grandchildren signing consent

[ANEESAHM]

if a adult grandchild is a current employee of the hospital can they sign consent for medical care if they are not next of kin and would this be considered a HIPAA violation

[RN403, BSN, RN]

Was this an emergency situation? Could they not get in touch with any other family members/next of kin? Without getting too specific a little more detail would be helpful...

[MunoRN, RN]

Why was the patient unable to give consent?

[ANEESAHM]

Was this an emergency situation? Could they not get in touch with any other family members/next of kin? Without getting too specific a little more detail would be helpful...

It was for emergency dialysis pt was intubated and comatose. The daughter could not be reached at the time. The employee was not on duty at the time. Yet was call into the hospital as an emergency contact.

[ANEESAHM]

It was for emergency dialysis pt was intubated and comatose. The daughter could not be reached at the time. The employee was not on duty at the time. Yet was call into the hospital as an emergency contact.

also i pt came into the ED awake and alert give the intake nurse the grandchild as emegency contact

[Esme12, ASN, BSN, RN]

If they gave that name when they came in for admission then yes...they can be called. Yes they can give consent if an emergent situation exists and all "reasonable" efforts have been made to find the patients children. If this persons a grandchild they are next of kin at the time.

No HIPAA here.

[Here.I.Stand, BSN, RN]

^^^ Right...1) the pt gave the admitting RN the grandchild's name, and 2) it sounds like this grandchild--employee or no--was the next-of-kin who could be reached at the time.

Since it was an emergent situation and the pt was unable to consent, it sounds like the choices were to contact this family member, dialyze without consent, or not dialyze and let the pt die.

[Rose_Queen, BSN, MSN, RN]

I would not even consider the grandchild's status as an employee relevant at all. Many patients are going to end up having relatives who are employees of the facility where they seek care.

As for whether this is a HIPAA violation: Absolutely not. The patient provided the name as the emergency contact; this was obviously an emergent situation.

As for signing the consent, sounds like reasonable measures were taken to find the next of kin; in the absence of the child, the grandchild would be the next logical choice. Also, in the absence of an advanced directive, could implied consent apply here as well?

[h=2]THE EMERGENCY EXCEPTION[/h]The legal requirement for obtaining consent before the rendering of medical care has always been tempered by the privilege to render emergency medical care without the patient's consent. This privilege is based on the theory of implied consent. The law assumes that an unconscious patient would consent to emergency care if the patient were conscious and able to consent. This is a "reasonable man" standard; that is the law assumes that reasonable person would want medical care in an emergency. The assumption of "reasonable" behavior is allowed only if the patient has not put the health care providers on notice that the patient refuses care. The health care providers may rely upon implied consent only in the absence of consent. Implied consent can never overrule the explicit rejection of medical care. This is very important for certain religious groups and can cause a great deal of confusion in an emergency room. There should be an explicit protocol to deal with persons with objections to medical care (as discussed later in this chapter).

Chapter 1 - Preventive Law in the Medical Environment - THE EMERGENCY EXCEPTION

[Altra, BSN, RN]

That the family member is a hospital employee has no relevance. Nor is there any HIPAA issue -- a family member named by the patient as a contact person was appropriately contacted in the course of the patient's care.