1. Privacy & Confidentiality

2. Consider for a moment…….
Have you ever been in an elevator and overhead information about a resident being discussed by other staff?
How would you feel if you knew that staff were discussing your care where other people could hear?

3. What is Privacy?
Privacy is a basic right in our society and is governed under law.
Privacy is……
A state of mind
A specific place
Freedom from intrusion or control over the exposure of self or personal information
The right of privacy gives residents the right to decide who gets access to information about themselves. Residents have the right to decide who, when and where to share their health information.
Privacy includes the right to choose care based on personal beliefs, feelings, or attitudes. It also includes the right to accept or reject treatment.
Privacy entitles us to keep our thoughts, feelings, and personal information from being shared with others. It is having control over our own information. Privacy is essential to maintain human dignity.

4. Privacy also…. Involves providing care in a way that does not expose
the body unnecessarily.
What are some examples of how care is done in a private way?
Pulling privacy curtain
Exposing only the part of the body involved in care
Asking visitors to leave during personal care

5. Privacy Legislation
Personal Health Information Protection Act (PHIPA):
Provides laws about the residents right to control
how his/her personal health information
is collected, used and disclosed.
There are many legislations that cover privacy and confidentiality:
PHIPA: the residents right to control how his/her personal health information is collected, used and disclosed. Consistent rules for the management of personal health information which must be kept confidential and secure.
Privacy Act: Applies to the handling of personal information by federal government agencies throughout the country.
Personal Information Protection and Electronic Documents Act (PIPEDA):Provide laws about the collection, use and disclosure of personal health information.
Resident Bill of Rights: An outline of basic rights for residents living in Long Term Care.
Quality Care Information Act: provides protection to quality of care information. Promotes open discussion of adverse events from being used in litigation or accessed by residents.

6. Marianhill Policy Privacy - Notice and Consent L.3.02
“The knowledge and consent of the individual are required for the collection, use, or disclosure of personal information, except where inappropriate (legal, medical, security reasons may make it impossible or impractical to seek consent.)”

7. What is patient confidentiality?
A conscious effort by every healthcare worker to keep private all personal information revealed by the resident while receiving care.
It includes the resident’s:
Identity
Physical or psychological state
Emotional status
Financial situation
Confidentiality refers to the handling of
information once someone discloses it to us
This means that when clients give information to us as health care workers, they are trusting us with their secrets. They trust we will not spread those secrets.
We can describe confidentiality as the client's right to expect that personal information revealed to a health care worker will remain secret, only to be used for the purposes for which it was given. In other words, confidentiality refers to the handling of information once someone discloses it to us.

8. Duty to Confidentiality
At all times respect the privacy of residents, their families, and other employees/volunteers.
Treat all clinical, administrative and financial information about residents, their families, and other employees/volunteers as confidential information.
Ensure that private and confidential information is not inappropriately accessed, used or disclosed either directly or by virtue of password to systems.
Do not give out assigned confidential passwords.
Health care providers have a duty to ensure that the client’s health information is kept secret. It cannot be accessible to others, unless the client consents.
As a health care worker, you have a duty confidentiality to your employer and to your client. You have a duty not to disclose this information..
Remember, private information about your client and your client’s health should not be disclosed unless the client consents.

9. Marianhill Policy Confidentiality L.3.02
“ Under no circumstances may information concerning residents or the operation of Marianhill be discussed with anyone other than those people concerned in the discharge of their duties. Marianhill depends on the maturity and loyalty of each employee to keep private any such information. Breach of the duty of confidence is a serious matter and may result in discipline up to and including dismissal”

10. Privacy and Confidentiality Violated
Privacy is violated when an unauthorized person gains access to another person’s private information.
Confidentiality is violated when someone talks about a persons private information to another person without the first person’s consent.
The health care worker who eavesdrops on a client conversation with a visitor violates that person’s privacy
The employee who discusses personal issues about her resident’s health care status with others during coffee break is breaching confidentiality.

11. Privacy and Confidentiality Violated
Violations to privacy and confidentiality may include but are not limited to:
Accessing personal information that are not require for work / volunteering purposes.
Misusing or disclosing personal information (verbally, through the computer system or in hard copy) without proper authorization.
Altering personal information of residents or other employees.
Exposing a Resident unnecessarily during care.
A breach of any one of these conditions is grounds for termination
Both privacy and confidentiality are the basis for trust in the client-caregiver relationship.
Remember that the information a client has entrusted to you is not yours. It is not yours to share with fellow workers. It is not yours to bring home to gossip about with your friends and family.
Example:
Not closing privacy curtains
Leaving window blinds up during care and when dressing a resident.

