HIPAA violations by nurses can happen for many different reasons and, although HIPAA violations by nurses are often accidental or a consequence of wanting to “get the job done”, if a nurse violates HIPAA, the violation should be reported to prevent minor violations with minimal consequences deteriorating into a culture of non-compliance.
In addition, HIPAA violations by nurses that result in an impermissible use or disclosure of Protected Health Information must be notified to the affected individual(s) and HHS’ Office for Civil Rights. The failure to report a breach of unsecured PHI (which an impermissible disclosure is) would be a violation of the HIPAA Breach Notification Rule.
Common types of HIPAA Violations that Nurses may Inadvertently Commit
There are common types of HIPAA violations that nurses may inadvertently commit, compromising patient privacy and data security. One prevalent violation involves unauthorized access to patient records, where nurses may succumb to curiosity or lack of awareness about proper access procedures. Disclosing patient information to unauthorized individuals, such as friends or family members, poses another significant risk, potentially leading to breaches of confidentiality. Nurses might also inadvertently engage in improper disposal of patient records, exposing sensitive data to unauthorized individuals due to inadequate shredding or disposal methods. Lost or stolen devices containing patient information, sharing passwords, and taking patient information home without proper authorization are additional ways in which nurses may unintentionally compromise patient privacy. These violations highlight the importance of continuous training and vigilance to ensure that nurses uphold the principles of HIPAA regulations and maintain the trust and confidentiality that patients expect from their healthcare providers.
| HIPAA Violation | Description |
|---|---|
| Unauthorized Access | Nurses accessing patient records without a legitimate reason, often driven by curiosity or lack of understanding about proper access procedures. This breaches patient privacy and compromises confidentiality. |
| Disclosing Patient Information | Inadvertently sharing patient information with unauthorized individuals, such as family members or friends, leading to breaches of patient confidentiality and potentially exposing sensitive medical details. |
| Improper Disposal of Records | Incorrectly disposing patient records without proper shredding or disposal methods, risking unauthorized exposure of patient information to individuals who may misuse or exploit the data. |
| Lost or Stolen Devices | Misplacing laptops, smartphones, or tablets containing patient data, if not properly secured, can result in data breaches when accessed by unauthorized parties, leading to potential privacy violations. |
| Sharing Passwords | Sharing passwords for electronic health record systems or other platforms can result in unauthorized personnel gaining access to patient information, compromising data security and patient confidentiality. |
| Taking Patient Information Home | Transporting patient records offsite without proper authorization exposes patient data to risks outside the healthcare setting, potentially leading to unauthorized access and breaches of privacy. |
| Discussing Patient Cases in Public | Engaging in conversations about patient cases in public areas inadvertently exposes sensitive patient information to unauthorized individuals, undermining patient confidentiality. |
| Social Media Posts | Posting patient-related content on social media platforms, even without direct patient identification, can lead to inadvertent breaches of patient confidentiality, as well as potential ethical and legal issues. |
| Unauthorized Photography | Capturing images of patients or their records without proper authorization violates patient privacy and could lead to misuse of these images, compromising patient confidentiality and dignity. |
| Inadequate Computer Security | Leaving computers unlocked or unattended in patient care areas allows unauthorized individuals to access patient information, potentially leading to privacy breaches and data exposure. |
| Lack of Encryption | Sending patient information via unencrypted emails or messaging platforms risks exposing sensitive data to potential breaches, undermining the security and confidentiality of patient records. |
| Misdirected Communications | Mistakenly sending patient information to the wrong recipient due to errors in email addresses or fax numbers could result in unauthorized individuals gaining access to patient data, violating confidentiality. |
| Failure to Log Off | Failing to log off from electronic health record systems or applications after use can lead to unauthorized access by others using the same workstation, compromising patient privacy and data security. |
| Sharing Patient Information in Multi-Patient Areas | Discussing patient cases in shared spaces where others can overhear breaches patient confidentiality and risks exposing sensitive medical information to unauthorized individuals. |
| Improper Faxing | Sending patient information via fax to incorrect numbers can lead to unauthorized individuals receiving sensitive data, potentially compromising patient confidentiality and data security. |
| Not Providing Privacy | Conducting patient discussions in areas without appropriate privacy measures can result in unauthorized individuals overhearing patient information, undermining patient confidentiality and privacy. |
| Accessing Records of Friends or Family | Accessing the medical records of friends or family members out of curiosity breaches their privacy and violates HIPAA regulations, potentially leading to disciplinary actions and legal consequences. |
| Inadequate Training | Lack of proper training on HIPAA regulations can result in inadvertent violations due to ignorance about proper privacy measures, compromising patient confidentiality and exposing healthcare organizations to risks. |
| Leaving Patient Information Visible | Leaving patient records or information visible on desks or computer screens in patient care areas can lead to unauthorized access by individuals, compromising patient confidentiality and data security. |
| Sharing Personal Devices | Using personal devices for work-related tasks can lead to unintentional breaches of patient data if the devices are not properly secured, potentially exposing patient information to unauthorized parties. |
Examples of HIPAA Violations by Nurses
Example: Minimum Necessary Rule Breach by Nurses
In 2015, Diane Hereford was fired from the Norton Audubon Hospital for alleged HIPAA non-compliance. A patient had filed the complaint saying that Hereford had breached the “minimum necessary” rule from HIPAA. However, Hereford contested this and filed an unfair dismissal suit.
