TN006 Policy and Regulation Supporting Informatics and Technology

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NURS 6051 Transforming Nursing and Healthcare Through Technology

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What is the Health Insurance Portability and Accountability Act (HIPAA)?

The Health Insurance Portability and Accountability Act (HIPAA) is a set of governmental laws aimed at safeguarding patients’ health records from unauthorized access or use (HealthIT.gov., n.d.; U.S. Department of Health & Human Services [HHS], n.d.). It encompasses several key provisions:

Protecting the transmission of electronic health records (EHR) (HHS, n.d.)
Granting patients the right to access their health records (HHS, n.d.)
Limiting healthcare staff on how they can use and access patients’ EHR (HealthIT.gov., n.d.; HHS, n.d.)

Impact of HIPAA on Bedside Shift Report (BSR):

HIPAA has significant implications for Bedside Shift Report (BSR), including:

Requiring nurses to safeguard patient personal information under penalty (Gialanella et al., 2017; HHS, n.d.)
Serving as a legal reminder to healthcare workers to obtain permission before sharing personal medical information in front of family members, visitors, and/or other patients (Malfait et al., 2019; HHS, n.d.)
Entailing cost implications such as redesigning double occupancy rooms to private or semi-private (Malfait et al., 2019)
Presenting ethical considerations to nurses regarding privacy breaches and the importance of communicating information effectively (HHS; n.d.; Hoover, 2016; Malfait et al., 2019)

Improvements to Bedside shift report (BSR) through HIPAA:

HIPAA also offers avenues for enhancing Bedside Shift Report (BSR), including:

Embracing health information technology (HIT) to incorporate EHR and facilitate meaningful use of patient data (Gialanella et al., 2017; HealthIT.gov, n.d.)
Reinforcing patient privacy rights and the need for permission to share health information in front of family members (Gialanella et al., 2017; Malfait et al., 2019)
Empowering patients by involving them in decision-making processes regarding their health information (The Joint Commission [JC], 2017; Malfait et al., 2019)
Streamlining workflow through patient involvement and utilizing checklists integrated into the EHR (Gialanella et al., 2017)

What can we do? Implement an updated BSR policy – in compliance with HIPAA: Dynamic Dialogue Bedside Shift Report (DDBSR):

The Dynamic Dialogue Bedside Shift Report (DDBSR) policy aims to engage patients (and their families as appropriate) as active participants in discussing essential patient information during shift handovers. This approach optimizes communication, ensures patient satisfaction, enhances nursing workflow, and protects personal health records and sensitive information.

How does DDBSR meet HIPAA guidelines?

Reducing errors in information sharing by involving the patient, thereby improving workflow and empowering patient involvement in their care plan (JC, 2017; Malfait et al., 2019)
Providing safe and accurate care through the use of EHR and meeting meaningful use of HIT (HealthIT.gov., n.d.; HHS, n.d.)
Implementing hard stops with checklists in the EHR and requiring dual nurse sign-on and sign-off to assure patient safety of medical records (Gialanella et al., 2017)
Adding an additional security layer with recorded stamps on who accesses patients’ records (Gialanella et al., 2017; Hoover, 2016)

References

Gialanella, K.M., Mastrian, K. & McGonigle, D. (2017). Legislative Aspects of Nursing Informatics: HITECH and HIPAA. In Nursing informatics and the foundation of knowledge (4th ed., pp. 141-166). Jones & Bartlett Learning.

HealthIT.gov. (n.d.). Health IT legislation. https://www.healthit.gov/topic/laws-regulation-andpolicy/health-it-legislation

Hoover, R. (2016). Benefits of using an electronic health record. Nursing, 46(7), 21–22. doi: 10.1097/01.NURSE.0000484036.85939.06

NURS 6051 Assessment 6 TN006 Policy and Regulation Supporting Informatics and Technology

The Joint Commission. (2017). Inadequate handoff communication: Sentinel alert event. https://www.jointcommission.org/-/media/tjc/documents/resources/patient-safetytopics/sentinel-event/sea_58_hand_off_comms_9_6_17final(1).pdf.pdf)

Malfait, S., Van Hecke, A., Van Biesen, W., & Eeckloo, K. (2019). Is privacy a problem during bedside handovers? A practice-oriented discussion paper. Nursing Ethics, 26(7–8), 2288– 2297. https://doi.org/10.1177/0969733018791348

U.S. Department of Health & Human Services. (n.d.). The HIPAA Privacy Rule. https://www.hhs.gov/hipaa/for-professionals/privacy/index.html

TN006 Policy and Regulation Supporting Informatics and Technology