Patient Confidentiality

Guidelines:

• Perioperative RNs are accountable to advocate for patient safety, patient’s right to information, privacy, and confidentiality 
• Challenges related to patient confidentiality
  • Physical surroundings and time pressure in the clinical setting
    • Rounding
    • Multi-patient rooms
  • Communication challenges
    • Where and with whom
    • Relatives
    • Language problems
      • Minor translating for parent
      • Uncomfortable with interpreter
  • Navigation of the clinical setting to ensure privacy
    • Speaking with parents or colleagues on the phone where others can hear
    • Maintaining patient confidentiality for something the patient told in confidence
    • Offering split consultations for parents/young adult patients

Considerations:

• Caring for Transgender Patients:
  • An estimated 1.6 million people aged 13 years or older in the United States identify as transgender
  • Politely ask patient how they would like to be addressed
    • Questions about pronouns and names should occur in private, when possible
    • Do not assume pronouns
    • Medical record name may be different thal information as dictated by state laws and policies
  • Only ask questions required to provide care
  • Sensitively obtain the needed information
  • Be cautious when talking to or around patients’ family members and friends

Nurse’s role:

• Follow professional standards of care
  • State board of nursing practice act
  • Facility policies/procedures
• Advocate for patient safety, privacy, dignity, and confidentiality in all phases of perioperative care
  • Pull curtains
  • Ensure conversations are private
  • Enforce patient privacy and confidentiality
• Follow facility policies/procedures
  • Patient rights
  • Adolescent privacy
  • Custodial/non-custodial parent
  • Interpreters
• Provide information about the patient according to HIPAA guidelines
  • Status
  • Updates

Pitfalls:

• Consequences of breaches of confidentiality:
  • Patients withholding information
  • Patients being embarrassed when they hear things about others
  • Patients losing trust 
• Especially important to consider when talking about hospitalized children and young people

Examples:

• N/A

Linchpins (Key Points):

• The perioperative RN is the patient advocate
• The perioperative RN maintains patient privacy and confidentiality
• The perioperative RN follows professional standards of care
• The perioperative RN follows facility and regulatory guidelines