Safely administering medications for coworkers violating hipaa if we're not asssigned pt ?

[Cynnie24]

Hi everybody,

I was just wondering if something that seems to happen a lot constitutes a hipaa violation. For example, in my clinical rotations as a student, I would see floor nurses in the hospital who were occupied in emergency situations having to have fellow floor nurses who were NOT assigned to the patient's care team (and not the charge nurse) pass some meds to other patients for them. For example, another floor nurse would pass a prn pain medication or a breathing treatment for that nurse's other patients. Now as a prudent nurse we need to follow the rights of medication and know WHY we are giving a medication, so that means knowing a bit of the patient's history right? We cannot blindly give medications. So, is safely administering medications for coworkers violating hipaa in some way if we are not assigned to their care?

Another example, how about when fellow floor nurses ask other floor nurses to insert a foley in their patient, or to help start an IV on a patient after failed attempts?

Or if there is no charge nurse on duty and there is a possible emergency situation, is it a hipaa violation if I pull an experienced RN in the room with me to validate my assessment if I wasnt sure of something/help assist with an emergency situation? Ok and I know we would always ask the patient before if another person can come assess but what if the patient is not able to communicate. I know obviously the number one priority is to keep the patient safe but are we technically violating hipaa in the process? Sorry if this is a silly question, Im still a very new nurse and am just curious of the technicalities of this. Thank you in advance!

[wanderlustnurse88, RN]

I think having a coworker come in and verify an assessment or help with a skill that we are unable to do is acceptable. We need to know where our limitations are. We don't want to keep poking at a pt trying to find a vein if we cannot get it, but a coworker could get in one shot.

I do think we need to be careful in medications. I think as long as we know why we are giving it and we know some of the pt history, it is ok. I work in a small 14 bed hospital so I usually know why all the pts are there (especially when a lot of them are waiting for LTC).

That's just my two cents.

[MunoRN, RN]

HIPAA doesn't actually limit you to accessing information on only the patients assigned to you, HIPAA specifically allows access to any information related to care we are providing, whether it be to our own assigned patient or another nurse's assigned patient.

[Katie71275]

You ARE providing care to the patient so no it's not a violation at all. When I go to lunch someone else watches my patient and they get a quick report on them so they do know what's going on.

[SubSippi]

Additionally, keep in mind that nurses, and their patients, absolutely depend on teamwork to get the job done.

I think previous posters have done a good job explaining why it's not a HIPAA violation. As far as knowing why we are giving certain medications...if you're giving lisinopril I think it's safe to assume it's because the patient has high blood pressure. If you're giving dilaudid, it's because the patient is in pain. Ideally we are able to know everything about a patient's history, but it's just not reality sometimes.

Anyway, I understand why you asked the question, especially with all this HIPAA crap shoved down everyone's throats. Keep wondering and keep learning!

[Karou]

No violation in either situation.

When administering medication to another nurses patient, you are automatically now providing care to that patient and can look up any information necessary to administer it safely.

Most facilities use electronic medical records and it doesn't take very long to briefly review a patient's medical history, lab values, vitals, ect... Whatever you need to administer a medication safely.

Same rationale for a second nurse assessing a patient or doing a procedure (foley insertion, IV, recording vital signs, even taking a patient to the bathroom and documenting output). They have now been asked to provide care for that patient and there is no violation.

[Here.I.Stand, BSN, RN]

It's not a violation because the covering nurse IS providing direct care. We do it every single day because it is required for patient care. For example, RN A goes to lunch, and then pt asks for pain meds, or pt is on a vasoactive drip and their BP has gone outside of parameters; does RN B wait for RN A to come back, or call RN A back to titrate the drip, or does RN B do it because RN A is off the clock? Or RN A gets an unstable admit; RN B is starting a drip so has to chart it, and RN C is administering blood while RN A does the assessment? RN B *has* to chart the drip b/c she started it; RN C *has* to chart the blood products given (along w/ whoever double checked the units.) To refuse to open or document in a chart on a pt not assigned to us would disrupt safe pt care. It's very different than saying, "Oooh, this is that guy who was on the news! Let's look in his chart and see what's going on!"--that is a CLEAR HIPAA vio.

As for blindly giving meds, like PP said it doesn't take long to find out the pertinent info. Not to mention, in the case of RN B covering for RN A, A would have given report on pts to B before leaving the floor. Lots of times it's not rocket science; there are sometimes obscure reasons for giving a med, but usually the meds we've given for each other are things like pain meds, prn BP meds or titrating the drip--when we report off to each other, one of the things we advise of is the pt's BP parameter.

[BrnEyedGirl, BSN, MSN, RN, APRN]

HIPAA protects private information from getting into the wrong hands. If you are providing care, you need the information. I work in the ED, while I may only be assigned to 3 or 4 patients, not only is it acceptable, but necessary for me to have access to all the pts in the department. If a coworker gets tied up with a critical pt or leaves the floor with a pt I may need to go give a med to one of her/his pts. I may need to draw labs or check on xray results on other pt's. This is all done during the course of providing care to the pt, completely legal, above board and ok! Accessing a chart for personal reasons is not,...for instance when a friend calls you at work and says "Hey, my co-worker Joe Smith just called into work, he says he is in your ER with a broken ankle,..can you check that out for me?",..that is not ok even though you technically have access to the chart! It happened,..saw it,..couldn't believe it :)

[psu_213, BSN, RN]

Being "assigned" to the patient does not really matter in this situation. Even if a nurse is assigned to a patient, that does not give the nurse carte blanche to look though all parts of the chart--only the parts relevant to patient care. Likewise, if you are not assigned the patient, you can go into the chart to provide care to the patient if, for example, that other nurse is tied up. This could mean going to the EMAR, going to the vital signs to check most recent BP before giving and antihypertensive, looking for a doctor's order for a Foley, etc.

[KelRN215, BSN, RN]

This is not a HIPAA violation. It is necessary for the covering nurse to look up this information to safely care for the patient.

If you called your MD's office for a sick appointment and it was a day he wasn't working and you made an appointment with another doctor, you'd expect that doctor to look at your records, right? No HIPAA violation. It would be a violation if, say, a famous person was on the floor and every nurse looked at the chart to see what was going on with him just because.

[Cynnie24]

All of the responses have been so wonderful. Thank you all so much for clearing this up for me!

[BuckyBadgerRN, ASN, RN]

What do YOU think, op? Is this a homework assignment?