Confidentiality
What is confidentiality in nursing?
Patient information being kept private.
What is privacy under the PHIPA?
"The client's right to control how his/her personal health information is collected, used and disclosed".
A family member calls the floor wanting to know a status update of your patient. The family member is not on the list of patient contacts that the patient gave this morning on admission, but they insist they are a first relative. Can you give them updates? Why or why not?
No! They do not have the authorization as they are not on the contact list given by the patient.
What are the different forms of express consent?
What is verbal and written express consent?
Are nurses healthcare custodians or 'agents' of custodians?
Nurses can be BOTH, depending on where they work!
Can a client request a change in their PHI if it was an observation made in good faith by a healthcare professional?
What personal health information data might a nurse rely on during a shift?
Physical or mental health, family history , care provided (identification of people providing care), a plan of service (fixing long term care act), payments or eligibility of health care, donation of body parts or substances (blood) or information gained from testing these body parts or substances, patients health number/address/contact info or patient’s substitute decision-maker
Who is responsible for providing consent on behalf of a patient when a patient is unable to provide consent independently?
Substitute decision maker
Can a custodian use PHI without consent to conduct research?
the custodian can only use PHI without consent if the research is approved by an REB!
If a client's request to change their PHI was refused, does the client have the right to complain?
Yes, the client can complain to the organization or to the Information and Privacy Commissioner about any breaches to PHIPA.
What precautions might a nurse need to take to ensure that he/she is maintaining confidentiality and privacy?
Being cautious of open charts, closing and signing out of charts, looking at information only pertaining to relevant care, speaking to the patient about their preferences for sharing their information with family, informing the patient about who is in their circle of care, obtaining expressed consent with who they want their information being shared with
When is express consent required from a patient?
When personal health information of a patient is being disclosed outside of the healthcare team or not used to provide health care.
Name 4 types/examples of PHI
information relating to:
- Physical or mental health
- Family health history
- the care provided
- the people providing care
- eligibility for health care
- a person’s health number
- the name of a client’s substitute decision-maker
- names
What does "security" refer to in the PHIPA?
Security refers to the processes and tools that ensure confidentiality of information
If a client requests that the nurse not share a part of their PHI with the doctor, what would be the nurse's action?
The nurse would tell the doctor that a relevant piece of information was withheld at the request of the client.
What is the difference between implied and express consent?
Implied consent is not given explicitly unlike express consent. Implied consent is understood through actions, while express consent is understood through words.