Breaks In Confidentiality Flashcards
Student is in a lift with multiple member of the public when 2 registrars enter and are audibly discussing patient case with identifiable information being mentioned.
How appropriate is the following:
(1) take the registrars aside once they gave exited the lift and mention to them that they were likely to be overheard discussing the patient case
Since identifiable information was mentioned, in this situation we know that identifiable information was mentioned because the student was able to to discern what patient was being mentioned and so other people, members of the public , can be assumed to have done the same thing. IT IS VERY APPROPRIATE that the registrars are pulled aside after they have left the lift and informed that they have been overheard and so there is a break in confidentiality. This should be done privately in order to maintain public confidence.
Med student (Akino) on placement in an A&E ward is approached by a patient who is concerned that she has just overheard a consultant discussing audibly patient information and she is worried that if the consultant has done this to other patients that her information may have also been spoken about openly in public. The med student apologises but the patient would like to know what will be done.
How appropriate are the following:
(1) “I will let the supervisor on the ward know”
(2) “I think it would be more appropriate if you spoke to the consultant about this issue”
(3) “I will ensure that the consultant is made aware”
(1) “I will let the supervisor on the ward know” is a very appropriate response as Akino isn’t directly involved in the situation and isn’t responsible for the actions of the consultant. Informing the proper senior member of staff who can appropriately handle the situation is the best course of action.
(2) “I think it would be more appropriate if you spoke to the consultant about this” is appropriate but not ideal because it would be more appropriate if the patient spoke directly to the parties involved in the situation however if the patient is coming to you, a med student, directly about the issue then it is likely she if uncomfortable doing so. You have been brought into the situation by the patient it is in your best interest and theirs to do something.
(3) “I will ensure that the consultant is made aware” is an inappropriate but not awful thing to say as it is vague and doesn’t imply that Akino will talk to the consultant directly. It downplays the break in confidentiality and doesn’t solve the issue in the here and now
Ciara is a medical student and she notices a message on social medics by another medical student on the same placement as her with notes that the student made during a patient consultation. The caption reads: “notes from Mr X’s consultation, I thought other students may find this useful” however Ciara can see the actual name of the patient is visible.
How important are the following:
(1) that other students may find these notes helpful in their studies
(2) the fact that the location of the placement is not revealed
(1) that other students may find the notes helpful, is of minor importance as whilst possibly true this is overshadowed by the break in confidentiality and so is very minor in comparison.
(2) the fact that the location of the placement has not been revealed is of NO IMPORTANCE as the location of the placement isn’t of concern, it’s the break of confidentiality containing identifiable patient information.
Douglas is a medical student on placement with another fellow med student, Alisa, she mentions that after a patient consultation they had left a pair of sunglasses behind and so she will call the patients phone to explain this to them in order for them to pick them up at some point in the future. After calling the patient’s phone their husband picks up and becomes distressed that his wife has a hositpial appointment without telling him. Alisa begins telling him information about the reason for her visit and and the treatment she received or is to receive.
How important are the following:
(1) if Alisa regularly discusses confidential patient information with their family members
(2) if Alisa has undertaken the appropriate confidentiality training
(3) whether Alisa knows that her supervisor can advise her on what action to take in this situation
(1) If Alisa regularly discusses confidential information with patient’s family members, is of minor importance, at this current moment in time the important thing is the current break in confidentiality and so the fact that other breaks may have happened is of minor importance and to be investigated by the relevant senior members of staff in the future.
(2) if Alisa has undertaken the appropriate confidentiality training, is VERY IMPORTANT as it could mean that Alisa is simply naive to her actions rather than her being deliberately negligent or malicious.
(3) that Alisa knows that her supervisor can advise her on what to do in difficult situations, is IMPORTANT as the duties of medical professionals to foster a healthy and collaborative working environment where less senior members of staff/ students can reach out to more senior members and patient concerns can be freely discussed.
Stephan is a med student and is on placement when a fellow student calls him to say that her friend is on his ward and requests their file in order for them to check up on them as they are worried.
How appropriate is the following:
(1) “why don’t you check up on your friend when you are free”
is very appropriate as you avoid the break of confidentiality and provides a practical solution to the problem/ issue at hand.
Med students, Carl and Lucy, are on placement together and during a tutorial, Lucy notices that Carl is recording, hospital policy states that this is only allowed if the lecturer is aware and allows this and that patient names are not mentioned. Lucy doesn’t know if Carl has permission to record and patient names have been mentioned in the tutorial.
How important are the following:
(1) that she doesn’t know whether Carl has permission or not
(1) very important, she shouldn’t make an assumption or work off knowledge she doesn’t have.