12. If confidentiality is broken
The consequences are:
Person reluctant to seek care
Reluctance to give information which could affect their well being
False rumors, upset family and friends, and media harassment

13. Security
Is the measures taken to protect personal health information, e.g. locked cabinets, passwords, closing PCC when you walk away from the computer.
Residents have the right to expect that the information reveal to us will be protected and remain private.
 We are living in an age where the exchange of information in health care is moving towards a completely computerized system. Health information is documented, stored, and retrieved from computers.  We must protect resident information by:
-computer passwords
-regularly changing passwords
Those who need information in the health records to plan and deliver care must be able to access that information.
The stories that we hear about the abuse of information and the need for more security and control of our computerized health information are disturbing. However, common breaches (or breaks) of confidentiality such as cafeteria gossip, hallway chatter and even elevator discussions do far more harm. This is the area where you have full control. Be careful to maintain your duty of confidentiality to your client.

14. What is Personal Health Information (PHI)?
Any identifying information about clients that is in verbal, written or electronic form
Any information that identifies a person without being named For example:
Room number
Diagnosis
Physical or mental including family health history
Care previously provided
Payments or eligibility for health care
Information about donation of body parts or blood
Health number
Name of SDM

15. Circle of Care and Need to Know
Circle of Care is any health care provider involved with care, service, monitoring of care and administration in the home and on referral
Examples: Dr, Nurse, NP, PSW, Program Staff, Office Manager, Unit Clerk, Dietitians, Physiotherapy, CCAC, hospital, Specialists (on referral), Massage therapy, Agency, Lab, Pharmacy, Administrative Staff, Compliance Advisors
Professionals within the Circle of Care may access resident personal health information.
Staff may only access what they need-to-know
to perform their role
In order to provide quality health care, it is important that information is shared among care providers. This is called the Circle of Care.
However, confidential information should only be disclosed on a need to know basis. In ordinary circumstances, you should only release information to those who must know. Residents may also have some thoughts on who should or should not know information. They may not want information released to immediate family members. You must respect the client’s wishes.
There are also ethical and legal reasons that may permit the disclosure of information.   

16. Resident Consent for Collection, Use and Disclosure of PHI
Resident/SDM must be informed upon admission sign the Notice and Consent Form.
A client has the right to privacy, but can give up that right by agreeing to disclose.
Upon admission the Notice and Consent Form is signed. This informs the resident about the collection, use and disclosure of Personal Health information.  

17. Staff Responsibilities
Only share and access information that you need to know to provide care and perform your role
Maintain confidentiality of resident PHI while a resident of the home and after discharge or death
Do not discuss residents in public places
Remind co-workers of the need to maintain confidentiality
Deny access to resident PHI to individuals not in the circle of care
Do not share your computer password and LOG out when leaving the computer

18. Staff Responsibilities (cont’d)
Destroy paper with resident PHI i.e assignment, reports, notes
Not sending resident PHI by
Use only resident initials on any correspondence leaving the home by fax and use confidentiality warning on fax cover sheet/ s
Direct complaints about the management of PHI to the administrator
Read and sign employee confidentiality agreement

19. Accountability The Administrator is the privacy contact for the home
Privacy of Information Policy O.1.24

20. a responsibility for ensuring resident confidentiality and privacy!
Be On Guard
Everyone has
a responsibility for ensuring resident confidentiality and privacy!
There is potential to do significant harm to residents, staff and Specialty Care if we are careless about confidentiality and privacy issues.
It is easy to get drawn into inappropriate chats in the hallways, staff room or outside of work.
Remember the saying: Loose lips sink ships.
Breaching confidentiality will cause residents loose trust in you and in other health care workers. Employees have been known to be suspended or to lose their jobs over careless disclosures. Persons who are harmed by information misuse may take legal action for the damage that has occurred.
At this point get staff to sign and hand in the Confidentiality Agreement

21. Questions
What are examples of activities which demonstrate that residents’ privacy is respected and confidentiality is maintained?
Personal care is completed in privacy at all times (bathing, toilet aid, continence care, dressing changes, medical examination).
Knocking before entering a resident’s room
Providing space for residents to meet privately with spouse
Resident determines information he wishes shared with family members or others.
Staff discuss issues related to residents in a setting where confidentiality can be maintained
Medical records are kept in a secure place and are only seen by people responsible for resident’s care.