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Ethics of Nursing Informatics

Currently, health care has embraced the use of computers in its operations. Computers are used mainly to speed up processes and procedures, and they ease communication and access. In addition, they are used in the monitoring and evaluation of patient data. However, growing concerns have been raised about the use of computers in storing and monitoring patients’ electronic health records (EHRs). The concerns are mainly based on the confidentiality or privacy of patients’ information. Several incidences of unauthorized and inappropriate access to patients’ health records have been witnessed in the health care sector. This paper will evaluate two incidences in which there was inappropriate access to patients’ data.

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First and foremost, both cases involve abuse of confidentiality about patients’ information. Therefore, they are relevant to Health Insurance Portability and Accountability Act (HIPAA). With respect to the rules of HIPAA, protecting the security and confidentiality of the patient’s health records takes precedence (Ziel, 2009). With regard to confidentiality, HIPAA recommends authorization for any disclosure or use of patients’ health records, especially those unrelated to health operations, treatment, and payment. In both cases, the nurses’ incentive of getting patients’ information was illegal and prohibited by HIPAA regulations. In the first case, the nurse invaded the privacy of his/her neighbor. In the other case, the nurse attempted to retrieve a celebrity’s EHRs for illegal business deals.

Prior to the above incidences, there were questions regarding who has or who does not have the authorization to access EHRs. To begin with, EHR refers to stored patients’ data stored in a digital form and shared privately by authorized users. Those who can use such information include all medical practitioners and sometimes patients or their guardians. With respect to this case, both nurses were not authorized to obtain the patient’s data. Only those with authority were allowed to view and open patients’ electronic health records. In addition, the medical practitioners undertaking their respective duties are given the privilege to access such data, but this is extended only to the patients they are handling (Terry, 2012).

There are limitations to medical practitioners while using the EHR system in their respective working places. The most significant limitation to the use of EHRs is insufficient knowledge relating to the EHR system. It can be noted that most of the nurses have little knowledge and skills regarding computer literacy. A study by Campbell and McDowell (2011) showed that the majority of the nurses had little knowledge concerning computer literacy. In most instances, many had fewer skills that were limited to emailing, data entry, among others. In addition, the levels of computer literacy correlated with age. The older nurses were disadvantaged more than the young nurses. Surprisingly, most of the health care systems were served by many older registered nurses as compared to younger ones (Campbell & McDowell, 2011). With the change of the EHRs structure, significant complications have come to the fore. The earlier EHR system differentiated between the various elements. The elements include time, problem, and source of information. Today, the EHR system incorporates all the three elements. In a time-oriented structure, electronic health records follow a chronological order. On the other hand, in problem-oriented, information is updated for each and every patient assigned. At the same time, each problem is evaluated depending on the information collected. Lastly, in the source-oriented structure, information is presented on the basis of the method of collection such as x-ray reports and blood tests (Campbell & McDowell, 2011).

Furthermore, to enhance the security and confidentiality of patients’ EHRs medical practitioners should exhibit informatics ethics. This has benefits and shortcomings to the patients based on the nature of informatics ethics possessed by the nurse. This can either be good or bad. In regards to good ethics, patients and their guardians have confidence about the safety of their health records, especially those with lengthy medical records. In short, there exists a good nurse-to-patient relationship (Goodman, 2010). Patients will feel free to share information regarding their health. Nurses with good ethics will preserve patients’ privacy rights. This is in regard to whom or under what situation should their identifiable health records be disclosed.

Additionally, patients should be allowed to access and supplement their own health records. This is of great significance in enhancing the correction of erroneous health records and addressing their discrepancies. On the contrary, medical practitioners with poor informatics ethics are a threat to the security and privacy of patients’ health records. They would disclose patients’ identifiable health records without their informed consent to suit their self-interests. Therefore, patients limit sharing of the information at the expense of their own health. Furthermore, medical practitioners with good informatics ethics enhance good decision-making among themselves and their respective patients. A good clinical decision is directly proportional to good information. The use of electronic health record systems in health care makes patient health records to be readily available and reliable. The availability of such information is relevant in facilitating good decisions (Paneth-Pollak, et al, 2010). Both the nurse and the patient may have different opinions concerning the information that is relevant and useful in health care. This requires mutual agreement and clarification from both parties. Similarly, nurses with poor informatics are not effective in decision-making. In most cases, they do not involve patients in decision-making.

References

Campbell, C.J., & McDowell, D.E. (2011). Computer literacy of nurses in a community hospital: Where are we today? Journal of Continuing Education In Nursing, 42 (8), 365-370.

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Goodman, K. W. (2010). Ethics, information technology, and public health: New challenges for the clinician-patient relationship. The Journal of Law, Medicine & Ethics, 38 (1), 58–63.

Paneth-Pollak, R. et al. (2010). Using STD electronic medical record data to drive public health program decisions in New York City. American Journal of Public Health, 100 (4), 586-590.

Terry , K. (2012). EHR Access Improves Patient Medication Compliance. Web.

Ziel, S. (2009). Legal checkpoints: Get on board with HIPAA privacy regulations. Nursing Management, 23 (10), 28-29.

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