Feb 23, 2024 NUR 514 Week 7 DQ 2 Discuss one ethical and one legal issue related to the use of EHRs that directly impact advanced registered nursing practice
NUR 514 Week 7 DQ 2 Discuss one ethical and one legal issue related to the use of EHRs that directly impact advanced registered nursing practice
NUR 514 Week 7 DQ 2 Discuss one ethical and one legal issue related to the use of EHRs that directly impact advanced registered nursing practice
Review HIPAA, protected health information (PHI), and requirements for privacy and confidentiality in EHRs. Discuss one ethical and one legal issue related to the use of EHRs that directly impact advanced registered nursing practice. Consider the emerging role of the telehealth and the EHR in patient care delivery and compromise of patient data using telehealth applications and measures you can implement in your own practice to protect patient privacy and confidentiality.
Some of the HIPAA guidelines related to EHRs are ensuring the access to health information is monitored and secured and only authorized users may be able to access it, a system of monitoring and tracking unauthorized use should be in place, as well as a system to communicate the health information should be secured and monitored for breaches. Some practical applications of these guidelines include the use of unique passwords and periodic changing of passwords, remote monitoring and the ability to delete information remotely if there is a breach (lost mobile device, or work laptop), automatic log-off if the system has been idle for a certain period, use of HIPAA-compliant information exchange portals (secured or encrypted emails, secure messaging or apps), use of privacy screens for computer monitors and ensure that devices are kept in secure locations that may allow some privacy (HIPAA Journal, 2023).
The nurses’ primary commitment is to their patients. Effective communication is vital to this relationship. EHR may have a negative effect on this relationship, potentially reshaping the nurse-patient interaction, and diverting the nurse away from the patient. Nurses are at the forefront to ensure that EHR is patient-centered and contributes to safe and ethical practice. The current impact of EHR in quality and outcome is significant, however, the ethical issues around organizational priorities versus patient-centered practice is presented as one of the more significant issues related to EHR (McBride et al., 2018).
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Another area where ethical legal issues arise while using EHR relates to consent, privacy and confidentiality. The use and exchange of patients’ data and information may present legal issues. Hence, providers must abide by the fundamental principles of consent, disclosure, and willingness of patients (Afzal & Arshad, 2021).
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NUR 514 Week 7 DQ 2 Discuss one ethical and one legal issue related to the use of EHRs that directly impact advanced registered nursing practice References:
HIPAA Journal (2023). HIPAA guidelines on telemedicine. https://www.hipaajournal.com/hipaa-guidelines-on-telemedicine/
McBride, S., Tietze, M., Robichaux, C., Stokes, L., Weber, E. (2018). Identifying and addressing ethical issues with use of electronic health records. The Online Journal of Issues in Nursing 23 (1). https://doi.org/10.3912/OJIN.Vol23No01Man05
Afzal, S. & Arshad, A. (2021). Ethical issues among healthcare workers using electronic records: A systematic review. Computer Methods and Programs in Biomedicine Update 1. https://doi.org/10.1016/j.cmpbup.2021.100030
The American Informatics Association (AMIA) has a code of ethics for nursing informatics that addresses ongoing ethical and legal in healthcare informatics (McBride et al., 2018). For example, legal and ethical issues around patient data availability and sharing across different healthcare institutions. Another consideration is the automation and EHR triggered protocols. A case study from Texas showed an increase in patient harm by nurses relying on EHR triggered protocols and not using critical thinking and clinical judgment to determine if the protocols were in the patient’s best interest (McBride et al.,2018). EHR and telehealth has made great advances to automate and protocolize healthcare. However, taking away ability for nurses to use critical thinking and consider customized care for patients can dehumanize patient care. It is important as nurses to always consider the individual needs of a patient and apply critical thinking to meet the needs of the patient.
A way to implement patient privacy is to ensure that no computer is left unlocked that someone can access a patient chart without permission. In addition, to be cognizant of patient information that is stored on the unit. In addition, our current EHR has full access for all allied health staff to see patient name and room number. To help protect patient information, I could work with my informatics colleagues to change the patient names listed as initials instead of full name and medical records numbers.
NUR 514 Week 7 DQ 2 Discuss one ethical and one legal issue related to the use of EHRs that directly impact advanced registered nursing practice Reference
McBride, S., Tietze, M., Robichaux, C., Stokes, L., Weber, E., (January 31, 2018) “Identifying and
Addressing Ethical Issues with Use of Electronic Health Records” OJIN: The Online Journal of Issues in Nursing Vol. 23, No. 1, Manuscript 5.
HIPAA and PHI are laws that regulate the use and dissemination of consumer data. The regulations through the requirements for privacy and confidentiality ensure that healthcare providers do not misuse patient information in unauthorized ways (Balestra, 2018). For example, one of the legal issues that might arise is sharing patient information with a third party. Patient information should remain confidential and private. Registered nurses might share patient information through their social media posts, violating the privacy rule. Sharing patients’ identifiable information can lead to serious repercussions including loss of license or a lawsuit against the hospital. An ethical issue that a registered nurse might be involved in based on confidentiality and privacy of data is accessing information patient health information from an uncensored location (Pool, 2022). For example, accessing patient data from home computers or other personal devices is unethical because of the potential for a security breach. This is because personal devices do not have the cybersecurity features required to protect patient data. Moreover, the registered nurse might leave that information in open access to family members who will end up seeing sensitive patient information.
As the implementation of electronic health records and telehealth systems increases, they also present a challenge in the effective protection of patient data. These systems involve the electronic transmission of patient data, in the process exposing such information to a security breach (Zhou et al., 2019). To promote the security of sensitive patient information, one measure is to install cybersecurity features and make cybersecurity part of an organization’s culture (Pool, 2022). For example, electronically transmitted data should be in an encrypted format so that even if intercepted by a third party, they cannot access it. Another feature of cybersecurity is password protection using two-step verification and strong passwords to prevent other people from bypassing a provider’s passwords and accessing the system.
NUR 514 Week 7 DQ 2 Discuss one ethical and one legal issue related to the use of EHRs that directly impact advanced registered nursing practice References
Balestra, M. (2018). Electronic Health Records: Patient Care and Ethical and Legal Implications for Nurse Practitioners. The Journal for Nurse Practitioners, 13(2), 105-111. https://doi.org/10.1016/j.nurpra.2016.09.010.
Pool, J. (2022). Data privacy concerns and use of telehealth in the aged care context: An integrative review and research agenda. International Journal of Medical Informatics, 160. https://doi.org/10.1016/j.ijmedinf.2022.104707.
Zhou, L., Thieret, R., Watzlaf, V., Dealmeida, D., & Parmanto, B. (2019). A Telehealth Privacy and Security Self-Assessment Questionnaire for Telehealth Providers: Development and Validation. International Journal of Telerehabil, 11(1):3-14. https://doi.10.5195/ijt.2019.6276.
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