HIPAA violation or not..?

pagandeva2000, LPN · Oct 19, 2006

I am surprised that both the hospital and school took such quick action. I am in agreement with the action because I know how many forms I signed prior to entering any clinical unit or hospital. I believe it is better for the student to learn this lesson now prior to having control over a client's records as a nurse. The hospital can still have financial ramifications due to the student's behavior as set forth by the HIPPA regulations.
The good news is that if the student is still apart of the program, perhaps the school has completed some more education on the issue of HIPPA and the student will learn that it is the staff's responsibility to protect records of any client.
I recently had a hospital stay at my own place of employment and most of the nursing staff didn't seem concerned about protecting my medical history.

I can see what you mean about being treated by your place of employment. I would not let anyone in my hospital touch me, because, now that I am a nurse, I am closer to the physicians, nurses and other members of the team than I was as a CNA, and they say horrible things about collagues when they know their personal business.

I'd have given the student a chance, because I know where I attended, they were not really clear about much of anything. I happened to know about the HIPPA laws because I was already employed in a hospital; but there were some students that were not really very enlightened by the lectures of our professors. I do admit though that I would NOT have called anyone I knew casually to inform them of family members and friends that were admitted in the hospital.

PreemieNurse · Oct 19, 2006

Absolutely this is a HIPAA violation, and the instructor was correct in sending her home. I am a clinical instructor for an ADN program, and HIPAA is drilled into the students before they hit the nursing unit for the first time. HIPAA is a big deal, and if you doubt that, breach confidentiality at your place of employment and get caught. You will not have a job, or at the least, be suspended.

If this student were at the school I teach at, she would be gone. Permanently.

There is a huge ordeal in my clinical group. I have managed to stay out of it (thankfully I wasn't there when it happened and haven't been forced into getting involved), but was wondering what you guys thought about this.
The week before last in clinical, one of the students went to the nurses desk, called a friend, and told them that their step-mother was in the hospital with pneumonia and it looked pretty bad. The student did this in front of 2 students, a nurse (or more?), a doctor, and the unit secretary.
She was turned in for violating HIPAA and was told by the hospital that she was not welcome back. Our clinical instructor told her to go home. She was later notified by the department that she had been dropped from the program.
She appealed, of course, and continued to attend class.
Her clinical review was last Thursday and this morning she was in class for our test... so I guess she is still in..
what are your thoughts on this?

SummerGarden, BSN, MSN, RN · Oct 19, 2006

the first nurse came back later and said, "Oh, since you had your mom in here, I figured she knew. Sorry." like she meant it about 5%.
Too bad HIPAA wasn't in force then...and it's situations like that that probably helped enact a law that was needed for folks who don't have a lick of common sense....

No, some people are just mean!!! That nurse though it was her place to humiliate your daughter because she probably thought your daughter was at fault. It was absolutely not her place to judge and sentence your daughter. Unfortunately HIPPA does not keep people like this from being rude or mean in the future, but it is nice that it keeps mouths shut! :rolleyes:

SummerGarden, BSN, MSN, RN · Oct 19, 2006

And to use the phone at the nurses station.. I wouldn't dare touch that phone..

I was blown away! I re-read the original post a second time because I thought I did not read this part correctly!

I can imagine a student who is not used to working under HIPPA making the mistake of talking to a relative or friend or someone because that person might be emotional and so the student is eager to help. However, I cannot imagine that a student will actually pick up a phone that does not even belong to him/her to tell someone something that is against the law. That mistake took effort! :jester:

olderthandirt · Oct 19, 2006

It was deffinately in violation of the HIPAA act. She could have called the "in an emergency call...." But as a student, she should have checked with her supervisor and suggested that maybe the family should be called. I do not think that an expuillsion (my delete key won't work so I cannot remove errors) was necessary.

