AFAN, MARGARETTE B.

BSN2 - B

CHAPTER 5 REVIEW EXERCISES

1. Unauthorize- Since the woman told the nurse not to tell the police, but
insists on doing so.
2. Authorize- The staff has the right to report it to the police since the staf
f's judgement reflects on how the parents actions during the interview an
d while observing the child as well.
3. Authorize- Patients chart/records are confidential, but since she is an in
tern in that department, it is her patient as well.
4. Unauthorize- It is part of client confidentiality so you can't just speak of
it to anyone. You are violating the patient's right to tell her name and the
case.
5. Unauthorize- violating patient's confidentiality,
6. Authorize- for further care and interventions, the nurse should tell the
physician if there is something wrong with the patient.
7. Unauthorize- The situation doesn't state any form of legal search for th
e said document. They could just be pretending to be the FBI and you will
be violating pt's rights as well.
8. authorize- It is rightful that the physician tells the district. It's just for t
heir own safety.
9. Unauthorize- It is not the health care personnel's business anymore.
10. Authorize- Situations like this are done in consultation of doctors so th
at other doctors can learn from it. They can share it to others but they sh
ould protect the personal privacy of the pt, like name and address.

B. Under the HIPAA legislation, each covered health care institution is

required to provide patients with a clear, written explanation of the
conditions of use and disclosure of health information. If possible, collect
several of these from your local area hospitals and clinics. Evaluate the
provided information for clarity of understanding and for compliance with
the intent of the HIPAA legislation. Several sites on the Internet will
provide you with a review of the exact legislation
requirements.
 General Right. The Privacy Rule typically requires HIPAA covered
entities (health plans and the majority of health care providers) to give
individuals with access to protected health information (PHI) about them
in one or more "designated record sets" kept by or for the covered entity
upon request.

C
1- No, as per my opinion there is no breach in confidentiality since the su
rgeon's name should be read aloud before the surgery, the whole team in
cluding the patient should know about the surgeon. Otherwise also, the p
atient would have known the name of the operating surgeon, by hospital
charts or discharge summary.
2- No, the radiographer is not in fault as per the lawsuit. As it is not confi
dential information.

D.
The HIPAA Privacy Rule requires that the nurse provides confidentiality re
garding a client's health information. As a nurse if a patient requests for c
onfidentiality you have to uphold the request unless the law requires you t
o provide such information.

Therefore since the husband requested for confidentiality the nurse has to
uphold the request.

E. The steps of the process are:

(R) Review facts involved.

What are the relevant facts of the case?
Who, if anyone, is at fault?
How did the situation come about?
Who is charged with making the decision?
  I am the pharmacist at the local community pharmacy, and I have
been filling Mrs. Arthur's medications for several years. Bob wants to
see Mrs. Arthur's medical record or medicine prescription to ensure
that she is taking the proper medications for her illness.
(E) Estimate of the problem or conflict involved in the case.
What options do you have?
What difficulties are presented by the case?
What is the major ethical dilemma involved?
  A possible issue here is that I am giving her meds she should not
be taking, or Mrs. Arthur is not taking the prescriptions as prescribed.

(S) State the solutions with initial credibility.

Group the options into a small number of potential choices.

 Mrs. Arthur travels to a hospital or clinic for a test and diagnostic, as

well as to see whether the medicines she is taking need to be
adjusted. Bob can also engage a private nurse to check Mrs. Arthur's
complaint of taking in the medications, and someone will assist Mrs.
Arthur with her problems while Bob is not around.

(O) Examine the outcomes of the solutions.What are the significant

possible outcomes that will result from following each of the potential
solutions?
  Bob can now tell if Mrs. Arthur takes her medications on schedule
every day. A hospital check-up will also tell us if Mrs. Arthur's
condition is improving or worse.

(L) Likely impact on those involved.

In what way are those involved hurt or helped by the solutions?
  I believe that everyone engaged in the scenario is being assisted,
including myself, as a physician, who will know the medications she
requires and the amount of drugs she requires on a daily or weekly
basis. Bob will also be aware of her medications and whether or not
she is taking them correctly. Mrs. Arthur will be well cared for with a
private nurse by her side, and she may also be assisted with taking
medicine.
(V) Values upheld/compromised.
Which of the basic values are upheld or sacrificed by the solutions?
  None

(E) Evaluation and refining of solution and weighing values.

Which solution seems to have the best consequences for the individuals
involved and sacrifices the
least principles?
  Having a private nurse appears to be the greatest outcome for each
person.

(D) Decision arrived at, clarified, and shown to implement equal

consideration of interest. Decide how the decision will be carried out, and
explain why this was the best of the possible solutions.
  Mrs. Arthur will have a private nurse hired by Bob. With a private
nurse, someone can care after Mrs. Arthur when Bob is gone or at
work, and someone can assist Mrs. Arthur with her drugs; this time,
Bob does not have to worry about whether she is compliant in taking
her drugs because she has a private nurse to remind or give her pills
to take.

(D) Defense of that decision against objections to its main weaknesses.

What are the major weaknesses of the decision?
What are the best answers to objections based on the weaknesses?

Take each step as a separate exercise, and work the problem through.

  The Nurse may not care about Mrs. Arthur and just leaves her to
her own devices. The best response to complaints based on the
weakness is to terminate the nurse and find a new one, or for Bob to
just give Mrs. Arthur more time.