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Discussion

Hippa rules

:typingHi,

I work at a LTC facility that has computer charting. One of the new nurses was going to take her hall sheet and census report, both of these have information like name , room number and admit date. She had made notes to remind her of the resident's diagnosis. I told her she couldn't take those home because of HIPPA, she told me she had a file full of notes and info from everyplace she had worked so that she could prove she had done her job. She stated she had lost a couple jobs because she couldn't prove she had done the treatment or ect, so now she keeps these to prove she has done her job. This was her second day on the job so I gave her the benefit of the doubt about taking personal information of our resident's home, but she in no uncertain terms told me she was doing it . I don't know if I am ticked off because of what she did or how much disrespect she showed to me. It is a violation of HIPPA isn't it??? Also I can access the computer program from my home with a password, so maybe it isn't such a big deal to take printed material out. Just was wondering. Thanks,

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  • Experts

This would be considered a violation of HIPAA. Lots of nurses keep notes at home, with or without personal identifiers, but that doesn't make it right or legal. She is doing what she feels is best for her situation. The question is what do you intend to do about this? This is a difficult thing. Are you just feeling spiteful? If so, inform your supervisor. Otherwise, you have spoken to the nurse and it is now in her hands what she does about your warning. If you really feel strongly about it then inform the supervisor anyway. It is the facility's responsibility to maintain strict compliance with HIPAA and what this nurse is doing is putting her employer as well as herself at risk.

  • Author

I didn't realize that most nurses took their notes home, I am such a pollyanna,, I also am not spiteful, just protective of my resident's privacy, HIPAA is such a hole waiting for us all to fall into. I just do not think from the stories this nurse has told about her family stealing from her and some other info that she has "shared" that I would want her to have my information or that of my family's. Don't know what to do. I'll have to think about it, I certainly don't want to appear spiteful or naive.

I agree that notes shouldn't be removed from a password protected system in the hospital and taken home. In addition to the supervisor, maybe you can speak to someone from the medical records or health information management department about this scenario and get their input without volunteering who done it. This type of situation falls into their purview as well. I'm surprised that you can access the hospital program from home. Is this typical with most hospitals that use computerized patient records? If so, what is the rationale?

She stated she had lost a couple jobs because she couldn't prove she had done the treatment or ect, so now she keeps these to prove she has done her job.

If she believes that her report sheet is going to provide "proof" that she has completed a treatment or other procedure, she is sadly mistaken. The only legal document which "proves" what has or hasn't been done for a patient is the chart. If she has faced questions in the past over her care of residents, it is probably because of inadequate charting, not because she lost her scratch paper!

I'm surprised that you can access the hospital program from home. Is this typical with most hospitals that use computerized patient records? If so, what is the rationale?

I agree this is unusual. In my experience, the only employees with access to the computer system from outside of the hospital are the system administrators who may need to troubleshoot computer problems at odd hours of the day and night, perhaps from home at 2:00 am.

I used to work in Medical Records and I don't really see anything against HIPAA if you take the notes home. as long as you don't share the information. What's the difference between taking notes home and taking yourself home with all the pt. information you know. As long as you don't say anything or show anybody anything.

I used to work in Medical Records and I don't really see anything against HIPAA if you take the notes home. as long as you don't share the information. What's the difference between taking notes home and taking yourself home with all the pt. information you know. As long as you don't say anything or show anybody anything.

Most facilities have policies against removing documents that contain identifying information.

so this is not a HIPAA thing it's a facility thing then?

so this is not a HIPAA thing it's a facility thing then?

In truth, it's both. Back in the olden days, no one knew or cared if nurses took their report sheets home with them, used them as bookmarks, wrote shopping lists on the back or wallpapered their houses with them. It just wasn't an issue.

Since the advent of HIPAA, healthcare facilities have become anal about anyone having access to patient identifying information, almost to the point of ridiculousness.

I don't honestly know what the actual HIPAA legislation says about removing report sheets from a facility, but to protect themselves from potential HIPAA violations, most insitiutions have policies against removing anything with patient identifying information without jumping thru hoops to demonstrate a need to do so. And there is just no need to keep a report sheet once a shift is over.

Frankly, I could care less if a co-worker leaves the hospital with a report sheet. I just don't think it is wise to let anyone know that it is being done, and they had better be kept in a secure place so that they never "turn up" later.

Back in the day BH (before HIPAA), I used to worry about getting in an accident and my notes flying all around with pt information. I was glad when the facility placed "shred boxes" for us to deposit our "notes" before we walk out the door. NOT to even throw them away in the trash because they could be found by someone else.

I agree that she should NOT be taking them home now which could be a violation. The excuse that she needs them to back her up is the problem. Again, if something isn't charted, no court is going to give leniency (sp) if you have the notes from home to back you up.

In truth, it's both. Back in the olden days, no one knew or cared if nurses took their report sheets home with them, used them as bookmarks, wrote shopping lists on the back or wallpapered their houses with them. It just wasn't an issue.

Really? It was my understanding that even before HIPPA, patient information was considered confidential and only to be shared with necessary/approved parties. The difference with HIPPA, I thought, was that it legally made it a CRIME to breach that confidentiality.

Really? It was my understanding that even before HIPPA, patient information was considered confidential and only to be shared with necessary/approved parties. The difference with HIPPA, I thought, was that it legally made it a CRIME to breach that confidentiality.

Just because someone has a report sheet does not mean that they are going to share the information on it. If one left work with a report sheet and then proceeded to stop at the neighbor's house and relay all the details someone's hospitalization that was certainly actionable. But that's not what happens with report sheets. Some nurses prefer to keep them in a file for their own reference. I left work many a time with my report sheet in my pocket and simply tossed it in the trash at home. 20 years ago, no one cared. Now, I would likely be called on the carpet, even if no one else ever laid eyes on it.

With my first employer, care plans were not part of the legal record, so when a patient was discharged, the care plan was placed in the primary nurse's mailbox. We kept them as they were part of our annual evaluations. I'm sure that has changed!

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