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TN006 Policy and Regulation Supporting Informatics and Technology

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Western Governors University

D029 Informatics for Transforming Nursing Care

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What is the Health Insurance Portability and Accountability Act (HIPAA)?

The Health Insurance Portability and Accountability Act (HIPAA) is a federal law designed to protect the confidentiality and security of patients’ health information. It establishes strict guidelines to prevent unauthorized access, use, or disclosure of electronic health records (EHRs) (HealthIT.gov, n.d.; U.S. Department of Health & Human Services [HHS], n.d.). HIPAA contains several critical provisions, including:

  • Ensuring secure transmission of electronic health records (HHS, n.d.)

  • Granting patients the right to access their own medical records (HHS, n.d.)

  • Limiting healthcare staff’s access to and use of patient information to only what is necessary for their duties (HealthIT.gov, n.d.; HHS, n.d.)

What is the Impact of HIPAA on Bedside Shift Report (BSR)?

HIPAA plays a crucial role in shaping how Bedside Shift Reports (BSR) are conducted within healthcare settings. Its impact includes:

AspectDescriptionReferences
Protection of Patient DataNurses are legally required to safeguard patient information, facing penalties for breaches.Gialanella et al., 2017; HHS, n.d.
Legal ReminderHealthcare workers must obtain consent before discussing patient information in the presence of family, visitors, or other patients.Malfait et al., 2019; HHS, n.d.
Cost ImplicationsModifications to healthcare facilities, such as redesigning shared rooms for privacy, may be necessary.Malfait et al., 2019
Ethical ConsiderationsNurses must balance patient privacy with effective communication, avoiding breaches while ensuring quality care.HHS, n.d.; Hoover, 2016; Malfait et al., 2019

How Does HIPAA Facilitate Improvements in Bedside Shift Report (BSR)?

HIPAA not only protects privacy but also supports enhancements in BSR by encouraging the integration of technology and patient involvement:

Improvement AreaExplanationReferences
Use of Health Information Technology (HIT)Encourages the use of electronic health records to streamline information sharing and improve patient care.Gialanella et al., 2017; HealthIT.gov, n.d.
Patient Privacy ReinforcementEmphasizes the importance of obtaining patient consent before sharing information with family members.Gialanella et al., 2017; Malfait et al., 2019
Empowering PatientsInvolving patients in their care decisions enhances satisfaction and compliance.The Joint Commission [JC], 2017; Malfait et al., 2019
Workflow OptimizationUtilizing patient participation and checklists integrated into EHRs to streamline nursing workflows.Gialanella et al., 2017

What Can Be Done? Implementing an Updated Bedside Shift Report Policy Compliant with HIPAA: Dynamic Dialogue Bedside Shift Report (DDBSR)

The Dynamic Dialogue Bedside Shift Report (DDBSR) model promotes active patient (and family when appropriate) participation during nursing shift changes. This approach aims to:

  • Enhance communication accuracy and clarity

  • Increase patient satisfaction and engagement

  • Improve nursing workflow efficiency

  • Protect sensitive patient health information according to HIPAA standards

How Does DDBSR Align with HIPAA Regulations?

The DDBSR policy complies with HIPAA by:

Compliance MeasureDescriptionReferences
Error ReductionBy involving patients directly in the shift report, it reduces communication errors and enhances patient involvement in care plans.JC, 2017; Malfait et al., 2019
Safe and Accurate Use of EHREmploys electronic health records and meets meaningful use criteria to ensure high-quality care.HealthIT.gov, n.d.; HHS, n.d.
Enhanced Security FeaturesIncludes “hard stops” with checklists and requires dual nurse sign-on and sign-off for access to patient records, increasing safety.Gialanella et al., 2017
Access TrackingRecords detailed logs of who accesses patient records, adding an additional layer of security.Gialanella et al., 2017; Hoover, 2016

References

Gialanella, K. M., Mastrian, K., & McGonigle, D. (2017). Legislative Aspects of Nursing Informatics: HITECH and HIPAA. In Nursing informatics and the foundation of knowledge (4th ed., pp. 141–166). Jones & Bartlett Learning.

HealthIT.gov. (n.d.). Health IT legislation. https://www.healthit.gov/topic/laws-regulation-and-policy/health-it-legislation

Hoover, R. (2016). Benefits of using an electronic health record. Nursing, 46(7), 21–22. https://doi.org/10.1097/01.NURSE.0000484036.85939.06

The Joint Commission. (2017). Inadequate handoff communication: Sentinel alert event. https://www.jointcommission.org/-/media/tjc/documents/resources/patient-safety-topics/sentinel-event/sea_58_hand_off_comms_9_6_17final(1).pdf.pdf

TN006 Policy and Regulation Supporting Informatics and Technology

Malfait, S., Van Hecke, A., Van Biesen, W., & Eeckloo, K. (2019). Is privacy a problem during bedside handovers? A practice-oriented discussion paper. Nursing Ethics, 26(7–8), 2288–2297. https://doi.org/10.1177/0969733018791348

U.S. Department of Health & Human Services. (n.d.). The HIPAA Privacy Rule. https://www.hhs.gov/hipaa/for-professionals/privacy/index.html

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