Introduction
Medication administration is one of the most sensitive activities in the nursing practice since it involves legal, ethical, and professional responsibilities that seek to enhance patient safety and quality health (Alrabadi et al., 2021). This paper aims to focus on the problems regarding the range of the nurse’s competence and legal and ethical questions based on the medication administration case. The situation will be discussed by reference to NMBA standards, the Therapeutic Goods Act 1989 and other legislation and ethical codes.
Scope of Practice Issues
The scope of practice identifies activities for which registered nurses are prepared and which they are legally allowed to practice based on their experience (Wheeler et al., 2022). In Australia it plays the Nursing and Midwifery Board of Australia (NMBA). The following limitations apply to the nurses to facilitate safe practice that enhances effective delivery of patient care services (NMBA, 2023). Several scope of practice problems are illustrated in the video case of medication administration: Concerning the scope of practice the following problems can be depicted at the example of the medication administration scenario, which takes place in the video:
It is same that the nurse was asked to administer Morphine 5mg/1ml, but did not ensure that they had confirmed the patient’s identity on their own and had reviewed their medical record as well as the patient’s medication chart. This violation is a violation of the state’s Nurse Practice Act under the Five Rights of Medication Administration (Mutesasira, 2021). Subsequently, the intended medication Morphine was administered to the wrong Mr. Cunningham instead of the he intended patient. Nurses’ shift-to-shift handover was also suboptimal, and did not meet professional communication standards required for patient care (Feeley, 2023).
This action is prohibited under the state’s Nurse Practice Act which enjoins nurses from practicing beyond the bounds of their training where facets like the ‘Five Rights’ of medication administration would dictate (Mutesasira, 2021).
Legal Aspects
Laws and legislation in Australia regulate medication administration to the patient and the law that guides the action of the nurse. Under the Therapeutic Goods Act 1989 Morphine is ranked as an unlawful substance in the form of medication which can only be administered based on prescribed medical standards (Gallagher et al., 2020). This means that by giving this medication to the wrong person without proper identification you have violated this law and the nurse and the health care center can face the law. Also, the Poisons and Therapeutic Goods Act 1966 (NSW) regulates the usage and administration of medicines, which has raised the bar for documentation and identification of the patient before administering a drug (NSW, 2024).
The Therapeutic Goods Act 1989 categorises Morphine under Schedule 3 as a restricted substance whose production has to complies with set standards (Gallagher et al., 2020). Giving it to the wrong patient without identification infringes this law and expounds the nurse as well as the healthcare facility legally. The Poisons and Therapeutic Goods Act 1966 (NSW) also reinforces severe patient identification and documentation before using any drue (NSW. p. 28). The Health Practitioner Regulation National Law Act 2009 shows that the following are the roles of nurses; observe, implement, and comply with institutional policies, national laws, and safeguards for patients (Leslie et al., 2021). The omission to report also was a breach of the ACSQHC open disclosure policy, a legal requirement that would require healthcare service providers to inform patients or members of staff where a mistake has been made (Malik et al., 2021). Such failure is not only unethical, but also unlawful in most jurisdictions, which mark such actions of corporations as fraud.
Also, the nurse is not inform to the patient or any other staff of the medication error which violates the ACSQHC open disclosure that is a legal requirement. The general form of disclosure implies reporting of any mistakes made to the patient, and the failure to do so is unlawful.
Ethical Aspects
Nursing ethics goals for safe, compassionate, and person-centred care to patients and respect the code of ethics of the profession (Price, 2024). The ethical principles that can be seen in the nursing practice are beneficence, non-maleficence, autonomy, justice, and veracity according to the ICN Code of Ethics and the NMBA Code (NMBA, 2023). Their authors found that there are clear ethical dilemmas associated with Morphine administration to the wrong patent in the case that was offered.
It seems that the concept of autonomy was diminished since the patient had the right to receive full information about the medication but failed to do so. It was observed that the nurse did not explain to the patient regarding the drug being given and also the nurse did not check the identity of this patient (Rhim et al., 2021). Risky patient-care-mistake could potentially have caused severe damage to the patient if Morphine was administered to him/her with potential allergies or contraindications (Donaldson et al., 2024).
Concerning the principle of justice, the intended patient and the patient who mistakenly administered with the medication were adjudged unfairly. Such differential treatment indicated that fairness and accountability in-care model had not been honored as expected (Fernholm et al., 2020). Finally, the nurse has failed to own up to, or admit the error in the course of practicing, which is every contrary to accountability and fidelity to the practice of the profession of nursing (Tsamados et al., 2021).
In addition, the principle of justice was not considered since both those who benefited from the medication intended patients, and those who did not- faith patients were put into different categories and not treated equally as they should (Fernholm et al., 2020). The lack of responsibility towards identifying the problem and the inability to inform others regarding the issue also violates accountability and fidelity, which are basic principles in nursing values (Tsamados et al., 2021).
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Conclusion
Therefore, this case study focuses on the vital necessity of following the nursing procedures, laws, and ethical principles while providing medication. The actions of the nurse including the failure to check the patients’ information before administering Morphine to the wrong patient are considered to be in violation of the scope of practice as defined by the NMBA. Different legal concerns such as a lack of compliance with the Therapeutic Goods Act 1989 and Poisons and Therapeutic Goods Act 1966 NSW, also exemplify negligence in this regard.
References
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13 Years | (PhD) in Healthcare
