...Ethics Case Study Heather Holcomb University of Phoenix Ethics: Health Care and Social Responsibility HCS 335 Deborah Laughon RN BSN MS DBA January 23, 2012 Ethics Case Study Case Study Jerry McCall is Dr. William’s office assistant. He has received professional training as both a medical assistant and a LPN. He is handling all the phone calls while the receptionist is at lunch. A patient calls and says he must have a prescription refill for Valium, an antidepressant mediation, called in right away to his pharmacy, since he is leaving for the airport in thirty minutes. He says that Dr. Williams is a personal friend and always gives him a small supply of Valium when he has to fly. No one except Jerry is in the office at this time. What should he do? (Fremgen, 2009). Overview Health care providers are faced with making difficult ethical decisions everyday. Moral and value systems influence the ethical decision process, but the law and licensure regulations do as well. This case study is an example of a potential ethical dilemma and a possible breach of the law. The following questions will be explored: 1. Does Jerry’s medical training qualify him to issue this refill order? 2. Would it make a difference if the medication is for controlling high blood pressure that the patient critically needs on a daily basis? 3. If Jerry calls in the refill and the patient has an adverse reaction while flying, is Jerry protected from a lawsuit under the doctrine of respondent...
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...Practice Standard – Safety and Quality Patient safety is a high-priority issue for all professionals including pharmacists. Patient safety is defined as ‘the prevention of harm to patients, including through errors of commission and omission’. The role of pharmacists has been clinically proven to improve many outcomes regarding patient health, including greater patient safety, improved disease and drug therapy management, effective healthcare spending, improved adherence and improved quality of life (Canadian Pharmacists Association, 2008). The focus on patient care stemmed from a 1999 US report by the institute of Medicine titled, ‘To Err is Human: Building a safer Health System’. This report detailed the costs of medical errors to the US economy and how medical errors numbered higher than deaths due to AIDS, motor vehicle accidents, and breast cancer, combined. The report went on to descried how errors can be reduced (Institute of Medicine,1999). For centuries, pharmacists have been the guardians/safeguards against "poisons" those substances which could cause harm to the public. Now more than ever pharmacists are charged with the responsibility to ensure that when a patient receives a medicine, it will not cause harm. As highlighted in a report produced in November 2009 "Pharmacy Intervention in the Medication-use Process - the role of pharmacists in improving patient safety", the involvement of pharmacists in patient safety can be as early at the prescribing phase and...
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...the public including prenatal screening of the fetus in utero to screening adults for genetic disorders, such as Parkinson's disease and breast cancer. Share your thoughts on the legal, ethical, and social implications that may be related to genetic screening. How would you educate your patient that is considering having genetic screening? Week 2: Question 1= Choose an FDA-approved prescription medication and discuss the pharmacokinetics and pharmacodynamics of the medication, including any differences that would be expected based on the patient's age, a condition of pregnancy, or lactation. Address any adverse effects the medication may have based on age, pregnancy, or lactation. Question 2= Active acquired immunity can be achieved through the use of childhood immunizations. Many parents voice concerns regarding the safety of vaccinations. What is your opinion on the current use of vaccinations? How would you educate parents regarding the safety and effectiveness of vaccinations? Defend your answers with evidence-based research. Week 3: Question 1= Share a case study of an electrolyte imbalance from your practice or from the...
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...critically analyze a nursing research conducted on methodological and ethical challenges in investigating the safety of medication administration. The paper will focus on problem statement, purpose and research question, literature review and examine the conceptual and theoretical framework of the study. Problem Statement The problem statement signifies the importance of the research to the profession it serves in this case the nursing profession. The problem statement identifies the specific gap in the knowledge needed for practice (Burn, Grove 2010). The research clinical problem was identified as safety of medication administration. What was not known was the methodological and ethical challenges faced by a researcher who attempted to conduct the research on this issue. The research significance was supported by position statement from the World Health Organization and the Department of Health noting the increase prevalence of research into patient safety and the methodical approaches used in research regarding patient’s safety, there were also previous studies that investigating e critical care nurses’ views on safety of medication administration. Purpose and Research Question The purpose of the study was to highlight some of the methodological and ethical challenges that the researcher faced when conducting a study of the safety of medication administration (Mansour, M 2011). There were two focused research question...
