I am a nursery RN and I recently ran into a question regarding HIPPA at my job. Again, I am a nursery RN. I attend every single delivery, lady partsl and cesarean. In order to obtain necessary information pertinent to my job (i.e. GBS status, HIV status, blood type, Rubella, gestational age, and other maternal history, std status, etc.) it is necessary for me to get into the expecting mother's chart. I recently had an l&d nurse question me as to why I was in her patient's chart who was listed as an observation patient in l&d. I responded by stating I (as well as every other nursery nurse) have a potential patient every time she has a patient, so in order to gather necessary information I have to access the mother's chart. The l&d nurse repeatedly stated that she has known other nurses at previous jobs who have been reprimanded for getting in chart's of individuals whom they are not taking care of. My response again was that I only access the mother's chart to gather information which pertains to the care of the baby (who would be my patient upon delivery). Does anyone have any input on this? I plan to speak with my manager about this, but I feel she either needs to be educated or the nursery nurses need to be given alternative ways of gaining the necessary information. I was caught off guard that this would even be considered a breach in HIPPA (which I still don't believe it is), and even more caught off guard that a nurse whom I work side by side with daily would even be questioning this. Any input would be greatly appreciated! Thank you!

Hmm, this is an interesting situation. Accessing a medical record to obtain information necessary to do your job is absolutely not a HIPAA violation. But are these observation patients in active labor and likely to deliver on your shift? I imagine things might get tricky if you're in the habit of looking up every patient in L&D just in case” you get called to the delivery at some point during your shift. Just like I couldn't look up every patient on my unit just in case” I get reassigned or asked to cover someone for lunch, you probably shouldn't look up a patient until you've been notified that you need to attend a delivery. I'd discuss this with your hospital's Compliance Officer and see what they recommend.

HIPAA works under a "need to know" principle. You are authorized to review the chart to the extent you need to know.

We just went through a somewhat similar situation and had one person lose their job.

Our ER calls up to our floor to secure a bed for an upcoming patient. Our HUC would then go into the e-chart to get ready for the patient, make their chart, follow up with any imaging or testing that might not be completed in the ER etc.

There were times that these patients ended up either going to a different floor or discharging so when our HIPAA officer started reviewing they decided this HUC shouldn't have been accessing the chart. All of us nurses on the floor loved how organized and prepared she was, but that wasn't the point.

I know this isn't quite the same scenario as yours, but we were all surprised about this ruling too.