CWO

What does HIPAA consist of?

. Standardized Electronic Data Interchange transactions and codes for all covered entities. 2.Standards for security of data systems. 3.Privacy protections for individual health information. 4.Standard national identifiers for health care.

STANDARD PRECAUTIONS

1. Used for all patients, regardless of their diagnosis 2. Applies to all blood & body fluids except sweat. Use the right PPE (personal protective equipment) for the job * Gloves * Face/Eye Protection * Gowns/Protective Apparel 3. Use Respiratory Etiquette & Cough Hygiene to minimize the spread of germs 4. Wear a surgical mask when entering the epidural canal to prevent spread of meningococcal meningitis 5. Injection Safety - one needle, one syringe, one time only 6. Clean & disinfect the environment; use appropriate PPE during cleaning 7. Bloodborne pathogen concerns - HIV, HBV, HVC * Handling blood and body fluids with care to avoid exposure to bloodborne pathogens * Cover your "portals of entry" (eyes, nose , mouth, non-intact skin) when potential exposure is possible * Choose the right gown to protect clothing (paper vs fluid-resistant) * Use safety devices to reduce risk of needlesticks * No two-handed recapping of needles * Annual review of safety devices to mitigate risk * Always use safe injection practices

WHAT ARE SOME WAYS HIPAA CAN BE VIOLATED?BREACH

A breach is, generally, an impermissible use or disclosure under the Privacy Rule that compromises the security or privacy of the protected health information.

Durable Power of Attorney for Health Care (or Health Care Proxy)

A document in which you appoint someone else to make medical treatment decisions for you if you cannot make them for yourself. The person you name is called your agent, proxy, representative, or surrogate. You can also include instructions for decision-making.

Living Will

A document in which you state your wishes about life-sustaining medical treatment if you are terminally ill, permanently unconscious, or in the end-stage of a fatal illness.

Examples of Business Associates

A health care clearinghouse that translates a claim from a non-standard format into a standard transaction on behalf of a health care provider and forwards the processed transaction to a payer. A third party administrator who assists a health plan with claims processing. An independent medical transcriptionist who provides transcription services to a physician. A CPA firm whose accounting services to a health care provider involve access to protected health information. A pharmacy benefits manager who manages a health plan's pharmacist network.

What is Electricity?

A medium that provides a very convenient means for transferring energy from one place to another Correctly used, electricity is our most versatile form of energy Control of most electrical hazards is neither difficult or expensive, but ignoring them can cause serious consequences Electricity is one of those things we usually take for granted. We flip a switch and the lights come on, set the timer and our popcorn pops. We rarely think about the dangers and need for safety other than ensuring our kids do not stick forks in outlets. But there are other hazards and they are easy to remember with a little common sense.

What are some ways Hipaa can be violated?Incidental disclosure

A secondary use or disclosure that cannot reasonably be prevented, is limited in nature, and occurs as a by-product of an otherwise permitted use or disclosure. Examples of Incidental Disclosure A hospital visitor may overhear a provider's confidential conversation with another provider or a patient A hospital visitor may glimpse a patient's information on a sign-in sheet or nursing station whiteboard

ROUTES OF ENTRY

Absorption- soaks through skin Inhalation- you breath it; most common Ingestion- you eat it Injection- puncture wound Many hazmats are odorless, colorless and tasteless You may be exposed before you know it Approach safely

What are the HIPAA rules and regulations that protect these rights?Accounting of disclosures

Accounting of Disclosures is the patient's right to request a list of people and organizations who have received their Protected Health Information [PHI]. Patients must submit a written Request for Accounting of Disclosures. A Covered Entity [CE] must respond to a the patient's request for an accounting within 60 days of receipt of the request. Some Examples of Disclosures are disclosures that are: Required by law For public health activities About victims of abuse, neglect, or domestic violence For judicial and administrative proceedings For research activities For law enforcement activities For workers compensation

IN CASE OF SMALL SPILLS

Act Quickly Contain the spill Wear PPE Notify proper personnel

What are the HIPAA rules and regulations that protect these rights?Authorizations

An Authorization is a detailed document that gives covered entities permission to use Protected Health Information [PHI] for specified purposes. It is required for the use and disclosure of Protected Health Information [PHI] not otherwise allowed by the Privacy Rule. Does not apply to Treatment, Payment and Health Care Operations [TPO]. Does not apply to uses and disclosures required by law. AN AUTHORIZATION MAY BE REVOKED AT ANY TIME IN WRITING.

