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Question

Difficulty: HardConfidentiality and Information Security

A charge nurse is auditing information security and privacy practices on a busy medical-surgical unit. Which of the following staff actions represent a violation of the Health Insurance Portability and Accountability Act (HIPAA) and require immediate intervention by the charge nurse? (Select all that apply)

  1. Accessing the electronic health record (EHR) of a former client currently admitted to another unit to review the outcomes of a previous care plan.Answer
  2. Discussing a client's newly prescribed psychiatric medication with their spouse over the telephone without verifying the client's authorized disclosure list.Answer
  3. Leaving a mobile workstation logged into a client's EHR in the hallway while quickly retrieving supplies from the clean utility room.Answer
  4. D
    Notifying the local public health department about a client's confirmed diagnosis of active tuberculosis without obtaining the client's explicit consent.
  5. E
    Delegating the task of placing printed client assignment sheets into the unit's locked secure shredding bin to an unlicensed assistive personnel (UAP).
  6. Printing a copy of a client's recent diagnostic results and placing it in a personal bag to use as a case study for a graduate school assignment.Answer

Answer

The actions that represent HIPAA violations are: accessing the EHR of a former client without a current care relationship, discussing PHI with a spouse without verifying authorization, leaving a logged-in workstation unattended in a hallway, and removing printed diagnostic results for a school assignment.
HIPAA mandates that protected health information (PHI) is only accessed by individuals with a direct need-to-know based on their current clinical assignment. Accessing records out of curiosity, leaving active electronic sessions unattended, disclosing information to unverified family members, and taking printed records off-site without strict de-identification are all direct violations of federal privacy laws and institutional security policies.

Step-by-Step Solution

1
Analyze the question requirements.
The question asks to identify actions that constitute a violation of HIPAA regulations requiring intervention.
Understanding whether to select compliant actions or non-compliant actions ensures accurate evaluation of the options.
2
Evaluate each staff action against HIPAA principles of minimum necessary access, authorized disclosure, and data security.
Actions involving unauthorized access (former client), unauthorized disclosure (spouse not on list), poor physical security (unattended workstation), and improper removal of PHI (school assignment) are identified as breaches.
HIPAA strictly regulates who can access PHI, to whom it can be disclosed, and how it must be physically and electronically secured.
3
Identify legal exceptions and appropriate delegation practices that do not violate HIPAA.
Reporting active tuberculosis to the health department and delegating secure document disposal to a UAP are recognized as compliant actions.
Mandatory reporting laws override standard consent requirements, and UAPs are trained and legally bound to maintain confidentiality when handling secure disposal.

Key Concept

HIPAA Violations vs. Mandatory Reporting Exceptions
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Topics

Confidentiality and Information Security

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