Could shift reports at the bedside violate HIPAA? (696 hits)
Wednesday November 23, 2011
Dear Nancy, Our hospital is requiring nurses to give shift reports at the bedside. Is this a HIPAA violation? Can the nurse be sued for giving the report? They want us to answer all questions asked by family. What are our liabilities? Nina
Nancy Brent replies: Dear Nina, It is a little unclear why the hospital wants shift reports to be given at the bedside, and you did not indicate why this policy was put into place. However, there are some concerns related to the Health Insurance Portability and Accountability Act that need to be mentioned. I cannot explain how these issues are resolved in the brief situation you described, but I can highlight briefly some of the possible issues under HIPAA.
Remember that HIPAA protects the security (Security Rule) and privacy (Privacy Rule) of Protected Health Information. If a patient gives consent to have his PHI shared with any and all family members, whether that takes place at the bedside or in the hallway does not matter because patient consent has been obtained. What causes concern is when a more “public” sharing of information takes place and there are others who are in the room (e.g., the other patient and his family), visitors or other family members in a hallway who overhear the information.
There is another aspect of HIPAA that also must be discussed briefly. HIPAA includes the fact that “incidental disclosures” of PHI sometimes occur and if prohibited entirely, would not allow a facility to function. So long as there are privacy and confidentiality protections in place for the protection of PHI, these incidental disclosures generally are not a violation of HIPAA. So, with the bedside reports, and with the patient’s consent to discuss issues with his or her family in place, if others in the room overhear the report “incidentally,” there is arguably no violation, assuming, for example, the bedside curtain is pulled, the report is done by speaking as quietly as possible and any other privacy concerns are followed.
You might want to raise your concerns with your nurse manager and CNO. Before doing so, review “Incidental Uses and Disclosures” of the Privacy Rule at (www.hhs.gov/ocr/privacy/hipaa/understanding/coveredentities/incidentalusesanddisclosures.html). Both the facility and nursing staff benefit from a shift report practice that conforms to HIPAA and other legal mandates governing privacy and confidentiality of patient information.