What are the requirements of an Authorization?

An Authorization must include: The Protected Health Information [PHI] to be used and disclosed; The person authorized to make the use or disclosure; The person to whom the Covered Entity may make the disclosure; An expiration date; and The purpose for which the information may be used or disclosed.

Electrical SafetyPolicy...

An equipment management plan exists to identify, evaluate, inventory, and maintain medical equipment to reduce the physical and health risks associated with its usage All biomedical and electrical equipment used in a Hospital must be inspected and tested prior to use and labeled with a safety sticker All electrical devices a patient may bring into the hospital need to be inspected and tested prior to use and labeled with a safety sticker prior to their use.

WBAMC CODES

BOMB THREAT: CODE BLACK COMBATIVE PERSON/ WORKPLACE VIOLENCE: CODE GREEN DISASTER: CODE GRAY HAZMAT:CODE ORANGE ARMED ASSAILANT:CODE WHITE

BE SURE TO WASH YOUR HANDS

Before entering or leaving the work area Before and after contact with a patient After handling items such as bedpans, dressings, etc. After removing gloves After using the toilet, blowing your nose or covering a sneeze Before eating, drinking or handling food or smoking

Who else is responsible for protecting patient privacy?Business associates

Business Associate A person or entity that performs a function or activity on behalf of a Covered Entity [CE] that requires the creation, use or disclosure of Protected Health Information [PHI] but who is not considered part of the Covered Entities' workforce. They must have a written contract or agreement that assures they will appropriately safeguard Protected Health Information [PHI] they create or receive.

ARMED ASSAILANT

CODE SILVER Except WBAMC

Code Blue

Cardiac Arrest Emergency Codes......cardiovascular arrest- all hospitals locally call Code Blue....specific hospital procedures are in the handouts

Prevention of Legal Trouble

Checking the patient's & family's level of understanding lessens the likelihood of mistakes & unrealistic expectations from the patient. Resolution is a vital component in providing closure to an incident for you & the patient. Deal with the facts & feelings of everyone involved. Also, ask yourself what valuable lesson can be learned? How can you either improve your care or the systems & processes that impact patients and patient care? Extend compassion to the patient & their family/significant others. Understand that they are scared, angry, frustrated, & just don't feel well. Reach beyond yourself & understand that we have also encountered these emotions as well. How would we want to be treated? Know your policies & procedures regarding equipment safety. Know how to appropriately remove equipment from service. When in doubt-ask! The only "dumb" question is the unasked question. The dangerous practitioner is the one who thinks they know it all. Healthcare is changing everyday. Ask questions. Ask for clarification. Ask for help. Know your limitations & the limitations of those around you. Anger is a breeder of law suit behavior. When a patient feels he has been "wronged," "ignored," "done things to," & attacked with hostility, there is a greater likelihood that the patient may take legal action which may or may not be legitimate. Unmanaged expectations affect everyone negatively. Greet patients & their families. Be warm & friendly. Anticipate their needs & don't make them wait. Be attentive & upbeat. Make sure to introduce yourself by giving your name & title. Use good communication skills. Always thank the patient. Be sincere. Follow-up as needed. Keep your promises. Keep the patients informed regarding the length of time a request or procedure will take. Be realistic; check for level of understanding. Adhere to the time frames you set. Answer questions that are within your domain to answer. Refer other questions to the proper person. You can facilitate future conversations through referral & follow-up. The Joint Commission Standards now mandate that patients be told of mistakes that are made. If you make an error, please notify your instructor & the person in charge of your area for assistance. Use terms that are easy to understand. Clarify & check for understanding. Be honest, direct & respectful in all interactions with patients & their families. By following these guidelines, you will meet or exceed your patients' expectations. You will also decrease the risk of legal action throughout your career.

