Could shift reports at the bedside violate HIPAA?

By | 2022-02-14T18:10:22-05:00 November 23rd, 2011|2 Comments

Question:

Dear Nancy,

Our hospital is requiring nurses to give shift reports at the bedside. Is this a HIPAA violation? Can the nurse be sued for giving the report? They want us to answer all questions asked by family. What are our liabilities?

Nina

Nancy Brent replies:

Dear Nina,

It is a little unclear why the hospital wants shift reports to be given at the bedside, and you did not indicate why this policy was put into place. However, there are some concerns related to the Health Insurance Portability and Accountability Act that need to be mentioned. I cannot explain how these issues are resolved in the brief situation you described, but I can highlight briefly some of the possible issues under HIPAA.

Remember that HIPAA protects the security (Security Rule) and privacy (Privacy Rule) of Protected Health Information. If a patient gives consent to have his PHI shared with any and all family members, whether that takes place at the bedside or in the hallway does not matter because patient consent has been obtained. What causes concern is when a more “public” sharing of information takes place and there are others who are in the room (e.g., the other patient and his family), visitors or other family members in a hallway who overhear the information.

There is another aspect of HIPAA that also must be discussed briefly. HIPAA includes the fact that “incidental disclosures” of PHI sometimes occur and if prohibited entirely, would not allow a facility to function. So long as there are privacy and confidentiality protections in place for the protection of PHI, these incidental disclosures generally are not a violation of HIPAA. So, with the bedside reports, and with the patient’s consent to discuss issues with his or her family in place, if others in the room overhear the report “incidentally,” there is arguably no violation, assuming, for example, the bedside curtain is pulled, the report is done by speaking as quietly as possible and any other privacy concerns are followed.

You might want to raise your concerns with your nurse manager and CNO. Before doing so, review “Incidental Uses and Disclosures” of the Privacy Rule at (www.hhs.gov/ocr/privacy/hipaa/understanding/coveredentities/incidentalusesanddisclosures.html). Both the facility and nursing staff benefit from a shift report practice that conforms to HIPAA and other legal mandates governing privacy and confidentiality of patient information.

Regards,
Nancy

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2 Comments

  1. Avatar
    Sarah Simon January 7, 2017 at 2:34 am - Reply

    Bedside report is one of the Joint Commission initiatives based on 2006 study at Banner Desert Medical Center and subsequent studies. Keeping up with evidence-based practice is probably the reason the institution wants report to be conducted at bedside.

  2. Avatar
    jane doe February 23, 2019 at 12:01 am - Reply

    I am a nurse that gave a postop bedside report that was mandatory at the hospital I was traveler in. There were people in the room when I arrived and the hospital also encourages family to participate in the recovery of the patient. I asked family if it would be ok to talk about her mothers history, knowing the patient had HIV. The woman nodded yes. I gave a quiet bedside report which included the pts history and left the room. Later I was named in a law suit for malpractice and HIPPA violation by the family. It was their word against mine that I obtained consent. My license is hemmed up now, I cannot work as a nurse. At this point even if I could work as a nurse again Im not sure that I would. 15 yrs in PACU down the drain.

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