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Difficulty: HardConfidentiality and Information Security

A practical nurse (PN) is entering vital signs into a wall-mounted electronic health record (EHR) terminal inside a client's room. A consulting specialist enters the room, states their tablet battery just died, and urgently asks the PN to pull up the client's morning magnetic resonance imaging (MRI) report on the wall monitor. What is the priority action for the PN?

  1. Decline the request and explain that staff members must use their own credentials to access client records.Answer
  2. B
    Open the MRI report on the monitor but ensure any visitors are asked to step out of the room first.
  3. C
    Access the requested report for the specialist and immediately log out of the terminal once it is displayed.
  4. D
    Ask the client to provide verbal consent before opening the MRI report on the screen for the specialist.

Answer

The PN must decline the request and explain that staff members must use their own credentials to access client records.
Facility information security policies and federal privacy regulations require all healthcare workers to access protected health information (PHI) using their own unique credentials. Allowing another individual, even a credentialed specialist, to view or obtain records through the PN's active session constitutes a severe security breach. The PN is legally responsible for all activity conducted under their login, and the EHR audit trail must accurately reflect the true user.

Step-by-Step Solution

1
Analyze the request made by the consulting specialist.
The specialist is asking the PN to access the EHR using the PN's active login session.
Identifying the nature of the request is required to evaluate it against facility policies.
2
Evaluate the request against HIPAA guidelines and EHR security protocols.
It is a violation of information security for any healthcare worker to view or access records using another employee's unique credentials.
The EHR audit trail must accurately reflect which specific individual accessed a client's protected health information.
3
Determine the priority nursing action.
The PN must refuse the request to protect the client's information security and maintain personal accountability, regardless of the provider's urgency.
Nurses are legally and professionally responsible for all activity conducted under their electronic signature and login credentials.

Key Concept

Electronic Health Record (EHR) Security and Login Accountability
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Topics

Confidentiality and Information Security

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