Breach of patient confidentiality?

[chelleshocked]

Hello all,

I am a prenursing student.

I have a friend who is seperated from her husband currently. She is not divorced yet, but her husband is living with his pregnant girlfriend.

Here is my question. The pregnant girlfriend's mother, who lives in a completely different city, has accessed my friend's daughter's shot record. My friend's daughter is about to start kindergarten. The girlfriend's mother is a school nurse in a different city. If you are familiar with Texas, the mother (my friend) lives in Fort Worth, and the person who looked up the child's shot record lives in Big Spring. There was no reason for this school nurse to look up my friend's daughters shot record. The child will not be attending that school. We don't even know this woman's name. All we know is my friend went to her husband's house to pick up her daughter a few days ago, and he told her that the school nurse (pregnant girlfriend's mother) looked up her shot record and informed them that she needs 3 shots before school starts.

My opinion is, this is a breach of patient confidentiality, because the school nurse has no direct contact with or need to know basis to access this record.

What is your opinion, and is there anything that my friend can do? She is quite upset about the whole thing.

Thanks for any/all advice!

Chelle

[GrumpyRN63, ADN, RN]

I don't think it would be very hard to get her name....

[bagladyrn, RN]

Thank you for this reply. The problem is, he told her that the mother accessed this information before speaking to anyone (I assume it was the girlfriend's idea) This is how I understood it as going down. He said, "she was just trying to do us a favor."

I understand that this has not harmed the child in any way. I just kind of equating it to this: when I worked in the pharmacy at a local hospital, and my friend comes in to the ER, I can't just log in to the system to see how my friend is doing and what is wrong with them. It is none of my business. Just as I felt this child's shot record was none of this school nurse's business.

Thanks for all of the thoughtful replies. I am going to send a link to this forum to the my friend so she can make her decision from there

Chelle

If your friend feels it would be in the child's and her best interest, she should call the department responsible for these records and ask for the name of their Compliance Officer. All healthcare institutions are required to have a HIPAA Compliance person and I would think that the school system (if they are responsible for these records) would need to have a similar person to assure compliance with FERPA.

[sjt9721, BSN, RN]

If your friend feels it would be in the child's and her best interest, she should call the department responsible for these records and ask for the name of their Compliance Officer. All healthcare institutions are required to have a HIPAA Compliance person and I would think that the school system (if they are responsible for these records) would need to have a similar person to assure compliance with FERPA.

http://www.ed.gov/policy/gen/guid/fpco/index.html

[tofunurse]

Hi. In order to prevent anything like this from happening again, you can request that the childs info be withheld from certain individuals and have a copy of the request in the childs school file. That way when the childs file is pulled up, it will clearly say "do not give out personal info to anyone NOT listed" or something like that. It may help in preventing futher unwanted nosiness (sp?) from from that lady! I have done it.....HTH

[santhony44, MSN, RN, NP]

Since the information is maintained by DSHS (formerly TDH) then that's where it should be reported.

For those not in Texas, it's a state immunization registry and has nothing to do with school records.

[Jolie, BSN]

For those not in Texas, it's a state immunization registry and has nothing to do with school records.

Is participation in this registry legally mandatory, or is it voluntary? If it is voluntary, I would never consent to it. Records maintained by old fashioned pen and paper are much more secure than anything electronic, if for no other reason than they exist in only one place.

I realize that it can be a pain to reconstruct shot records, as most of us who have attended nursing school remember, but that served as a warning to me to request copies of my daughters' vaccine records everytime they are updated with new shots. That way, I have all the current information in one location, and the pediatrician has a second record that isn't accessible by nuts on the internet.

Our school district in IL requested parental permission to link with our pediatricians' offices to obtain medical information related to vaccines and sports eligibility. I said, "No way!" A lot of parents didn't understand my objection, but this case highlights one reason for it.

[santhony44, MSN, RN, NP]

This is a voluntary registry; parents can sign a consent when they sign the consent for immunizations (separate signatures). FWIW, in ten years in Texas, this is the first case I've heard of it being used inappropriately.

[StrwbryblndRN]

Just a side note on top of all the previous posts.

Even though what the person did was wrong, whether HIPAA or not, I would think about the repercussions involved if you spoke to someone about who accessed the records. I would hate to have a "war" started with this child in the middle of it all. Could be an innocent gesture from a well meaning person or a nosy busy body who feels justified to find any info possible against the child's mother. (Granted I can not think that kindness was behind the search)

Before going to the top I would suggest to have the mom talk to the father and go from there. Maybe more info will come to light. Besides, if the name of the person is not known then it sounds that not enough info has been accumulated.

This person could potentially be close to the child in the future. This child's future sibling is the peron's grandchild.