What is Privacy and Confidentiality in Nursing? (PLUS, Importance, Key Principles, & How to Maintain)

Written By: Darby FaubionDarby Faubion RN, BSN, MBA

Darby Faubion is a nurse and allied health instructor with over 20 years of clinical experience. Darby lives in Louisiana and loves exploring the state’s rich culture and history. Darby has a passion for caring for veterans and a special interest in those affected by post-traumatic stress disorder. In her quest to make a difference for veterans, she founded a non-profit called “Operation Battle Buddy.” Read Full Bio »» RN, BSN, MBA

As nurses, there are many things we must do to provide quality nursing care, ensure patient satisfaction, and promote positive patient outcomes. Among those things, protecting patient confidentiality and privacy are priorities. While you may know what privacy and confidentiality are, you may wonder, "What is privacy and confidentiality in nursing," or how you can promote it.

In this article, I will tell you about privacy and confidentiality in nursing, explain the differences between the two, and tell you why it is important for nurses to adhere to confidentiality and privacy practices. You will also learn about possible consequences nurses could face when we do not follow privacy and confidentiality guidelines and the seven key principles of privacy and confidentiality in nursing.

What Is Privacy And Confidentiality In Nursing?

Privacy and confidentiality in nursing refer to the patient's right to assume that their personal and health information will be guarded, safe and shared only with the staff directly involved in their care. Patient privacy and confidentiality are protected by state and federal laws and upheld by state boards of nursing.

What Is The Difference Between Privacy And Confidentiality In Nursing?

Privacy and confidentiality in nursing are associated and often used interchangeably, although their meanings differ slightly. Privacy is the patient's right to determine who has access to their personal information and to be free from being observed by anyone not directly involved in their care. Confidentiality is the term used to describe the patient's right to have their personal health information kept secret from anyone they have not designated as an authorized representative.

5 Reasons Why Privacy And Confidentiality Are Important In Nursing

Privacy and confidentiality in nursing are essential to providing quality patient care, protecting patients and organizations, and promoting positive patient and organizational outcomes.

As a nurse and healthcare educator, I have learned through the years to value what privacy and confidentiality mean in nursing, not only to our patients but to our peers and the organizations we serve. Our patients appreciate that we respect them enough to advocate and protect their right to privacy and confidentiality. Our peers and employers value us as ethical professionals when they see we are willing to stand up for patient rights by protecting patient rights. The following are five of the main reasons why privacy and confidentiality are essential in nursing.

Reason #1: Protecting Patient Privacy and Confidentiality Creates a Trusting Nurse/Patient Relationship

Among the many reasons why privacy and confidentiality in nursing are vital, the fact that they help build a trusting nurse/patient relationship is among the most important. When patients feel they can trust you, they are more likely to disclose valuable information, which is crucial when planning appropriate care.

Reason #2: Better Patient Outcomes

When patients feel nurses protect their privacy and confidentiality, it fosters trust, which helps build better nurse/patient relationships. Because good nurse/patient relationships encourage patient compliance and satisfaction, they are also associated with better patient outcomes.

Reason #3: Reduced Risk of Lawsuits or Other Legal Problems

Better patient outcomes have long-lasting implications for patients, nurses, interdisciplinary healthcare professionals, and healthcare organizations. When we protect patient privacy and confidentiality, we protect the hospital or healthcare organization's brand or name, reducing the risk of being accused of improper or unethical behavior, which could tarnish the organization's reputation and lead to legal action and consequences.

Reason #4: Privacy and Confidentiality in Nursing Helps the Healthcare Organization

Healthcare professionals at all levels of education and in diverse roles are obligated to protect patient privacy and confidentiality. Protecting privacy and confidentiality in nursing helps us protect the healthcare organizations that employ us and promotes positive outcomes for our organizations.

For example, when patients are happy with our services, such as our willingness to ensure privacy and confidentiality, patient satisfaction scores are higher. Patient satisfaction scores are commonly used indicators for measuring the quality of care at healthcare facilities. In many cases, the availability of private or government grants and other funds is based on patient satisfaction scores. Therefore, it is essential that we, as nurses, do our part to ensure scores are the best they can be.

