Bedside Reporting: HIPPA Violation?

[rnccf2007, BSN, RN]

Hi Everyone:

A trend that comes and goes (I am seeing a new resurgence) is bedside reporting. I am on the fence with this practice (leaning towards don't agree). Let me tell you why. At this time, I work at two different hospitals on tele floors with semi-private rooms (two patients per room) and one with private rooms. The tele units with semi-private rooms at both hospitals are now initiating bedside reporting. We are required to give full report at the bedside. This includes ALL of the shift report.... the patient's condition, past medical history, level of function, etc. Personally, I think that this is a HIPPA violation as well as a dignity issue. You can pull the curtains...but the other patient hears (in addition to any family members or visitors). I was trying to write this and combine dignity and HIPPA issues related to this practice, but my post would be too long. As far as HIPPA (and dignity), I brought this hypothetical question up at work the other morning..."What happens if Johnny A (and/or his family or visitors) find out that Johnny B is Hep C and HIV positive after hearing bedside report? What happens if this information is spread to others in the community...it can easily happen! I was looked at as if I had grown two heads.

I would like to hear what other nurses think about bedside reporting and their experiences. Thank you.

[ArmaniX, MSN, APRN]

Is it feasible to initiate a "no visitor" policy between 6-8? Allowing for report to be given and maintain privacy. The double occupancy beds is a tricky thing. When I use to have to deal with semi-private I would do report at the door and then we would go in and introduce and check things quickly.

[T-Bird78]

*HIPAA--Health Insurance Portability and Accountability Act of 1996.

[klone, MSN, RN]

Per HIPAA and the AHRQ, bedside reporting in a semi-private room does not violate privacy laws. It's considered "incidental disclosure."

See 45 CFR 164.530©(2)

[rnccf2007, BSN, RN]

Lol, sorry for the typo!

[K+MgSO4, BSN]

Things like HIV status should be on your handover sheet, medical staff round and have no issue discussing pt status in a shared room. Sensitive issues should be dealt with in a sensitive manner but seriously is the pt room mate going to be concerned about the status of his IV cannula?

[rnccf2007, BSN, RN]

'Is it feasible to initiate a "no visitor" policy between 6-8? Allowing for report to be given and maintain privacy. The double occupancy beds is a tricky thing. When I use to have to deal with semi-private I would do report at the door and then we would go in and introduce and check things quickly."

Thank you for your comment. I think that a "no visitor policy" between shift change would be great. Unfortunately, with the open visitation policies that seem to exist in may hospitals today, this may be a challenge. Also, just to clarify, we are expected to give report directly at the bedside (we are not just quickly checking things and introducing the on-coming nurse to the patient, which is a practice that I totally agree with r/t continuity of patient care)...while the Nurse Manager or members of Quality Control listen at the doorway.

"Things like HIV status should be on your handover sheet, medical staff round and have no issue discussing pt status in a shared room. Sensitive issues should be dealt with in a sensitive manner but seriously is the pt room mate going to be concerned about the status of his IV cannula?"

[COLOR=#000000]Another clarification. The hand-off sheet is completed at the bedside by the on-coming nurse as you give report. We are not talking about the status of an IV line! I guess that bedside reporting can be a good thing if it is done correctly. If not, I see some major issues occurring in the future. And...just because something is legal...it does not make it ethical.[/COLOR]

[klone, MSN, RN]

And...just because something is legal...it does not make it ethical.[/COLOR][/font]

Okay, but you didn't ask about ethics. You asked if it's a HIPPA (sic) violation. It is not. (It's HIPAA)

[SubSippi]

So far it's been my experience that some idiot in charge will decide something like this is important, jump up everyone's butts for a while, and then forget about it and move on to their next thing.

It'll either fizzle out, or people will just start doing "bedside" report outside the room and then walking in together for a second.

[KelRN215, BSN, RN]

So far it's been my experience that some idiot in charge will decide something like this is important, jump up everyone's butts for a while, and then forget about it and move on to their next thing.

It'll either fizzle out, or people will just start doing "bedside" report outside the room and then walking in together for a second.

Hahaha that's exactly how it happened in my hospital. To the point that the leadership team stayed late or came in on weekends to micromanage staff and ensure that we did it. Then they moved on to med scanning or some other stupid thing and forgot all about it.

[rnccf2007, BSN, RN]

Oh for goodness sakes. How many times does my typo of HIPAA have to be replayed? Unfortunately, snideness seems to be too common in nursing. All that I asked for in my original post was what other nurses think of bedside reporting and/or their experiences with it. Thank you ArmaniX, SubSippi, and KelRN215---for your comments---and sorry for any typos!

[klone, MSN, RN]

I apologize, I did not read the other responses closely and did not realize it was already addressed. It wasn't meant to be interpreted as snide, but merely a clarification, as this is a commonly misspelled acronym amongst many people, including many healthcare professionals, unfortunately.