Change Management and Ethical and Legal Influences in Advanced Practice Nursing Assignment Paper

Change Management and Ethical and Legal Influences in Advanced Practice Nursing Assignment Paper

Change management and Ethical and Legal Influences in Advance Practice Nursing Assignment Paper

Ethical and Legal Implications

Medical assistant

Legally, the medical assistant does not have prescriptive authority to prescribe medications for patients. The medical assistant can only transmit prescription orders reviewed and approved by a physician or nurse practitioner with prescriptive authority. Mrs. Smith has violated state and federal laws prohibiting medical assistants from prescribing medications. The implications include a possible lawsuit, and disciplinary action by the professional body leading to suspension or loss of license and certification (Vaismoradi et al., 2021). The ethical implications of the medical assistant’s actions include exposing the patient to the risk of harm by giving a medication whose safety and efficacy have not been evaluated by the nurse practitioner for use by the patient. Similarly, using the practitioner’s name yet she did not prescribe the medication is unethical conduct.

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Nurse Practitioner

The nurse practitioner risks lawsuit for negligence in case the medication cause harm to the patient. Her name is indicated on the label and she is also responsible for the actions of her medical assistant. The patient might be harmed by this decision because of the failure to evaluate the risks and benefits of the drug before giving the patient (Vaismoradi et al., 2021). The practitioner phases loss of license or suspension by the state medication board.

Medical Director

The medical director will also be affected by the actions of his staff with possible suspension or loss of license. Additionally, the actions are unethical exposing the patient to the risk of harm, which could damage the reputation of the facility (Vaismoradi et al., 2021). The facility could be faced with a lawsuit based on corporate negligence.

Practice

The poor decisions made by the medical assistant are damaging to the practice. Ethically, the implications include risk to patient safety and poor patient outcomes. Legally, loss of license and certifications to practice are the repercussions of such actions.

Strategies for improvement

1. Create a policy outlining medication prescribing authority and procedure, and the responsibility of other healthcare workers pertaining to drug ordering, refilling, and administration(Yousef & Yousef, 2018). Include the ethical and legal repercussions of failing to adhere to the procedures.
2. Conduct training for all staff to sensitize each person on their roles in the medication chain. Continuous training on medication issues, potential errors, and risks that put patients at risk of harm is essential for all staff so that they can employ effective clinical judgment before making a decision that violates ethical and legal provisions(Yousef & Yousef, 2018).
3. Install computerized physician order entry. This option will ensure that all prescription orders are managed electronically and a physician/nurse practitioner will receive an alert when a medication is ordered using their names without their knowledge.

Leadership Qualities

The first leadership quality that would promote change is a transformational leadership approach. According to (Faupel & Süß, 2019), transformational leadership is synonymous to change because it inspires, motivates, and encourages employees to become creative, innovative, and critical thinkers who seek to solve problems, making them more receptive to improvements. Moreso, transformational leadership goes beyond change management to influence change in procedures and processes. Another important quality of leadership that promotes change is effective communication. Effective communication is a key ingredient for successful change because it ensures that employees are involved and have the necessary information about change and the potential benefits (Faupel & Süß, 2019). In most cases, staff resists change because of a lack of information/miscommunication about the change, leading to uncertainty. Finally, strategic thinking is an important leadership quality for a change. Strategic thinking helps leaders execute change effectively through the management of change obstacles and activities.

References

Faupel, S., & Süß, S. (2019). The Effect of Transformational Leadership on Employees During Organizational Change – An Empirical Analysis. Journal of Change Management, 19(3), 145-166, https://doi.10.1080/14697017.2018.1447006.

Vaismoradi, M., Jordan, S., Logan, P. A., Amaniyan, S., & Glarcher, M. (2021). A systematic Review of the Legal Considerations Surrounding Medicines Management. Medicina, 57(1), 65. https://doi.org/10.3390/medicina57010065.