Reason #5: Promoting Privacy and Confidentiality in Nursing Demonstrates True Patient Advocacy

One of the primary responsibilities of nurses is to advocate for patients, and protecting their right to confidentiality and privacy is one way to do so. By ensuring measures are in place and followed to protect and secure protected health information, you become an advocate for patients, sometimes even without their knowledge, which is a true testament to your dedication to your role.

7 Key Principles Of Confidentiality And Privacy In Nursing

Protecting patient privacy and confidentiality in nursing is every nurse's responsibility. Following guidelines established to adhere to privacy and confidentiality practices, we help promote stronger nurse/patient relationships, better patient and organizational outcomes, and reduce risks. The following are seven fundamental principles of confidentiality and privacy in nursing.

Principle #1: Be Aware of Your Responsibilities When Accessing Patient Information

Privacy and confidentiality in nursing involve more than sharing information. It also involves the type of information you access and how you gain that access. It is your duty to maintain confidentiality of your patient's personal and health information in both work and off-duty settings. This means you should not access social media accounts, send messages to their private emails, give out their phone number or email address to another person, or use them to contact them yourself.

Principle #2: Do Not Use Identifiable Patient Information Unless Absolutely Necessary

Whenever possible, avoid using identifiable patient information. For instance, the patient's name, address, telephone number, social security number, or any financial information can be used to access their identity. This identifiable information should be safeguarded at all costs and shared only when absolutely necessary.

Principle #3: Use the Minimum Amount of Identifiable Information Possible

If the use of identifiable information is unavoidable, keep its use to a minimum. Use the most discreet means of identifiable information first. Avoid writing identifiable information on any form, typing it into any electronic device, and leaving it within sight of anyone not authorized to view it.

Principle #4: Disclosure of Information Should Be Limited to Only What is Necessary to Fulfill Immediate or Specific Medical Care

In my experience as a nurse, it is common for healthcare providers to discuss patients. At times, especially in relaxed work environments, conversations become too comfortable, and conversations may lead to too much information being shared. To protect patient privacy and confidentiality in nursing, nurses must disclose only the information that is necessary to complete specific medical care or to fulfill immediate needs. Anything beyond this puts you at risk of breaching the patient's right to privacy and confidentiality.

Principle #5: Understand the Law Regarding Patient Privacy and Confidentiality

HIPAA is a federal law that protects patient information. As nurses, we are responsible for understanding the law regarding patient privacy and confidentiality and always uphold those laws to the best of our knowledge and ability. Failure to do so could result in severe legal and professional consequences.

Principle #6: Always Justify Your Use of Patient Information

Another essential principle of privacy and confidentiality in nursing is the justification of the use of patient information. Each time you share any information about your patient, you should have a verifiable, justifiable reason for why the information is needed by the person or agency with whom the information is shared.

Principle #7: Get Consent to Release Information Before Disclosing Any Personal Patient Information

Before sharing any patient information, you must get their consent to release any information. Most healthcare organizations have patients or their designated representatives sign a Release of Information form at the time of admission to service. This form should state any individual, physician, or healthcare facility that may access their protected health information. If you do not have access to this form, get your patient's consent before sharing any information.

How To Maintain Privacy And Confidentiality In Nursing?

(The following are the 10 most important things nurses must do to successfully maintain privacy and confidentiality in their daily practice.)

Thing #1: Follow HIPAA Guidelines

HIPAA, the Health Insurance Portability and Accountability Act of 1996, is a federal law requiring the creation of national standards designed to protect patient health information from being unnecessarily disclosed without the patient's knowledge or consent. HIPAA compliance is an essential part of every nurse's duties. However, as patient information is increasingly available in a digital format, safeguarding the information can be challenging. Ways to protect privacy and confidentiality in nursing by following HIPAA guidelines include:

• Securing electronic devices.
• Keeping your password and login credentials confidential.
• Logging out of all electronic devices when not in use.
• Being aware of your organization's policies regarding the disposal of paper records or electronic media that contain protected health information.

