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

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



This discussion discusses organizational changes and ethical-legal influences in a clinical scenario at an outpatient family practice. Students will explore potential effects on patient outcomes and ethical and legal implications for healthcare team members due to illegal behaviors.  Students will develop strategies that prevent untoward outcomes that result in a 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) 

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, filing, answering patient calls, 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. She knows almost every patient in practice and has an excellent rapport with all 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 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 concerned about her cough last week and spoke to Stephanie. You do not recall discussing this patient with Stephanie or the other providers in the practice. 

Case Study Questions: 

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

    Medical assistant nurse
    1. PractitionerMedical Director
    1. 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.

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