Week 2 Organizational Change and Ethical

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University of Nairobi *

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GPR 209

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Nursing

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Nov 24, 2024

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Week 2 Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study 1. What are the potential ethical and legal implications for each of the following practice members? o Medical assistant Cross-trained medical assistants (MAs) can only handle administrative and clinical tasks. Vital signs monitoring, EKGs (if trained), vaccinations (if taught), and charting patient history and medicines are all that are required clinically (Janett & Yeracaris, 2020). It is outside of Stephanie, the medical assistant's area of practice, for her to make diagnoses or write prescriptions. By doing this, she has created a potentially dangerous situation for her patient and herself. Medical assistants (MAs) are responsible for practicing nonmaleficence while caring for their patients. By giving Mrs. Smith amoxicillin, Stephanie went against that. Mrs. Smith may have been harmed or killed by the drug, and Stephanie has the training and expertise to provide an accurate assessment, diagnosis, or treatment plan. In addition, Stephanie fraudulently provided an electronic signature for the prescription while using a license and prescriptive authority number that did not belong to her. She may face disciplinary action such as dismissal from her job, suspension or revocation of her license, monetary penalties, or even jail time due to her acts. o Nurse Practitioner Before prescribing a drug, the nurse practitioner (NP) must examine and diagnose the patient. The inappropriate drug being prescribed might have been

harmful and injured the patient. Additionally, since the MA could falsely prescribe a prescription without the NP's awareness, the NP needed to safeguard her credentials. The NP's responsible for locking or logging out of her computer while it is not in use. The NP could be held accountable for wrongdoing and suffer moral and legal penalties. Additionally, when providing treatment, the NP failed to treat the patient with beneficence and non- maleficence. Since the MA utilized the NP's name and license during the telehealth encounter, the NP may experience consequences. Even while telemedicine has benefited patients and clinicians, in situations like these, the possibility of security breaches is a drawback since provider credentials may be taken, and patient data could also be in danger (Chike-Harris et al., 2021). The NP may be penalized, have their license suspended or revoked, lose their right to prescribe medications or have their work terminated for malpractice. o Medical Director The medical director did not fulfill his obligation when informing personnel of their privileges and restrictions. They also did not keep an eye on the practice or give the staff he was in charge of enough control. The medical director's job is to set up guidelines for what to do when a patient calls to report symptoms and if the MA answers the call (Rutledge et al., 2021). Even though Stephanie was in charge of the clinic's paperwork, she should not have had unfettered access to the facility. Staff members should have access commensurate with their duties. Since the NP needs to be overseen by a doctor and the medicine given under that NP was not done correctly, it could be considered theft. Since

the MA has worked for the medical director for so long, there may be ethical questions about how to treat her. The medical director must decide whether to fire Stephanie or give her a warning and more training. Since the medical director oversees the NP's licensure, they may be held guilty of malpractice if Mrs. Smith were injured. o Practice The clinic must take precautions to prevent a repeat of this kind of incident. To prevent the practice's morale from being completely shattered, an ethical problem will arise. To address this, management must take action against the responsible MA, such as terminating her job or taking other disciplinary measures, to tell the rest of the staff that such behavior will not be permitted and that patient safety and security violations are treated seriously. The office will also have to retrain the rest of its employees and set clear boundaries for the roles of each employee. In addition, the clinic must ensure each employee has the level of access they need to avoid any similar security lapses. The clinic will have legal ramifications due to its duty to report the incident to the proper authorities. The practice might be fined or shut down if there are enough complaints or similar incidents (Shah et al., 2021). Insurance and Medicare/Medicaid contracts for the practice might also be terminated. 2. What strategies would you implement to prevent further episodes of potentially illegal behavior? Staff training is required to ensure that all team members know their boundaries and that such unlawful activity does not recur. Assessing employee access to patient

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records and credentials is also important to eliminate potential abuse. In addition, employees must be taught to safeguard their passwords and other access data to prevent misuse. Internal employee incompetence or misuse is often cited as the primary reason for security lapses (Li et al., 2021). It was shown that moral convictions about a given scenario are the primary driver of security breaches. Not only should Stephanie be told she was wrong for what she did, but she must also explain why she justified it in her mind. Further education may be offered by evaluating her thinking process and explaining to patients that staff members may have an excellent connection with them. However, they are still bound by procedure and cannot behave or do things outside their practice area. 3. What leadership qualities would you apply to effect a positive change in the practice? Be thinking about the culture of the practice. To maintain a productive, trustworthy, and safe work environment, I will apply a range of leadership skills in my role as a nurse practitioner. I will only assign work to employees if it is within their skill set and responsibilities. Staff members must have high levels of integrity so that they feel comfortable reporting their own mistakes or pointing out the mistakes of others. I will also provide easy access to me so that employees may bring up any concerns or questions. When employees understand what is expected of them, it helps to create a more positive work atmosphere. Successful leaders must communicate effectively with their team (Heinen et al., 2019). Leadership skills with a dual emphasis on patients and the organization are essential for NPs. Safe patient-centered treatment that includes patient education and advocacy is essential. The NP should encourage teamwork, good communication, mentoring and coaching of other

employees, using evidence-based procedures, and setting a good example across the business. References Chike-Harris, K. E., Garber, K., & Derouin, A. (2021). Telehealth educational resources for graduate nurse faculty. Nurse Educator , 46 (5), 295. https://doi.org/10.1097%2FNNE.0000000000001055 Heinen, M., van Oostveen, C., Peters, J., Vermeulen, H., & Huis, A. (2019). An integrative review of leadership competencies and attributes in advanced nursing practice. Journal of advanced nursing , 75 (11), 2378-2392. https://doi.org/10.1111/jan.14092 Janett, R. S., & Yeracaris, P. P. (2020). Electronic Medical Records in the American Health System: challenges and lessons learned. Ciencia & saude coletiva , 25 , 1293-1304. https://doi.org/10.1590/1413-81232020254.28922019 c H., Luo, X., & Chen, Y. (2021). Understanding Information Security Policy Violation from a Situational Action Perspective. Journal of the Association for Information Systems, 22(3). https://doi.org/10.17705/1jais.00678 Rutledge, C. M., O'Rourke, J., Mason, A. M., Chike-Harris, K., Behnke, L., Melhado, L., ... & Gustin, T. (2021). Telehealth competencies for nursing education and practice: The four P's of telehealth. Nurse educator , 46 (5), 300. https://doi.org/10.1097%2FNNE.0000000000000988 Shah, M. K., Gandrakota, N., Cimiotti, J. P., Ghose, N., Moore, M., & Ali, M. K. (2021). Prevalence of and factors associated with nurse burnout in the US. JAMA network open , 4 (2), e2036469-e2036469. doi:10.1001/jamanetworkopen.2020.36469

Week 2 Organizational Change and Ethical

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