Daytonite, BSN, RN · Oct 19, 2006

i am always amazed at these kinds of vigilante mentality threads where there has been some supposed wrong doing by someone. there is a frenzy to step up and hang the person(s) without considering all the evidence! the only evidence provided is one-sided and coming from gossip to boot! one of the things students are supposed to be learning in the nursing process is the gathering of data--from as many sources as you can find it. how amazing that this process breaks down when an emotional issue such as this is at hand.

first of all, hipaa, the health insurance portability and accountability act of 1996, pertains to healthcare information transmitted electronically, as in over the internet, fax lines or telephone lines. it specifically has to do with information in patient's charts that is shared with insurance companies and third party payers of the patient's medical bill.

secondly, confidentiality, which is what many of the posts are referring to and what the wrong doing talked about by the op "seemed" to have violated, is different from hipaa.

third, we are all entitled to confidentiality in regard to any judgments made about our performance on the job or in your nursing program. yes, some states have adopted specific laws about confidentiality. in reading the beginning post to this thread it was obvious to me that there is a great deal of information that is unknown as to why the student was allowed back into the nursing program. and, that information is going to remain unknown to all of us for the protection of the student's confidentiality. is anyone other than me concerned about protecting the confidentiality rights of the student here?

just using my common sense and experience as a manager tells me that there had to have been a very good explanation for the student's actions that prompted the school to reverse their original judgment of the student. despite the disappointment many might feel that this poor person was not crucified nearly as brutally as (s)he should have been, it is quite possible that once school officials reviewed all the information there was, in fact, no violation of hipaa or breach of confidentiality at all. has anyone considered that possibility? is anyone putting any of their critical thinking skills that they're supposed to be learning in school to work here at all?

pagandeva2000, LPN · Oct 19, 2006

i am always amazed at these kinds of vigilante mentality threads where there has been some supposed wrong doing by someone. there is a frenzy to step up and hang the person(s) without considering all the evidence! the only evidence provided is one-sided and coming from gossip to boot! one of the things students are supposed to be learning in the nursing process is the gathering of data--from as many sources as you can find it. how amazing that this process breaks down when an emotional issue such as this is at hand.
first of all, hipaa, the health insurance portability and accountability act of 1996, pertains to healthcare information transmitted electronically, as in over the internet, fax lines or telephone lines. it specifically has to do with information in patient's charts that is shared with insurance companies and third party payers of the patient's medical bill.
secondly, confidentiality, which is what many of the posts are referring to and what the wrong doing talked about by the op "seemed" to have violated, is different from hipaa.
third, we are all entitled to confidentiality in regard to any judgments made about our performance on the job or in your nursing program. yes, some states have adopted specific laws about confidentiality. in reading the beginning post to this thread it was obvious to me that there is a great deal of information that is unknown as to why the student was allowed back into the nursing program. and, that information is going to remain unknown to all of us for the protection of the student's confidentiality. is anyone other than me concerned about protecting the confidentiality rights of the student here?
just using my common sense and experience as a manager tells me that there had to have been a very good explanation for the student's actions that prompted the school to reverse their original judgment of the student. despite the disappointment many might feel that this poor person was not crucified nearly as brutally as (s)he should have been, it is quite possible that once school officials reviewed all the information there was, in fact, no violation of hipaa or breach of confidentiality at all. has anyone considered that possibility? is anyone putting any of their critical thinking skills that they're supposed to be learning in school to work here at all?

i can totally agree with this statement. while i would not have called the family and informed them of the patient's whereabouts, i can easily see how this can happen. i attended a school that did not have us sign anything regarding hippa, and they were not explicit about much, from hippa to pharmacology. in fact, most of my clinical instructors were so hell bent on leaving early that most of the time, instead remaining on site for 8 hours, we would be at our location for a total of two. did we miss alot of experiences? shoot, yeah!! what i learned about hippa came from my employment at a hospital, that had us sign, not my school.

i support the fact that they gave the student another chance. i am sure that she learned from it, and if not, then, it will show another time. too many times, people are mercilessly thrown out of nursing programs, and actually, even some of the ones that made it through and passed nclex are questionable.

kgkarma · Oct 20, 2006

There is a huge ordeal in my clinical group. I have managed to stay out of it (thankfully I wasn't there when it happened and haven't been forced into getting involved), but was wondering what you guys thought about this.
The week before last in clinical, one of the students went to the nurses desk, called a friend, and told them that their step-mother was in the hospital with pneumonia and it looked pretty bad. The student did this in front of 2 students, a nurse (or more?), a doctor, and the unit secretary.
She was turned in for violating HIPAA and was told by the hospital that she was not welcome back. Our clinical instructor told her to go home. She was later notified by the department that she had been dropped from the program.
She appealed, of course, and continued to attend class.
Her clinical review was last Thursday and this morning she was in class for our test... so I guess she is still in..
what are your thoughts on this?

