HIPAA violation or not..? - page 5

There is a huge ordeal in my clinical group. I have managed to stay out of it (thankfully I wasn't there when it happened and haven't been forced into getting involved), but was wondering what you... Read More

  1. by   olderthandirt
    It was deffinately in violation of the HIPAA act. She could have called the "in an emergency call...." But as a student, she should have checked with her supervisor and suggested that maybe the family should be called. I do not think that an expuillsion (my delete key won't work so I cannot remove errors) was necessary.
  2. by   Daytonite
    i am always amazed at these kinds of vigilante mentality threads where there has been some supposed wrong doing by someone. there is a frenzy to step up and hang the person(s) without considering all the evidence! the only evidence provided is one-sided and coming from gossip to boot! one of the things students are supposed to be learning in the nursing process is the gathering of data--from as many sources as you can find it. how amazing that this process breaks down when an emotional issue such as this is at hand.

    first of all, hipaa, the health insurance portability and accountability act of 1996, pertains to healthcare information transmitted electronically, as in over the internet, fax lines or telephone lines. it specifically has to do with information in patient's charts that is shared with insurance companies and third party payers of the patient's medical bill.

    secondly, confidentiality, which is what many of the posts are referring to and what the wrong doing talked about by the op "seemed" to have violated, is different from hipaa.

    third, we are all entitled to confidentiality in regard to any judgments made about our performance on the job or in your nursing program. yes, some states have adopted specific laws about confidentiality. in reading the beginning post to this thread it was obvious to me that there is a great deal of information that is unknown as to why the student was allowed back into the nursing program. and, that information is going to remain unknown to all of us for the protection of the student's confidentiality. is anyone other than me concerned about protecting the confidentiality rights of the student here?

    just using my common sense and experience as a manager tells me that there had to have been a very good explanation for the student's actions that prompted the school to reverse their original judgment of the student. despite the disappointment many might feel that this poor person was not crucified nearly as brutally as (s)he should have been, it is quite possible that once school officials reviewed all the information there was, in fact, no violation of hipaa or breach of confidentiality at all. has anyone considered that possibility? is anyone putting any of their critical thinking skills that they're supposed to be learning in school to work here at all?
  3. by   pagandeva2000
    Quote from daytonite
    i am always amazed at these kinds of vigilante mentality threads where there has been some supposed wrong doing by someone. there is a frenzy to step up and hang the person(s) without considering all the evidence! the only evidence provided is one-sided and coming from gossip to boot! one of the things students are supposed to be learning in the nursing process is the gathering of data--from as many sources as you can find it. how amazing that this process breaks down when an emotional issue such as this is at hand.

    first of all, hipaa, the health insurance portability and accountability act of 1996, pertains to healthcare information transmitted electronically, as in over the internet, fax lines or telephone lines. it specifically has to do with information in patient's charts that is shared with insurance companies and third party payers of the patient's medical bill.

    secondly, confidentiality, which is what many of the posts are referring to and what the wrong doing talked about by the op "seemed" to have violated, is different from hipaa.

    third, we are all entitled to confidentiality in regard to any judgments made about our performance on the job or in your nursing program. yes, some states have adopted specific laws about confidentiality. in reading the beginning post to this thread it was obvious to me that there is a great deal of information that is unknown as to why the student was allowed back into the nursing program. and, that information is going to remain unknown to all of us for the protection of the student's confidentiality. is anyone other than me concerned about protecting the confidentiality rights of the student here?

    just using my common sense and experience as a manager tells me that there had to have been a very good explanation for the student's actions that prompted the school to reverse their original judgment of the student. despite the disappointment many might feel that this poor person was not crucified nearly as brutally as (s)he should have been, it is quite possible that once school officials reviewed all the information there was, in fact, no violation of hipaa or breach of confidentiality at all. has anyone considered that possibility? is anyone putting any of their critical thinking skills that they're supposed to be learning in school to work here at all?
    i can totally agree with this statement. while i would not have called the family and informed them of the patient's whereabouts, i can easily see how this can happen. i attended a school that did not have us sign anything regarding hippa, and they were not explicit about much, from hippa to pharmacology. in fact, most of my clinical instructors were so hell bent on leaving early that most of the time, instead remaining on site for 8 hours, we would be at our location for a total of two. did we miss alot of experiences? shoot, yeah!! what i learned about hippa came from my employment at a hospital, that had us sign, not my school.

    i support the fact that they gave the student another chance. i am sure that she learned from it, and if not, then, it will show another time. too many times, people are mercilessly thrown out of nursing programs, and actually, even some of the ones that made it through and passed nclex are questionable.
  4. by   kgkarma
    Quote from RNgrad2008
    There is a huge ordeal in my clinical group. I have managed to stay out of it (thankfully I wasn't there when it happened and haven't been forced into getting involved), but was wondering what you guys thought about this.