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...Abstract Healthcare unlike many high-risk industries has made slow progress in improving patient’s safety. The role of nursing in improving medication safety has been largely underestimated. Much of the research undertaken to date in relation to adverse medication events has neglected the impact that nurses have or could have in improving patient safety. In examining literature regarding adverse medication events one can see the urgent need for significant improvement in medication practices and processes. In addition that this health care issue will only improve with the participation of all disciplines working towards a common goal of improving the safety of those in our care. Introduction Medications play a key role in healthcare but can also be a significant key cause of medical error and of adverse patient outcomes. Nurses by the nature of their roles in medication administration can be the last line of defense in eliminating or reducing adverse medication events. The administration of medication is a common and almost routine activity in a nurse’s daily work, yet it is fraught with complexity and risk for both the patient and nurse. As a student nurse working in partnership with a registered nurse I have observed a variety of practices in medication administration that have varied from what I have been taught in class. On reflecting on these practices and questioning nurses why such practice has been adopted has illustrated to me both the flawed processes and environment...
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...will demonstrate that as a student nurse, the author has gained the necessary skills to conduct an evidence-based literature search and review and implement that knowledge into practice. Starting with a brief discussion on EBN it will go on to identify a suitable research question. During a placement on a medical ward the author noticed that nurses experienced many interruptions whilst conducting medication rounds and this review will consider ways to minimise interruptions and thus improve patient safety. Using the PICO acronym a suitable research question was formulated, ‘do interruptions during medication rounds increase the drugs administration errors made by nurses?’ A short description of the literature search is given and a summary of findings is presented in tabular form. Five original articles were selected and one chosen to critically appraise (see appendix 2). The rest of the essay will focus on reviewing the five articles. It will furthermore demonstrate the link between interruptions during drug rounds and patient and nurse safety, consider the implications of the studies for nursing practice and include the nurse’s perspective of these interruptions. Dale (2005) defines EBP as ‘the nurse making conscious judgements...
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...(Kizer, 2001). In 2002, The Joint Commission established National Patient Safety Goals (NPSG) to help accredited organizations with patient safety in specific areas. An advisory group comprised of nurses, physicians, pharmacists, risk managers, clinical engineers, and others with appropriate experience advises The Joint Commission on how to address emerging patient safety issues. This group also periodically develops and updates the goals. The goals are grouped into broad categories and for 2011-2012, cover such categories as patient identification, health care-associated infections, improving communication, medication safety, reducing falls, and risk assessment. A discussion of selected elements underlying the current NPSG such as hand washing techniques, training, and lack of communication between healthcare personnel that can lead to medication errors, to falls, and even death, plus other related factors such as staffing shortages, problems with using outdated equipment, considerations in using the electronic medical records, and compliance with statutes provide insight into the challenges faced by today’s healthcare institutions and providers. Healthcare institutions have guidelines and laws they must follow to ensure patient safety. Some institutions have their own policies on patient safety, but these healthcare institutions must to adhere to standards set forth by national organizations for patient safety. For example, The World Health...
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...as a result of medication errors. Medication errors can be attributed to faults in both humans and medication use systems. Therefore, it is necessary to address resolutions to both of these predicaments. The anticoagulant heparin is amongst the most implicated medications. Thus, it has been documented in the top five high-alert medications. Two notable events that triggered recent interest in this topic are the heparin overdoses that occurred in California, associated with actor Dennis Quaid’s newborn twins, and those affecting neonates in an Indiana hospital. The Failure Mode Effect Analysis (FMEA) is a proactive approach to error prevention. Implementation of an FMEA system would serve as a crucial method that will help to recognize potential failures of a product or process before adverse events occur. FMEA can help identify where the use of technology can be implemented to facilitate the reduction of medication errors, especially pertaining to heparin as in this case. Studies have shown how technology, such as computerized heparin nomagram system (HepCare), smart pump infusion technology, computerized physician order entry (CPOE), and the bar coding system, can reduce medication errors. Expanding nationwide awareness of these methods should result in a significant decline of medication errors. Introduction Errors are unavoidable in today highly complex and technologically advanced medical treatment facilities and hospital. Recent studies have shown that...
