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Difficulty: Very hardConfidentiality and Information Security

An unlicensed assistive personnel (UAP) approaches the practical nurse (PN) and states, "The attending provider just called while driving. They gave me their username and password and asked me to log into the electronic health record (EHR) to read them the latest potassium level for the client in room 210." Which of the following actions is the priority for the PN to take?

  1. Instruct the UAP not to use the provider's credentials, and access the chart under the PN's own login to relay the result.Answer
  2. B
    Advise the UAP to refuse the request and ask the provider to call back when they can securely access the system.
  3. C
    Direct the UAP to log in using the UAP's own credentials to locate and communicate the laboratory result to the provider.
  4. D
    Permit the UAP to access the system using the provider's credentials just this once, provided the PN directly supervises.

Answer

The correct action is to instruct the UAP not to use the provider's credentials, and access the chart under the PN's own login to relay the result.
The correct response addresses both the information security violation and the client's clinical needs. Sharing electronic health record (EHR) credentials is a strict violation of HIPAA and facility security policies, so the UAP must be stopped from logging in as the provider. However, because a potassium level can be critical, the PN should use their own authorized access to obtain the result and communicate it to the provider, ensuring safe, continuous client care.

Step-by-Step Solution

1
Identify the primary information security violation.
The provider sharing their personal username and password with the UAP constitutes a severe breach of HIPAA and facility electronic health record (EHR) security policies.
Login credentials serve as the legal electronic signature and audit trail for health information access; they must never be shared.
2
Identify the competing clinical priority.
The provider is requesting a potassium level, which is a potentially critical laboratory value that can affect cardiac function and requires timely intervention.
Client safety mandates that critical information is not unnecessarily delayed, even when correcting a procedural error.
3
Evaluate the UAP's scope of practice.
UAPs are not licensed to interpret, evaluate, or officially report diagnostic laboratory results to healthcare providers.
Reporting diagnostic data requires nursing judgment to ensure the correct information is communicated accurately.
4
Synthesize the appropriate nursing response.
The PN must intervene to stop the unauthorized access, assume responsibility for the clinical task, log in with their own authorized credentials, and report the result to the provider.
This single action mitigates the security breach, respects delegation boundaries, and ensures the client's clinical needs are met safely.

Key Concept

Balancing strict EHR security protocols (preventing credential sharing) with the prioritization of critical client care and appropriate delegation.
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Topics

Confidentiality and Information Security

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