HIPAA/ Confidentiality Violation??

nurseprnRN, BSN, RN · May 8, 2015

A student asks for assistance on an assignment, trying to develop a nursing diagnosis. The student gives a set of assessment data (focused respiratory, age, gender, history, height weight, and a few lab values). None of the 18 Patient Identifiers are included in the information (age is less than 89 years, so it is not considered an identifier). It is not mentioned that this is for a clinical assignment, or that the information provided pertains to an actual patient. There is no facility listed, no demographic information.
Is this a HIPAA violation, or a breach of patient confidentiality?

"The student gives a set of assessment data..." ? To whom?

"It is not mentioned that ..." by whom? By the student? To the student? To somebody else? By somebody else?

I am sorry, I'm having a hard time following exactly what you mean. If this happened to you, could you be more specific as to what really happened, how, and who did what?

Or are you the person who posted awhile back about getting a sample case from your faculty with all this info, working it up hypothetically, not knowing it was a real patient, and then getting nailed by faculty for a HIPAA violation?

Otherwise, if this is a homework assignment, can you tell us what you think before we answer it for you?

Please clarify.

thunigan · May 12, 2015

A question was posted: "trying to come up with one more nursing diagnosis, for this concept map." Information included gender, age, Hx (chronic bronchitis & type 2 diabetes), Dx (COPD exacerbation), height and weight, as well a BG, BUN, and WBC. Also, "nonproductive cough & diminished breath sounds."

This was posted on a social media site, where classmates were "tagged." My question is, the post did not contain any of the 18 (Hipaa) listed patient identifiers, didn't state that it was an actual patient, etc.

The nursing student was given a zero on the assignment, after being reported to faculty, for a hipaa violation/ division policy violation ("posting anything related to clinic on social media") and is facing the possibility of not being allowed to participate in patient care/ have limited access to patient information, during future clinical rotations... pretty stiff penalties, for asking for help. Hipaa is not covered, in any detail, in the nursing program we attend. At orientation, students are given a website/ webinar to view, and then complete an online quiz. That is it. The student didn't knowingly violate patient confidentiality. The information was obtained from a preceptor, when the student stated they were "short material for concept map assignments." As far as the student knew, it was made up...

nurseprnRN, BSN, RN · May 12, 2015

A question was posted

By whom? You? A faculty member?

The nursing student was given a zero on the assignment, after being reported to faculty, for a hipaa violation/ division policy violation ("posting anything related to clinic on social media") and is facing the possibility of not being allowed to participate in patient care/ have limited access to patient information, during future clinical rotations... pretty stiff penalties, for asking for help.

Aha. It was by you. So even if you didn't do a HIPAA violation, what you did was, in fact, a division policy violation. Don't you think it's a teeny bit disingenuous (look it up) to say, "I didn't even say it was a real patient" when you're trying to finish homework on your clinical day during which you took care of ... a patient? Of course it was related to clinical. Your faculty is not as dumb as you think.

So your question isn't really about HIPAA in this context, is it?

What do you want? You want somebody to tell "the student," by which I think you mean "you," that you were grievously maltreated? You want resources to take to your appeal? What?

Be upfront here, apparently not having gotten the answer you wanted when you posted it before.At this point you want to go to your appeal with abject and very sincere apologies for an unforgivable lapse in judgment, because you did your best to leave off HIPAA-related identifiers but even if you did this successfully you have violated a division policy. You want to make good and sure you convince them that you will never, ever do it again, that you are ashamed of having violated that rule, and you understand how serious it is. Throw yourself on their mercy and then shut up and see what they do, because at that point it will be out of your hands.

Good luck.

Jenngirl34RN · May 14, 2015

First, what kind of program are you in that doesn't cover HIPAA? Second, if your school or clinical facility has a policy stating you cannot post anything about your patients on social media it does not matter if you did not violate HIPAA--you broke the rules. I hope you can work it out with your school, but further posting about it on social media may not be your wisest decision. In future, make sure you follow your school's policies.

la_chica_suerte85, BSN, RN · May 17, 2015

Don't you think it's a teeny bit disingenuous (look it up)

HAH! :roflmao:

You're the best GrnTea. You're that perfect kind of tough.

psu_213, BSN, RN · May 17, 2015

The nursing student was given a zero on the assignment, after being reported to faculty, for a hipaa violation/ division policy violation ("posting anything related to clinic on social media")
Hipaa is not covered, in any detail, in the nursing program we attend. At orientation, students are given a website/ webinar to view, and then complete an online quiz.

This may not have been a HIPPA violation, but it was a clear violation of the school and/or clinic social media policy. If the policy states not to "post anything relation to clinic," then it's pretty clear--if someone posts information about clinic (even with good intentions), that person has violated the policy and could be punished. If thee student wanted help, he/she could have gone to the faculty or fellow students to get some help. Instead the student knowingly posted on social media, and, unfortunately, is now feeling the consequences. Basically all facilities have social media policies that are quite specific. If someone violates that policy, they could lose their jobâ€¦.even if they were just "asking for help."

As for HIPAA being covered in detail--what they had you do is detail. You may think that because it is not being "spoon fed" in lecture, it is not being covered. Well, you are going to be held to all the details presented in the website/webinar. If the school faculty is not there to answer your questions and provide clarity, then shame on them. However, in the real world, on the job, you are going to watch a video, be given something to read, and be expected to be 100% compliant (and get used to it, because this will apply to pretty much all hospital policies).

klone, MSN, RN · May 17, 2015

Yep, agree with the others. Not a HIPAA violation, but it was a school policy violation. Sorry.

Jory, MSN, APRN, CNM · May 18, 2015

Yes and no.

If you were trying to help a classmate, no violation occurred. The reason is that HIPAA allows an exception if information is shared for educational purposes. That is why, for example, presenting a case study to a class is not a HIPAA violation, just as several students looking at a chart, is not a HIPAA violation.

However, that is WITHIN the program.

If you were helping out a nursing student that did not attend your program and was not in your class, it is a HIPAA violation because the line is drawn within your program.

nurseprnRN, BSN, RN · May 19, 2015

Yes and no.
If you were trying to help a classmate, no violation occurred. The reason is that HIPAA allows an exception if information is shared for educational purposes. That is why, for example, presenting a case study to a class is not a HIPAA violation, just as several students looking at a chart, is not a HIPAA violation.
However, that is WITHIN the program.
If you were helping out a nursing student that did not attend your program and was not in your class, it is a HIPAA violation because the line is drawn within your program.

The actual point is not that it probably wasn't a HIPAA violation. it was a very clear violation of a school policy, and that's why this student was disciplined. As she posted (my bolding),

The nursing student was given a zero on the assignment, after being reported to faculty, for a hipaa violation/ division policy violation ("posting anything related to clinic on social media")

NuGuyNurse2b · May 22, 2015

I'm just boggled as to why social media has to be such a presence in some of my cohorts' lives. they post EVERYTHING and this thread reminds me of them because while it's not so specific (like the case here), they do post things that could get them in trouble. There's no need to share with the world.

Red Kryptonite · May 22, 2015

I'm friends on Facebook with another CNA with whom I got trained. She works in a PICU and talks WAY too much about work on her page. I'm frankly shocked she hasn't yet been disciplined, but I think it's basically a matter of time. I've tried to warn her a couple times, but to no effect.

Now some people would probably tell you that I post too much on Facebook, have diarrhea of the keyboard, am overly opinionated, etc..... But I don't post about work. Like, ever. I did celebrate when I achieved CHPNA certification, but I don't talk about patients, units, anything. Why would you ever do that? Just trouble waiting to bite you.