Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study

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:

What are the potential ethical and legal implications for each of the following practice members?
Medical assistant
Nurse Practitioner
Medical Director
Practice
What strategies would you implement to prevent further episodes of potentially illegal behavior?
What leadership qualities would you apply to effect a positive change in the practice?  Be thinking about the culture of the practice.
A scholarly resource must be used for EACH discussion question each week.

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 health care team as a result of illegal behaviors. Students will develop strategies that result in the prevention of untoward outcomes that result in positive practice culture.

Activity Learning Outcomes

Through this discussion, the student will demonstrate the ability to:

Demonstrate effective leadership styles in the management of organizational change (CO3)
Interpret various forms of ethical theories and application into practice (CO4)
Discuss practice guidelines and malpractice prevention (CO2)
Students must post a minimum of two times in each graded discussion. The two posts in each individual discussion must be on separate days. Posting twice on two different days meets the minimum requirement however for full credit, the student must post at least three substantive posts on three different days. The student must provide an initial post to each graded discussion topic posted by the course instructor. Subsequent posts, including essential responses to peers. Students are expected to submit assignments by the time they are due. Threaded discussions are not considered assignments and are not part of the late assignment policy.

Total Points Possible: 100

Requirements:

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:

What are the potential ethical and legal implications for each of the following practice members?
Medical assistant
Nurse Practitioner
Medical Director
Practice
What strategies would you implement to prevent further episodes of potentially illegal behavior?
What leadership qualities would you apply to effect a positive change in the practice?  Be thinking about the culture of the practice.
A scholarly resource must be used for EACH discussion question each week.
DISCUSSION CONTENT

Category

Points

%

Description

Potential ethical & legal implications for healthcare team members

30

30%

Provides relevant evidence of scholarly inquiry of the potential ethical and legal implications for each of the practice members. Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion.

Strategies to prevent further conflict

30

30%

Provides relevant evidence of scholarly inquiry of strategies to implement to prevent further episodes of potentially illegal behavior. Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion.

Leadership qualities to effect positive change

15

15%

Provides relevant evidence of scholarly inquiry of leadership qualities to apply to effect a positive change in the practice. Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion.

 

75

75%

Total CONTENT Points= 75 pts

DISCUSSION FORMAT

Category

Points

%

Description

Interactive Dialogue

20

20%

4 Required Elements:

Responds a minimum of two other posts to peers and/or faculty in the threaded discussion;
Responses to peer/faculty are substantive (adds importance, depth, and meaningfulness to the discussion)
Responds to all direct questions from faculty (if no question asked directly, the student responded to questions posed to the entire class)
Summarizes what was learned from the lesson, readings, and other student posts for the week. The summary could be included in one of the three minimum posts.
Grammar, Syntax, Spelling, & Punctuation

5

5%

Grammar, syntax, spelling, and punctuation are accurate.

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