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The development of technology is associated with various opportunities and improvements, but it is also related to various problems. Nursing informatics can be seen as an example of this complex issue in the healthcare context. Sheridan (2012) stresses that healthcare professionals are reluctant to use extensive technology, which is being adopted rather slowly. One of the reasons for that arising legal and ethical concerns. Confidentiality and written consent forms are associated with these legal and ethical issues to be addressed. This paper includes a brief description and analysis of these two examples of concerns related to nursing informatics as well as several evidence-based recommendations alongside with some conclusions.
Ethical and Legal Problems
Nursing informatics provides healthcare practitioners with numerous effective ways to store, share, and access information, but each of these stages can be associated with confidentiality violations (Huber, 2013). In my working setting, I have witnessed several instances of confidentiality violations. For example, nurses often shared codes without much considerations concerning the status of the person they share this information with. Some data can be accessed by only a specific group of practitioners, which can be violated through the provision of codes to unauthorized people. One of the most striking cases is the way nurses tell stories about patients. Even without giving names (which is considered to be a sufficient way to protect patients’ confidentiality), they still share information that can reveal the person’s identity.
Another important issue is related to written consent forms. I have had to provide these forms many times. Patients differently react, but it is clear that the relationship between the healthcare professional and the patient is often disrupted. In many cases, nursing professionals could hardly explain to patients anything about the forms.
Confidentiality is one of the most delicate issues in the healthcare system of any country. In the USA, the Health Insurance Portability and Accountability Act (1996) is one of the central regulations governing the flow of data (Finkelman & Kenner, 2013). Code §7332 that focuses on the confidentiality of medical records is another important regulation. As for legal issues that can arise, it is necessary to note that cases of a privacy breach are quite common (Finkelman & Kenner, 2013). Healthcare facilities fail to use safe software (or it is used inadequately), which leads to breaches. Patients may lose their jobs, money, reputation as a result of such events. Healthcare professionals (intentionally or unintentionally) violate laws, which translates into lawsuits.
In terms of the rules mentioned, nursing practitioners are not allowed to share any information with unauthorized people (for example, nurses who do not provide care to the patient). More so, they cannot share information in places where it can be heard (elevators, corridors, and so on). There are particular ethical considerations to take into account. The Code of Ethics for Nurses includes particular guidance as to ensuring patients’ confidentiality (Finkelman & Kenner, 2013). One of the basic underpinnings is the fact that confidentiality violations can result in various issues for the patient whose well-being (emotional and even physical) can be threatened, which is unacceptable for the nurse whose job is to ensure the patients’ wellbeing.
As for legal issues, related to the written consent form they are closely connected with confidentiality rights. Pope (2015) notes that such records are often provided to the third party (insurance companies, courts, other healthcare facilities, and so on), which may lead to confidentiality breaches. The threats associated with confidentiality have been discussed above. It is also important to emphasize that these records disrupt the development of proper relationships between patients and nurses. The trust can often be lost. As to ethical issues related to written consent forms, nurses should always remember that they are to focus on patients’ well-being rather than their signing papers allowing healthcare facilities to avoid some legal issues.
The laws and regulations mentioned (as well as many other codes) provide specific guidance as to ways to store, share data, and so on. Nursing professionals should respect and ensure patients’ rights concerning information confidentiality. One of the ways to achieve this aim is to provide effective training (both formal and on-job) to nursing professionals (Hammond, Jaffe, Cimino, & Huff, 2013). Anthony and Stablein (2016) state that many healthcare professionals are still reluctant to focus on ethical issues when it comes to privacy and confidentiality, which is also contributed to insufficient training since nurses simply do not know how to ensure confidentiality.
As to written consent forms, it is clear that a less formalized approach should be applied. Pope (2015) claims that healthcare professionals should have effective dialogues with patients. Thus, it is insufficient to give the consent form and (if asked) answer some questions. Nurses should discuss all the provisions of these forms as well as possible outcomes and reasons for signing. To achieve this aim, training is also vital. Nurses should have the necessary knowledge concerning particular legal issues, and they should also have the necessary communicative skills.
On balance, it is necessary to note that nursing professionals complete various reports and forms containing different information concerning patients including their health conditions, contact details, personal information, and so on, which often leads to legal and ethical issues. Confidentiality and written consent forms can be seen as areas of specific concern. However, effective training can help nursing professionals address these issues and avoid the majority of legal and ethical problems that may occur.
Anthony, D., & Stablein, T. (2016). Privacy in practice: Professional discourse about information control in health care. Journal of Health Organization and Management, 30(2), 207-226.
Finkelman, A., & Kenner, C. (2013). Professional nursing concepts. Burlington, MA: Jones and Bartlett Publishers.
Hammond, W.E., Jaffe, C., Cimino, J.J., & Huff, S.M. (2013). Standards in biomedical informatics. In E.H. Shortliffe & J.J. Cimino (Eds.), Biomedical informatics: Computer applications in health care and biomedicine (pp. 211-255). New York, NY: Springer Science & Business Media.
Huber, D. (2013). Leadership and nursing care management. St. Louis, MO: Elsevier Health Sciences.
Pope, K.S. (2015). Record-keeping controversies: Ethical, legal, and clinical challenges. Canadian Psychology/Psychologie Canadienne, 56(3), 348-356.
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Sheridan, S. (2012). The implementation and sustainability of electronic health records. Online Journal of Nursing Informatics, 16(3). Web.