With the increase of health information technology used to store and access patient information, the likelihood of security breaches has also risen. In fact, according to the Canadian Medical Association Journal (CMAJ):

In the United States, there was a whopping 97% increase in the number of health records breached from 2010 to 2011… The number of patient records accessed in each breach has also increased substantially, from 26,968 (in 2010) to 49,394 (in 2011). Since August 2009, when the US government regulated that any breach affecting more than 500 patients be publicly disclosed, a total of 385 breaches, involving more than 19 million records, have been reported to the Department of Health and Human Services.

A large portion of those breaches, 39%, occurred because of a lost, stolen, or otherwise compromised portable electronic device—a problem that will likely only get worse as iPads, smartphones, and other gadgets become more common in hospitals. (CMAJ, 2012, p. E215).

Consider your own experiences. Does your organization use portable electronic devices? What safeguards are in place to ensure the security of data and patient information? For this Discussion you consider ethical and security issues surrounding the protection of digital health information.

To prepare:

• Review the Learning Resources dealing with the security of digital health care information. Reflect on your own organization or one with which you are familiar, and think about how health information stored electronically is protected.
• Consider the nurse’s responsibility to ensure the protection of patient information. What strategies can you use?
• Reflect on ethical issues that are likely to arise with the increased access to newer, smaller, and more powerful technology tools.
• Consider strategies that can be implemented to ensure that the use of HIT contributes to an overall culture of safety.

• Ask a probing question, substantiated with additional background information, evidence or research.
• Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
• Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
• Validate an idea with your own experience and additional research.
• Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
• Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Nursing Responsibility to Protect Patient Information

Office of the National Coordinator for Health Information Technology (ONC) developed a framework to address privacy and security challenges online related to health information (Brown, 2009).  The eight principles are (1) individual access; (2) correction; (3) openness and transparency; (4) individual choice; (5) collection, use, and disclosure limitation; (6) data quality and integrity; (7) safeguards; and (8) accountability (Brown, 2009).

The first four principles describe an individual’s rights regarding the accessibility, disclosure about how their information is collected and treatment of their personal health information.

The last four principles suggest measures ensure an individual’s health information is protected.  Data should be accurate and not changed without authorization, information that is transmitted electronically should implement reasonable administrative, technical, and physical safeguards to ensure confidentiality, integrity, and availability and to prevent unauthorized or inappropriate access, use or disclosure (Brown, 2009).  There should also be auditing policies in place to ensure the principles are being followed to prevent any breaches. 

HIT has made it more difficult to protect patient privacy

Protecting patient’s privacy is more difficult with HIT, particularly with the utilization of the internet to ensure real-time information is available to all departments, for example, in emergency medicine, orders need to be completed on an emergent basis.  The radiology department needs to be able to access orders and records in real-time to know which procedure to perform.  Through communication tools, electronic ordering, decision support features, and data management, EHR systems will guide many aspects of patient care.  Treatment success will often depend on their proper functioning (Hoffman & Podgurski, 2011). 

Security and ethical issues related to the use of smartphone and tablets are related to the type of information that is shared in some instances by healthcare workers.  In my organization, we are cautioned in orientation to be careful what we post about patients at our facilities.   McGonigle, & Mastrian, (2015, p. 70) as cited in Englund, Chappy, Jambunathan, & Gohdes, (2012, p. 244), comment above all, nurses must be mindful that once communication is written and posted on the internet, there is no way to retract what was written; it is a permanent record that can be tracked, even if the post id deleted.  In my organization strategies to safeguard patient information that promotes a culture of safety is by not only monitoring our computer workstations but holding educational workshops on ways to protect patient privacy.  In my facility since everything we do is virtual, anyone who enters our building needs to sign a privacy and confidentially statement.  The strategies in place instill confidence by our patients that we take their privacy seriously.

An area of improvement in my facility is with the way our workstations are configured.  As I work for our Virtual Care Center, our workstations are just computers and six screens, with what is called a “privacy sail” that we can move.  This sail is okay for some of the work that is done at our facility where nurses are monitoring ventilators or monitors, however for my department which is Case Management; we are talking to patients all day long, and conversations carry.  Those conversations are heard by everyone in the department.  One strategy to address this issue would be to move our department to the third floor, which has not yet been completed, with more of a cubical arrangement instead of open workstations.

