Week 4 discussion
Discussion Part One
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 one 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.
Discussion Question:
What is your next logically sound course of action? Provide
evidence to support your response.
Discussion Part Two
Upon further investigation, you learn that Stephanie spoke
with the patient and called the medication into the patient’s pharmacy without
consulting with a provider. Stephanie claimed that the patient was insistent
about needing a prescription. Since Mrs. Smith was coming into the office the
following week for an appointment, she didn’t think you would mind if the
patient received the prescription early.
Discussion Question:
What are the ethical-legal concerns associated with this
situation? Provide evidence to support your response.
Discussion Part Three
Due to the incident, you are concerned with office policies
and procedure. Upon investigation, you find there isn’t a policy in place to
address non-urgent patient requests for prescriptions.
Discussion Question:
What quality improvement strategies might you implement as
an APN in this practice to safeguard your role and assure patient safety?
Provide evidence to support your response.