GHS Action Plan

Chemical containers, bottles, etc. will begin to arrive with the newly-formatted labels. These new labels will include more information than ever before. Read them thoroughly to get used to the new format and content, even if it's not the first time you've used the product. Be sure you understand the meanings of the pictograms that will appear on the labels. REM will have laminated cards available, or an online resource such as the OSHA website, to check if you are unsure of what something means. You must keep any MSDS you already have Watch for new GHS-compliant (16-section) SDS to arrive They may come from the manufacturer or distributor with a shipment of the products you order You may go online or contact the manufacturer yourself to get it Replace old MSDS with new SDS in the active binder along with your current chemical inventory. Archive old MSDS for 30 years. SDS may not be available right away from all manufacturers.

Low Voltage Lethal Shock Computations...

Circuits of 110 volts or less can kill when the conditions are right. This is regular household current. Synchronized cardioversion 100mA When we cardiovert, the desire is to stop the heart so the normal pacemaker can take over with a regular rhythm. To do this we discharge energy across their body with two paddles.The body between the paddles is the conducting object. Most household current is 110 volts or 220 volts. By touching a live wire and standing on the ground the same scenario can occur and the heart can stop

What are the consequences of not complying with hipaa?Penalties for privacy violations

Civil Penalties under HIPAA: Maximum fine of $25,000 per violation. Criminal Penalties under HIPAA: Maximum of 10 years in jail and/or a $250,000 fine for serious offenses. Organization Actions: Employee disciplinary actions including suspension or termination for violations of the organizations policies and procedures.

Classes of Fire

Class A - Ordinary combustibles such as wood, paper, and trash Class B - Flammable liquids such as gasoline, xylene, and alcohol Class C - Electrical equipment Due to the multiple combustibles in the healthcare environment, they utilize a multiclass fire extinguisher, or what is termed an ABC class extinguisher. in the healthcare environment, they utilize a multiclass fire extinguisher, or what is termed an ABC class extinguisher. This fire extinguisher may be utilized on all classes of fire and takes the guess work out of which on to use on what combustible element

EL PASO VETERANS AFFAIRS (VA)

Code Silver - Missing Patient Code Pink - Abducted Child Code White - Weapon/Hostage Code Green - Disruptive Behavior Code Red- Fire Emergency Code Yellow - Utility Situation Code Orange - Hazmat Response Code Grey - External Emergency Code Black - Bomb Threat Code PEP - Potentially Exposed Patient

HOW DO I PROTECT MY PATIENT'S PRIVACY?SAFE COMPUTER AND FAX USE

Computer Use •Keep your password a secret •Do not log in using someone else's password •Log off of the computer when you are finished using it. •Turn the computer screen away from public view •Do not remove equipment, disks, or software without permission. Sending •Call the intended recipient before sending the fax •Use cover sheets for faxes •DO NOT SEND [HIV results, Mental Abuse, Narcotic Prescriptions, Alcohol/Substance/Child Abuse Receiving •Tell the person faxing information to alert you when he/she is about to send the fax •Take faxes off the machine immediately •Do not let faxed patient information lie around unattended

Fire Drills...

Conducted every quarter on every shift in Hospital Respond immediately as if actual fire. Remember R.A.C.E. and P.A.S.S. All corridor fire doors are connected to fire alarm & detection system and will close automatically once activated The corridor fire doors and the room doors are all rated for a particular time frame that it will take a fire to burn through them. This is why it is important to ensure that the fire doors in the corridors are free to close and that patients and visitors remain in their rooms with the doors closed. This provides them an added barrier between them and the fire, and also greater time for the fire department to respond and contain without loss of life. Assist with pulling doors shut and ensuring patients and visitors remain in their rooms. The corridor fire doors and the room doors are all rated for a particular time frame that it will take a fire to burn through them. This is why it is important to ensure that the fire doors in the corridors are free to close and that patients and visitors remain in their rooms with the doors closed. This provides them an added barrier between them and the fire, and also greater time for the fire department to respond and contain without loss of life.