I can't believe this. I'm a new nursing student and my instructor taught us the first week about that being a HIPPA violation. Even if the student is still in school it doesn't mean that the hospital will let her back in.

kgkarma · Oct 20, 2006

I find it hard to believe that a hospital orientation would not include HIPAA requirements. At every clinical I have been at, HIPAA has been explained over and over again, with numerous examples, and we have signed a form to indicate we have been trained on HIPAA. I have spent the past 25 years in the medical records field and HIPAA has been in the forefront and all over every one's faces in the healthcare field for the last 5 years at least, BIG TIME. I don't see how anyone could possibly miss what HIPAA regulations are and the ramifications for violating them. It's a federal law for crying out loud.
I would also bet that her Nursing Student Handbook at the school has a section regarding Confidentiality. Ours states: the concept of the right of individuals to privacy is taught throughout the nursing curriculum. Privacy rights are protected by maintaining confidentiality. On a routine basis, the faculty addresses the legal, moral and professional consequences of breaches of confidentiality. The profession of nursing respects the autonomy of every individual and demands the maintenance of confidentiality at all times.
Furthermore, what about the state's Nursing Practice Act? Illinois Sec 10-45 grounds for disciplinary action include:
(21) Willfully or negligently violating the confidentiality between nurse and patient except as required by law.
I see no excuse.

Not only did we have to sign something but we had to pass a HIPPA test before we were allowed to go to clinicals. If you didn't pass, you didn't go to clinicals.

kgkarma · Oct 20, 2006

Actually, I'm going to answer part of my own question. I got just my School of Nursing Undergraduate Handbook today and I was browsing through it and I found a paragraph on HIPAA. We are required to read it and sign it, and although I have not taken any nursing classes yet, just pre-reqs, I'm sure I will learn much much more about it, like in Nursing 101, which I take next semester.
I still have one question though.. I don't understand how if you go to a hospital, and there are visitors there, doctors and nurses are allowed to go up to them and explain the patient's status and health problems. Wouldn't that be a violation? Thanks!

The nurses that I've come in contact with have always referred me to the doctor or to a family member. I don't ever recall a nurse giving me any personal info. about a patient.

nursekare · Oct 20, 2006

I think kicking her out is a bit harsh.

Question:

Is it as harsh as having her prosecuted?

http://www.ehcca.com/presentations/HIPAA3/malone_1.pdf

Criminal Penalties for a Violation of 42 U.S.C. 1320d-6. Section 1320d-6(b) sets forth the maximum penalties allowable for a violation of 1320-6(a). Upon conviction, the actual sentence imposed is determined under the Federal Sentencing Guidelines. The Guidelines will be discussed in Section VIII, infra. Under 1320d-6(b), any person who violates subsection (a) shall:

1. Be fined not more than $50,000, imprisoned not more than one year, or both;

2. If the offense is committed under false pretenses,1 be fined not more than$100,000, imprisoned not more than 5 years, or both;

3. If the offense is committed with the intent to sell, transfer, or use individually identifiable health information for commercial advantage, personal gain or malicious harm, be fined not more than $250,000, imprisoned not more than 10 years, or both.

The key is did she knowingly, as an inexperienced student, knowingly violate the law as stated in the legislation or was it a case of not doing much critical thinking prior to acting upon the information her clinical experience afforded her.

IMHO, I think she got off easy.

Unitl the law is actively enforced, nurses nor students will understand the full gavity of choosing to reveal protected, private, patient information to those other than other patient care providers or the patient.

Waivers should be provided in all patient care areas for the staff to obtain written permission to reveal medical information and to whom this info may be revealed.

dauschundlover · Oct 21, 2006

Gee from the majority of responses getting kicked out of the hospital was way to lenient she should have been tarred and feathered. Look, none of us know the circumstances and I wonder if the event was truly investigated. Did the patient give the student permission to notify the stepdaughter? Yes HIPPA was violated but unless every patient throughtout the country is in a private room HIPPA is violated every day in every hospital setting. Curtains do not provide a sound barrier. Interviewing a patient in ear shot of anyone else not involved in that patients care is a violation of HIPPA. I worked in an endoscopy unit and every day I admitted someone for a test I was in violation of HIPPA. Patients sat next to each other during the admission process and none of them to my knowledge was deaf. They were privvy to all that was discussed. Altought this is an example of a blatant HIPPA violation did anyone take the time to talk with this student to find out her side? Gee I bet if she was a med student she wouldn't have been banned from the hospital. And as pointed out by working under the license of her nursing instructor the nursing instructor should have been held just as accountable for all of those reaching for the jugular.