HIPAA violation

[joe007]

Is it a HIPAA violation to give report with no identifying factors on another pt. in another room in the room of a pt. with dementia?

[KimberlyRN89, BSN, RN]

According to the law, disclosing identifying information in front of anyone who does not have a need to know for treatment or billing purposes is a violation, unless you have the express consent of the patient. Whether or not the person receiving said disclosure understands or can repeat the information is irrelevant.

Sorry to thread jack but I feel like this relates. Our manager wants us to do bedside reporting. Although the majority of our rooms are private, we do have thee semi private rooms on the unit. I feel like going inside the room and doing report while the other problems (and oftentimes, the family ) is there is breaking HIPAA.

[FurBabyMom, MSN, RN]

Sorry to thread jack but I feel like this relates. Our manager wants us to do bedside reporting. Although the majority of our rooms are private, we do have thee semi private rooms on the unit. I feel like going inside the room and doing report while the other problems (and oftentimes, the family ) is there is breaking HIPAA.

I would have no problem giving bedside report in private rooms. I would ask the patient if we have permission to discuss their admission/give report while family/etc are present. If the patient hesitates even a little, I'd kick the non-patient-in-question, non-staff folks out to give report. As for semi-private rooms? Um...no. Unless there were not multiple patients in the room, I'd suggest giving report for those beds in another area away from the room in question and simply going in the room to complete introductions/inform the patient who is assuming their care. When I worked in an inpatient care unit - the expectation of the facility was to transition to bedside report. BUT we had almost exclusively double occupancy rooms so that was um, not implemented, on our unit.

[NRSKarenRN, BSN, RN]

OCR HIPAA Privacy

December 3, 2002

INCIDENTAL USES AND DISCLOSURES

Frequently Asked Questions

\

Q: Can health care providers engage in confidential conversations with other providers

or with patients, even if there is a possibility that they could be overheard?

A: Yes. The HIPAA Privacy Rule is not intended to prohibit providers from talking to each

other and to their patients. Provisions of this Rule requiring covered entities to

implement reasonable safeguards that reflect their particular circumstances and

exempting treatment disclosures from certain requirements are intended to ensure that

providers’ primary consideration is the appropriate treatment of their patients. The

Privacy Rule recognizes that oral communications often must occur freely and quickly in

treatment settings. Thus, covered entities are free to engage in communications as

required for quick, effective, and high quality health care. The Privacy Rule also

recognizes that overheard communications in these settings may be unavoidable and

allows for these incidental disclosures.

For example, the following practices are permissible under the Privacy Rule, if reasonable

precautions are taken to minimize the chance of incidental disclosures to others who may

be nearby:

• Health care staff may orally coordinate services at hospital nursing stations.
  
• Nurses or other health care professionals may discuss a patient’s condition over the phone with the patient, a provider, or a family member.
  
• A health care professional may discuss lab test results with a patient or other provider in a joint treatment area.
  
• A physician may discuss a patients’ condition or treatment regimen in the patient’s semi-private room.
  
• Health care professionals may discuss a patient’s condition during training rounds in an academic or training institution.
  
• A pharmacist may discuss a prescription with a patient over the pharmacy counter, or with a physician or the patient over the phone.
  
  

http://www.hhs.gov/ocr/privacy/hipaa/understanding/coveredentities/incidentalu&d.pdf

[jadelpn, LPN, EMT-B]

It is not the best habit to get into to discuss patients in another patient's room. It becomes even more obvious when the supposed dementia patient repeats the conversation verbatim. Funny how that works sometimes.

In any event, if one needs to discuss information regarding a patient away from said patient, to step into a private area is much better than in another patient's room due to the fact that the patient is demented and won't repeat/remember anyways.....

Case in point: A demented person hung around the nurses station. Discussions were had on a patient that was acting out. Demented person made a beeline to patient in question and stated "you need to behave yourself, all this whining you do. The nurses know, and your butt will be kicked out of here!!" Then proceeded to do a sing-song--"you will be kickkkkedddd out of hereeeeeee and have to go liveeee with your nasty sister in Detroittttt". (the sister had been dead for 20 years, hence why patient was in the home) True story. Come to find out these two had quite a rivalry back in the day....You just never know.

Seriously, just don't do it on the assumption that the demented patient won't repeat anything anyways.

[stella789]

That bedside shift report in semi private rooms always gets me. I know it states it is "ok" to discuss but if I'm the patient and I have some potentially embarrassing thing going on...I would NOT be ok with that. I worked at a large teaching hospital and bedside shift report was a MUST. They did frequent audits on that and the white boards. In my opinion, they could have put their focus on other more important issues...

[gypsyd8]

That is hilarious