A nurse on a medical-surgical unit notices several situations involving protected health information (PHI). Which actions comply with HIPAA requirements? Select all that apply.
Select All That Apply
Choose your responses, then check the answer.
Explanation
HIPAA requires appropriate access controls and reasonable safeguards. A treatment discussion with the assigned physician can occur at the bedside when safeguards such as a low voice and protected screen are used (Choice 1). Logging out, protecting credentials, and preventing unauthorized entry reduce unauthorized access (Choice 2). Staff should report a potential unintended disclosure through the facility's privacy-incident process so the privacy officer can assess whether an impermissible disclosure or reportable breach occurred (Choice 3). Before telephone disclosure, verify both identity and authority using facility-approved procedures; for an outside provider or facility, independently obtained contact information may be used rather than a caller-supplied number (Choice 6). Accessing a chart without a work-related need is unauthorized even when the person is another RN (Choice 4). An admission date and rare diagnosis can make a case identifiable and do not meet HIPAA de-identification requirements merely because the name is omitted (Choice 5).
HIPAA Privacy Rule — Core Principles 1. Minimum Necessary: access only the PHI required for your role and task 2. Need-to-Know: only the care team directly involved may access 3. Reasonable Safeguards: low voice, angled screen, curtain, private discussion areas 4. Breach Notification Rule: report internally to charge nurse + privacy officer; HHS within 60 days; media if 500+ affected
Common Pitfalls - Snooping: accessing a non-assigned client's chart = violation, even by a coworker - Social media: rare diagnosis + admission date can re-identify; never post client info - Workstation: log out + never share credentials; do not badge-hold for unverified persons - Phone callers: voice ID is insufficient — call back to the published number
Memory Tip "MIN-NEED-VERIFY-REPORT: Minimum necessary, Need-to-know, Verify identity, Report breach"
ScenarioRN on a busy medical-surgical unit faces multiple PHI situations during the shift: bedside discussion, overheard disclosure, phone caller asking for PHI, workstation security, coworker chart access, social media post.
Action Map1. Bedside discussion: low voice + angled screen (incidental safeguard)2. Overheard breach: report to charge nurse + privacy officer3. Phone PHI request: call-back to published number4. Workstation: log out + no credential sharing5. Social media: never post client info, even de-identified
Avoid- Snooping non-assigned charts- Holding doors after badge auth for unverified persons- Discussing PHI in elevators/cafeteria
HIPAA Privacy Rule — U.S. federal law (Health Insurance Portability and Accountability Act, 1996) protecting protected health information (PHI). Core requirements: Minimum Necessary access, Need-to-Know basis, reasonable safeguards (workstation, conversation, paper/printed PHI). Civil penalties up to $50K/violation; criminal penalties for malicious release.
Incidental Disclosure (HIPAA exception) — Limited overheard or briefly visible PHI during reasonable care (e.g., another client overhears a curtain conversation). Permitted IF reasonable safeguards are used (low voice, angled screen, curtain, locked computer). Repeated incidental disclosures or those due to inadequate safeguards become reportable breaches.
HIPAA Breach Notification Rule — Unauthorized disclosure of unsecured PHI requires notification within 60 days to: (1) affected individuals, (2) HHS Office for Civil Rights, (3) prominent media outlets if 500+ individuals affected. Nurses report internally to the charge nurse and privacy officer per facility incident protocol; failure to report can result in personal and institutional penalties.