Reference

Brown, B. (2009). Improving the Privacy and Security of Personal Health Records. Journal Of Health Care Compliance, 11(2), 39-68.

Brown, S. M., Aboumatar, H. J., Francis, L., Halamka, J., Rozenblum, R., Rubin, E., & … Sarnoff Lee, B. (2016). Balancing digital information-sharing and patient privacy when engaging families in the intensive care unit. Journal Of The American Medical Informatics Association, 23(5), 995-1000. doi:10.1093/jamia/ocv182

Hoffman, S., & Podgurski, A. (2011). Meaningful Use and Certification of Health Information Technology: What about Safety?. Journal Of Law, Medicine & Ethics, 3977-80. doi:10.1111/j.1748-720X.2011.00572.x

McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones and Bartlett Learning.

  I NEED A GOOD COMMENT FOR THIS ARGUMENT. PLEASE CITE REFERENCES.

The standards of a professional nurse practices is attained when he is in a potion to portray, maintain and demonstrated his competence while working this is as stated by Basavanthappa, (2000). On the other hand, the given duties that a nurse is assigned matter on how he will carries them, with this the application of the nurse standard is portrayed because the hospital has some expectation from the nurse. As a result, every registered nurse has the duty to show competence in practicing safety and care to the patients that they are attending to by giving them the better skill they have. With this outline, a framework that will help the nurse’s standard be portrayed ought to be initiated, and this can be facilitated if only certain steps are kept in consideration.

  Firstly, it is that code of ethics that the nurse has this helps them meet their standards since it demonstrates how a nurse should behave while in the line of duty. This means the responsibility they offer while providing quality care determines if they are in a position to meet certain standards.  On the other hand ANA, nursing standards ought to be portrayed by the practices and utilization of resource according to the desired specifications. The practices define what nurses do with the responsibilities that associate them and the parameters that they work in as instructed by the institution. As a result, they are expected to act with competence and utilize the required resources in the right manner with this practices the standards ought to be raised.

  To develop a nurse standards they ought to be the ANA position statements with this it helps in keeping records of things that the nurse is carrying out, within this the nurse is in a position to explain, justify and recommend any action that he took. These statements help the nurse to be in track of things hence nothing ought to go astray since he has proof. As a result, his scope standards ought to be raised since the competence aspect is raised. In addition, the professional standards for every registered nurse may be raised so that by the practice they portray including the advanced practice registered nurses with this the nurse should be focused on engaging themselves in activities that enhance them to do research activities that will promote their competence and standards.

  Developing the practice standards of a nurse is a major factor that should be a key factor in an institution. It is out of this result that the nurses give out best, quality and competence services. In addition, most registered nurses have to offer the best so that they can meet the required standers. A nurse ought to develop a leadership aspect so that he can be able to handle a different situation; by this, the nurse can be in a potion to give different instruction regarding a different situation that will bring competence in the service that they are offering to the patient. In addition, the safety standards that the nurse gives reflect in his development standards practice since safety is paramount in both the patient and the nurses. The work environment the nurse are practicing their services is essential because they environment should be clean to raise their standards (Quinn, & Gordon, 2016).

  Another entity that might develop the standards of the nurse practices is the domain of nursing practices this means that every nurse has a duty that is assigned to him. Hence it is his duty to see to it that they duty will be well enhance without a miss interpretation of the instruction. By this, the standards aspect is developed since the nurse show transparency in his work. In addition, the connection that is created by the nurse and the patients that he is serving reflects on the development of the nurse standards since he can offer better services to the patients because he can communicate efficiently and understand the patient’s problem.

References

Basavanthappa, B. (2000). Nursing administration. New Delhi: Jaypee Brothers.

Quinn, L. & Gordon, J. (2016). Documentation for rehabilitation : a guide to clinical decision making in physical therapy. Maryland Heights, Missouri: Elsevier.