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Difficulty: HardConfidentiality and Information Security

While administering medications on a busy progressive care unit, a practical nurse (PN) encounters several situations involving the handling of protected health information (PHI). Which of the following actions demonstrate appropriate adherence to information security and confidentiality protocols? Select all that apply.

  1. Logging out of the electronic health record (EHR) system before stepping away from the mobile workstation to respond to a nearby bed alarm.Answer
  2. B
    Providing the client's spouse with printed laboratory results after the spouse expresses severe anxiety about the client's current condition.
  3. Providing a client's current vital signs to the respiratory therapist who is preparing to administer a scheduled nebulizer treatment to the client.Answer
  4. D
    Confirming the time of a client's scheduled surgery to a telephone caller who successfully verifies the client's full name and date of birth.
  5. Positioning the mobile workstation screen to face the wall while verifying a complex medication order with the pharmacy over the telephone.Answer
  6. F
    Placing empty intravenous fluid bags containing intact client prescription labels into the regular waste receptacle inside the client's room.

Answer

The correct actions are logging out of the EHR system before leaving the workstation, providing vital signs to the respiratory therapist for treatment purposes, and positioning the screen away from public view during phone calls.
Appropriate information security requires safeguarding protected health information (PHI) across all formats. PNs must secure unattended workstations by logging off to prevent unauthorized access, even during emergencies. Sharing PHI with interdisciplinary team members, such as respiratory therapists, is legally permitted because it directly facilitates client treatment. Finally, positioning screens away from public view effectively prevents incidental visual disclosures in busy clinical areas.

Step-by-Step Solution

1
Analyze each scenario to determine if the disclosure or security practice aligns with HIPAA regulations and the need-to-know principle.
Identified that logging out of the EHR, sharing information with direct care providers, and physically shielding screens are acceptable and required practices.
Information security involves securing electronic devices, ensuring appropriate interdisciplinary communication for treatment, and preventing incidental disclosures.
2
Evaluate the scenarios involving unauthorized parties or improper disposal.
Identified that sharing PHI with a spouse without consent, confirming medical details over the phone using only basic demographics, and throwing intact prescription labels in regular trash are violations.
Good intentions do not override the legal requirement for explicit client consent, strict telephone verification protocols, and secure destruction of physical PHI.

Key Concept

Under HIPAA, nurses must secure physical, electronic, and verbal PHI. Disclosures are permitted for treatment, payment, and healthcare operations (e.g., to interdisciplinary team members), but require explicit authorization or passcodes for family members and telephone callers.
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Confidentiality and Information Security

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