Peer Responses:
Due: Monday,
Length: A minimum of 150 words per post, not including references
Citations: At least one high-level scholarly reference in APA per post from within the last 5 years
Peer Post:Questions / Answer And Explanations
What concerns do you have about her current regimen, and what alternatives will you discuss and offer? What other screenings might you apply? What are your own ethical standards on this case that you might consider in addition to legal standards?
Concerns about Patient ML current regimenThe patient asked to refill her meds for 6 months, prescription drug addiction is so common. It’s not that they don’t believe in you or that they believe you’re a drug addict. If they prescribe controlled substances to persons who abuse them or sell them to others, they risk losing their medical license and facing criminal charges
alternatives:Let the patient sign a pain management agreement form or contract
pill counting
other screenings that I can apply random drug testingThis condition is frequently included in the contract since doctors want to make sure that the patient aren’t misusing the medications. They also want to make sure the patient is the only one who’s taking the drug. As a result, they test you at random and then determine how much drug is in the patient’s system.
Pill counting on a regular basis can be a valuable method for ensuring medication adherence and reducing diversion, such as selling, sharing, or giving away prescriptions.
my own ethical standards on this case it is the health care worker’s role to collaborate with the patient to better understand the symptoms and underlying causes. A healthcare worker must educate the patient on the problem and potential intervention choices, just as they must with any illness, while carefully weighing the risks and benefits of each approach. A treatment plan is created by the patient and the provider together.
Step-by-step explanation
Provide a sample of an appropriate pain contract that would suit this patient and address her specific safety concerns (cite it and attach the actual contract you found – you do not have to make your own – there are plenty online)
Patient Pain Medication Agreement And Consent
http://www.sdcms.org/Portals/18/assets/lev docs/patient_pain_agreement_english.pdf
Include your steps to ensure safe prescribing. Include the registry you will search prior to any prescribing; name the CA registry and if you are in a different state, you should name that registry also.
Step 1. Evaluate and define the patient’s issue clearly.
Step 2. Determine the therapeutic goal.
Step 3. Choose the Correct Drug Therapy
Step 4. Start therapy with the right information and nonpharmacologic treatments in mind.
Step 5. Provide information, instructions, and cautionary statements.
Step 6. Evaluate Therapy Regularly
Step 7. When prescribing, keep the cost of the drug in mind.
Step 8. Prescription Errors Can Be Reduced by Using Computers and Other Tools
Controlled Substance Utilization Review and Evaluation System (CURES) and Controlled Substance Prescriptions
If you were to keep her current list, what are the laws surrounding refills and the amounts you are allowed to dispense with the schedule II and III medications in the state of CA? In your own state?
Section 11164 of the Health and Safety Code
The prescription must be signed and dated in ink by the prescriber, and it must include the prescriber’s address and phone number, as well as the name of the ultimate user or research subject, or other contact information as determined by the Secretary of the United States Department of Health and Human Services; refill information and other information as determined by the Secretary of the United States Department of Health and Human Services. as well as the prohibited substance’s name, quantity, strength, and usage instructions.
Which medications on her list may you call into the pharmacy and which would you need a written script or electronic order? What are some elements required to include on the prescription form (paper or electronic signature) for the scheduled medications?
All of her medicines are prescription drugs (Losartan, Gabapentin, Atorvastatin, Diazepam, Norco)
Date of issue
Patient’s name and address
Clinician name, address, DEA number
Drug name
Drug strength
Dosage form
Quantity prescribed
Directions for use
Number of refills
Signature of prescriber
After you prescribe, how, when, and where would you (or your staff) go about making a report of your scheduled prescription in the state registry so that other prescribers and pharmacies could be aware?
Pharmacists and direct dispensers must disclose information on all Schedule II-IV restricted substances supplied within seven days of the dispensation.
After that, the data is entered into CURES.
The system currently provides prescription detail for an individual patient’s prescription records (Patient Activity Report, or PAR) to authorized prescribers and dispensers who have registered on the system, which includes the patient’s name, date of birth, and address; drug name, form, strength, quantity, dispensing pharmacy name, and license number;
DEA prescribes the certificate number, the prescriber’s name, the prescription number, the refill number, and the date of dispense are all included. This information can be used by a physician for a variety of purposes, including detecting a patient who may be a “doctor shopper,” evaluating medications supplied to the patient that was prescribed by other doctors and providing a complete picture of Scheduled pharmaceuticals dispensed to a patient.
In restricted states, APRN prescribers must follow a standardized procedure or protocol for furnishing schedule II and III controlled substances with a patient-specific approach. Please outline the minimum required components of a protocol. You may outline this in bullet form. Alternatively, you may find an appropriate protocol, clinical guideline, or standardized procedure from a literature search and attach it in lieu of outlining your own protocol.
https://www.mbc.ca.gov/Download/Publications/pain-guidelines.pdf
References
Guide to the Laws Governing the Practice of Medicine by …
https://www.mbc.ca.gov › Download › Documents
https://www.mbc.ca.gov/Download/Publications/pain-guidelines.pdf
Newsletter – Spring 2019 – Medical Board of California – CA.gov
https://www.mbc.ca.gov › Download › Newsletters