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...Abstract An electronic bar code medication administration was a system developed and successfully implemented in a 118-bed Veterans Administration hospital in February 2000. Known as Barcode Medication Administration (BCMA), this software proved useful in generating fast and accurate medication administration as well as online patient medication records preservation. The application created by the Eastern Kansas Health Care System in association with Colmery-O’Neil VA Medical Center has been modified a number of times to meet the general requirements in all U.S. Veterans Health Administration medical centers. The implementation of Barcode Medication Administration software has enabled electronic bedside administration of medication of medications. Online Barcode technology is revolutionizing medication administration more aspects than originally thought, and is such a blessing to the business industry in terms of cost cutting. To be honest, the force driving the momentum in the adoption of the new systems has been majorly based on financial, rather than safety concerns. The fee for- service compensation systems has done exceedingly well in increasing revenue to hospitals resulting from additional technology-related charges levied on patients for each dose dispensed (Cohen, 2002). From the evidences adduced in this research, bar code technology seems to hold great promise for general improvements in medication safety and efficiency. Nevertheless, evidence so far is limited...
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...Ethics Case Study Ethics Case Study Jerry McCall has received training as a medical assistant and as an LPN but given the fact that he was hired on at the facility to be Dr. Williams’s personal office assistant, he does not have the right to issue the patients’ refill order for Value and an antidepressant medication. He has been hired as Dr. Williams’s assistant in the office. This patient that has called in could be on restriction from receiving these medications he has requested and found a chance to get a refill because a new person took the phone call. There are questions to be asked when trying to understand the situation that the patient gives. Why didn’t the patient prepare for his trip in advance instead of waiting until the last minute to call in and get a refill for the requested medications? He could have given a time frame of 30 minutes so that Mr. McCall would not have time to consult Dr. Williams before making an ethical decision. There would be no difference if the medication that was being requested were for control of high blood pressure that the patient critically needs on a daily basis. Any type of medication request would need to be authorized by the doctor first. Dr. Williams could have changed the type of blood pressure medication that this patient needs or he may want to try the patient on a different type of medication when this patient’s medication refills are gone. You can never assume that the patient knows his or her doctor’s intentions...
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...Bar Code Safety and Efficacy http://www.psqh.com/sepoct05/barcodingrfid1.html Errors that occur earlier in the medication process are more readily detected (~50% are prevented during the ordering stage) while very few (< 2%) are caught at the administration stage (bates et al., 1995). further, it has been noted that more than one third of medication errors occur at the latter stage (leape et al., 1995). because of the relatively high proportion of errors and the lack of success preventing them, error reduction strategies targeted at the administration stage High rates of preventable medication errors have been repeatedly reported in studies in the medical literature (Bates et al., 1995; Leape et al., 1995; Flynn et al., 2002; Kanjanarat et al., 2003). It is difficult, however, to cite a single number to define the extent of the medication error problem due to differences in institutions, study methodologies, error definitions, and other variables. On the high end of estimates, one study that compiled data from 36 institutions reported 19% (~1 in 5) of the medication doses studied over a 4-day period involved medication errors (Barker et al., 2002). These errors included wrong time (43%), omission (30%), wrong dose (17%), and unauthorized drug (4%). The number of these errors deemed potentially harmful adverse drug events (ADEs) was 7%. A comprehensive review of medication error studies cited in the Institute of Medicine (IOM) 2000 report on errors in the U.S. healthcare system...