GHS - Major Changes

Container Labeling Classification and hazard identification of chemicals Safety Data Sheet (SDS), formerly known as Material Safety Data Sheet (MSDS), format and content

Covered Entities

Covered Entities [CE] - are the individuals responsible for implementing HIPAA rules and regulations. Some examples are: Health Plans Health Care Clearinghouses Health Care Providers who conduct certain financial and administrative transactions electronically

Who Carries out Hipaa rules and regulations?

Covered Entities are responsible for implementing HIPAA rules and regulations. These are Health Plans Health Care Clearinghouses Health Care providers

Causes Of Electric Shock...

Current flow is the factor that causes injury in electric shock; body resistance will determine the path of flow Once the skin is broken, a victim will have sharply reduced internal resistance to the flow of current

Labels - Signal Words Describe the Severity of a Hazard

Danger This is reserved for the more severe hazards Warning This is used on less severe hazards If there is no significant hazard, a signal word won't be used

HOW DO I PROTECT MY PATIENT'S PRIVACY?DO'S AND DON'TS

Don't: • Tell anyone what you overhear about a patient. • Discuss a patient in public areas, such as elevators, hallways or cafeterias. • Look at information about a patient unless you need it to do your job. Do: Close doors in patient's rooms when discussing treatments. Log off the computer when you are finished. Dispose of patient information by shredding or storing it in a locked container for destruction. Clear patient information off of your desk when your leave your desk.

Hospice Care

Dying patients may choose hospice care. A holistic and philosophical approach to end of life care, hospice brings doctors, nurses, social workers and other professionals together as a care team. The hospice team's goal is to make the patient as comfortable as possible during his or her final days. Hospice emphasizes pain control, symptom management, natural death, and quality of life to comfort the patient's physical body.

Characteristics of Electricity...

Electricity has most of the characteristics of water, in that it flows and has a current that can be measured

HOW DO I PROTECT MY PATIENT'S PRIVACY?BUSINESS ASSOCIATES PT.11

Examples of Business Associates A third party administrator who assists a health plan with claims processing. A CPA firm whose accounting services to a health care provider involve access to protected health information. A health care clearinghouse that translates a claim from a non-standard format into a standard transaction on behalf of a health care provider and forwards the processed transaction to a payer. An independent medical transcriptionist who provides transcription services to a physician. A pharmacy benefits manager who manages a health plan's pharmacist network.

MANAGING EXPECTATIONS

Expectations are individually-based concerns. They evolve from past experiences and are unique to the person. Low expectations may not allow the patient to get the full benefit of their hospital experience. High Expectations may set everyone up for failure as they may be unrealistic. One must balance reality with giving the patient hope & assurance when managing expectations. Managing the patients' & their family expectations regarding their care & their outcomes is often the first step in avoiding a legal battle.

Code Red

Fire or Visible Smoke

Electrical Faults Result in Shock, Burns or Fire...

Flow of Current Occurs when a person or a conducting object bridges the gap between live conductors and the ground or between live conductors. This action causes current to flow. This is the reasoning behind birds on high voltage wires and why they do not fry. Since the bird is only on the wire there is no conduction between ground or other live conductors. However, if I go to trim my trees and touch the wires or place my ladder on the wires, I have bridged the gap between the live conductor and the ground. Current flows from the line through my body and gets discharged into the ground. That is a big OUCH!

Chemistry of FireFire burns because there are three elements present..

