What to Do When a Patient Requires Extra Confidentiality?
Hospitalized patients may sometimes require increased confidentiality regarding their identity and who is allowed to receive information and updates regarding their condition. Examples of such patients include those who have been victims of domestic violence, those involved in gang activities, or celebrities and high ranked public officials. Nurses who care for these patients need to know the proper way to handle any situation involving the release of confidential information.
Hospitals and other health care facilities use similar systems to accommodate confidentiality matters and it involves the security department officers, the admitting and telephone operators, and the nurses on that unit. The most common technique used by hospital staff involves the use of a password or special word that is known only to the patient and the nurses taking care of that patient. This password is given out by the client to those who are allowed to visit or receive information about the client condition. There are special password documentation sheets that need to be signed by the client which ensure that the hospital staff is following the rules and regulations stated in the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
In those cases when the patient is not oriented or is unable to speak, the person who has power of attorney will choose the password and sign the documentation papers. Once this step is complete, only those who know the password are able to receive any information regarding the patient. Sometimes even those who do know the password may receive only brief statements with intentional lack of details, for increased confidentiality. Any visitors, friends or family members who do not know the password are being filtered by the receptionist and security officer. Absolutely no information is given out, not even if the patient is admitted on the unit or not, without a password.
The security officer is responsible for any incidents requesting restraining or force from unwanted visitors who cause trouble. In case of violence a special code is called to which all security personnel will show up for assistance. Hospital staff and especially nurses are being instructed and trained on specific policies and steps to be taken in cases of domestic violence and spousal abuse. The training takes place every year and it gives nurses the knowledge and confidence to handle specific situations.
Another approach to protect the identity of a patient and ensure confidentiality is to assign a name alias to the client. This is very similar to having a password and it works in the same manner. A conscious client will reveal the name alias only to those allowed to receive information. A name alias is more frequently used when the client identity needs to be protected at all costs. Visitors and anyone who does not ask about the client by its alias are not being given any information by staff. Again, the security officers are involved and they are the ones responsible for the proper paperwork in this case. This system has proven to be very effective at protecting the identity of a client.
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