Writer choice
35485Respond to at least two of your colleagues on two different days using one or more of the following approaches:
•Ask a probing question, substantiated with additional background information, evidence or research.
•Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
•Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
•Validate an idea with your own experience and additional research.
•Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
•Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.
WEEK 10 Discussion Post
A vital factor in nurses’ establishing a good rapport with patients, is in part through our ability to ensure and protect their personal and confidential information. It is our responsibility and obligation to maintain privacy and patient confidentiality. Prior to the new HIT coming into existence, we’ve had pre-existing confidentiality policies and procedures on our psychiatric and Alcohol & Drug units. Our patients’ admissions were kept discreet and information concerning their admissions were coded in a manner that no one knew their status. In our normal hospital computers, patients where admitted but their status was hidden as to which unit they were on. Our units and admissions remain confidential and we currently use code numbers and letters to identify outside individuals with granted access to inquire about our patients. These code numbers and letters are discussed with the patients only and they are responsible for allowing who they wish to have knowledge of their admission and/or illness and condition.
HIT has in a sense made it easier for our units. Before, we used paper charts and other employees such as file clerks and medical records keepers had access to our files. Now that we’ve adopted the new EHR system, only the psychiatric staff and physicians can access our patient’s charts. Our units are in ghost mode and exclusive access must be given for any other hospital employee, other than physicians and psychiatric staff, to access any information on our patients. When searched by name, our patients are hidden from the general hospital population.
Electronic portable devices are designed to store information until the information is deleted or destroyed. Most information deleted from a portable device is still being stored somewhere on a hard drive. Technically information is not erased, it’s only overwritten at some point. I question the use of cellphones as a means of texting and sending information to doctors outside of the medical facility. What happens if the portable device is lost or stolen? This would be considered as a breach of confidentiality. Loss of mobile devices constitutes a potential breach. In the case of a potential breach, if the provider can prove that all information on the devices is encrypted in the NIST Advanced Encryption Standard (Oatway, 2011).
One strategy our organization uses to safeguard patient information is having each patient sign a community agreement. Our patients sign a confidentiality agreement upon admission for themselves and for others that may be admitted on our units in agreeing not to discuss but to keep all information confidential concerning others on the units. We also refer to our patients in first names only on outer charts and in open conversations in unit areas that may not be secure. For example, when a group of patients are in activity or in meal areas.
An area where improvement is needed is maintaining patient confidentiality in our Emergency room after transfer. This has been an ongoing issue and has been addressed multiple times. When receiving patients from the ER, the staff are still supposed to maintain our patient confidentiality. However, there has been times when we receive calls from family, friends, and even nosy neighbors that suggest that a patient has been admitted to the psych or A&D unit. They obtain this information through the ER most times after finding out a patient has gone to the ER for whatever reason. They then call the ER inquiring about a patient. Instead of the ER staff sighting the confidentiality statement of our hospital, they automatically connect them to our units. This is not telling them that a patient is admitted to us but it is certainly suggesting it. We are then left to inform the person(s) that we cannot disclose whether a patient is admitted to our units or not. By this point, it’s somewhat suggestive that they are. One simple strategy that could address the situation is by having the ER staff tell a caller from the start that they do not have permission to give information on the patient. Upon admission, patients can list whomever they wish to disclose information to and is given their own personal code to provide to those individuals. Until then, when an unlisted person calls, we cannot confirm or deny a patient’s admission to out units.
Confidentiality of information, as an ethical issue, is primarily based on the principle of respect for autonomy. It is related to the person’s body and extensions of information related to that person. Nurses working closely with patients need to be informed and aware of individuals’ rights and sensitive to the use of these rights in order to meet patients’ needs, protect their prestige, honor and privacy while providing service and improve quality of service. Given the defensive role of nurses in the hospital and their functions falling within the scope of this role, there is a need for greater focus on patient rights in the orientation process and in-service trainings (Demirsoy & Kirimlioglu, 2016).
References
Demirsoy, N., & Kirimlioglu, N. (2016). Protection of privacy and confidentiality as a patient right: physicians’ and. Biomedical Research, 27(4), 1437-1448. Retrieved April 2017, from http://eds.b.ebscohost.com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?sid=e89c9ecd-50a3-4406-bc31-95361c86376e%40sessionmgr103&vid=1&hid=120
Oatway, D. (2011, May). Mobile devices contribute to PHI breaches. Long-Term Living: For the Continuing Care Professional, 20-23. Retrieved May 2017, from http://eds.b.ebscohost.com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?sid=5f7ca393-c2ff-486b-b725-7ba7e51a56c0%40sessionmgr104&vid=1&hid=120
second paper that needs response
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Security of Health Care Records
At my organization providers use their smartphones to receive work email, access patient charts, consult other providers, and look up diagnostic tests. Many times I have seen the patient information that comes across a provider’s phone because they have left their phone on the counter top. This is a breach of patient confidentiality. “Hospitals have experienced incidents in which doctors’ orders were posted to the wrong patient charts, and electronic drug orders were not delivered to nurses who needed to dispense them to patients” (Hoffman and Podgurski, 2011, p. 2) As our unit transitions to EPIC we will use our badges to sign in and out of the patient’s record.
This will eliminate the computer screen being left up when you walk away from a computer. This is to help with patient confidentiality, but also it will remove someone else from potentially putting information in on the wrong patient. Nurses can help through “participating in the development process of healthcare technology, the more efficient and effective nursing informatics may become” (McGonigle and Mastrian, 2012, p. 468).
Principles identified by the Bush administration to help promote security and privacy of online public health information are these eight principles as cited in Brown (2009) : (1) individual access; (2) correction; (3) openness and transparency; (4) individual choice; (5) collection, use, and disclosure limitation; (6) data quality and integrity; (7) safeguards;
and (8) accountability (p.3). These are some of the ways that nurses can help patients protect themselves against security breaches. “The more nurses participate in the development process of healthcare technology, the more efficient and effective nursing informatics may become” (McGonigle and Mastrian, 2012, p. 468).
Brown, B. (2009). Improving the Privacy and Security of Personal Health Records. Journal Of Health Care Compliance, 11(2), 39-68
Hoffman, S., & Podgurski, A. (2011). Meaningful Use and Certification of Health Information Technology: What about Safety?. Journal Of Law, Medicine & Ethics, 3977-80. doi:10.1111/j.1748-720X.2011.00572.x
McGonigle, D., & Mastrian, K. G. (2012). Nursing informatics: improving workflow and meaningful use. Nursing informatics and the foundation of knowledge (2nd ed.). Burlington, MA: Jones and Bartlett Learning
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