Thing #2: Understand What Information Qualifies As PHI (Protected Health Information)

The first step in ensuring privacy and confidentiality in nursing is to know what information we are responsible for protecting. The General HIPAA Provisions 160.103 states that health information is any information, including generic oral or written information, that "is created or received by a health provider, health plan, public health authority, employer, life insurer, school or university, or health care clearinghouse; and relates to the past, present, or future physical or mental health or condition of an individual; the provision of health care to an individual or the past, present, or future payment for the provision of health care to an individual." Protected health information is any health, treatment, or payment information that can be used to identify a patient.

Additionally, we must consider individually identifiable health information, which is any information collected from the patient, family, or other individuals that can be used to identify the patient, such as demographic information. Individually identifiable health information may be created or received by a health plan, employer, healthcare clearinghouse, or healthcare provider, must relate to the past, present, or future mental or physical health or condition of the patient, the provision of healthcare services, the provision of healthcare services or payment for services.

Thing #3: Keep Anything with Patient Information Away from Public View

One of the simplest ways to safeguard patient privacy and confidentiality in nursing is to make sure anything with patient information is placed in areas hidden from public view. For example, paper charts, lab reports, or other written documents should be in closed folders or binders and placed in designated places. Computer screens, tablets, and other electronic devices used for documenting or accessing patient information should be protected by using computer privacy screens or screen savers.

When I worked in hospitals and nursing homes, I often carried a small pocket notebook to make notes as I made patient rounds. Instead of writing patient names in my notebook, I used room numbers. Then, when I returned to the nurse's station to document in patient charts, I referred to my notebook to transfer information and later shredded the notebook pages. Today, most healthcare facilities use electronic health records, which makes bedside charting easier. Whatever method of collecting and transferring information you use, implementing measures to secure patient information from public access is essential.

Thing #4: Know Your Organization's Guidelines for Protecting Privacy and Confidentiality

While HIPAA is a federal guideline for protecting patient privacy and confidentiality, your workplace may have more stringent guidelines for protecting patients. It is your responsibility to not only follow HIPAA guidelines but also to be aware of your organization's policies and to follow them, even if they are stricter than the federal guidelines established by HIPAA. The best advice I can give you is to remember that it is always better to be safe than sorry. So, if you practice stricter safety guidelines to protect patient privacy and confidentiality in nursing, you will protect not only your patient but also yourself and your organization.

Thing #5: Confirm the Patient's Identity at the Beginning of Each Encounter

It is not enough to assume you are in the right patient's room or talking to the right patient. To ensure patient privacy and confidentiality, nurses should confirm a patient's identity at the beginning of a patient encounter before exchanging personal health information or protected information. Ask the patient their name and date of birth. A designated representative may answer if the patient cannot speak or respond.

Thing #6: Close the Door or Close the Privacy Curtain Before Assessing or Interviewing Patients

Before interviewing a patient, performing a procedure, or conducting an assessment, close the door or pull the privacy curtain to ensure others cannot see or hear. This step not only ensures privacy and confidentiality but also helps support patient dignity as you reduce the risk of exposing patients if they are undressed during the assessment.

Thing #7: Carefully Review Patient Release of Information Forms

Part of the admissions process is for patients to complete paperwork. One of the forms they must sign is the Release of Information, which designates who you may share their protected health information with. You can ensure privacy and confidentiality in nursing by referring to the Release of Information form and following your patient's wishes. You must review this information, as sharing information without your patient's consent is a breach of the HIPAA law, which could result in legal ramifications.

Thing #8: Only Discuss Patient Information with People Directly Involved in Their Care

As a nurse, I believe in patient advocacy, and protecting a patient's right to privacy and confidentiality is at the top of my list of priorities. Not much frustrates me as much as nurses who have little regard for the privacy of their patients.

Years ago, I attended an event to honor healthcare workers and sat with a friend of mine who was a nursing administrator. A group of employees from her hospital sat at a table near us. One of the nurses asked another nurse and lab technician if they knew a patient, Mr. "X." They both responded that they knew him. She then proceeded to talk about his diagnosis, his attitude, and his family. My friend and I overheard their conversation in its entirety. This serious breach of patient confidentiality was enough to cost every one of the employees involved in the conversation their jobs.

