NCLEX · Client Rights and Advocacy

Which is an example of a HIPAA violation?

Correct answer

Discussing a client's diagnosis in a public hallway where visitors can overhear, or accessing the chart of a celebrity patient out of curiosity, or sharing client information on social media

  1. A Documenting in the medical record
  2. B Discussing a client's diagnosis in a public hallway where visitors can overhear, or accessing the chart of a celebrity patient out of curiosity, or sharing client information on social media
  3. C Reporting communicable diseases to public health
  4. D Sharing information with other care team members involved in the client's treatment

Why this is the answer

HIPAA (Health Insurance Portability and Accountability Act of 1996) protects patient health information (PHI). Common HIPAA violations: (1) PUBLIC DISCUSSIONS — talking about clients in hallways, elevators, cafeterias, or anywhere unauthorized people can overhear; (2) SOCIAL MEDIA — posting any client information, photos, even vague descriptions that could identify someone; this includes well-intentioned 'sad day at work today, lost a patient' posts; (3) UNAUTHORIZED ACCESS — looking up records of family, friends, celebrities, coworkers, neighbors out of curiosity; EHRs track every access; (4) DISCUSSING WITH UNAUTHORIZED PEOPLE — friends, family of the patient who haven't been authorized, the patient's employer, journalists; (5) UNSECURED COMMUNICATIONS — emails or texts about patients on unencrypted devices; (6) LEAVING RECORDS VISIBLE — leaving paper charts open, computer screens unlocked; (7) DISCLOSURE WITHOUT AUTHORIZATION — sharing records with anyone not directly involved in care, billing, or operations without patient permission. Acceptable disclosures: (1) Treatment team members directly involved in care; (2) Billing and operations; (3) Public health reporting (communicable diseases, child abuse, gunshot wounds, certain other mandatory reports); (4) Legal requirements (court orders, subpoenas with proper authority); (5) Patient-authorized disclosures. Penalties: civil fines $100-$50,000 per violation up to $1.5M/year; criminal penalties up to $250,000 and 10 years imprisonment for malicious or commercial violations; nursing license discipline; employment termination. Each access to a celebrity patient's records by an unauthorized employee can be a separate violation.
Source: NCSBN NCLEX-PN, HIPAA

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