NR 506 Week 2 Discussion: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study/Health Care Policy (Spring 2021) GRADED A

Case Study Questions: 1. What are the potential ethical and legal implications for each of the following practice members?  Medical assistant: Medical assistants have many tasks that are in their scope of practice, but they are not licensed to prescribe medication. They have an ethical obligation to treat patients within their scope of practice. Regrettably, this medical assistant acted outside her scope of practice by filling a prescription without the Nurse Practitioners knowing. NP’s and physicians are responsible and liable for medical assistants working within the practice. The medical assistant has an ethical duty to practice within their scope, this includes calling in prescriptions, but only as ordered and approved action by an NP or physician (Medical Assistant Scope of Practice, 2016). For the patients’ safety, the medial assistant can lose her license if reported.  Nurse Practitioner: has a moral and legal commitment to report the medical assistant for prescribing medications by forging a prescription in their name.  Medical Director: must utilize strict regulations within the practice pertaining to medical conduct. This can be done with in-person or online. Education that each employee must sign off on. Roles need to be clear-cut; it is imperative for the Medical Director to acknowledge the close relationships between the patients and providers, but at the same time alter the performance within their practice to adhere that all parties that are involved takes responsibilities and improve protocols to prevent this behavior from reoccurring.  Practice: The Practice must assign punishment to the medical assistant such as terminating and legal action to prevent reoccurrence of this incident. If the practice could theoretically be closed due to illegal conduct if there are a certain number of reports to the medical board. 2. What strategies would you implement to prevent further episodes of potentially illegal behavior? As an advanced practice nurse (APN), a part of the nurse leader’s task is to guarantee that each staff members comprehend their individual duties in fulfilling the tasks and that all procedures are in place to support the work (Chamberlain College of Nursing, 2017). However, in this case study the office did not have any policies or procedures for staff regarding this matter to follow as it related to non-urgent demand from patients concerning their prescriptions. The quality improvement strategies that I would execute as an APN in this practice to safeguard my role, I would meet with the providers in the practice and create policies and procedures regarding patients request for prescriptions. According to Farmer and Lundy, nurse providers at every level are held responsible for promoting a culture of safety when caring for patients by protecting patients from harm (2017). By establishing policies and procedures for this office regarding prescription authorizations for patients would decrease the chances of this type of situation occurring again in the office. Tactics to stop this occurrence would be to establish appropriate delegation of work to medical assistant and reassure them to practice within their scope to avoid consequence. Always understand the limitations of training and expertise for healthcare professionals including medical assistance and myself as an NP (Buppert, 2015). I This study source was downloaded by from CourseH on :59:10 GMT -06:00 Your text here 1 want the medical assistant to feel comfortable in their role and to come to me for questions or concerns. Permitting the medical assistant to feel comfortable approaching me with questions and concerns will help sway our relationship making it a more effective and productive work environment. The medical assistant should have comfortable work structure to follow and allow for time to communicate with me during the day with such requests as an antibiotic. 3. What leadership qualities would you apply to effect a positive change in the practice? Be thinking about the culture of the practice. The case study above presents safety, ethical, and legal concerns for everyone involved, such as the patient, the practice, the medical assistant, and the nurse practitioner. Some leadership qualities that I would apply as the NP is improve communication with the other staff members and ensure their knowledge in their job performance. Regardless that Stephanie has worked in the practice for 10 years and is knowledgeable in her role as a medical assistant, she does not have authorization nor the capability to authorize a refill for any patient. Stephanie is clearly practicing out her scope of practice by filling Mrs. Smith’s prescription without the authorization of the NP or physicians. Medical assistants (MA) work under the direct supervision of a licensed physician and/or certified nurse practitioner. The physician or NP have the ability within their state to delegate certain medical tasks and procedures to the medical assistants that is within their scope of practice (Gregory, 2014). However, the prescribing medications is not within an MA’s scope of practice and even if the physician of NP would have asked Stephanie to call in the prescription for Mrs. Smith, it was up to Stephanie to notify the physician and NP her inability to do so. The practice Stephanie works for needs to make sure that good quality improvement strategies are implemented. These strategies will safeguard the patient, the NP and the practice from further harm. These strategies, are monitoring and assessing outcomes of patients, having skilled QI teams, and using system redesigns to improve patient and population health outcomes, system performance, and clinician experience, and to reduce health care costs, the final strategy is education of the staff in their roles and duties. References: Buppert, C. (2015). Nurse practitioner’s business practice & legal guide (5th ed.). Sudbury, MA: Jones and Bartlett. Medical Assistant Scope of Practice. (2016). Retrieved from This study source was downloaded by from CourseH on :59:10 GMT -06:00 Powered by TCPDF ()