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Confidentiality, HIPAA and the Correctional Nurse

An RN calls the hospital for discharge information on a patient transported back to the prison infirmary from the local hospital after his jaw was wired following an inmate brawl in the exercise yard. The emergency room nurse refused to provide any information stating it would be a violation of HIPAA. She instructs the prison RN to obtain any information she needs from the patient himself.

An NP is reprimanded for telling a housing officer that one of the inmates is a severe diabetic and needs his evening snack on time.



Confidentiality of patient health information has always been a concern for nursing. Valuing patient privacy is an ethical imperative, even in the correctional setting. In recent years the Health Insurance Portability and Accountability Act (HIPAA) has moved healthcare information confidentiality to a legal concern for nurses. In particular, HIPAA regulations ensure that private health information is not released to any third party without the patient’s permission.

Disclosure of medical information may be necessary for the health and safety of both the patient and the large patient community within a security facility. Officers may need to know about medical conditions or disabilities that require special equipment or scheduled appointments. Some medication side effects require additional attention or changes in work duty. Joint surgery may limit movements or abilities that security needs to be aware of. Fortunately, HIPAA regulations take into account the need for some information sharing within the correctional setting and have spelled this out is the 45 C.F.R. 164.512 (k) (5) (i) section of the code.

HIPAA Permitted Disclosure to Correctional Institutions

If the correctional institution represents that such protected health information is necessary for:
The provision of health care to such individuals
The health and safety of such individuals or other inmates
The health and safety of the officers or employees of or others at the correctional institution
The health and safety of such individuals and officers or other persons responsible for the transporting of inmates or their transfer from one institution, facility, or setting to another
Law enforcement on the premises of the correctional institution
The administration and maintenance of the safety , security, and good order of the correctional institution
 
According to this section of HIPAA regulations, an ER nurse can confidently share health information with the receiving nurse in the prison infirmary and a nurse practitioner can alert an officer to a health need of an inmate in his charge.

Many in corrections are confused about how to implement HIPAA regulations and the boundaries of patient privacy and confidentiality of medical information. Share your experiences in the comments section.

Photo Credit: © mirabile – Fotolia.com

This post originally appeared in CorrectionalNurse.Net

Guest post by Dr. Lorry Schoenly nurse author and educator specializing in the field of correctional health care. She has written 6 continuing education courses especially for the Correctional Healthcare Campus.

Correctional Healthcare Processes
Safety in the Correctional Setting
The Correctional Healthcare Patient and Environment
Medication Administration in the Correctional Setting
Risk and Documentation in the Correctional Setting
Special Issues in Corrections

You may see all of the online continuing education offered at the Correctional Healthcare Campus by clicking View Entire Catalog.
Posted: 5/27/2015 8:38:23 AM
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