Thing #9: Discuss Patient Information Only in the Appropriate Settings

One of the easiest mistakes to make when it comes to protecting privacy and confidentiality in nursing is discussing patient information outside safe or designated settings. For example, if you go to the hospital cafeteria for coffee or lunch, it is best to talk with your nurse friends about your kids or what is on sale at the local grocery or department store, not what is ailing Mrs. Jones in room 203. As nurses, we are responsible for always safeguarding our patient's right to privacy and confidentiality.

Thing #10: Use Organization-Approved Methods of Sending Patient Information

If you work in a large facility, such as a hospital, it may be necessary to send patient information from one department to another. When transmitting information to another department, you can protect patient privacy and confidentiality in nursing by using secure routes such as official facility mail. For example, one of the hospitals I worked at used a pneumatic tube system like those you find at a bank drive-through. The systems use cylindrical containers that are propelled through networks by compressed air. Other facilities have staff who transfer interdepartmental mail and messages to ensure delivery to the appropriate recipients.

5 Potential Consequences Nurses Can Face For Breaching Privacy And Confidentiality

Maintaining privacy and confidentiality in nursing is crucial. Failure to do so could result in severe consequences. The following are five potential consequences nurses can face for breaching privacy and confidentiality in nursing.

Consequence #1: Disciplinary Action at Work

Breaches of privacy and confidentiality in nursing can lead to disciplinary action at work. You may receive a verbal reprimand or suspension, depending on the situation and whether this is a first offense. Some employers have a zero-tolerance policy and may terminate you for any breach of patient privacy and confidentiality, even if it is a first offense. Other employers may require you to participate in HIPAA training to help improve compliance and prevent future breaches.

Consequence #2: Suspension or Loss of Nursing License

Being reprimanded at work is bad enough, but imagine having your nursing license suspended or revoked. Privacy and confidentiality in nursing are serious. Protecting this patient right is so serious that we risk losing the privilege to practice as nurses when we fail to do so.

Consequence #3: Damaged Patient and Nurse Reputations

Unfortunately, when privacy and confidentiality in nursing are compromised, it can affect more than your job. Some patient information can have detrimental effects on their reputation if it is shared with the wrong person and rumors are spread. For example, if a patient is diagnosed with a sexually transmitted infection or disease and that information is shared with unauthorized parties, it can have a devastating effect on the patient.

Also, if you are guilty of spreading information without authorization, you can be perceived as a gossiper or troublemaker at work. Neither of these bodes well for your professional relationship.

Consequence #4: Civil or Criminal Lawsuits

Because patients have a legal right to privacy and confidentiality, if you compromise or breach that right, you may be at risk of being sued in a court of law. While some sources state that patients may not sue nurses for breaches of privacy and confidentiality, in recent years, several states have ruled that patients could sue hospitals and individual nurses for breaches of confidentiality. The best advice I can give you to keep from risking the chance of being sued is, if you must question whether something is a breach of privacy and confidentiality in nursing, it probably is, and you should avoid risking it.

Consequence #5: Poor Nurse/Patient Relationships

Good nurse/patient relationships are based on trust and understanding. Therefore, a critical consequence of breaches of privacy and confidentiality in nursing is that nurse/patient relationships become strained. Remember, it is much easier to build trust and maintain it than to rebuild it once you have damaged the relationship between you and your patient by compromising their privacy and confidentiality.

My Final Thoughts

Nursing is a profession of constant growth and an ever-changing landscape. However, one thing that never changes is a patient's right to have their privacy and confidentiality protected. We must ask the question, "What is privacy and confidentiality in nursing?" and strive to protect it at all costs. In this article, I shared insight about privacy and confidentiality in nursing from years of experience as a nurse and healthcare educator and shared some tips on how to ensure privacy and confidentiality rights are upheld in your practice.

List Of Sources Used For This Article

1. https://www.nursingworld.org/resources/individual/nurse-managers/nurse-patient-relationship-trust
2. https://www.cdc.gov/phlp/publications/topic/hipaa.html
3. https://www.law.cornell.edu/definitions/uscode.php?width=840&height=800&iframe=true&def_id=42-USC-1985487160-746707014&term_occur=999&term_src=
4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3047732/