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.  

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.

senario

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.

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.

The unapproved use of approved drugs, also called off-label use, with children is quite common. This is because pediatric dosage guidelines are typically unavailable, since very few drugs have been specifically researched and tested with children.

When treating children, prescribers often adjust dosages approved for adults to accommodate a child’s weight. However, children are not just “smaller” adults. Adults and children process and respond to drugs differently in their absorption, distribution, metabolism, and excretion. 

 

Children even respond differently during stages from infancy to adolescence. This poses potential safety concerns when prescribing drugs to pediatric patients. As an advanced practice nurse, you have to be aware of safety implications of the off-label use of drugs with this patient group.

To Prepare

• Review the interactive media piece in this week’s Resources and reflect on the types of drugs used to treat pediatric patients with mood disorders.
• Reflect on situations in which children should be prescribed drugs for off-label use.
• Think about strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Consider specific off-label drugs that you think require extra care and attention when used in pediatrics.

Assignment:

Write a 1-page narrative in APA format that addresses the following:

• Explain the circumstances under which children should be prescribed drugs for off-label use. Be specific and provide examples.
• Describe strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. 
• Include descriptions and names of off-label drugs that require extra care and attention when used in pediatrics.
• Please use the rubric to formulate your assignment.

Rubric:

Explain the circumstances under which children should be prescribed drugs for off-label use. Be specific and provide examples.

Explain strategies to making off-label use and dosage of drugs safer for children from infancy to adolescence and descriptions and names of off-label drugs that require extra care and attention when used in pediatrics. Be specific. 

Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. 

Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation 

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.  All papers submitted include a title page, introduction, summary, and references.  

 The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. 

 

Research a health care organization or network that spans several states with in the United States (United Healthcare, Vanguard, Banner Health, etc.). Assess the readiness of the health care organization or network you chose in regard to meeting the health care needs of citizens in the next decade.

Prepare a 1,000-1,250 word paper that presents your assessment and proposes a strategic plan to ensure readiness. Include the following:

1. Describe the health care organization or network.
2. Describe the organization’s overall readiness based on your findings.
3. Prepare a strategic plan to address issues pertaining to network growth, nurse staffing, resource management, and patient satisfaction.
4. Identify any current or potential issues within the organizational culture and discuss how these issues may affect aspects of the strategic plan.
5. Propose a theory or model that could be used to support implementation of the strategic plan for this organization. Explain why this theory or model is best.

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.

PLEASE FOLLOW RUBRICS

 Health care organization or network is clearly and accurately described. 

 Assessment of overall organizational readiness is described in detail. Degree of organizational readiness is established. Strong evidence and rationale support the assessment. 

 The strategic plan is well developed. Network growth, nurse staffing, resource management, and patient satisfaction are addressed in detail. The plan is supported with strong evidence and rationale. 

 Current or potential issues in the organizational culture are clearly identified. The potential impact of these on the strategic plan is thoroughly described and supported with evidence and rationale 

 Theory or model to support strategic plan implementation is proposed. The theory or model demonstrates strong support for implementation of the strategic plan for the organization. Compelling rationale supports why the theory or model is the best choice. 

 Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear. 

 Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative. 

 Writer is clearly in command of standard, written, academic English. 

 All format elements are correct. 

 Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error. 

Hello, I m a student nurse in my Bachelor in Nursing, this assignment it‘s more of a discussion paper, has to have a nursing point of view, please refrain to use any nursing protocols from overseas, for eaxample, Australia or Asia, if using any references please use american nursing protocols, the last time my someone sent me a paper used references from New Zeland.This is a simple, straight forward paper, suggesting basic nursing principles and simple languaje is a must. Be familiar with Kosher jewish practice, no pork is allowed, seems to be adressed on this paper. 

COMPETENCIES

734.3.1 : Principles of Leadership

The graduate applies principles of leadership to promote high-quality healthcare in a variety of settings through the application of sound leadership principles.

734.3.2 : Interdisciplinary Collaboration

The graduate applies theoretical principles necessary for effective participation in an interdisciplinary team.

734.3.3 : Quality and Patient Safety

The graduate applies quality improvement processes intended to achieve optimal healthcare outcomes, contributing to and supporting a culture of safety.

INTRODUCTION

National initiatives driven by the American Nurses Association have determined nursing-quality outcome indicators that are intended to focus plans and programs to increase quality and safety in patient care. The following outcomes are commonly used nursing-quality indicators:

• complications such as urinary tract infections, pressure ulcers, hospital-acquired pneumonia, and DVT

• patient falls

• surgical patient complications, including infection, pulmonary failure, and metabolic derangement

• length of patient hospital stay

• restraint prevalence

• incidence of failure to rescue, which could potentially result in increased morbidity or mortality

• patient satisfaction

• nurse satisfaction and staffing

SCENARIO

Mr. J is a 72-year-old retired rabbi with a diagnosis of mild dementia. He was admitted for treatment of a fractured right hip after falling in his home. He has received pain medication and is drowsy, but he answers simple questions appropriately.

A week after Mr. J was admitted to the hospital, his daughter, who lives eight hours away, came to visit. She found him restrained in bed. While Mr. J was slightly sleepy, he recognized his daughter and was able to ask her to remove the restraints so he could be helped to the bathroom. His daughter went to get a certified nursing assistant (CNA) to remove the restraints and help her father to the bathroom. When the CNA was in the process of helping Mr. J sit up in bed, his daughter noticed a red, depressed area over Mr. J’s lower spine, similar to a severe sunburn. She reported the incident to the CNA who replied, “Oh, that is not anything to worry about. It will go away as soon as he gets up.” The CNA helped Mr. J to the bathroom and then returned him to bed where she had him lie on his back so she could reapply the restraints.

