I am an ER nurse who works in a facility that utilizes scanning technology for medication administration. Over the past 3 months I have been having issues w/ my scanning where I scan my medications, the computer accepts it and then an hour later all that I have scanned is no longer there. I have reported this problem numerous times to management only to be told, "huh, that's strange", or "well nobody else is having that problem".
I was recently asked to account for some undocumented medications from 2 months ago and told my manager that I would need to review the charts to attempt to determine if I was at fault or if it was a technical issue. He said that was fine and offered to let me use his computer but I chose to use one in our breakroom.
Next thing you know, I'm being told that I'm being investigated for possible HIPAA violations. 1st of all, I believe that I had every right to be in those charts, I reviewed only my documentation, the MD orders and the MAR, made no alterations to the charts and took no PHI out of the ED. I was asked if I had been given permission by my manager to review these charts and I told them I did, however my manager is denying he knew that I intended on looking in the charts (he even came into the break room as I was looking at the charts and made a pot of coffee. I told him I was almost done and he told me to take my time-of course he has conveniently forgotten that as well.)
Fortunately my union rep witnessed someone having the same scanning issues as myself, but rather than give me a pat on the back for catching the errors that I did (who knows how many have been missed), all they can concentrate on are my HIPAA related issues which could lead to termination .
Although I understand the general concept of HIPAA, I am unfamiliar with any rule that prohibits a nurse from reviewing her charting. Does anyone know any information pertaining to this? I have searched several HIPAA sites regading this matter and have come up empty handed.
It is ABSOLUTELY within your right to review your charting, in fact kudos for doing so! So many nurses seem to be lax when it comes to charting. Let me just offer some friendly advice. First: Always document incident reports when equipment such as the barcode scanner or computerized system is not functioning properly. Second, I suggest you retain legal counsel. Third: Since you see your nurse managers true colors, I suggest you have a paper trail with regards to correspondence with this manager. Good luck!
Specializes in Agency, ortho, tele, med surg, icu, er.
Sounds like they are trying to fire you and looking for reasons. You are reviewing your documentation pending an investigation on your actions on your patients and they are trying to make a hippa violation out of it. And the manager is lying about giving you the ok.
It's time for a review of your time there on that job and your relationship with that manager. It sounds like you are being invoted to leave.
I think you need to get advice from a couple of attorneys TODAY. Do NOT DELAY. NOW.
Start looking for a new job, too. Why wait any longer? What do YOU think is going on? Have you sat down with this guy, your manager, and asked him outright why it feels like he's throwing you to the sharks? No, don't ask that, just say you are confused and would appreciate some information from him. How could he forget your conversation, etc. Who did you inform that your charting wasn't lasting and when? Anything in writing there so you can prove you reported the problem and to whom, when? Record any conversations you hold with your boss. Let him know you are doing that, just so you can review it later and keep yourself honest, ha ha.
I believe I would be having a one-on-one conversation with this manager. That would pi$$ me off to be betrayed like that. I would lay it out on the line how you dont appreciate his dishonesty and lack of support. If thats how he conducts business, then I would be finding another job. And I would tell him just that. A good manager is honest and accepts responsibility and will give support to their staff. I would tell him exactly how his behavior is unacceptable and unprofessional. OOOH, I would tell him what I think, then I would find another job. I had a boss like that and I had no respect for her whatsoever and found another job. It was one of the hardest decision Ive ever made, but it had to be done. It sounds like you or your license are not safe with that job. My boss now is so supportive and admits when she makes a mistake and supports us. Im very lucky. You have to protect yourself. Honestly, I dont see how that was a HIPPA violation. You have already seen that info and you are the one who submitted the info. Its not like you are reading something you've never seen before on someone you've never taken care of. Thats just so bizarre. But the most damaging is your manager. OOOH, that makes me mad! I cant stand a liar.
I agree that my manager is a "wuss" to put it mildly. Unfortunately it sounds as if he admits to knowing, and/or gave permission to review the charts that he could face consequences (which I do not understand either. I still believe I had EVERY right to review those charts with or without my manager's approval). I tell ya, I'm so SICK of HIPAA and JACHO. Their intentions are good, but they go way overboard with all of their rules and regulations.
No need to be sick of HIPPA- it is basically what we have been doing all these years anyway. HIPPA legislation changed day to day practice very little, IMO. Your manager/administration just has no concept of what it actually is, unfortunately.
Both hospitals I have been at specifically had rules about charts not being allowed in breakrooms, bathrooms, cafeterias, etc. But we were specifically told and it was in writing...so I would think that if this was probably not the case in your situation. According to HIPAA the facility has to set it's own guidelines as far as to how they will maintain confidentiality. I hope this turns out ok for you, it seems like they don't really have a leg to stand on. Good Luck!
The HIPAA violation is not so much that you were viewing the charts perhaps....
But perhaps that you were doing so in a public unsecure place?
Specializes in Management, Emergency, Psych, Med Surg.
If those were patients that you had cared for and there are questions about medications that you gave then how can it be a violation? You have already seen the chart? How can you investigate something or account for something you did without looking at the chart? People get so caught up in this HIPPA stuff when they actually have no idea what the law says and what it means. If they want you to account for anything you did or gave, you have to have access to the chart.
Specializes in Vents, Telemetry, Home Care, Home infusion.
hhs regs to printout in your defense. only way to protect yourself while working on this unit is to have manager sign off note that you are doing qi review of following charts in order to cover yourself... going way overboard here.
“health care operations” are certain administrative, financial, legal, and quality improvement activities of a covered entity that are necessary to run its business and to support the core functions of treatment and payment. these activities, which are limited to the activities listed in the definition of “health care operations” at 45 cfr 164.501, include:
conducting quality assessment and improvement activities, population-based activities relating to improving health or reducing health care costs, and case management and care coordination;
reviewing the competence or qualifications of health care professionals, evaluating provider and health plan performance, training health care and non-health care professionals, accreditation, certification, licensing, or credentialing activities;
underwriting and other activities relating to the creation, renewal, or replacement of a contract of health insurance or health benefits, and ceding, securing, or placing a contract for reinsurance of risk relating to health care claims
conducting or arranging for medical review, legal, and auditing services, including fraud and abuse detection and compliance programs;
business planning and development, such as conducting cost-management and planning analyses related to managing and operating the entity; and
business management and general administrative activities, including those related to implementing and complying with the privacy rule and other administrative simplification rules, customer service, resolution of internal grievances, sale or transfer of assets, creating de-identified health information or a limited data set, and fundraising for the benefit of the covered entity. general provisions at 45 cfr 164.506.
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SFRN
104 Posts
It is ABSOLUTELY within your right to review your charting, in fact kudos for doing so! So many nurses seem to be lax when it comes to charting. Let me just offer some friendly advice. First: Always document incident reports when equipment such as the barcode scanner or computerized system is not functioning properly. Second, I suggest you retain legal counsel. Third: Since you see your nurse managers true colors, I suggest you have a paper trail with regards to correspondence with this manager. Good luck!