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Difficulty: Very hardConfidentiality and Information Security

During a routine compliance audit on a medical-surgical unit, several staff interactions involving protected health information are observed. Which of the following documented actions by a practical nurse (PN) demonstrate appropriate adherence to confidentiality and information security guidelines? Select all that apply.

  1. A
    Accessing the electronic health record (EHR) of a client assigned to another unit at the urgent request of the client's highly anxious spouse.
  2. Disclosing a client's room number and general condition to a visiting clergy member after confirming the client has not opted out of the facility directory.Answer
  3. C
    Discussing a client's complex discharge barriers with the assigned physical therapist while riding in an empty hospital elevator.
  4. Reporting a client's positive test result for a state-mandated communicable disease to the local health department despite the client's explicit refusal of consent.Answer
  5. E
    Providing a clinical update over the telephone to an individual who correctly verifies the client's full name, date of birth, and home address without a privacy passcode.
  6. Logging out of the mobile electronic health record (EHR) workstation before stepping away to assist a nearby client experiencing sudden emesis.Answer

Answer

The compliant actions include disclosing basic directory information when the client has not opted out, fulfilling mandated public health reporting despite client objections, and consistently securing the EHR workstation even during urgent unit events.
Compliance with confidentiality regulations requires understanding both the strict limitations of data access and the specific legal exceptions. Releasing general directory information (when not opted out), fulfilling mandated public health reporting (even over client objections), and consistently securing electronic workstations (even during urgent unit events) demonstrate accurate application of these legal frameworks.

Step-by-Step Solution

1
Evaluate the facility directory scenario.
Disclosing directory information to clergy is permissible.
Unless a client explicitly opts out upon admission, basic directory information (room number, general condition) can be legally shared with clergy and callers who ask for the client by name.
2
Evaluate the public health reporting scenario.
Reporting the communicable disease is compliant and mandatory.
State-mandated reporting for specific communicable diseases is a direct legal exception to privacy laws and does not require client consent.
3
Evaluate the EHR workstation security scenario.
Logging out before assisting another client is strictly compliant.
Information security must be maintained without exception; abandoning an active EHR session, even for an urgent clinical need, is a punishable security breach.
4
Evaluate the remaining scenarios involving unassigned chart access, elevators, and telephone updates.
These represent breaches of confidentiality.
Viewing unassigned charts without authorization, discussing clinical cases in public areas like elevators, and providing clinical data without a verified privacy passcode violate information security regulations.

Key Concept

HIPAA Privacy and Security Rules regarding permissible disclosures and unauthorized access.
Estimated Time:2m 0s
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Topics

Confidentiality and Information Security

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