    The week before last in clinical, one of the students went to the nurses desk, called a friend, and told them that their step-mother was in the hospital with pneumonia and it looked pretty bad. The student did this in front of 2 students, a nurse (or more?), a doctor, and the unit secretary.

    She was turned in for violating HIPAA and was told by the hospital that she was not welcome back. Our clinical instructor told her to go home. She was later notified by the department that she had been dropped from the program.

    She appealed, of course, and continued to attend class.

    Her clinical review was last Thursday and this morning she was in class for our test... so I guess she is still in..

    what are your thoughts on this?
    I can't believe this. I'm a new nursing student and my instructor taught us the first week about that being a HIPPA violation. Even if the student is still in school it doesn't mean that the hospital will let her back in.
  5. by   kgkarma
    Quote from jov
    I find it hard to believe that a hospital orientation would not include HIPAA requirements. At every clinical I have been at, HIPAA has been explained over and over again, with numerous examples, and we have signed a form to indicate we have been trained on HIPAA. I have spent the past 25 years in the medical records field and HIPAA has been in the forefront and all over every one's faces in the healthcare field for the last 5 years at least, BIG TIME. I don't see how anyone could possibly miss what HIPAA regulations are and the ramifications for violating them. It's a federal law for crying out loud.

    I would also bet that her Nursing Student Handbook at the school has a section regarding Confidentiality. Ours states: the concept of the right of individuals to privacy is taught throughout the nursing curriculum. Privacy rights are protected by maintaining confidentiality. On a routine basis, the faculty addresses the legal, moral and professional consequences of breaches of confidentiality. The profession of nursing respects the autonomy of every individual and demands the maintenance of confidentiality at all times.

    Furthermore, what about the state's Nursing Practice Act? Illinois Sec 10-45 grounds for disciplinary action include:
    (21) Willfully or negligently violating the confidentiality between nurse and patient except as required by law.

    I see no excuse.
    Not only did we have to sign something but we had to pass a HIPPA test before we were allowed to go to clinicals. If you didn't pass, you didn't go to clinicals.
  6. by   kgkarma
    Quote from slou!
    Actually, I'm going to answer part of my own question. I got just my School of Nursing Undergraduate Handbook today and I was browsing through it and I found a paragraph on HIPAA. We are required to read it and sign it, and although I have not taken any nursing classes yet, just pre-reqs, I'm sure I will learn much much more about it, like in Nursing 101, which I take next semester.

    I still have one question though.. I don't understand how if you go to a hospital, and there are visitors there, doctors and nurses are allowed to go up to them and explain the patient's status and health problems. Wouldn't that be a violation? Thanks!
    The nurses that I've come in contact with have always referred me to the doctor or to a family member. I don't ever recall a nurse giving me any personal info. about a patient.
  7. by   nursekare
    Quote from CRNASOMEDAY25
    I think kicking her out is a bit harsh.
    Question:
    Is it as harsh as having her prosecuted?


    http://www.ehcca.com/presentations/HIPAA3/malone_1.pdf

    Criminal Penalties for a Violation of 42 U.S.C. 1320d-6. Section 1320d-6(b) sets forth the maximum penalties allowable for a violation of 1320-6(a). Upon conviction, the actual sentence imposed is determined under the Federal Sentencing Guidelines. The Guidelines will be discussed in Section VIII, infra. Under 1320d-6(b), any person who violates subsection (a) shall:

    1. Be fined not more than $50,000, imprisoned not more than one year, or both;
    2. If the offense is committed under false pretenses,1 be fined not more than$100,000, imprisoned not more than 5 years, or both;
    3. If the offense is committed with the intent to sell, transfer, or use individually identifiable health information for commercial advantage, personal gain or malicious harm, be fined not more than $250,000, imprisoned not more than 10 years, or both.



