Does a nurse have the right to review her charting w/o violating HIPAA?

[925_ER_RN]

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.

Trish

[SuesquatchRN, BSN, RN]

If they were your patients and you made entries into their charts how could you possibly be violating HIPAA by looking at them?

So is your union rep sticking up for you or criticizing you? That isn't clear.

[925_ER_RN]

My union rep does not believe me to be in the wrong either. However management and our legal person are stating that I should not have reviewed the charts unless I had premission from management (which I thought I had).

My understanding of HIPAA is that as long as I provided direct care and limit my access to the chart to my charting and care provided, that I was entitled. Aren't we allowed to make late entries should we need to? Although I made no late entries, I do not see how this is any different.

This is VERY frustrating as I can find no information regarding this exact scenario.

[caliotter3]

Well, I was provided my charting to review during a lawsuit. I thought it would have been bizarre had they disallowed my access seeing as how the other side had all the access they wanted. Nobody there had taken care of the patient or written charting concerning their care.

[925_ER_RN]

I also likened my situation to one of reviewing a chart for legal purposes. I just don't see where a violation was made. Thanks for the reply though.

[HeartsOpenWide, RN]

People do chart reviews on patients that are not even theirs and its ok for them to do it...why would it not be ok for you to review a chart of one of your own patients to see if an error on your part was made. Maybe you were suppose to call medical records for it.

[andreaskyeLVN]

That is so strange. Working in Texas in a long term care facility, it is actually a must that I have all access to the chart for the resident in which I am directly involved in care. Including even social services, therapy, dietary and of course all nurses notes. How else do you assure continuity of care?? Even the previous months MARS are there.This is no violation of HIPAA in my opinion unless, of course, your state or your discipline (ER) has some kind of different rules.

[mindlor]

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?

I am not sure...just a thought

[ghillbert, MSN, NP]

The manager screwed you. Sounds like rubbish to me - HIPAA protects patients' PHI from people who have no need to know. You had a need to know. They can track electronically exactly what you looked at, so there's a trail as to what pages you checked etc. Tell them to check it. Does your facility have an anonymous compliance helpline? If so, try calling them with a hypothetical.

I would not be too concerned - but I would be printing out the HIPAA guidelines and getting a lawyer if you are fired.

[925_ER_RN]

I was alone in the breakroom. All of our other computers are at the nurses' stations and are alot more public.

[morte, LPN, LVN]

The manager screwed you. Sounds like rubbish to me - HIPAA protects patients' PHI from people who have no need to know. You had a need to know. They can track electronically exactly what you looked at, so there's a trail as to what pages you checked etc. Tell them to check it. Does your facility have an anonymous compliance helpline? If so, try calling them with a hypothetical.

I would not be too concerned - but I would be printing out the HIPAA guidelines and getting a lawyer if you are fired.

that is what i was thinking.......or set up.....have you had issues with this manager? if this does not result in your termination, get it in writing next time!

[SuesquatchRN, BSN, RN]

And pick up malpractice.

www.nso.com