M in the Box

[95PGTTech]

Recently my hospital has instituted (on the floors only) a new policy "M in the box." The RN is supposed to write the date, the medication name, and one side effect of this medication on the special white board on the wall. Ideally, it is a new medication from this admission and once the patient can "teach back" that med, a new one is put up.

I don't pay much attention to it, I have an education-thorough reputation as it is and discuss far more than one med with each patient. I had a patient yesterday when I floated to telemetry that was a newly diagnosed HCV and his only new med was an antiviral. When the CC rounded and saw the M in the box blank, she asked me about it and I told her I refused to put that med up there because it would broadcast his new diagnosis to anyone with a smartphone and google. I personally have HCV from a bad blood transfusion in 1988 and I don't make it public knowledge, I have gotten a lot of bad feedback in the past, mostly people assuming I have HCV because I'm an IV drug user or homosexual (not that there is anything wrong with that, I'm just happily married for 9 years to my beautiful wife and I don't appreciate unwanted advances from either sex).

She agreed, and told me to just put up one of his HTN meds to be compliant. That begs the question - isn't ANY medication on there a privacy violation because these boards are in plain sight, some even from the hallway?

[Double-Helix, BSN, RN]

It's not a HIPAA violation in an of itself. HIPAA laws cover personally identifying information- name, DOB, address, etc. The same way that is isn't a HIPAA violation to put an isolation sign on a door, simply writing a medication on a white board doesn't violate HIPAA unless you're including personally identifying information with it. Where it would get dicey, though, is if you have visitors present who know who the patient is, but the patient has not consented for those visitors to receive information about his condition. And whether or not this would specifically be considered a HIPAA violation, it very well may be a privacy violation, especially if the patient doesn't give permission for their medications to be written on the wall. I would advise contacting your hospital's compliance department.

[AJJKRN]

This is just one more way for the customer service model to eat away at our souls. I agree that we need a better way to consistently communicate important details of patients hospital stays to the patients but whiteboards and all the BS surrounding them just ain't it!

[blondy2061h, MSN, RN]

I'd be pretty insulted if I were in the hospital and people were giving unsolicited information on my medications I am thoroughly informed about.