Are we not allowed to discuss patient cases at all?

[ChristyRN2009]

Even if we speak in generalities and don't disclose locations, names, dates, etc? Really? I don't understand but I've seen admonitions on a couple of threads lately that I saw no real violations on. I understand being cautious but I use these threads to sharpen my thinking and learn. I hope that this doesn't mean in the future those discussions will stop.

[caliotter3]

There is a way to talk about something and a way not to discuss it. I always tell my patients that when I am using an example during my teaching, that I will jumble up information so that nothing is identifiable. I am the only one aware of the "montages" that I put together. Any doubt, I don't bring it up at all.

[JavaMama98]

I haven't looked up your posts or anything butI do know that sometimes people are quick to yell "That's HIPPA!" without even knowing exactly what HIPPA covers and in some cases what HIPPA even stands for. If you are speaking generally, without any identifying information, I don't see the issue.

From the Health and Human Services website: http://www.hhs.gov/ocr/privacy/

Health Information Privacy

The Office for Civil Rights enforces the HIPAA Privacy Rule, which protects the privacy of individually identifiable health information; the HIPAA Security Rule, which sets national standards for the security of electronic protected health information; and the confidentiality provisions of the Patient Safety Rule, which protect identifiable information being used to analyze patient safety events and improve patient safety.

Hope this helps.

[CASTLEGATES]

The rule is if you can identify a patient by the poster's location and their condition and specifics. For example if I'm the only one in the county with a knife in my head, someone posts about it here, gotchya!

Make it unidentifiable. Mix up location, say it's a case in hawaii, change male to female and add one and subtract one diagnosis. Say you read about a case that...anything to keep someone from being identified by their condition. Suits have occurred from diagnosis talk in certain localities (the famous elevator...talking about the xxx case when a family member is in there...or reading here...). They lost their licenses and the hospital was sued and lost. No names were mentioned.

[HyperTension]

My opinion only.....

Use common sense. If your discussing something rather graphic / unusual, be very aware of the environment around you, and to who you are talking too. Heck, just do that anyways'. It has a tendency to keep things much simpler-er-er for all those involved.

You can present anything and be fairly descriptive.... However making it "personal" (with regards to that patient / family, or anything that can lead back to the patient) is a no-no.

I'm sure others can get far more specific with regards to HIPAA, and I'll leave that to people far more tolerant to that stuff than I.

[JOSEPH-EVER]

of course we may not be allowed but this dependes on whom your discusing with and your environment.if your talking to afellow medical work i think that is ok and this helps to plan for the pateint and even the student nurse will learn about that case, if done in right place and time.

[cjcsoon2bnp, MSN, RN, NP]

You have to make sure that when your discussing cases it is in the appropriate setting and done in a way that makes it not possible for others to identify the patient of whom you are speaking about. You should not be discussing patients at a cocktail party or when your just out-on-the-town as conversational ice breakers, we discuss cases with other health care professionals to serve as teaching tools to improve our practice. That being said, we need to make sure that you change critical details about the patient/case in question to make sure that others can not identify the patient. This may include changing the age, gender and some other critical aspects of the specific case to protect the patient's identity. Its not always easy but its a necessary to protect the privacy of our patients.

!Chris

[animal1993]

I have been wondering the same thing. Also, after visiting my grandma in the hospital over the weekend, I started wondering about another aspect of HIPAA. How do you avoid a violation when it comes to having more than one patient in a room? I mean, how can the medical staff have any kind of consult with a patient, without the other patient being able to hear what is being said about that patient's condition? (I'm still a nursing student, so I admit that I don't know a lot about how hospitals deal with this.)

[classicdame, MSN, EdD]

the more you say the more risk you are taking. For instance, if you say "how would you reply to a schizo patient that his IV pump is not talking to him?" is different than, "I had a 29 year old guy at "X" hospital yesterday who was diagnosed with Schizophrenia and was in for pneumonia. He had an IV-------".

Stay as generic as possible. If I had a 29 year old relative with that dx in that hospital I would suspect you were talking about him.

[Shenanigans, RN]

I think its important, and cathartic to discuss certain patients, though its gotta be done with respect to their privacy, of course. A lecturer was telling me once how she overheard a conversation in teh supermarket where two nurses were discusing a patient and using names and conditions!! I've even had a friend start talking to me about "Mr So and So" on a full pubic bus! I changed the subject really quickly and then told her later to just be careful with naming.

If I'm out in public and run into another collegue and I haven't been at work and I want to know how a patient is I just "how is room six?" If I use a patient's story to scare people off smoking I don't even give a gender, I just say something like "some patient smoked up a storm and now has a trache, you dont' want a trache".

I work now in a well known unit that cares for people with a needs for specalised care. There's often a lot of pubicity around those people, in fact, I say nothing about anything now to people outside my work. I used to be able to just say "Oh, some person fell down some stairs at home and broke their hip", which is so common it could be anyone, but now I can't say anything about the patients on the unit because it could have been in the media, and if someone asks me "Did you look after that person who got in that particular incident" i just say "can't tell you that".

[MassED, BSN, RN]

Even if we speak in generalities and don't disclose locations, names, dates, etc? Really? I don't understand but I've seen admonitions on a couple of threads lately that I saw no real violations on. I understand being cautious but I use these threads to sharpen my thinking and learn. I hope that this doesn't mean in the future those discussions will stop.

um, no, why would any of these be considered violations of HIPAA? For reasons you state, they are not.

[MassED, BSN, RN]

I have been wondering the same thing. Also, after visiting my grandma in the hospital over the weekend, I started wondering about another aspect of HIPAA. How do you avoid a violation when it comes to having more than one patient in a room? I mean, how can the medical staff have any kind of consult with a patient, without the other patient being able to hear what is being said about that patient's condition? (I'm still a nursing student, so I admit that I don't know a lot about how hospitals deal with this.)

they don't handle it. In ER's, patients know what's going on with other patients, thanks to our hallway patients. Or them being RIGHT in front of the nurse's station, so they hear the EMS report on that patient that just came in. Should there ever be a solution to that, then perhaps HIPAA could really really be taken seriously. Seriously.