Week 2: Organizational Change and Ethical-Legal Influences in Advanced Practice
Nursing Case Study
Chamberlain University
Healthcare Policy and
Leadership NR506NP-12913
Dr. Candice Philips
Case Study Questions:
1. What are the potential ethical and legal implications for each of the
following practice members?
o Medical assistant:
Medical assistants are cross trained to perform only clinical and administrative duties. They
don’t have prescriptive authority, Stephanie the medical assistant was practicing outside
her scope of training. She has violated state and federal laws (AAMA 2019).
Ethical: Medical assistant Stephanie failed to provide Ethic of Care because she failed to
provide a caring environment for the patient. Patient safety is considered an environment,
when she refilled the prescription of amoxicillin, she violated patient safety because the
patient could have been injured by her action. Even though her intentions were good, the
outcome could have harmed the patient. Stephanie to reflect on her actions and ensure
that she is acting ethically and within her range of their skills. She needs to recognize the
warning signs that she may breach the AAMA code of ethics.
Legal: The medical assistant Stephanie practiced outside her scope of training and could
face legal action such as reprimand, probation, temporary and/or permanent revocation of
CMA (AAMA) credentials (AAMA 2019).
o Nurse Practitioner:
Ethical: The NP is now facing an ethical dilemma of patient safety and unlawful use of
prescriptive authority by Medical assistant Stephanie. The NP must decide on how she is
going to approach the situation and whom she will address her concerns. Medical
assistant Stephanie has compromised the NP practice and place the patient at risk
without her knowledge. The NP as an ethical responsibility to evaluate and define the
patient’s condition before determining drug therapy and selecting the appropriate
medication.
After selecting the medication, she must inform the patient on the possible side effects,
warning signs and instruction. She had an ethical duty to monitor the patient and consider
the cost of the medication. None of the following took place before the medication of
amoxicillin was refilled.
Legal: The NP could be facing negligence and/or a malpractice lawsuit.
, NP could be facing negligence because she failed to disclose necessary information about
the patient condition since an assessment nor an evaluation was not done or give the
necessary care for the diagnose. Under malpractice the NP care fell below the standard of
care, because the patient was not assessed before prescribing amoxicillin. We don’t know
if the patient really needed the amoxicillin. The case study did not state if the patient was
harm. If the patient was not harm than the NP could only be facing negligence instead of
malpractice. For the NP to be charge with malpractice four elements must take place.
1. The NP owes the patient a duty.
2. The care fell below the standard of care.
3. The actions caused the patient injury.
4. The patient was injured (Buppert, 2017).
The NP would have to state she didn’t authorize the prescription of amoxicillin. There is
many outcomes and it depends on the actions of the NP on how she would handle the
situation.
o Medical Director:
Ethical: The Medical Director is facing an ethical dilemma as well, because he/she will
have to decide how to address the issues. The patient was placed at risk and the case
study does not mentioned if the patient was harmed. Should Medical assistant Stephanie
receive coaching, disciplinary action, termination or be reported to the AAMA. Should
the patient be told about the un authorize prescription refill of amoxicillin?
Legal: The Medical Director could be facing legal fines due to the violation of state and
federal laws. If the patient was injured or death occurs there would be a lawsuit toward
the company, the NP and Medical Assistant. Fraud charges could be a possibly for
reimbursement of services that didn’t take place.
o Practice:
Ethical: The Practice as the Ethic of Care issues due to patient safety. How to ensure this
issue does not occur and what action should be taken for individual you violate the policy
and laws. It also facing Ethic of Justice, should the patient be told and what about
mandatory reporting and the effects of patient safety. The Practice as an ethical duty to
medication prescriptions. To ensure that the appropriate tools such prescribing software
and electronic drug references, to reduce prescription errors and used to ensure patient
safety. In this case the practice failed Mrs. Smith and place her in harm.
Nursing Case Study
Chamberlain University
Healthcare Policy and
Leadership NR506NP-12913
Dr. Candice Philips
Case Study Questions:
1. What are the potential ethical and legal implications for each of the
following practice members?
o Medical assistant:
Medical assistants are cross trained to perform only clinical and administrative duties. They
don’t have prescriptive authority, Stephanie the medical assistant was practicing outside
her scope of training. She has violated state and federal laws (AAMA 2019).
Ethical: Medical assistant Stephanie failed to provide Ethic of Care because she failed to
provide a caring environment for the patient. Patient safety is considered an environment,
when she refilled the prescription of amoxicillin, she violated patient safety because the
patient could have been injured by her action. Even though her intentions were good, the
outcome could have harmed the patient. Stephanie to reflect on her actions and ensure
that she is acting ethically and within her range of their skills. She needs to recognize the
warning signs that she may breach the AAMA code of ethics.
Legal: The medical assistant Stephanie practiced outside her scope of training and could
face legal action such as reprimand, probation, temporary and/or permanent revocation of
CMA (AAMA) credentials (AAMA 2019).
o Nurse Practitioner:
Ethical: The NP is now facing an ethical dilemma of patient safety and unlawful use of
prescriptive authority by Medical assistant Stephanie. The NP must decide on how she is
going to approach the situation and whom she will address her concerns. Medical
assistant Stephanie has compromised the NP practice and place the patient at risk
without her knowledge. The NP as an ethical responsibility to evaluate and define the
patient’s condition before determining drug therapy and selecting the appropriate
medication.
After selecting the medication, she must inform the patient on the possible side effects,
warning signs and instruction. She had an ethical duty to monitor the patient and consider
the cost of the medication. None of the following took place before the medication of
amoxicillin was refilled.
Legal: The NP could be facing negligence and/or a malpractice lawsuit.
, NP could be facing negligence because she failed to disclose necessary information about
the patient condition since an assessment nor an evaluation was not done or give the
necessary care for the diagnose. Under malpractice the NP care fell below the standard of
care, because the patient was not assessed before prescribing amoxicillin. We don’t know
if the patient really needed the amoxicillin. The case study did not state if the patient was
harm. If the patient was not harm than the NP could only be facing negligence instead of
malpractice. For the NP to be charge with malpractice four elements must take place.
1. The NP owes the patient a duty.
2. The care fell below the standard of care.
3. The actions caused the patient injury.
4. The patient was injured (Buppert, 2017).
The NP would have to state she didn’t authorize the prescription of amoxicillin. There is
many outcomes and it depends on the actions of the NP on how she would handle the
situation.
o Medical Director:
Ethical: The Medical Director is facing an ethical dilemma as well, because he/she will
have to decide how to address the issues. The patient was placed at risk and the case
study does not mentioned if the patient was harmed. Should Medical assistant Stephanie
receive coaching, disciplinary action, termination or be reported to the AAMA. Should
the patient be told about the un authorize prescription refill of amoxicillin?
Legal: The Medical Director could be facing legal fines due to the violation of state and
federal laws. If the patient was injured or death occurs there would be a lawsuit toward
the company, the NP and Medical Assistant. Fraud charges could be a possibly for
reimbursement of services that didn’t take place.
o Practice:
Ethical: The Practice as the Ethic of Care issues due to patient safety. How to ensure this
issue does not occur and what action should be taken for individual you violate the policy
and laws. It also facing Ethic of Justice, should the patient be told and what about
mandatory reporting and the effects of patient safety. The Practice as an ethical duty to
medication prescriptions. To ensure that the appropriate tools such prescribing software
and electronic drug references, to reduce prescription errors and used to ensure patient
safety. In this case the practice failed Mrs. Smith and place her in harm.
