017). If the patient had developed an allergic reaction to amoxicillin, the practice could have been sued. Patients can be difficult to handle, especially when they feel hey know what’s best for their health. I understand and value that Stephanie just wanted to help, but her actions put the practice, the patient’s health, and my license at risk. As nursing students, we receive extensive training about our scope of practice and laws governing what we can and cannot do. It is safe for me to assume that Stephanie has done this before since she has been at the practice for 10 years. The medical assistants in the office need to undergo staff training about scope of practice and policies regarding patient interaction. Stephanie should face disciplinary action, which may affect her ability to work as a medical assistant. The ethical dilemma is that the physician or myself will have to report a co-worker when she was only trying to assist. On the other hand, Stephanie is a veteran medical assistant. She should have known that she was acting outside of her scope of practice. All she is authorized to do with patients is to take vital signs and write down the health complaint of the patient (Chapman & Blash, 2017). The medical ramifications of her actions put the patient at risk. Prescribing medications over the phone pose a great risk to a patient’s health because the patient has not been tested for infections or been given a physical assessment (Ewen et al., 2015). Stephanie obviously did not know that prescribing an antibiotic for a cough was useless, and she put the patient at risk for developing a yeast infection or resistance to the antibiotic. I do not believe I am liable because Stephanie used my name without my consent. This could also be considered identity theft. The practice is liable because it employs Stephanie and must report her actions to clear up any legal action that will affect me or the livelihood of the practice in the future. Stephanie may be a good employee, but I believe she knew the legal ramifications of using my name. Her actions pose ethical concerns. She should never misrepresent her role, scope of practice, or assume the role of another provider (Chapman & Blash, 2017). In the future, the office may establish a policy that requires NPs to call in their own prescriptions for patients. The office can also establish a sign-off rule in which the NP and physician must sign a prescription order.
References:
Chapman, S. A., & Blash, L. K. (2017). New roles for medical assistants in innovative primary care practices. Health Services Research, 52(S1), 383-406. Retrieved from https://doi.org/10.1111/1475-6773.12602
Ewen, E., Willey, V. J., Kolm, P., McGhan, W. F., & Drees, M. (2015). Antibiotic prescribing by telephone in primary care. Pharmacoepidemiology And Drug Safety, 24(2), 113-120. Retrieved from doi:10.1002/pds.3686