Confidentiality and Boundaries.pptx

Confidentiality and Boundaries NURS 1090  Confidentiality and Boundaries  Law: Chapter 4723 of the Ohio Revised Code (Nurse Practice Act)  Rules: Chapter 4723-1 through 4723-27 of the Ohio Administrative Code (Rules of the Board)  www.nursing.ohio.gov  HIPAA  Health Insuranc...

Confidentiality and Boundaries NURS 1090  Confidentiality and Boundaries  Law: Chapter 4723 of the Ohio Revised Code (Nurse Practice Act)  Rules: Chapter 4723-1 through 4723-27 of the Ohio Administrative Code (Rules of the Board)  www.nursing.ohio.gov  HIPAA  Health Insurance Portability and Accountability Act  American Nurses Association  Disclosure of certain information ONLY to another specifically Confidentialit authorized person y Information about the patient is shared only with people who are directly involved in the patient’s care Includes written and verbal communication as well as electronic  Example  Discussion of a patient’s admitting history with other staff members to determine a consistent treatment plan is not a breach of confidentiality  The nurse’s release of information to the patient’s employer about the patient’s condition, without the patient’s consent, is a violation of confidentiality.  Four Questions  Do you need this information?  Do you have a right to know this information?  Where are you going to discuss this information?  With whom are you discussing it?  Boundaries  Definition of Boundaries  A limit - The point at which something ends or beyond which it becomes something else (Webster’s dictionary)  National Council of State Boards of Nursing  “an invisible line that provides limits to a professional’s behavior that allow for a safe relationship with a patient based on the patient’s needs.”  Defines, separates, and clarifies the responsibilities and limitations of the nurse in a professional (therapeutic) relationship  When does an action cross a boundary?  Ohio Law- The Nurse Practice Act  A licensed nurse shall delineate, establish, and maintain professional boundaries with each patient.  Provide privacy during examination and treatment  Treat each patient with courtesy, respect, and with full recognition of dignity Ohio Law- The Nurse Practice Act  A licensed nurse shall not  Engage in behavior that causes or may cause physical, verbal, mental, or emotional abuse to a patient  Engage in behavior to seek or obtain personal gain at the patient’s expense  Engage in behavior that constitutes inappropriate involvement in the patient’s personal relationships  Very Important In other words, the The patient is always responsibility for presumed incapable of maintaining boundaries giving free, full, or in the nurse - patient informed consent to the relationship belongs to behaviors by the nurse the nurse, never the patient!  Boundary Crossings  A departure from commonly accepted practice  May or may not benefit the patient  i.e., staying after shift to care for a particular patient or believing you are the only one who understands patient  A brief excursion across a boundary with a prompt return  i.e., attending a patient’s wedding, performance, etc.  How will it be perceived by the patient?  Discuss with patient and always document   More serious  Departure from accepted practice that places the patient or the therapeutic process at serious risk or exploits the patient  Occur when there is confusion of the Boundary professional’s needs with the patients’ needs Violations  Is a shift away from the patient needs to the professional’s needs.  Discussing them with the patient doesn’t make them OK  i.e., accepting money in the form of a loan  Boundary Violations  Going beyond the established standards of the nurse- patient relationship  Recognize that the nurse has power by virtue of his/her professional position and access to private knowledge about the patient.  That power must be channeled through appropriate boundaries.  REMEMBER:  It is always the nurses’ responsibility to set and maintain the boundaries   Role  Becoming too close to patient/family  Time, Place, and Space  Social Media- (Facebook, twitter, etc.)  Money, Gifts, and Services Examples of  LCC’s policy regarding faculty Boundary  Clothing & Language (Professional at all times) Violations  Physical contact – intimate relationship  Self-disclosure  Does it benefit the patient?  Redirect patient: “the time we spend together is for you to discuss your concerns”  You talk to your patients about your personal life Evaluate You tell patients where you live your and give them your phone boundaries number if: You plan activities with patients outside of the unit You complain about patients to other patients  You complain to patients about your own problems Evaluate You complain to patients about other staff your members boundaries You accept gifts from patients if:: You visit patients in their home as a friend, not in your professional capacity You buy or sell items from or to patients  Prevention of Boundary Violations  Know OBN Law  Establish patient centered goals  Pay attention to warning signs of poor boundaries  “bad feeling”  Don’t want to tell anyone else  Would not want to document  Seek help from coworkers and managers if you are not sure  Keep in Mind  Limit physical contact to that which is therapeutic  Limit contact with patient/families to on-duty time only  Avoid financial/legal dealings  Limit self-disclosure to superficial information  Avoid making your patient’s problems your own  Social Media & Boundary Guidelines for Nurses  Professional Boundaries in Nursing  https://www.youtube.com/watch?v=LirG9tc88M s  Social Media Guidelines for Nurses:  https://www.youtube.com/watch?v=i9FBEiZRnm o