1. UNH Nursing Transcultural Trip to Mexico 2010 Becca Knowles, Mellissa Cadime, Jenn Pawson, Ashley Brown, Diana Bartash, Briana Terrill Patient Privacy and Implementation in Mexico

2. Emerge in a transcultural nursing experience Observe nursing care in a different culture Recognize a problem or need Research using evidence based practice Create a plan of improvement Implement the plan of improvement Evaluate the plan of improvement

3. The Problem? a lack of patient privacy and dignity in the hospital was observed by the American students

4. What Exactly are “Privacy” &“Dignity”? “In simple terms privacy can be defined as freedom of intrusion and dignity can be defined as being worthy of respect” (PPD, 42)

5. Observations of Lack of Privacy: Medical Records Breeched Patient Privacy Disorganization of charts Lack of communication between health care team Misplaced charts Unattended charts

6. Other Observations of Lack of Privacy Close proximity to other patients Open ward No Curtains Drawn OR doors left open Community bathroom

7. 7 University of Wisconsin-Extension, Program Development and Evaluation Goal: To promote dignity through patient privacy in a hospital setting What we do Who we reach What results INPUTS OUTPUTS Activities Participation OUTCOMES Short term Long term  PowerPoint teaching  Surveys & Questionnaires  Video visual  PowerPoint teaching  Surveys & Questionnaires  Video visual  Participants  Patients  Satisfaction  Decision-makers  Participants  Patients  Satisfaction  Decision-makers  Awareness of importance of patient privacy.  Confidential patient conversations  Utilizing resources to maintain privacy  Awareness of importance of patient privacy.  Confidential patient conversations  Utilizing resources to maintain privacy  Less stressful environment  Social expectations of privacy while in the hospitalization (standardization)  Possibility of HIPPA (in Mexico) or equivalent  Less stressful environment  Social expectations of privacy while in the hospitalization (standardization)  Possibility of HIPPA (in Mexico) or equivalent What we invest  Time  Resources Available  Technology  Materials  Students  Staff  Time  Resources Available  Technology  Materials  Students  Staff

8. Helps patients feel...In controlValuedRespectedComfortable

9. According to the Code of Ethics, Patients Deserve… AUTONOMY BENEFICENCE DIGNITY VERACITY JUSTICE NON MALEFICENCE

10. “It is clear that some patients even have quite low expectations of privacy, being accustomed to the low standards offered in much health care. When we direct patients to use bathrooms, toilets, commodes, and other facilities, we must also ask what would we want for ourselves, and our relatives, in the same situation.” (Johnson, 2005) Why Is Dignity IMPORTANT In Health Care Settings? It facilitates nurse-patient relationship so we must encourage high standards

11. Four Aspects Of Privacy & Dignity (Johnson, 2005)  bodily privacy: patients felt that having their body exposed and being treated as an object were threats to their dignity and that this “embarrassment” leads to a patient’s embarrassment and lack of confidence in the healthcare team  space privacy: patients reported that pulling the curtains maintained the privacy of their space, as well as their body  information privacy: keeping medical records and medical information confidential helps to increase patients dignity  privacy of individual behavior: ensuring privacy of patients’ intimate social relations with relatives, friends, and others

12. Patient Dignity is at the of what nurses do! How Can Nurses and Other Health Care Providers Promote Dignity??? Label a patient with a name, not a diagnosis Pulling a curtain for privacy Help patient feel comfortable & confident with their care Allow patients to have a voice in their care Keep medical records confidential Provide a non-threatening, safe environment

13. An Example of Care That Promotes Patient Privacy & Dignity INSERT LINK TO VIDEO HERE!

14. Privacy Survey For Patients NEVERRARELYSOMETIMESOFTENALWAYS Did your HCP close the curtains? Were you treated with dignity throughout your stay? Do you feel that all the aspects of your care were kept confidential? Did you feel anxious related to close proximity to other patients? Did you feel you were informed about the care you were receiving? Did you feel exposed at any time during your stay? If so please describe: _______________ _______________________ _______________________ Did you overhear information about other patients’’ care?

15. Privacy Survey For Health Care Providers 1. Do you feel you have a better understanding of the importance of patient privacy and dignity? 2. Do you feel you will implement these privacy measures in your practice? 3. Do you feel your peers could benefit from this, as well? 4. Can you anticipate any barriers to implementing patient privacy? Explain ___ 5. Do you believe this will improve patient/provider therapeutic relationships?

16. WHAT HAVE YOU LEARNED??? You should close the curtain when… a. Cleaning a patient b. Examining the patient c. Discussing patient care and treatment d. All of the above

17. WHAT HAVE YOU LEARNED??? As a health care provider, what are three ways that you can protect the privacy of your patients?

18. WHAT HAVE YOU LEARNED??? SCENARIO #1 A male patient is in a room with 6 other patients. His nurse is discussing his condition (AIDS) with him and everyone in the room can see and hear the conversation. 1.Is the nurse promoting patient privacy? 2.If not, what can be done to promote patient privacy in this situation? 3.How would you feel if you were in this situation?

19. WHAT HAVE YOU LEARNED??? SCENARIO #2 Nurse Betty likes to leave the charts open at the end of her patients’ beds because this saves the time of shuffling through charts to record new information. When nurse Betty finishes charting her patients vitals, she leaves all charts open at the end of the patient’s beds. 1.Is this nurse promoting patient privacy? 2.If not, what can be done to promote patient privacy in this situation? 3.How would you feel if you were one of the patients in this situation?

20. WHAT HAVE YOU LEARNED??? SCENARIO #3 Nurse Lisa enters a post-partum room full of 8 female patients. None of the curtains are drawn between the patients. All of the patients’ medical records are open and at the end of their beds. Another nurse, nurse Paula, is examining the patients for edema and leaving each women uncovered when she is done with her examinations. 1.Which nurse is displaying behavior that does NOT promote patient privacy and dignity? 2.What should nurse Lisa do in this situation to promote patient privacy and dignity? 3.How can nurse Lisa make sure that nurse Paula understands the importance of patient privacy and dignity? SCENARIO #3 Nurse Lisa enters a post-partum room full of 8 female patients. None of the curtains are drawn between the patients. All of the patients’ medical records are open and at the end of their beds. Another nurse, nurse Paula, is examining the patients for edema and leaving each women uncovered when she is done with her examinations. 1.Which nurse is displaying behavior that does NOT promote patient privacy and dignity? 2.What should nurse Lisa do in this situation to promote patient privacy and dignity? 3.How can nurse Lisa make sure that nurse Paula understands the importance of patient privacy and dignity?