    The key is did she knowingly, as an inexperienced student, knowingly violate the law as stated in the legislation or was it a case of not doing much critical thinking prior to acting upon the information her clinical experience afforded her.

    IMHO, I think she got off easy.

    Unitl the law is actively enforced, nurses nor students will understand the full gavity of choosing to reveal protected, private, patient information to those other than other patient care providers or the patient.

    Waivers should be provided in all patient care areas for the staff to obtain written permission to reveal medical information and to whom this info may be revealed.
  8. by   dauschundlover
    Gee from the majority of responses getting kicked out of the hospital was way to lenient she should have been tarred and feathered. Look, none of us know the circumstances and I wonder if the event was truly investigated. Did the patient give the student permission to notify the stepdaughter? Yes HIPPA was violated but unless every patient throughtout the country is in a private room HIPPA is violated every day in every hospital setting. Curtains do not provide a sound barrier. Interviewing a patient in ear shot of anyone else not involved in that patients care is a violation of HIPPA. I worked in an endoscopy unit and every day I admitted someone for a test I was in violation of HIPPA. Patients sat next to each other during the admission process and none of them to my knowledge was deaf. They were privvy to all that was discussed. Altought this is an example of a blatant HIPPA violation did anyone take the time to talk with this student to find out her side? Gee I bet if she was a med student she wouldn't have been banned from the hospital. And as pointed out by working under the license of her nursing instructor the nursing instructor should have been held just as accountable for all of those reaching for the jugular.
  9. by   nursekare
    Quote from 25yearsofnursing
    Gee from the majority of responses getting kicked out of the hospital was way to lenient she should have been tarred and feathered. Look, none of us know the circumstances and I wonder if the event was truly investigated. Did the patient give the student permission to notify the stepdaughter? Yes HIPPA was violated but unless every patient throughtout the country is in a private room HIPPA is violated every day in every hospital setting. Curtains do not provide a sound barrier. Interviewing a patient in ear shot of anyone else not involved in that patients care is a violation of HIPPA. I worked in an endoscopy unit and every day I admitted someone for a test I was in violation of HIPPA. Patients sat next to each other during the admission process and none of them to my knowledge was deaf. They were privvy to all that was discussed. Altought this is an example of a blatant HIPPA violation did anyone take the time to talk with this student to find out her side? Gee I bet if she was a med student she wouldn't have been banned from the hospital. And as pointed out by working under the license of her nursing instructor the nursing instructor should have been held just as accountable for all of those reaching for the jugular.
    So true, no one knows the actual circumstance. It is somewhat of a hypothetical situation as neither the name of the student, the school, the patient name, the instructors name, the name of the hospital, nor the name of the relative called have all been omitted from the scenario.

    It is a fine teaching tool, however, for those of us in healthcare to instruct us on the need to keep patient info between care providers and those to whom the patient has given written permission.

    Furthermore, if the law is violated with such impunity, maybe it should be repealed or enforced.
  10. by   jov
    Quote from daytonite
    first of all, hipaa, the health insurance portability and accountability act of 1996, pertains to healthcare information transmitted electronically, as in over the internet, fax lines or telephone lines. it specifically has to do with information in patient's charts that is shared with insurance companies and third party payers of the patient's medical bill.

    secondly, confidentiality...is different from hipaa.
    i disagree with these statements.

    hipaa covers portability of health insurance. it also encourages electronic medical recordkeeping. because electronic healthcare records present a new opportunity for erosion of patient privacy, congess established accountability for protecting privacy of patient health information. all of this is covered under hipaa. specifically, "the hipaa privacy rule for the first time created national standards to protect individuals' medical records and other personal health information." daytonite may have concluded that hipaa pertained only to protected health information transmitted electronically because the privacy rule part of hipaa came about because of the push for electronic health care records.

    there is an excellent web site at united states department of health and human services. http://healthprivacy.answers.hhs.gov...i=&p_topview=1


    faq's include:
    may a hospital or other covered entity notify a patient's family member or other person that the patient is at their facility?
    can health care providers have confidential conversations, even if they might be overheard?
    may physicians offices use patient sign-in sheets or call out the names of their patients in their waiting rooms?

