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Did we/she violate HIPAA?

HIPAA   (971 Views | 12 Replies)
by hippahippo hippahippo (New) New Nurse

hippahippo has 1 years experience .

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What is the position of somebody who deals with HIPaA concerns?  Who should I be looking for regarding questions?

I have a coworker who is charge sometimes.  When she is on the floor as a nurse, she still uses the EMR as a charge.  She will basically “surf”.  For example, click into the other units like the Emergency Room, their holding room, surgery unit, tele, etc… is that OK?  She doesn’t access any charts by clicking on or into them.  She just counts how many patients there are.  Could I/we do that?  I am a new graduate. 

Edited by hippahippo

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BostonFNP has 9 years experience as a APRN and specializes in Adult Internal Medicine.

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HIPAA not HIPAA 😉 

Your facility should have a compliance officer you can discuss with. 

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10 Posts; 843 Profile Views

Since there is only one reply, I would like to add to the reality of the corporate compliance officer availability. There are additional resources; but none better than a direct communication with the Corporate Compliance Officer, facility Risk Management and/or a seasoned and friendly staff member that can help guide you in Policy and Procedure review. Often times moving from the charge nurse to the floor nurse role can be tricky. Most Information Technology Policies and ( HIPAA)

https://www.hhs.gov/HIPAA/for-professionals/privacy/laws-regulations/index.html

have strict guidance about accessing electronic and or physical medical records that are patients for whom you as the staff member have a direct care interest in while on shift and providing that care. There are no gray areas/except in print when it comes to patient privacy. The requirement is that she should not be discovering her neighbor is in the ED, or her Teacher, or any friend or family unless they had provided the information personally. Sure there is the reality of chance meetings on the unit or throughout the facility - but, only the patient (with some additional circumstances) should ever be the one to disclose that a patient is in the hospital. 

Good luck; using the link above you have to copy and past the whole thing, I messed it up. Hospital Policy and Procedure cannot be less strict then HIPAA laws; but can be more restrictive. 

Happy Nursing!  

You could just have the conversation with the nurse openly to understand if she knows what is right and wrong. 

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13 Followers; 4,056 Posts; 31,619 Profile Views

23 hours ago, hippahippo said:

Could I/we do that?  I am a new graduate. 

Why would you need to?

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hippahippo has 1 years experience.

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On 2/18/2020 at 4:40 PM, ilhamtony said:

You could just have the conversation with the nurse openly to understand if she knows what is right and wrong. 

I am not "reporting or telling".  I will be asking the compliance officer.

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hippahippo has 1 years experience.

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On 2/19/2020 at 12:47 PM, JKL33 said:

Why would you need to?

For possibility of floating in the middle of a shift based on census, transfers from other units, prescreening admissions from the ER, and having to work if we are placed on call because of maximum nurse to patient ratio will be exceeded.  On call Nurses will call the unit and ask other nurses to check even.

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13 Followers; 4,056 Posts; 31,619 Profile Views

I doubt that kind of activity is approved by your employer's policies; I wouldn't do it even if it isn't strictly prohibited. People who are on-call should address their inquiries to the supervisor; you should not look up this type of information for them or use your system for any of the other activities you mentioned.

The charge nurse is responsible for her own activity and may be asked to answer for it at some point if she is using the system for unauthorized purposes.

Make good habits for yourself whether that is what everyone else does or not; be especially cautious with stuff that relates to privacy practices and/or HIPAA. 👍🏽

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juniper222 has 2 years experience and specializes in Pre Nursing.

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Basically if you don't need to know, you shouldn't know.😇

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MunoRN has 10 years experience as a RN and specializes in Critical Care.

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I've worked in places where the charge nurses must also do shifts in direct patient care, but they are still expected to support the charge while doing so.  This typically involves just what you described; proactively looking out for patients that might be coming your way so that the unit can respond appropriately, either by helping to avoid and avoidable transfer, adjusting plans for things like procedures, imaging trips, etc based on what's coming your way, adjusting next shift staffing, etc.  So no, what you describe is not an automatic HIPAA violation by any means.

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hippahippo has 1 years experience.

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23 hours ago, MunoRN said:

I've worked in places where the charge nurses must also do shifts in direct patient care, but they are still expected to support the charge while doing so.  This typically involves just what you described; proactively looking out for patients that might be coming your way so that the unit can respond appropriately, either by helping to avoid and avoidable transfer, adjusting plans for things like procedures, imaging trips, etc based on what's coming your way, adjusting next shift staffing, etc.  So no, what you describe is not an automatic HIPAA violation by any means.

I am too new to be a charge. 

But I did check the other floors for a couple of on call nurses before.  Basically said, "we're full, and the emergency room has somebody in the holding/fast track area.  you're probably going to have to come in.  don't get drunk, yet." Or "we have 2 open beds on our floor and the emergency room is empty.  high possibility you might stay home."   

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13 Followers; 4,056 Posts; 31,619 Profile Views

On 2/22/2020 at 12:49 AM, hippahippo said:

But I did check the other floors for a couple of on call nurses before.  Basically said, "we're full, and the emergency room has somebody in the holding/fast track area.  you're probably going to have to come in.  don't get drunk, yet." Or "we have 2 open beds on our floor and the emergency room is empty.  high possibility you might stay home."   

People don't need this info; they just don't. It's no guarantee anyway so it isn't as if they can make big plans based on what they're told in this unofficial manner.

Secondly, you are playing with fire. I agree w/ Muno that some work places might have a culture that supports, allows, or requires the monitoring of census or bed availability elsewhere in the system by RNs in certain roles. But we've also had other people come here and report how they were terminated or in big trouble for something where "everybody does it" or that they themselves had been taught that way. The problem is half of this "we have to check some other department's activity [for x, y, z reason]" is not official system-wide policy or even an approved practice in the offending unit. And when the wrong person finds out it's going on (privacy officer, some other PTB), there's big trouble.

Hope you were able to get the official word from your compliance/privacy officer about the expectations at your place.

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brownbook has 35 years experience.

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On 2/21/2020 at 9:49 PM, hippahippo said:

I am too new to be a charge. 

But I did check the other floors for a couple of on call nurses before.  Basically said, "we're full, and the emergency room has somebody in the holding/fast track area.  you're probably going to have to come in.  don't get drunk, yet." Or "we have 2 open beds on our floor and the emergency room is empty.  high possibility you might stay home."   

I'd think you'd be waaay to busy with your own patients to be taking calls from on call staff as to whether they'll be called in. Refer them to the staffing coordinator or charge nurse.

It's absolutely not your job and a shady if not black and white example of a HIPAA violation.

How or why did you become the go to person for the on call staff?

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