How to Avoid a Breach of Confidentiality as a Nurse

Patients are in a vulnerable position when it comes to their health information. Nurses, physicians, nursing assistants, and many other health professionals must communicate confidential health details to provide care. Yet when information gets leaked, even accidentally, this causes a breach of confidentiality and trust. How can you avoid these breaches and protect your patients?

Information privacy has been a concern for medical practice since the time of Hippocrates, and confidentiality is an essential principle in nursing. Patients must have the right to privacy when they access care — otherwise, how can they trust their providers? This means that medical professionals are obligated to protect health information in its varying forms, including the following:

• Personal identifiers, such as name, birthday, medical record number, address, phone number, and social security numbers
• Medical records, including diagnoses, treatment history, test results, medications
• Interpersonal and family details, such as the names and relationships of the people closest to the patient
• Billing and insurance information
• Genetic and familial history

Keeping health information private sounds like a simple concept. Just avoid talking about patients when it’s not necessary, right? But as healthcare and digital communication channels have grown more complex, it’s easier than ever for medical data to slip through the cracks and lead to a breach. Despite increased education about health privacy laws, healthcare data breaches have been on the rise. Let’s discuss the various forms that these data breaches can take, and how you can avoid and prevent them to protect your patients.

Breach of Confidentiality: Definition and Explanation

What is a breach of confidentiality? In medicine, this means that private information has become accessible to people who are not members of the care team or who are not authorized by the patient. Confidentiality breaches are covered and defined by the Health Insurance Portability and Accountability Act (HIPAA).

Enacted in 1996, HIPAA created nationwide standards for how health information should be protected by healthcare providers, insurers, healthcare clearinghouses, and other groups that may handle sensitive patient details. Additionally, HIPAA breaks down sensitive health information into two forms:

• Protected health information (PHI) may be shared in conversations between providers or in writing.
• Electronic protected health information (e-PHI) is health information that is received, transmitted, or maintained in digital form.

The majority of healthcare breaches involve e-PHI. Digital health data is vulnerable to human error, as well as ransomware and hacker attacks. In 2023, 168 million records were stolen or exposed due to breaches like these.

Data encryption and protection may fall under the scope of nurse informaticists, but clinical nursing professionals can help prevent the second-most common type of information breach: unauthorized disclosures within healthcare systems. These small and large breaches typically happen by accident, but there are some basic guidelines you can follow to protect patients.

6 Tips to Avoid a Breach of Confidentiality as a Nurse

Protecting patient privacy requires diligence in daily practice. Here are some key ways to prevent breaches of confidentiality:

1. Be mindful of conversations. Avoid discussing patient details in public spaces, such as hallways, elevators, or cafeterias. If a patient has a new family member in the room, be wary of sharing sensitive information in front of them. If someone calls to ask for an update on a patient, verify their access in the patient’s medical record to be sure they’ve been authorized.

2. Secure electronic health records (EHRs). Always log out of your accounts when stepping away from the computer, and never share login credentials. If you’re working on a mobile computer in a hallway, use a screen shield so no one can read over your shoulder.

3. Use secure communication channels. When sharing patient information electronically, use encrypted messaging systems or designated secure platforms instead of personal email or text messages.

4. Follow HIPAA guidelines. Only access and share patient information with authorized personnel on a need-to-know basis. If a patient isn’t under your care anymore, you shouldn’t need to log in to their chart. If you log in to your work accounts from home, follow the same precautions you would at work.

5. Dispose of and transport sensitive documents properly. Use shredders or secure disposal bins for any paperwork containing patient details. If you bring physical charts home, be sure they’re secured.

6. Be cautious with social media. Never post about patients, even in vague or anonymous terms.

Examples of Confidentiality Breaches for Nurses

Most breaches aren’t malicious — studies show that the majority are accidents. Below are three examples to be aware of:

• Discussing patient information in public spaces. A nurse is on break in the hospital cafeteria and casually talks with a coworker about a challenging case they handled that morning. Even though they don’t use the patient’s name, a visitor nearby recognizes details about their loved one’s condition, leading to an unintended breach.
• Unauthorized access to medical records. A nurse is curious about a high-profile patient admitted to the hospital and looks up their medical record, even though they are not involved in the patient’s care. This unauthorized access is a serious HIPAA violation that could lead to disciplinary action or termination.
• Accidental disclosure to family members. A nurse sees a patient’s spouse in the hallway and, assuming they already know, mentions that the patient is recovering well from surgery. However, the patient had explicitly requested that no details be shared, making this an unintended but serious breach of confidentiality.

Protect Patients in a New Nursing Role

Now that you’re confident in how to avoid a breach of confidentiality, you might be curious about new opportunities. Learn about roles in your area when you sign up for personalized job notifications.

Legal Disclaimer: This article contains general legal information, but it is not intended to constitute professional legal advice for any particular situation and should not be relied on as professional legal advice. Any references to the law may not be current as laws regularly change through updates in legislation, regulation, and case law at the federal and state level. Nothing in this article should be interpreted as creating an attorney-client relationship. If you have legal questions, you should seek the advice of an attorney licensed to practice in your jurisdiction.