HIPAA Compliance in Semi-Private Rooms. How?

[BabyRN2Be]

OK, forgive me if you've already seen this as I had posted about this in another forum, forgot which one it was and now I can't find it.

My questions is, how can semi-private rooms be HIPAA compliant?

Last January, I had a little accident in my kitchen resulting in a head injury. My doctor was a little concerned and she wanted me monitored for possible problems. First of all, I will say that as a patient I hate semi-private rooms. I hate dealing with roommate visitors who are complete strangers when a) I'm not comfortable with people seeing me in a hospital gown and b) they seem to have no concept of what visiting hours means. Yes, an announcement is made but the thinking is, "That pertains to everyone except us."

As the nurse was going through my admission process which included a history. I had this patient's visitors listening with rapt attention about my problems, and also, since the patient was slightly deaf, she wanted things repeated for her. :angryfire The nurse understood my concerns and pulled the curtain around the bed, went on doing the history with her visitors listening in and THEY would repeat the stuff that "mom" didn't catch. I really felt that this was an invasion of my privacy.

One of the residents came into my room at 2:00AM to discuss the results of one of the tests (he was actually preparing me for the possibility of an LP) and this lady wanted to know all about it. The doctor said, "You'll have to ask her because it's really none of your business ma'am." (He said it nicer than that). But I really became concerned about more doctors coming in and discussing my case with a lady who wanted to know all my business. Not that I had anything really wrong or personal wrong with my, but my medical information is MY business.

Well, a few minutes later, she started snoring like a freight train. I'm not kidding, it was TERRIBLE!!! My husband on occasion snores but this was NOTHING like that. There was no way I could sleep through this.

I put my call light on and expressed my concerns. Since I picked the middle of January to nearly bust my head open, there were absolutely NO private beds available on med-surge due to flu season. I told her I understood, and I explained the snoring problems and asked if there was another room I could be moved to. While we were having this conversation, this lady starts to snore soooo loud again, and she said to me, "Yeah, I see what you mean and there's no way anyone could sleep through that. Let's see what I can do."

Within a few minutes, I was moved next door into a room with a pt who was in a coma and in the active process of dying. While I felt badly for the daughter in law who was staying there (we ended up having many nice conversations and actually left the room when the doctors made their rounds to talk with me), this was a much better situation.

My question is, how can semi-private rooms be considered compliant with HIPAA? When a pt is admitted, a history is done and the roommate can hear everything. When the docs do rounds, the roommate hears this conversaton as well. When I was in the room with the first lady, I really felt that my privacy was being violated by that woman. Fortunately I wasn't dealing with STD's or anything of an embarassing nature, but I do feel bad for those who feel like they are not only sharing their problems with a nurse/medical team, but with a nosey roommate as well.

Can anyone shed some light on this subject for me?

Next time I need to go to the hospital, you bet I'm going to go to the only one in town with private rooms. :)

[Jolie, BSN]

The short answer is that semi-private rooms are absolutely not conducive to privacy or HIPAA compliance. Unfortunately, most hospitals have insufficient numbers of private rooms, so semi-privates must continue to be used. It is possible though, for staff members to do a better job of protecting your privacy.

The nurse should have insisted that your room-mate's visitors LEAVE (What a novel concept!) while your admission history was taken, and while any other private conversations or treatments took place. You also had the right to make that request, although you probably didn't think of that given that you weren't feeling well.

I'm curious to read other's suggestions for improving patient privacy in an imperfect setting.

[texas_lvn]

I'm curious to read other's suggestions for improving patient privacy in an imperfect setting.

I'm curious also. I do no have any suggestions at this time. Thanks.

[wooh, BSN, RN]

The visitors are supposed to be asked to leave, but does the nurse get in trouble for violating HIPPA or for violating customer service? These days, violating customer service will actually get you in more trouble.

As for the roommate, this is considered "incidental" or some other word we were always quoted when I asked our educator about it. To summarize, it's not a violation for the roommate to hear. It always irritated me because we have to follow all these rules that are just plain stupid at times, but this big glaring violation of the spirit of the law is covered by the fine print.

[Justhere, BSN, RN]

Was going to do a paper about Hippa and semi-private rooms, and there is a clause in the HIPPA regulations that semi-private rooms are an exception to the rule.

Guess they don't think about the nosey neighbors and that people can hear through those thin curtains. It is true, pt 1 knows everything going on about pt. 2 and visa versa. I don't like them as a patient or a nurse. You get some patients on the buddy system, and what ever bed 1 wants, bed 2 wants also.

Like, Pt. 1 calls on the call system "I would like a pain pill."

Pt 2 yells out "While your at it can you bring me one also."

Pt. 2 "I would like a sandwich, hey so-so would you like anything also?

Pt. 1 "I guess so, also bring me a coke."

Pt. 2 "That sounds good, I'd like a coke also."

Pt. 2 "Also if its time Ms. So-so looks like she is in pain, you might want to bring her a pain pill.

Nurse "Ms. So-so would you like a pain pill."

Pt. 1 "Well if its time I might would like to have another."

These were examples of true conversations.

But until you can get hippa to take out that clause, semi-privates will still exist.

[PANurseRN1]

It's "HIPAA."

[lpnQT25]

I too wonder that same question... I can totally relate on the Horrible roommate situation! I have only been hospitalized twice for illness. And both times I had severe migraines and my roommatte knew it! yet her 5 kids with babies in toe hung out all day with their mom in her room cause not one of them had a car.. so someone dropped them off! Everytime the nurse came in my room I scowled at her like why was it my place to complain and say something when she could obviously see the circus in the next bed. If one baby wasn't screamin' then another was toddling around the IV poles and tables! I constantly tell myself I will always remember my patients when it comes to things like this! If I ever become so programmed in my nursing job that I can't see the obvious in front of me ...then I need a change!

[banditrn]

To hail with customer relations - I feel that my PATIENTS come before the visitors!! If the visitors for bed 1 are disturbing the patient in bed 2, they're out of there.

I would chart it, tho, and inform my nurse manager of the situation.