When the alleged violation took place, the patient was in a secluded area shielded by a curtain undergoing an echocardiogram. Before the procedure took place, Hereford checked to make sure the patient understood what was happening. She then proceeded to tell the other two attending healthcare professionals to wear gloves as the patient was positive for Hepatitis C. The patient alleges that the volume at which Hereford spoke meant that everyone in the vicinity, including other patients, heard her.
Hereford argued that this was an incidental disclosure, and thus not a violation. However, her motion for unfair termination was dismissed by the court.
Example: Social Media Breach by Nurses
In a social media HIPAA violation, a ProPublica investigation revealed that since 2012, over 35 instances of violations involving social media have been identified. In one instance, Edward J. Melock, a 21-year old nurse’s aide, took photos of an incontinent patient and shared them on Snapchat. This was a serious violation of patient privacy, as well as being degrading and inhumane. The aide plead guilty to the charges and surrendered his license.
Several employees at the UR Medicine Thompson Health nursing home in Canandaigua are facing investigation and possible termination for sharing photos of patients over Snapchat. The investigation is being conducted by the Medicaud Fraud Control Unit, part of the Attorney General’s office.
Similarly, in 2013, Ericha Brown – a former certified nurse’s aide – plead guilty to a misdemeanor for sharing a video of a resident at St. Anne’s Home being harassed. The video was shared on Facebook.
Example: Unauthorized Access of PHI by Nurses
HIPAA was established to protect PHI from unauthorized personnel, medical professionals or not. In 2011, two Minnesota hospitals undertook large-scale firing of employees after it was discovered that a number of them were accessing PHI. The Mercy Hospital and Unity Hospital both had accepted patients from a single incident where synthetic drugs were supplied to attendants at a party. One person died and 11 more needed hospital treatment. The high-profile nature of such an event attracted the attention of many staff members, but many of those accessing the information had no legitimate interest in it. This resulted in 32 terminations across the two hospitals.
Consequences of HIPAA Violations by Nurses
Consequences of HIPAA violations committed by nurses can have far-reaching effects, both legally and professionally. These violations can result in serious repercussions that impact both the individuals involved and the healthcare organizations they work for. Two significant consequences are legal and regulatory repercussions and the impact on a nurse’s professional reputation and licensure.
Legal and regulatory consequences stemming from HIPAA violations are profound. Penalties and fines associated with such breaches can be substantial, as they are determined by the Office for Civil Rights (OCR) within the U.S. Department of Health and Human Services (HHS). The range of fines varies widely, from thousands to millions of dollars, depending on the severity of the violation and the extent of harm caused. The imposition of these fines is intended to serve as a strong deterrent against healthcare entities and professionals neglecting patient privacy regulations. In cases where violations are particularly severe, legal action may be pursued against the nurse and the healthcare organization involved. Patients affected by the breach can also initiate lawsuits seeking compensation for damages caused by the breach of their confidential information. Legal proceedings can result in significant legal expenses, as well as potential financial settlements or judgments against the nurse or the healthcare facility.