Yousef, N., & Yousef, F. (2018). Using total quality management approach to improve patient safety by preventing medication error incidences. BMC Health Serv Res, 17, 621. https://doi.org/10.1186/s12913-017-2531-6.

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This is a graded discussion: 100 points possible

Week 2: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study (Orig Post due Wednesday, Responses due Sunday)
Purpose

due May 15

The purpose of this discussion is to discuss organizational changes and ethical-legal influences in a clinical scenario at an out-patient family practice. Students will explore potential effects on patient outcomes and ethical and legal implications for members of the heath care team as a result of illegal behaviors. Students will develop strategies that result in prevention of untoward outcomes that result in a positive practice culture.
Activity Learning Outcomes
Through this discussion, the student will demonstrate the ability to:

1. Demonstrate effective leadership styles in the management of organizational change (CO3)
2. Interpret various forms of ethical theories and application into practice (CO4)
► 3. Discuss practice guidelines and malpractice prevention (CO2)
Due Date: Wednesday by 11:59PM MST of Week 2

Initial responses to the discussion topic must be posted by Wednesday 11:59pm MT. Two additional posts to peers and/or faculty are due by Sunday at 11:59pm MT. Students are expected to submit assignments by the time they are due.
A 10% late penalty will be imposed for discussions posted after the deadline on Wednesday of week 2, regardless of the number of days late. NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0).
Total Points Possible: 100 Requirements:
You are a family nurse practitioner employed in a busy primary care office. The providers in the group
include one physician and three nurse practitioners. The back office staff includes eight medical assistants
who assist with patient care as well as filing, answering calls from patients, processing laboratory results and taking prescription renewal requests from patients and pharmacies. Stephanie, a medical assistant, has

worked in the practice for 10 years and is very proficient at her job. She knows almost every patient in the practice, and has an excellent rapport with all of the providers.
Mrs. Smith was seen today in the office for an annual physical. Her last appointment was a year ago for the same reason. During this visit, Mrs. Smith brought an empty bottle of amoxicillin with her and asked if she could have a refill. You noted the patient’s name on the label, and the date on the bottle was 1 week ago.
You also noted your name printed on the label as the prescriber. The patient admitted that she called last week concerned about her cough and spoke to Stephanie. You do not recall having discussed this patient with Stephanie nor do the other providers in the practice.
Case Study Questions:
1. What are the potential ethical and legal implications for each of the following practice members? Medical assistant
Nurse Practitioner Medical Director Practice
2. What strategies would you implement to prevent further episodes of potentially illegal behavior?
3. What leadership qualities would you apply to effect a positive change in the practice? Be thinking about the culture of the practice.
4. A scholarly resource must be used for EACH discussion question each week.

DISCUSSION CONTENT

► Category

Points
%

Description
Potential ethical &
legal implications for
30
healthcare team
members

30%

Provides relevant evidence of scholarly inquiry of the potential ethical and legal implications for each of the practice members. Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion.

Strategies to prevent
30
further conflict

30%

Provides relevant evidence of scholarly inquiry of strategies to implement to prevent further episodes of potentially illegal behavior. Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion.

Leadership qualities to effect positive change

15 15%

Provides relevant evidence of scholarly inquiry of leadership qualities to apply to effect a positive change in the practice.
Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion.

75 75% Total CONTENT Points= 75 pts

DISCUSSION FORMAT

Category

Points
%

Description

4 Required Elements:

Interactive Dialogue

20 20%

Responds a minimum of two other posts to peers and/or faculty in the threaded discussion;
Responses to peer/faculty are substantive (adds importance, depth, and meaningfulness to the discussion)
Responds to all direct questions from faculty (if no question asked directly, student responded to questions posed to the entire class)
Summarizes what was learned from the lesson, readings, and other student posts for the week. The summary could be included in one of the three minimum posts.

Grammar, Syntax, Spelling, &
Punctuation

5 5%

Grammar, syntax, spelling, and punctuation are accurate.

25 25%

Total FORMAT Points= 25 pts DISCUSSION TOTAL=100 points

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