The diet order for Mr. J was “regular, kosher, chopped meat.” The day after his daughter arrived, Mr. J was alone in his room when his meal tray was delivered. The nurse entered the room 30 minutes later and observed that Mr. J had eaten approximately 75% of the meal. The meal served was labeled, “regular, chopped meat.” The tray contained the remains of a chopped pork cutlet.

The nurse notified the supervisor, who said, “Just keep it quiet. It will be okay.” The nursing supervisor then notified the kitchen supervisor of the error. The kitchen supervisor told the staff on duty what had happened.

When the patient’s daughter visited later that night, she was not told of the incident.

The next night, the daughter was present at suppertime when the tray was delivered by a dietary worker. The worker said to the patient’s daughter, “I’m so sorry about the pork cutlet last night.” The daughter asked what had happened and was told that there had been “a mix up in the order.” The daughter then asked the nurse about the incident. The nurse, while confirming the incident, told the daughter, “Half a pork cutlet never killed anyone.”

The daughter then called the physician, who called the hospital administrator. The physician, who is also Jewish, told the administrator that he has had several complaints over the past six months from his hospitalized Jewish patients who felt that their dietary requests were not taken seriously by the hospital employees.

The hospital is a 65-bed rural hospital in a town of few Jewish residents. The town’s few Jewish members usually receive care from a Jewish hospital 20 miles away in a larger city. 

REQUIREMENTS

Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. An originality report is provided when you submit your task that can be used as a guide.

You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course.

Analyze the scenario (suggested length of 2–3 pages) by doing the following:

A.  Discuss how the application of nursing-quality indicators could assist the nurses in this case in identifying issues that may interfere with patient care.

B.  Analyze how hospital data of specific nursing-quality indicators (such as incidence of pressure ulcers and prevalence of restraints) could advance quality patient care throughout the hospital.

C.  Analyze the specific system resources, referrals, or colleagues that you, as the nursing shift supervisor, could use to resolve an ethical issue in this scenario.

D.  Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.

E.  Demonstrate professional communication in the content and presentation of your submission.

File RestrictionsFile name may contain only letters, numbers, spaces, and these symbols: ! – _ . * ‘ ( )
File size limit: 200 MB
File types allowed: doc, docx, rtf, xls, xlsx, ppt, pptx, odt, pdf, txt, qt, mov, mpg, avi, mp3, wav, mp4, wma, flv, asf, mpeg, wmv, m4v, svg, tif, tiff, jpeg, jpg, gif, png, zip, rar, tar, 7z
RUBRICA:UNDERSTANDING OF NURSING QUALITY INDICATORS

NOT EVIDENT

A discussion of applying nursing-quality indicators is not provided.

APPROACHING COMPETENCE

The discussion does not logically address how the application of nursing-quality indicators could assist the nurses in the scenario with identification of issues that may interfere with patient care.

COMPETENT

The discussion logically addresses how the application of nursing-quality indicators could assist the nurses in the scenario with identification of issues that may interfere with patient care.

B:ADVANCING QUALITY PATIENT CARE

NOT EVIDENT

An analysis of potential advancement(s) to patient care is not provided.

APPROACHING COMPETENCE

The analysis does not identify specific nursing-quality indicators from the scenario or does not logically discuss how hospital data on the identified indicators could advance quality patient care throughout the hospital.

COMPETENT

The analysis identifies specific nursing-quality indicators from the scenario and logically discusses how hospital data on the identified indicators could advance quality patient care throughout the hospital.

C:RESOLUTION OF ETHICAL ISSUES

NOT EVIDENT

An analysis of the use of system resources, referrals, or colleague for resolving ethical issues is not provided.

APPROACHING COMPETENCE

The analysis describes one or more system resources, referrals, and/or colleagues that are inappropriate for the candidate to use in the role of nursing shift supervisor to resolve the ethical issue from the scenario.

COMPETENT

The analysis describes specific system resources, referrals, or colleagues that are appropriate for the candidate to use in the role of the nursing shift supervisor to resolve the ethical issue from the scenario.

D:SOURCES

NOT EVIDENT

The submission does not include both in-text citations and a reference list for sources that are quoted, paraphrased, or summarized.

APPROACHING COMPETENCE

The submission includes in-text citations for sources that are quoted, paraphrased, or summarized and a reference list; however, the citations or reference list is incomplete or inaccurate.

COMPETENT

The submission includes in-text citations for sources that are properly quoted, paraphrased, or summarized and a reference list that accurately identifies the author, date, title, and source location as available.

E:PROFESSIONAL COMMUNICATION

NOT EVIDENT

Content is unstructured, is disjointed, or contains pervasive errors in mechanics, usage, or grammar. Vocabulary or tone is unprofessional or distracts from the topic.

APPROACHING COMPETENCE

Content is poorly organized, is difficult to follow, or contains errors in mechanics, usage, or grammar that cause confusion. Terminology is misused or ineffective.

COMPETENT

Content reflects attention to detail, is organized, and focuses on the main ideas as prescribed in the task or chosen by the candidate. Terminology is pertinent, is used correctly, and effectively conveys the intended meaning. Mechanics, usage, and grammar promote accurate interpretation and understanding.