Read the case scenario and answer the case questions:

Case Scenario

A patient is confused about how to make payments for a recent visit to urgent care and hospital stay. Her employer-based insurance provider’s website allows her to use her HSA account to make a payment online. She uses her HSA debit card to make the payment, but her insurance provider sends her a check instead of sending it to the Tri-City HealthCare Agency. After contacting her insurance help desk via the website, she is told to send the check to Tri-City HealthCare Agency herself. The patient asks the insurance provider’s help desk representative why they cannot just make the payments for her. She is told about the various payment types and payers in the health care industry and how the market influences the integrated delivery systems in the industry.

Case Questions

1. Describe the payer systems mentioned in the case study.
2. Explain how the market forces have influenced the need for integrated delivery systems.
3. How might the insurance provider explain the payment system it utilizes for its clients? Explain if this method is effective or not for the insurance provider’s clients.
4. What has been the most significant legal and regulatory effect on managed care organizations?
5. How would this case study have differed if the patient was using public or social insurance?

The response to each question should be a minimum of 200 words. Formal essay structure is not required; differentiated responses to each question are acceptable. 

Integrate two to four scholarly sources in the collective assignment.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. 

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Mr. F is a 38-year-old man in overall good health who has been complaining about an aching pain in his knees when working around the house and often when simply walking. He has noticed that his knees feel “hard” and tight. His history indicates that he has always been involved in athletics and was on the college football team, but recently family responsibilities and work have not made it easy for him to exercise.

Discussion Questions

Relate Mr. F’s case history to the pathophysiology of osteoarthritis.

How do anti-inflammatory drugs and analgesics help Mr. F deal with this form of arthritis? Why is moderate, non–weight-bearing exercise recommended?

What is the probable prognosis for Mr. F?

Ethical and Legal Implications of Prescribing Drugs

What type of drug should you prescribe based on your patient’s diagnosis? How much of the drug should the patient receive? How often should the drug be administered? When should the drug not be prescribed? Are there individual patient factors that could create complications when taking the drug? Should you be prescribing drugs to this patient? How might different state regulations affect the prescribing of this drug to this patient?

These are some of the questions you might consider when selecting a treatment plan for a patient.  

Photo Credit: Getty Images/Caiaimage

As an advanced practice nurse prescribing drugs, you are held accountable for people’s lives every day. Patients and their families will often place trust in you because of your position. With this trust comes power and responsibility, as well as an ethical and legal obligation to “do no harm.” It is important that you are aware of current professional, legal, and ethical standards for advanced practice nurses with prescriptive authority. Additionally, it is important to ensure that the treatment plans and administration/prescribing of drugs is in accordance with the regulations of the state in which you practice. Understanding how these regulations may affect the prescribing of certain drugs in different states may have a significant impact on your patient’s treatment plan. In this Assignment, you explore ethical and legal implications of scenarios and consider how to appropriately respond.

To Prepare

• Review the Resources for this module and consider the      legal and ethical implications of prescribing prescription drugs,      disclosure, and nondisclosure.
• Review the scenario assigned by your Instructor for      this Assignment.
• Search specific laws and standards for prescribing      prescription drugs and for addressing medication errors for your state or      region, and reflect on these as you review the scenario assigned by your      Instructor.
• Consider the ethical and legal implications of the      scenario for all stakeholders involved, such as the prescriber,      pharmacist, patient, and patient’s family.
• 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, including whether you would disclose any      medication errors.

By Day 7 of Week 1

Write a 2- to 3-page paper that addresses the following:

• Explain the ethical and legal implications of the      scenario you selected on all stakeholders involved, such as the      prescriber, pharmacist, patient, and patient’s family.
• Describe strategies to address disclosure and      nondisclosure as identified in the scenario you selected. Be sure to      reference laws specific to your state.
• Explain two strategies that you, as an advanced      practice nurse, would use to guide your decision making in this scenario,      including whether you would disclose your error. Be sure to justify your      explanation. 
• Explain the process of writing prescriptions, including strategies to minimize medication errors.

Scenario

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.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The College of Nursing Writing Template with Instructions provided at the Walden Writing Center offers an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.

Standardized Terminology and Language in Informatics is an important part of healthcare. Nurses and healthcare workers need to understand and be able to communicate clearly.

Please select one of the following options and discuss your understanding of the role in healthcare and its potential impact on your practice.

• Usability
• Integration
• Interface
• Interoperability
• Meaningful Use
• Reimbursement from Centers for Medicare and Medicaid Services (CMS) payment
• NANDA
• NIC/NOC