Flu Vaccinations

[lilajan]

I'm looking for input regarding the posting of flu vaccination status in an obvious, well seen location. If patients who receive the vaccine have stickers/labels posted on their chart, door, or ID band, would that be considered a violation of their privacy under the guidelines of HIPAA? Is this posting of information unaffected by posters/flyers/notices posted in open areas such as hallways, patient and family waiting areas, lobbies, and the cafeteria stating that those individuals who do not have a sticker/label posted have not received the flu vaccine? Just curious to hear what others think.

[Double-Helix, BSN, RN]

Since immunization status is not considered PHI, and there is no way to identify personal information about the patient by a sticker on their door, I don't see how this could be a HIPAA violation. In order for it to be a violation, the information posted would have to allow other people to know the patient's identity, such as name, birthday, MR number, photograph, address, etc.

[sauconyrunner]

Agree with Ashley.

Does this really have to do with patients? It seems to me that more people are concerned as the flu season starts, with the stickers that many hospitals are using to identify staff members who have not been vaccinated. As of January 2013, hospitals that want FULL reimbursement from CMS will be reporting the Health Care Worker Vaccination rates.

Our hospital has stickers on Employees badges that let us know who has and has not had the vaccine. Those with no sticker, need a mask and there are signs that inform visitors etc that "No sticker=mask" And our No sticker staff are often called out by the patient to put on a mask.

I think the patients have a right to know if their health care worker is vaccinated or not during flu season.

If this is really about patients- We already Post isolation signs on doors and charts. They are not HIPAA violations, so a sticker identifying vaccination status would fall under the same rules.

If we put a poster in our cafeteria stating that patients who have isolation signs on the doors, are in isolation, well that would be silly, but not a HIPAA violation.

[lilajan]

Stickers for patients, identifing vaccination status, seems to me a bit intrusive. More than one patient has stated they felt "forced" to accept the vaccination and resented being questioned by each staff member who noticed there was not a sticker present. As a nurse, I am required to ask if a patient has received information regarding the availibility of the vaccine and to give accurate patient education stating the benefits and risks. My concern is when patients and family members tell me they feel "punished" and "repremanded" if they refuse. No other vaccination status is posted or addressed in such a public manner.

In response to isolation signs on doors and charts, yes those are in public view. But, those signs do not identify a specific organism, and no public notices are posted stating what organism is related to specific types of isolation.

Personally, I have resigned myself to the fact my PHI has become public. You state patients have a right to know whether or not their health care worker is vaccinated. I have to disagree with that statement. If a patient has the right to know if I have received the flu vaccine, then that patient could also claim to have a right to know about any other immunizations I have received, and any other information related to my delivery of care -- for example, wheter or not I have screened positve for TB, MRSA, Hepatitis, or HIV. Each time I have to explain to a patient, family member, or co-worker why I have not been vaccinated, my PHI becomes public .

Truly, patients are at more risk from visitors and family members who do not wash hands before and after each encounter and who are frequently in much closer contact (hugging, kissing, sharing food and drink) with patients than any health care worker.

[lilajan]

I must question your statement that immunization status is not considered PHI. Any information regarding the care of the patient, including medications, is PHI. Whether or not Mr. Smith takes an asprin each day and why, is as private as his diagnosis. Vaccinations are medications and I take exception to the policy that we can, and do, disclose this particular med administation and no other. Would you post any other medication, given to or refused by a patient, on the door?

[Jory, MSN, APRN, CNM]

I don't understand the necessity of it at all. Lilajan stated, vaccinations are medications, and why would this need to be advertised to anyone? Staff or visitor?

I also don't agree that staff members should be "flagged" as having the flu vaccine or not. That is a violation of their privacy and they have a right to HIPAA as well.