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...Case Study: Merck and the Vioxx Recall Kelvin Gabel Benedictine University Case Study: Merck and the Vioxx Recall According to Lawrence and Weber (2014), former Merck CEO George W. Merck implied a corporate vision of social responsibility for Merck & Co., Inc. (Merck) when he stated in 1950 that medicine was for the people and that loyalty to that concept would lead to greater profits. On the surface, it appears Merck has historically lived its declared mission of putting people first. This is demonstrated by the company forfeiting patent and profits from the antibiotic streptomycin and the drug Mectizan (Lawrence, 2014). Merck was well rewarded for its people first philosophy. Though it was ranked fifth in asset and market value, it ranked first in profits. Additionally the company had a stellar reputation of being perceived as the most ethical and socially responsible of the major drug companies (Lawrence, 2014). Today Merck Pharmaceutical’s mission statement is “to discover, develop and provide innovative products and services that save and improve lives around the world (Merck, 2015).” Reading Merck’s current mission statement lacks both the compassion of placing people first and the implied social responsibility of Mr. Merck’s statement in 1950. To be contextually correct historically in forming a view of Merck and the Vioxx recall issue, I sought to find a corporate mission statement from the period of the recall which was in 2006. According to Culp...
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...http://www.nap.edu/catalog/9728.html We ship printed books within 1 business day; personal PDFs are available immediately. To Err Is Human: Building a Safer Health System Linda T. Kohn, Janet M. Corrigan, and Molla S. Donaldson, Editors; Committee on Quality of Health Care in America, Institute of Medicine ISBN: 0-309-51563-7, 312 pages, 6 x 9, (2000) This PDF is available from the National Academies Press at: http://www.nap.edu/catalog/9728.html Visit the National Academies Press online, the authoritative source for all books from the National Academy of Sciences, the National Academy of Engineering, the Institute of Medicine, and the National Research Council: • Download hundreds of free books in PDF • Read thousands of books online for free • Explore our innovative research tools – try the “Research Dashboard” now! • Sign up to be notified when new books are published • Purchase printed books and selected PDF files Thank you for downloading this PDF. If you have comments, questions or just want more information about the books published by the National Academies Press, you may contact our customer service department tollfree at 888-624-8373, visit us online, or send an email to feedback@nap.edu. This book plus thousands more are available at http://www.nap.edu. Copyright © National Academy of Sciences. All rights reserved. Unless otherwise indicated, all materials in this PDF File are copyrighted by the National Academy of Sciences. Distribution, posting, or copying...
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...Rivera, & Heather Ryan 2. Problem: According to a recent study (www.nejm.org/doi/full/10.1056/NEJMsa1103053?query=featured_home (Links to an external site.)), warfarin, insulin, oral antiplatelet agents, and oral hypoglycemics accounted for more than two-thirds of the drugs tied to hospitalization for adverse drug events in older adults. Most events were associated with unintentional overdoses at home. Medication errors can occur in clinical settings or at home because humans are not perfect and therefore, they make errors too and so do the man-made machines. The patients are more likely to experience medication errors at home than a hospital because a health professional is not present to double check medications, no standard process to follow like the hospital does, no set schedule take them, and no alerts before taking them. The patients have to be more cautious when taking high-alert drugs such as warfarin, antiplatelet agents, insulin, and oral hypoglycemics because these can lead to serious and even life-threatening situations....
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...Colby Joe Carver 10/16/15 PR Case Study 1. Tylenol is a elite corporate company that had a couple issues with its products of pain medication with people tampering with its products. This caused people to die in the first case and the second case of these events. The first case someone was putting cyanide in the capsules in the Chicago distribution center and it wasn’t found to be at where they make the medicine. With the public then very skeptical on Tylenol and its products they had to make something to gain the customers trust back. They came out with a new packaging bottle. It featured the triple safety seal on its packages so no one could tamper with them. If one was unbroken then it was urged to not use the product. The second case was about another woman dying in New York after taking Tylenol. The company then sprang into action again by halting all production. They then decided to come out with the caplets instead of capsules because it was easier for people to tamper with the capsules vs. the caplets. 2. This case study is the primary story that has helped many businesses around the world deal with similar problems within their own companies. The way Tylenol and Johnson & Johnson handled these issues is paramount to how they should’ve been handled. Even President Reagan said that they have their deepest appreciation for living up to the highest ideals of corporate responsibility and grace under pressure. Today this case study is the threshold of how to conduct...
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