Hippa Violations and Roomates

[nurturing_angel]

Could I please get some input on this problem that has bothered me since I first heard about HIPPA?

How do you deal with new admits to rooms with a patient and family already in the room. A lot of personal information is exchanged during the admission interview and assessment. I have asked the roomates visitors to step out of the room before and this is sometimes done and other times refused. I had one lady report me because I made her visitors leave.

Also, you can't make a patient leave his/her room and I had a new admit get very angry with me because she heard her room mate and her daughter talking about her diagnosis once.

I try to be very quiet so that we can't be heard on the other side of the curtain but that can't always be done with the new pt who is hard of hearing and asking you to speak up all the time.

Its getting to the point that I would just rather go to the emergency room before my pt is brought up and do the admission. But who has time for that?

[memphispanda, RN]

I am so glad my hospital is all private rooms! It sounds to me like it may be time to have a policy that the ER does the admissions forms...if not, then they could have an admissions nurse who does all the forms in the ER before the patient goes to the floor. There aren't a lot of options that protect privacy when you have roommates involved in the scenario.

[tntrn, ASN, RN]

Your concern is well-founded. We have a 3-bed triage room in our brand-new OB unit. The beds are so close that the patients could almost reach and touch each other. There's not a chance in h*** of any privacy there. Once, when speaking in Spanish to the patient in Bed 1, the husband of the patient in Bed 3 offered to interpret for me!

It goes beyond just asking the patient's visitors and family to leave. I[m sure there could be a case made for the roommate overhearing you ask for and get the pain level response.

While I agree with privacy and have practiced keeping confidential information confidential for years, I think there are aspects of HIPPA that are almost completely unworkable.

[Altra, BSN, RN]

I'd like to get input on this too ...

Just last week I faced this situation. I was assigned to a patient in a semi-private room and the other patient in the room was the MIL of a classmate of mine ... very chatty. She kept asking me "what's wrong with that woman?" (my patient)

I deflected that question, and others, but ... doing a complete system-by-system assessment of a HOH pt. in a semi-private room with any privacy at all seems nearly impossible.

[fab4fan]

Originally posted by memphispanda

I am so glad my hospital is all private rooms! It sounds to me like it may be time to have a policy that the ER does the admissions forms...if not, then they could have an admissions nurse who does all the forms in the ER before the patient goes to the floor. There aren't a lot of options that protect privacy when you have roommates involved in the scenario.

You have got to be kidding. ED nurses have enough on their plates without having that dumped on them, too!

They already hold pts for hours/days due to staffing issues on the floors, now you want them to do your admits?

Sorry if this seems hostile, but get serious. BTW, many, many ED's have litters that are only separated by curtains, so the same problem would exist.

[memphispanda, RN]

Well, I certainly didn't mean to imply that ER nurses were sitting around eating bon bons when they could be filling out forms. Good grief. I do know that from time to time our ER fills out the admission forms.

[Tweety, BSN, RN]

Originally posted by memphispanda

I do know that from time to time our ER fills out the admission forms.

You ER fills out your admission data base?? :eek:

We have patients spend 12 to 24 hours in the ER, without admission forms done. I wish there was a way to integrate the intake information the ER does and the exact same information that the floor nurse does. However, I don't think the ER should have this task put on them.

Back to the original question. Don't have any answer, we have semi-private rooms, don't know how to protect their privacy.

[Burnt Out, ASN, RN]

IMHO, ALL semi-private rooms violate HIPPA. We talk about this constantly at work...I wish we could do away with them entirely.

When I have to ask the patient a sensivite question (ie. one of our routine admission questions is about HIV/AIDS) I tend to lean in and ask them in their ear or I will write it out. But it still is hard to maintain privacy for both of the patients...

[Speculating]

Originally posted by memphispanda

I am so glad my hospital is all private rooms! It sounds to me like it may be time to have a policy that the ER does the admissions forms...if not, then they could have an admissions nurse who does all the forms in the ER before the patient goes to the floor. There aren't a lot of options that protect privacy when you have roommates involved in the scenario.

Memphispanda,

It's not any different in the ER there are generally only curtains separating the pts. downstairs too. Except most of the time they have a roommate on each side of them. Maybe you folks upstairs should have an admissions room one bed only. We could bring them up from the ER and place them in the assessment room. A nurse could then do the assessment on the pt. then transfer them into their designated room. We could kill two birds with one stone the patients can wait in the assessment room while they are waiting for their room to be cleaned.

[SmilingBluEyes]

While not practical, you not only desire but must REQUIRE all private rooms to be in compliance with HIPAA. Even IF you accomplish admissions processes privately, You can NOT teach them privately regarding their medical conditions and home care. Nor can you treat them privately. Just having a semi-private room violates the basic tenets (however annoying and frustrating they are) of HIPAA. I don't know the answer. Those hospitals and personnel with semiprivate rooms are violating HIPAA daily.

Total Compliance is IMPOSSIBLE.

Perhaps, IF fined enough, maybe the funds to make all rooms private won't seem so excessive to such institutions. I dont' know....

Which will be a cold day in hell in military hospitals. UGH.

My HIPAA rights and those of my roommate were violated the first day I arrived. I knew HER condition, and she was privvy to mine,just hearing what was going on. How do nurses say a THING to you w/o your roommate and her family hearing it? How do the doctors, making rounds, examine you and NOT reveal a THING about your condition thru a paper-thin curtain??? THIS IS WRONG!!!! She knew I lost a baby, not just had surgery.

Which brings up another concern: visits from clergy/religious leaders/healers. In My case, the military chaplain came to see me and it was NOT a totally private conversation. Her family was respectful and did leave. And As nice as she was, still, it was not fair. And it angered me. NOT as I could ask HER to get out HER bed and leave us alone hmm???!