HIPPA rules and consent

[Epona]

Hi everyone!! :) I have a few more questions as I am getting ready for NCLEX.

As far as HIPPA rules go and patient confidentiality, say a husband is in the hospital and his wife calls and wants to know how he is doing, can we give this info. over the phone? What about if she comes to see him... can we tell her of his medical status?? What about another family member like a brother or sister?? Can we share this info. with other family members?? We cannot divulge info. to friends, though, right??

As far as consent, in reference to minors, as long as they are under 18, you have to have parental consent for a procedure, right? I know if they are pregnant, that negates it and the minor can then speak for themselves.

Thanks for helping me out here!!

[Reno1978, BSN, RN]

I doubt you'll find too many questions on these topics on your NCLEX, but here goes:

As far as HIPPA rules go and patient confidentiality, say a husband is in the hospital and his wife calls and wants to know how he is doing, can we give this info. over the phone? What about if she comes to see him... can we tell her of his medical status?? What about another family member like a brother or sister?? Can we share this info. with other family members?? We cannot divulge info. to friends, though, right??

Where I work, the patient gets a password set-up and when people call over the phone, they must provide the password in order to receive information about the patient. No password, no information, no matter who they say they are.

As far as consent, in reference to minors, as long as they are under 18, you have to have parental consent for a procedure, right? I know if they are pregnant, that negates it and the minor can then speak for themselves.

Sounds right to me. Two physicians, in my state, need to sign for emergency cases when family cannot be located and action needs to be taken. There's probably other exceptions, but I can't think of any right now.

[hypocaffeinemia, BSN, RN]

Hi everyone!! :) I have a few more questions as I am getting ready for NCLEX.

As far as HIPPA rules go and patient confidentiality, say a husband is in the hospital and his wife calls and wants to know how he is doing, can we give this info. over the phone? What about if she comes to see him... can we tell her of his medical status?? What about another family member like a brother or sister?? Can we share this info. with other family members?? We cannot divulge info. to friends, though, right??

HIPPA is vague on this and from my experience the amount of information to be given varies with hospital policy. At my current facility, you may state their status (good, fair, etc.) if they are not a confidential patient. With family, we encourage our patients at admission to identify contact info with whom their medical details can be shared with, and for phone calls we create a "passcode" which allows us to reveal information to patient-authorized parties.

As far as consent, in reference to minors, as long as they are under 18, you have to have parental consent for a procedure, right? I know if they are pregnant, that negates it and the minor can then speak for themselves.

Thanks for helping me out here!!

This varies state to state. Texas has a list of qualifications in which minors can give consent.

[RN1982]

We do the password thing too. If the patient doesn't have one I just say that the patient is stable and I can not give out any other medical info over the phone because of state/federal privacy laws. They usually don't persist after I say that. In my hospital, a minor over 15 can make their own decisions in regard to their health.

[Jolie, BSN]

hi everyone!! :) i have a few more questions as i am getting ready for nclex.

as far as hippa rules go and patient confidentiality, say a husband is in the hospital and his wife calls and wants to know how he is doing, can we give this info. over the phone? what about if she comes to see him... can we tell her of his medical status?? what about another family member like a brother or sister?? can we share this info. with other family members?? we cannot divulge info. to friends, though, right??

generally speaking, you cannot disclose protected medical information to anyone without the patient's consent. (there are a few exceptions such as blind research studies.) you can disclose to other healthcare professionals who need the information in order to care for the patient. usually, upon admission, the patient will be asked to specify who may be given information (the wife, for example) and she will be given a "code" to identify herself over the phone. so if the wife calls and uses the proper code to identify herself, you may given information. or if the wife calls, and the husband gives you permission to release information to her, then you may. some people don't have family, or aren't involved with their family. in those circumstances, the patient may authorize a friend to receive information. it is not important that there be a familial relationship. it is important that the patient has identified the individual as someone authorized to be given information.

as far as consent, in reference to minors, as long as they are under 18, you have to have parental consent for a procedure, right? i know if they are pregnant, that negates it and the minor can then speak for themselves.

laws regarding consent from "emancipated minors" vary from state to state. in general, children under age 18 require parental/guardian consent. in some states, minors seeking care for pregnancy and/or stds are considered emancipated and may give consent for themselves, but this is not universal.

[Elvish, BSN, DNP, RN, NP]

Generally speaking, health info can be shared between entities for reasons of treatment, payment, or healthcare operations. Ex: I'm in the hospital calling report to a nursing home; I'm a pharmacy calling to question a prescription; I'm an insurer calling to verify medical necessity of a procedure. Those are all instances where a pt does not have to give consent for health info to be shared.

If you are talking about individuals, you can only disclose info to people with whom you have the patient's permission. Our hospital does not use the password system, though it sounds like a very good idea. If you do not have the patient's permission to share info even with his/her spouse, you do not share it. You can get written permission from the patient to share, or you can get verbal consent from the patient, as long as you document that you have it. (This is at my facility; others may be different.) Then and only then can you share, no matter who they are.

Regarding minors, every state is different, and some states are very unclear. In my state, pregnant adolescents can sign for themselves to receive treatment for STDs, pregnancy, or mental health issues. If they are married, they're considered emancipated. Other than that, you've pretty much got to have parental input.

[Epona]

THANK YOU! These are all excellent bits of advice!

Here is a situation-- say the person has been in a bad car accident and arrives via ambulance-- they are unconscious and you are not able to get consent-- the family comes rushing into the ER soon after and wants to know the status of the patient. What do you do? The patient is unconscious and you did not get consent.

THANKS!!! :typing

[Elvish, BSN, DNP, RN, NP]

I believe there is a clause in there that allows a physician to share information without pt consent in an extreme situation like the one you describe if s/he deems that it is in the patient's best interest.

If you want to find out more than you ever wanted to know, you can visit: http://www.hhs.gov/ocr/hipaa/

[Epona]

Ok. I will refer to that link. THANKS for providing it.

Take care! E

[Elvish, BSN, DNP, RN, NP]

No prob. :)

[anapoo]

Glad i saw this posting because i have a question too lol

On admission we have a question that states, "if anyone calls about you are we allowed to give them information and tell them you are here"

so if they say yes, that means whoever calls right????

Or should i still say "they are stable yada yada yada" and still not give the info to cover my butt. Which of course is what i do unless it's the POA. But i have family members and co-workers get mad at me for not telling family stuff.

[Riseupandnurse]

One thing I have never been able to understand: the majority of patients are alert and oriented and fully able to state how they are doing, what the doctor said, what treatment they are getting, etc. Why the heck don't these concerned family members and friends just call the patient or the spouse and leave the nurse out of it? We have enough to do nursing the patient without all these phone calls that take us away from doing that.