Discussion

Purpose

The purpose of this discussion is to discuss organizational changes and ethical-legal influences in a clinical scenario at an out-patient family practice. Students will explore potential effects on patient outcomes and ethical and legal implications for members of the heath care team as a result of illegal behaviors.  Students will develop strategies that result in prevention of untoward outcomes that result in a positive practice culture. 

Preparing the Discussion

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 1 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. 

Case Study Questions: 

1. What are the potential ethical and legal implications for each of the following practice members? 

· Medical assistant

· Nurse Practitioner

· Medical Director

· Practice

2. What strategies would you implement to prevent further episodes of potentially illegal behavior? 

3. What leadership qualities would you apply to effect a positive change in the practice?  Be thinking about the culture of the practice.

4. A scholarly resource must be used for EACH discussion question each week.

See attached report

A predominant theme in research and practice today is obesity, which is increasing at an alarming rate worldwide in all ages. As a future nurse practitioner:

1. How would you approach or discuss the topic of obesity and diet with your adult or geriatric patients?
2. What are the possible health consequences of obesity and what factors need to be taken into consideration when treating the obese patient who also has multiple comorbidities (e.g., hypertension, diabetes, high cholesterol)?

instructions: APA format discussion post, must have at least 3 references. a page is enough length.

Discussion Board 1.

Apply the differences between negligence and malpractice to the practice of nursing. Provide examples to illustrate your points.

Compose at least 2-3 paragraphs all in APA format with proper references.

Discussion Board 2.

Read the following article and view the video on the same case. How can this example be used as an illustration of maintaining patient safety and providing safe, effective care? Identify some of the possible barriers that nurses face when acting on what they believe to be the morally correct action in this particular case. 

For Colorado mom, story of daughter’s hospital death is key to others’ safety | Colorado Public Radio (cpr.org)

Patient Safety Advocate Carole Hemmelgarn 
Links to an external site.

https://www.youtube.com/watch?v=3SfrQnwRIjU&t=4s

Compose at least 2-3 paragraphs all in APA format with proper references.