Nurses and Patient Confidentiality

NursingFebruary 15, 2014

Nurses consistently rank as some of the most trusted professionals, as noted by Gallup. Patients in a clinical setting share some of their most personal information with nurses. People sometimes find themselves at the complete mercy of a nurse. Then, they have to trust nurses.

Federal Law Mandates Patient Privacy

Patient confidentiality is one of the foundational tenets of nursing, and patient privacy is a right assured by federal law, specifically the Health Insurance Portability and Accountability Act (HIPAA). To implement this law into regulatory standards, the U.S. Department of Health & Human Services has established the Privacy Rule. The primary purpose of the rule is to balance the critical need for a flow of information between health care providers, while simultaneously ensuring an individual's right to privacy. It is imperative that any prospective nurse become familiar with this rule.

Maintaining Patient Confidentiality

The common sense guide for nurses is the same rule guiding doctor patient confidentiality: don't convey any health information identifiable to a particular patient. The only exceptions are specific ones allowed by the Privacy Rule or information permitted in writing by patients or their authorized representatives. It is important to understand that an authorization to release information is limited to the information specified by patients or their authorized representatives. Authorized means that the patient or court has appointed that person to represent the patient within the requirements of state law.

Stay vigilant for any mishandled patient information. Charts and papers scattered around a nurses' station is just one example. You cannot talk to a coworker about a patient unless he or she has a right to know. When you discuss a patient's medical information with family, limit it to only what the patient wants them to know. This is a particularly difficult area for nurses, who often interact with multiple family members throughout a shift. Pause and think about this before you answer questions or want to divulge information. The best fail-safe for these situations is to defer to the patient or his or her representative.

"Minimum Necessary"

The Privacy Rule's guiding principle, which assures patient confidentiality, is "minimum necessary" use and disclosure. This means that any health information you do convey must be specific to that entity's need to know. For example, suppose your patient signs a release limiting information to only what relates to his or her gall bladder surgery. When you call or report to another floor, as a nurse, you have no right to disclose any information other than what has been specified in a signed release.

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