For fire to burn, it requires three elements, fuel, heat, and oxygen. If one of these elements is missing then fire will not burn. Many laws and policies have been implemented to ensure the safety of patients in relation to fires and fire hazards. One of these laws was that all healthcare facilities are non-smoking. Healthcare facilities normally have a ready supply of oxygen and numerous combustibles. By removing a common source of heat for a fire (the lit cigarette) a major player in the big three is missing. But there are other sources of heat for fires and this requires the healthcare facility to have a plan of action in the event that all three elements collide.

Ground Fault Circuit Interrupter...

GFCI is a fast-acting circuit breaker that is sensitive to very low levels of current leakage (5mA) to ground. When leakage becomes hazardous, it interrupts circuit. You can find GFCIs in what electricians call "wet" areas such as the bathroom and kitchen. GFCIs are normally used for outside wiring outlets also. You can find GFCIs in what electricians call "wet" areas such as the bathroom and kitchen. GFCIs are normally used for outside wiring outlets also.

PERSONAL PROTECTIVE EQUIPMENT (PPE)

Gloves Goggles Masks Respirator Gowns Aprons Footwear Good hygiene

Hand Hygiene Protocol

Good hand hygiene practices are the single most effective means of preventing the spread of infection. REMEMBER THIS: Hands must be washed/decontaminated before touching the patient, and after touching the patient or the patient's environment, whether gloves are worn or not Finger nails should be kept short -- ¼ INCH No artificial nails in patient care areas Artificial nails and long natural nails have been linked to disease transmission in the healthcare setting.

DISASTER....INTERNAL or EXTERNAL

HCA: CODE D TENET: CODE INTERNAL/ EXTERNAL TRIAGE UMC: HICS (Hospital Incident Command System) WBAMC: CODE TRIAGE

INFANT/CHILD ABDUCTION

HCA: CODE PINK TENET: CODE ADAM UMC: CODE PINK WBAMC: CODE PINK Actual or attempted infant abduction- be aware of exits/stairwells and do not allow visitors to leave area- be aware of strangers with packages, bundles, overly dressed....

Bomb Threat

HCA: ORANGE TENET: CODE ORANGE UMC: CODE ORANGE WBAMC: CODE BLACK Receipt of warning: When phone call is received, and this may be anywhere in the hospital, individual receiving the call should: Prolong the conversation as much as possible. Be alert for distinguishing background noises, such as music, voices, airplanes, etc. Note distinguishing voice characteristics. Ask where and at what time the bomb will explode. Note if the caller indicates knowledge of the hospital by this description of locations. IF BOMB OR SUSPICIOUS OBJECT IS FOUND, DO NOT TOUCH IT. Clear area, close doors. Inform hospital administrator or designee, who will obtain professional assistance. Do not alarm patients. Do not divulge to the patients that a bomb threat has been received in order that patients will not become alarmed. Reassure patients, if they do discover what is taking place, that all is under control.

What are the HIPAA rules and regulations that protect these rights?Minimum necessary standard

HIPAA requires Covered Entities to take reasonable steps to disclose only the information that is necessary for the purpose for which the disclosure is to be made [the minimum necessary amount of information needed to perform the job]. The Minimum Necessary DOES NOT APPLY TO: Treatment Disclosures to the individual who is the subject of the Protected Health Information [PHI] Uses or disclosures made pursuant to an individual's authorization Uses or disclosures that are required by law.

Proper Hand Washing & Alcohol Gel/Foam Use

Hand Washing: Use tepid water, wet hands and apply soap Use good friction cleaning front and back of hand, paying attention to nails and between fingers for at least 15 seconds Pat hands dry with paper towel and turn off faucet with a paper towel. Always use hand washing when hands are VISIBLY soiled Using Alcohol Gel/Foam: Apply appropriate amount of foam/gel into palm of hand Rub hands together using good friction to all surfaces, paying attention to nails and in between fingers Rub hands together until product is evaporated and hands are completely dry Wash with soap & water if hands feel tacky or dirty from hand gel