    careful reading at this site will dispel many of the myths roaming this thread...
  11. by   pagandeva2000
    Quote from 25yearsofnursing
    Gee from the majority of responses getting kicked out of the hospital was way to lenient she should have been tarred and feathered. Look, none of us know the circumstances and I wonder if the event was truly investigated. Did the patient give the student permission to notify the stepdaughter? Yes HIPPA was violated but unless every patient throughtout the country is in a private room HIPPA is violated every day in every hospital setting. Curtains do not provide a sound barrier. Interviewing a patient in ear shot of anyone else not involved in that patients care is a violation of HIPPA. I worked in an endoscopy unit and every day I admitted someone for a test I was in violation of HIPPA. Patients sat next to each other during the admission process and none of them to my knowledge was deaf. They were privvy to all that was discussed. Altought this is an example of a blatant HIPPA violation did anyone take the time to talk with this student to find out her side? Gee I bet if she was a med student she wouldn't have been banned from the hospital. And as pointed out by working under the license of her nursing instructor the nursing instructor should have been held just as accountable for all of those reaching for the jugular.
    You are dead right...HIPPA is essentially broken every day, and in many cases, it is because of the administration not supporting the needs that nurses have to create a therapeutic environment. I work in a cardiac clinic as an LPN, and while the providers have almost all of the exam rooms, we nurses only have one exam room to do vital signs, do EKG's, give injections and discharge people from. We have an endocrine clinic in the morning, which spills over into cardiac in the afternoon, with only a one hour window between the two clinics. Therefore, we are doing vital signs with cardiac while sending home endocrine patients. Also, because of the lack of space, I have given injections in the clean utility room and had to block the door with chairs so that the patient is not accidently exposed. When the cardiologists arrive and do not at least see 8 charts ready for them, they are calling nursing administration to complain, so, we have to pull a curtain between the patient receiving an EKG and the patient having vital signs done, and as you mentioned, curtains are not sound proof. We have physicians that will walk into the one room we have, and pull up information on our computer on one patient while another one is being discharged, and the doctor will question me about this case, saying the person's name, diagnosis and all. I worked in this same clinic as a CNA before I became a nurse, so, I am aware that nursing has fought hard to try to create a more therapeutic and private atmosphere for our patients, but this has fallen on deaf ears thus far.

    Personally, based on the information the the original poster stated, it may sound like a HIPPA violation, and I would not have done this, however, I am glad to see that she was not thrown out of the program because it is true, we don't know all of the circumstances, and I also know from my personal experience, that not all schools (mine is one of them), that was not explicit in explaining HIPPA nor did they have us sign any contract telling us that we were committed to honoring it. I knew about HIPPA because I already worked in a hospital. Had I not, things may have been different.
  12. by   pagandeva2000
    Quote from nursekare
    So true, no one knows the actual circumstance. It is somewhat of a hypothetical situation as neither the name of the student, the school, the patient name, the instructors name, the name of the hospital, nor the name of the relative called have all been omitted from the scenario.

    It is a fine teaching tool, however, for those of us in healthcare to instruct us on the need to keep patient info between care providers and those to whom the patient has given written permission.

    Furthermore, if the law is violated with such impunity, maybe it should be repealed or enforced.
    That is true, we are only hearing one side of the situation. What I try and be careful of is being completely judgemental in situations with nursing, because we never know if we may be inadvertantly placed in an odd situation ourselves. And, bottom line, I can agree with you. I appreciate this thread as well as many other ones because it IS a teaching tool for us to proceed with caution.
  13. by   kukukajoo
    I grew up in a city in New Hampshire- fairly small to national standards but the local paper used to have a community section that listed hospital admissions and discharges. I remember this practice through the 70's and into the 80's- not sure when exactly it stopped. They would put what they were in for sometimes too. "Lennie Patient was admitted to Local Hospital on 9/18/76 for a gallbladder surgery" "Mrs. X. was admitted for complications related to her fourth pregnancy"

    Anyone else remember stuff like that?

    But... when I had my kids in 1987 I had to sign a permission form for them to put the birth announcement in the paper.

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