Importance of Nursing Ethics - Coursework Example

Running Head: Nursing Ethics Nursing Ethics Name Course Lecture Date Introduction In our society, privacy and confidentiality are considered basic rights. Healthcare institutions and care providers are under ethical and legal obligations to uphold the confidentiality of hospital records. Under the Australian nurse’s professional code of conduct nurses are obliged to respect the confidentiality of patients’ records. One statement in the Code of Ethics for Nurses in Australia declares that “Nurses value ethical management of information”. Under legislations such as the Privacy Act 1988, a nurse is obliged to ensure that patient’s private information is protected. The Information Privacy Principles (IPPs) obligates nurses to protect patient’s confidentiality in the collection, disclosure, storage and use of patient information by public sector agencies. Despite being aware of these obligations, the nurse in the case study accessed patient records for improper purposes. This paper first analyzes the ethical and legal issues that arise from the nurse’s actions. It also outlines the nursing code of conduct which gives rise to ethical and professional obligations as regard patient data. Secondly, the paper identifies several Australian legislations that were breached by the nurse’s confidentiality breach. They include provisions contained in the Privacy Act 1988, and Information Privacy Act 2009 require strict adherence to the Information Privacy Principle and the National Privacy principles for all healthcare providers. Thirdly, the paper details risk management strategies healthcare organizations can employ to reduce the possibility of confidentiality breaches occurring. It also considers communication strategies that will also uphold the confidentiality of patient records. Finally, the paper concludes by noting that issues of confidentiality breaches should be taken seriously and care providers should strive to uphold patient records confidentiality. Legal and Ethical Issues raises by the Nurse’s conduct The male nurse breached his ethical and legal obligation to keep patients health records confidential. Nurses and other healthcare providers are under legal, professional and ethical obligations to ensure the information entrusted to their care by patients is not misused (Gray et al, 2008). Confidentiality is concerned with an obligation on health care practitioners and organization to ensure information about patients is not disclosed to third parties without the patients consent. Nurses are only allowed access to patient information for professional purposes only. Although, there are legal exceptions that allow nurses to access patient information, these exceptions do not apply in the case (Vest and Gamm, 2010). The usage of patient information for non-professional purposes is a clear breach of the patient’s confidentiality rights. The breach clearly violates the nurse’s professional code of conduct which obligates nurses to use patient information ethically (Nursing and Midwifery Council, 2008). Several ethical and legal issues regarding the confidentiality of patient records can be found in this scenario. They include (Gray et al, 2008): 1. Patients’ Right to Privacy. 2. Dignity and respect of carer. 3. Respect for Autonomy. The patient’s right to privacy Privacy is basic human right which is protected under Australian legislations (Erickson and Millar, 2005). It falls upon nurses to ensure that patient’s right to privacy are upheld to the fullest extent. Dignity and respect for care Provider Care providers are allowed to make use of records protected under the principle of confidentiality (Erickson and Millar, 2005). Any decision regarding their usage of confidential data must uphold the care providers dignity and respect. Respect for Autonomy Western society values personal autonomy and privacy greatly (Erickson and Millar, 2005). The male nurse’s visit to the female patient home was a violation of the patient’s right to personal autonomy. His access of the patient’s record regarding where she lives, and the subsequent visit can be considered a violation of the patient’s privacy rights. Professional Integrity The Australian Medical Association obliges nurses and other healthcare through statement 24 to ensure the security of patient information (Australian Medical Association, 2006). On the other hand, the Code of Ethics for Nurses in Australia statement 7 asserts that “Nurses value ethical management of information” (Nursing and Midwifery Council, 2008). The male nurse’s conduct was clearly in breach of these ethical guidelines as issued by his professional associations. Legislations The National Privacy Principle as contained in Schedule 3 of the Privacy Act 1988 sets a number of guidelines regarding collection, disclosure, storage and use of personal information. NPP2 outlines how private healthcare providers may use or disclose a patient’s personal information. On the other hand, Information Privacy Principles (IPPs) in section 14 of the Privacy Act 1988 relate to the collection, disclosure, storage and use of patient information by public sector agencies. Under principle 9, it is illegal for employees and public agencies to use information other than for the relevant purpose. The male nurse contravened principle 9 by using Private information for an improper and non-work related purpose. The Information Privacy Act 2009, Section 27 makes it mandatory for public health providers to comply with the IPP. Under the section, Public healthcare providers are obligated not to act or engage in a practice that contravenes the NPP. Therefore, the Information Privacy Act 2009 obligates public healthcare institutions and their workers to uphold the privacy and confidentiality of patient’s personal information. Section 31 also Information Privacy Act 2009 also obligates other healthcare institutions to comply with the NPPs. Risk Management Strategies for Confidentiality Breaches As the Health Information manager at the hospital in this case I would implement a new information management policy that contains various elements relating to the usage of confidential information (Cannoy and Salam, 2010). The policy would detail the sanctions for breaches of confidentiality and the procedure to be followed in implementing such sanctions. Once a policy has been put into place, the organization should train workers to ensure they know their responsibilities and obligations as regard the privacy of patient information. The policy should also include confidentiality clauses to be effective. It should also reference the relevant