The impact on a nurse’s professional reputation and licensure cannot be understated. A nurse’s professional standing is fundamentally built on trust, ethics, and the quality of patient care provided. When a nurse commits a HIPAA violation, it tarnishes this reputation, eroding trust from patients, colleagues, and supervisors. Such a breach can lead to diminished relationships within the healthcare community, potentially resulting in isolation and exclusion. It is also important to be aware that nursing licensure boards at the state level can initiate investigations into HIPAA violations. Depending on the severity of the violation, a nurse’s license to practice could be suspended or revoked temporarily or permanently. The loss of a nursing license not only disrupts the nurse’s career trajectory but also impacts patient care continuity and hampers their ability to secure a livelihood.
Preventing HIPAA Violations by Nurses
Preventing inadvertent HIPAA violations among nurses demands a proactive strategy centered on education, training, and heightened awareness. An essential element of this strategy involves providing nurses with continuous education and training opportunities. Regular HIPAA training tailored for nurses is of paramount importance in fostering a culture of privacy and compliance within healthcare settings. These comprehensive training programs equip nurses with an in-depth understanding of the nuances of HIPAA regulations, potential pitfalls, and best practices for upholding patient privacy. The training covers a range of critical topics, including proper handling of electronic health records, secure communication protocols, and accurate procedures for accessing patient information.
Recognizing the significance of regular HIPAA training for nurses is crucial. HIPAA regulations evolve to address the ever-changing landscape of healthcare and data security. For this reason, nurses need to receive updated information through consistent training sessions. Such sessions serve to reinforce the vital nature of HIPAA compliance and also keep nurses informed about the latest developments and potential risks. Armed with current knowledge, nurses can make informed decisions when handling patient information, thereby minimizing the chances of inadvertent violations. Education plays a role in raising awareness and minimizing the occurrence of inadvertent violations among nurses. Interactive training sessions expose nurses to real-life scenarios that could lead to unintentional breaches. By understanding the subtleties of patient consent, secure information sharing, and proper documentation, nurses are better equipped to navigate complex situations responsibly. These training programs not only cultivate a strong sense of ethical responsibility but also foster heightened awareness regarding the critical importance of maintaining patient confidentiality.
Nurse Violations and HIPAA: FAQ
Can nurses lose their licenses if they violate HIPPA?
HIPAA violations may result in the nurse being referred to their State’s Board of Nursing. Many State Boards require that nurses respect the privacy of their patients, so HIPAA violations would also contravene the requirements of the nursing board. The nursing board will then implement their own disciplinary procedures, which may include revoking the nurse’s license. Even if the license is not revoked, HIPAA violations are serious and having such a violation on their record could make it difficult for nurses to find jobs in healthcare settings.
Is it a violation if a nurse accesses PHI for a patient in their hospital that they are not treating?
Yes, it is still a breach of HIPAA. If the nurse accesses information for a patient that is not under their care, they are considered to be violating HIPAA. This “snooping” is a serious event and should be protected against with appropriate safeguards.
What is the Minimum Necessary Rule?
The Minimum Necessary Rule requires that, when disclosing information, healthcare staff only disclose the minimum amount of information needed to complete the task at hand. So, for example, if a nurse is sending information to billing, they do not need to transmit the patient’s entire medical record.
Can nurses be sued for HIPAA violations?
There is no private cause of action in HIPAA, meaning that patients whose PHI is part of a HIPAA breach cannot sue individual nurses. In some cases, they may be able to sue under state privacy laws.
Can nurses lose their jobs if they violate HIPAA?
In some severe cases, yes, nurses can lose their jobs if they violate HIPAA. The penalties for a HIPAA violation are determined by the CE; HIPAA itself does not explicitly state what types of HIPAA violations will and will not result in the loss of a job. However, as violations of HIPAA are so severe, then CEs will choose to terminate the contract of an employee that violates HIPAA. Alternatively, they may be put on extra training courses.
What happens if a nurse violates HIPAA?
This depends on the nature of the violation and the contents of the healthcare organization´s sanctions policy. If a nurse violates HIPAA, but does not disclose unsecured PHI (for example, by failing to document the distribution of a Notice of Privacy Practices), the consequences will be dependent on the healthcare organization´s sanctions policy.
However, if the nurse´s actions result in an impermissible disclosure of unsecured PHI, the violation will have to be notified to HHS´ Office for Civil Rights. HHS´ Office for Civil Rights may impose a Corrective Action Plan on the healthcare organization to prevent the event happening again; or, if the event involves the knowing and wrongful disclosure of PHI, it may refer the case to the Department of Justice for investigation and possible criminal prosecution.