Hipaa?

[RN79]

I am a nurse (specifically ED nurse) at a small rural facility. Recently the registration staff has been told by their management (which I assume trickled down the line from administration) that they are NOT allowed to ask a patient his/her complaint when they present to the ED because it is a Hipaa violation. Now, that being said, they were told they were allowed to let us know if there is a chest pain/sob at the window so that we can meet core measures. I was not aware of any changes in Hipaa laws that don't allow a presenting complaint to be taken at the time of presentation. I find this to be very much an issue in that #1 if registration cannot ask a complaint then how are they going to let me know if there is a chest pain or sob so that core measures CAN be met, #2 if several patients present during a very close time (and this did happen on a recent shift) how am I to prioritize care if I don't know what a patient complaint is. Point is... even if i know about chest pains and/or sob pts what about the others? I mean a kidney stone or ams would definately come before the toothache or earache that frequents the ED, regardless of who presented first. I have worked at other facilities (relatively large and small) in the distant and recent past and have never had issues such as this. Have there been changes in Hipaa regulations? Sorry, just needed to vent!

[mariebailey, MSN, RN]

Nope. No changes to HIPAA. Just changes to how your employer is interpreting the law.

[iluvivt, BSN, RN]

That seems a bit too much!. PHI is on a need to know basis and any employee of a healthcare facility needs to know the information to perform their duties then they need it. If their job duties entail getting the initial compliant(s) then they can have that information. They too would then have to follow all HIPAA regulations.

[mariebailey, MSN, RN]

I totally agree.

[Larry77, RN]

All the facilities I've worked at (which is a lot as agency nurse) the registration staff has access to the patient board which has chief complaint on it. Many facilities have limited what the reg staff can see, nurses notes, MD notes, etc, but I have never seen them limited from seeing the pt's complaint and name--this is required for them to be able to register the patient is it not?

Now, there has been a huge push by the governing bodies that the FIRST person a patient sees when they come in to the ED is a licensed staff member (not a tech or reg staff member), I wonder if this is what your leadership has possibly misinterpreted. The reason is along the lines of best practice/safety, not protecting the patients privacy from registration. A registration staff member is not trained to know some of the more dangerous conditions that can present with minor complaints (ie backpain on a pt with hx of AAA).

In my opinion registration or EDtechs should not be taking initial complaints and deciding who sees the triage nurse first...safety issue, not a HIPAA/privacy issue.

[KelRN215, BSN, RN]

I think your facility is interpreting HIPAA very narrowly but I can kind of see how they would come up with this. On a floor, secretaries/registration staff don't need to know what the patient is admitted for because the patient is already admitted and has a nurse assigned to him at that point. It's not a vital function of the secretary's job to know that the patient in room 1 was admitted for gallstones. In the ED, if the way you function is for the registration staff to find out the chief complaint so the triage nurse can appropriately triage the patient, then I don't see how it's a violation at all for them to ask.

[RN79]

Being that it is a very small facility and there is limited nursing staff (1-2 nurses in the ED) and that the patients actually present at the registration desk initially to be registered because the ER is behind the registration desk there is no way for nurses to know a patient is there until they are notified by admission staff so being seen by a nurse when they initially walk up is not an option. Again not sure how they expect us to prioritize care