legislations and legal obligation healthcare professionals have under their professional code of conduct and privacy legislation. Identifying confidential information I would also urge my organization to clearly identify information that is confidential and the extent of sensitivity of the subject information (Zandbergen, 2014). People assessing confidential information must be warned that they are committing a potential breach. Information should be classified along such measures as highly confidential, confidential and non-confidential. Security labels should be assigned to particularly sensitive documents. For example some information should be labelled "in-confidence" and other "protected" (Zandbergen, 2014). Sensitivity should be concerned with circumstances and to whom confidential information can be communicated. Secure storage As the health record manager I would ensure all documents containing confidential information are stored securely (Cannoy and Salam, 2010). Physical records should be stored under lock and key where only authorised individuals can access them. On the other hand, electronic records should be protected using passwords and access mechanisms (Cannoy and Salam, 2010). Access control mechanism should only allow access of information for relevant and proper purposes only. Document Tracking I would also ensure that possession and transfer of personal information around the hospital is tracked so that all possible breaches are noticed (Cannoy and Salam, 2010). The healthcare institution should be aware of every person who handles and accesses patient information as it moves around the hospital. Removal of Confidential information as soon possible I would also implement a health record access policy that ensures that confidential information is only available when it is needed (Cannoy and Salam, 2010). Personal identifiable information should be removed from laptops, PCs and mobile computing devices as soon as possible (Butts and Rich, 2013). This strategy would have ensured that the male nurse did not have access to the patient’s personal information months after the patient was discharged from hospital. Assigning overall responsibility I would assign of granting access to patient records only to senior employees or Health information staff (Cannoy and Salam, 2010). This should be especially the case for patient information for individuals who have already been discharged (Humayun et al, 2008). The nurse would have had to ask for this information from the individual responsible for granting access. A more senior employee would have questioned the nurse’s motive in wanting to access the information. Communication strategies to uphold Confidentiality As the hospitals health information manager I would have recommended the implementation of the three communication strategies discussed below to guard against confidentiality breaches: Communication with family members Always keep the patient’s family best interest in mind (Otlowski, 2007). Legal Guardians of the patient and family members should be adequately informed in case of elderly or demented patients. Do not assume Right to Know Nurses should never assume that they have the right to know while handling any health information (Butts and Rich, 2013). They should never communicate patient information to third parties on the assumption they have the right to know. Before sharing of such information the communicating party should make sure the receiving party has the right to access the patient’s personal information. Caution colleagues about potential breaches Healthcare practitioners should caution their collegues when they see a potential violation of confidentiality (Cannoy and Salam, 2010). For example, a nurse may be attempting to discuss his notes with colleagues. Responsible practitioners should approach him/her politely and remind him of his obligation to protect the privacy and confidentiality of patient’s records. Conclusion Patients have a basic and unalienable right to have their patient information protected from confidentiality breaches. However, the nurse in this scenario acted in breach of his legal, ethical and professional obligations. He disregarded the IPPs declaration that the usage of patient records should only be for relevant purposes only. Healthcare institutions are obligated to ensure that patient records are protected from privacy breaches. This objective can be realized by implementing the risk management strategies recommended in this paper. In addition, a number of communication strategies can be used to ensure patient information privacy and confidentiality is maintained References Australian Medical Association. (2006). AMA code of ethics. The Association. Butts, J. B., & Rich, K. L. (2013). Nursing ethics: Across the curriculum and into practice. Jones & Bartlett Publishers. Cannoy, S. D., & Salam, A. F. (2010). A framework for health care information assurance policy and compliance. Communications of the ACM, 53(3), 126-131. Erickson, J., & Millar, S. (2005). Caring for patients while respecting their privacy; renewing our commitment. Online journal of issues in nursing, 10(2). Gray, B., Robinson, C., Seddon, D., & Roberts, A. (2008). ‘Confidentiality smokescreens’ and carers for people with mental health problems: the perspectives of professionals. Health & social care in the community, 16(4), 378-387. Hattingh, H. L., Knox, K., Fejzic, J., McConnell, D., Fowler, J. L., Mey, A., ... & Wheeler, A. J. (2014). Privacy and confidentiality: perspectives of mental health consumers and carers in pharmacy settings. International Journal of Pharmacy Practice. Humayun, A., Fatima, N., Naqqash, S., Hussain, S., Rasheed, A., Imtiaz, H., & Imam, S. Z. (2008). Patients' perception and actual practice of informed consent, privacy and confidentiality in general medical outpatient departments of two tertiary care hospitals of Lahore. BMC Medical Ethics, 9(1), 14. Information Privacy Act 2009 Nursing, A., & Council, M. (2008). Codes of Professional Conduct & Ethics for Nurses & Midwives, 2008. Australian Nursing and Midwifery Council. Otlowski, M. F. (2007). Disclosure of genetic information to at-risk relatives: recent amendments to the Privacy Act 1988 (Cwlth). Medical Journal of Australia, 187(7), 398. Privacy Act 1988 Vest, J. R., & Gamm, L. D. (2010). Health information exchange: persistent challenges and new strategies. Journal of the American Medical Informatics Association, 17(3), 288-294. Zandbergen, P. A. (2014). Ensuring Confidentiality of Geocoded Health Data: Assessing Geographic Masking Strategies for Individual-Level Data. Advances in Medicine, 2014. Read More