Communication is a key skill that we learn at a very young age. It involves the exchange of information between two or more parties. It helps us express our feelings and emotions and enhances comprehension about a person’s overall health state. Although communication is used by everyone, it is crucial to health care field. Doctor’s, nurses’, surgeons, and other health care professionals need to communicate important patient information in order to enhance quality of care. With that being said, they cannot simply send a text message or an email as we would in our everyday lives. There must be rules and regulations that monitor and protect a patients’ personal data, including how, when and what kind of information can be shared among different platforms.
What is HIPPA?
As defined by Gale Encyclopedia of Nursing and Allied Health, “The Health Insurance Accountability and Portability Act (HIPAA) helps to protect the privacy of patients by giving them certain rights over the use of their medical information, and providing limitations on who may have access to this information.” (Cataldo & Granger, 2013) HIPAA also has regulations in effect that make sure confidential records stay secure. The Health Insurance Portability and Accountability Act of 1996 was signed by President Bill Clinton and intended to help workers who could not change their jobs because their family members had serious pre-existing health problems. HIPAA requires employer-sponsored insurance plans to accept workers from other plans without denying coverage based on preexisting condition clauses. (Stebnicki, 2015) It also allows patients to view their medical records online, giving them control to view how their personal health information is used.
How it affects Nursing?
According to Gallup’s December 3-12 polls, Nurses were the most trusted profession for 17 years in a row, outranking Doctors by 17% (Brenan, 2018.) It is no doubt that patient privacy is key to this professions’ success. Subjective data is essential for developing nursing diagnoses and establishing rapport with a patient. However, if a nurse does not guarantee confidentiality, the patient may not disclose all of the information needed to continue his or her care. Nurses are held at an all-time high standard to protect the privacy of their patients, and only disclose information relevant and necessary to their care. Doing so builds trust in the nurse-patient relationship.
What happens if it is violated?
A breach in the privacy of a patient can have very serious consequences including monetary penalties, loss of a nursing license, employment termination, prison time, and now, the exposure of a new cause of action a lawsuit. (De Simone, 2019) Nursing students are also held accountable for protecting patient health information. There are many factors that surround a HIPAA violation by a nursing student, such as the case of a senior nursing student who was assigned during clinical to a hospital where she worked for as a Certified Nurse’s Assistant. She was instructed to prepare a presentation on how the patient’s family dynamics affect the nursing students’ ability to care for the patient. She had only 2 weeks to prepare her material, meanwhile she was working night shifts as a CNA. During her working shifts, a covering preceptor advised her that there was a patient whom would be perfect for her needs since the patient had “complicated family dynamics, complex medical history, prolonged length of stay, and high profile nature of the case.” (Caldwell, H. Cannon, A. 2016) The student and preceptor also came to an agreement that the student had limited options since she was working night shifts. The student gave the report on the chosen patient in front of other senior nursing students, and representatives from the facility’s education department. That same day, the Director of Clinical Education from the facility called the Clinical Placement Coordinator from the school to inform that the senior student had been terminated from the practicum experience due to a HIPAA violation. It was also said by the Director of Education, who attended the student presentation, that the student was unprofessional in her approach on speaking about the patient’s situation, that she had shared Protected Health Information about the patient, and made comments regarding the care that the nurses had given the patient, often blaming them on the complications of the case. The Director said she was “offended” by the manner in which the material was presented. It was also argued that before the nursing student was given the assignment, the student and other employees were instructed to not share any of this patient’s information due to current litigations with the hospital. Even though the student did not include the patients name, medical record number or room number, her report contained enough identifiable ques to connect the patient to the case. The student argued that her report was given in the same fashion as her CNA hand-off reports are given and did not understand why she was being accused. Nursing students are held at the standard as licensed nurses to protect patient privacy, therefore, it is imperative that the nursing educator be competent in HIPAA compliance in order to prevent these preventable mistakes. After careful review of nursing education policy for the school, the student was disciplined by written or verbal reprimand, she received a failing grade for all her senior practicum course and was suspended for one term. After returning from suspension and without instruction, wrote a letter of apology to the Director of Education and Human Resources Department. Within 30 days of the incident the hospital allowed her to return as a CNA and she did continue her career and eventually passed her NCLEX-RN.
Protecting a patients’ privacy is extremely important because it helps establish rapport between patient and provider. A requirement by HIPAA is that a patient must receive a Notice of Privacy Practices in which “Individuals must be informed through a written notice of the privacy practices that are used by their health care providers and health plans, as well as their privacy rights regarding their protected health information.” (Stebnicki (2015.) When a patient knows that their health information will be kept private, they feel safer in discussing valuable symptoms, diseases and past medical history without fear that their PHI (Protected Health Information) will be wrongfully exposed. Nurses, nursing students, nursing faculty, nursing coordinators also have a legal and ethical oath to protect patient information that is use for educational purposes. Protecting the patient’s health information aids in having more personalized care during treatment.
- Brenan, M. / Gallup, Inc. (2018) Nurses Again Outpace Other Professions for Honesty, Ethics. Retrieved from https://news.gallup.com/poll/245597/nurses-again-outpace-professions-honesty-ethics.aspx
- Caldwell, H., & Cannon, A. (July 20, 2016). HIPAA violations among nursing students: Teachable moment or terminal mistake-A case study. Journal of Nursing Education and Practice, volume 6 (issue number 12), pp 1-8. Doi: https://doi.org/10.5430/jnep.v6n12p41
- De Simone, D. M. (2019). Data Breaches Are Not Just Information Technology Worries! Pediatric Nursing, 45(2), 59–62. Retrieved from http://search.ebscohost.com.lscsproxy2.lonestar.edu/login.aspx?direct=true&AuthType=ip,cpid&custid=s1088435&db=a9h&AN=136004039&site=ehost-list
- Granger, J. I., & Cataldo, L. J. (2013). HIPAA. In Gale (Ed.), The Gale encyclopedia of nursing and allied health (3rd ed.). Farmington, MI: Gale. Retrieved from http://lscsproxy.lonestar.edu/login?url=https://search.credoreference.com/content/entry/galegnaah/hipaa/0?institutionId=5037
- Stebnicki, M. (2015.) A synopsis of the health insurance portability and accountability act and the affordable care act. The professional counselor's desk reference (2nd ed.) Retrieved from http://lscsproxy.lonestar.edu/login?url=https://search.credoreference.com/content/entry/sppcd/a_synopsis_of_the_health_insurance_portability_and_accountability_act_and_the_affordable_care_act/0?institutionId=5037