JOINT COMMISSION REGULATIONS

Hazardous materials and waste: Handling, use, and storage are guided or defined by local, state, or federal regulation Occupational Safety and Health Administration's (OSHA) Regulations for Bloodborne Pathogens regarding the disposal of blood and blood-soaked items; Nuclear Regulatory Commission's regulations for the handling and disposal of radioactive waste Other, hazardous vapors (e.g., gluteraldehyde, ethylene oxide, nitrous oxide), and hazardous energy sources (for example, ionizing or non-ionizing radiation, lasers, microwave, ultrasound). Big long JCAHO definition of Hazardous materials and waste... Hazardous Energy Sources Ionizing or non-ionizing radiation, lasers, microwave, ultrasound The Joint Commission considers infectious wastes falling into this category of materials (Hazardous Waste) Federal regulations do not define infectious or medical waste as hazardous waste

What is HIPAA?

Health Insurance Portability and Accountability Act

Emergency Power

Hospitals are equipped with emergency generators which will start automatically if there is a loss of electrical power Emergency generators are tested monthly in Hospitals Red electrical outlets provide emergency power for critical patient care equipment Critical care areas have an abundance of red outlets due to the critical nature of the devices they run. They will also normally be the areas with lighting during a power outage.

TYPES OF HAZARDOUS MATERIALS

INFECTIOUS SUBSTANCES Some infectious substances (such as some viruses) can be transmitted by blood and other body fluids, equipment, containers, paper goods, glassware, linens and by people. RADIOACTIVE MATERIALS These require special handling techniques to prevent exposure to personnel and visitors. FLAMMABLE LIQUIDS AND GASES For example, chemicals, such as ether or alcohol, can burn or explode. TOXIC CHEMICALS A person may be exposed over a long period of time before effects are noticed.

Are there other laws that protect patient privacy?State law vs. hipaa

If there is a conflict or inconsistency between an applicable state law and the HIPAA Privacy Rule, follow the law that provides the patient: Greater privacy rights, Greater access to information, or Greater privacy protections.

HIPaA Reference Contacts

If you have any questions regarding HIPAA contact: Souraya A. Hajjar, EPCC Compliance Officer at (915)831-4143 Or email her at [email protected] Your HIPAA Compliance officer at your campus or facility. Your Clinical instructor/coordinator at your campus or facility. Or refer to http://www.hhs.gov/hipaa/index.html for more information regarding HIPAA policies and regulations.

Why was HIPAA created?

In 2000, many patients that were newly diagnosed with depression received free samples of anti-depressant medications in their mail. This left patients wondering how the pharmaceutical companies were notified of their disease. After a long and thorough investigation, the Physician, the Pharmaceutical company and a well-known pharmacy chain were all indicted on breach of confidentiality charges. This is one of the many reasons the Federal Government needed to step in and create guidelines to protect patient privacy.

KNOW THE POTENTIAL HAZARDS

In each area of the facility where you work: Observe signs Take precautions when entering an area identified as hazardous Know what's inside a container before you handle it!

Fire Prevention Practices...

Keep passage ways and exits clear Ensure fire extinguishers and fire alarm pull stations are accessible at all times Place trash in proper receptacles Ensure that fire doors are not blocked Part of the plan is based on preparation for a fire. You should always know the location of fire extinguishers and exits and make sure they are accessible. While you are in our facilities, you are not a bystander, you can move equipment blocking doors and exits and report problems to your preceptor or the charge nurse. Patient safety is everyone's responsibility.

HAZARDOUS MATERIALS & WASTES

Knowledge of the proper procedures in the special handling, use, storage, and disposal of hazardous materials (hazmats) and wastes.

PREVENT INJURIES FROM SHARPS

Let falling objects fall Practice safe handling techniques Don't reach into containers Dispose of sharps carefully

What are the HIPAA rules and regulations that protect these rights?Research activities

NO ONE is permitted to use Protected Health Information for research without complying with the new HIPAA requirements. These HIPAA requirements are entirely separate from the existing federal human subject research regulations. The Privacy Policies and Procedures do not replace or override other rules or procedures established by the Institutional Review Board [IRB], both must be complied with in order to conduct human research.

GHS Pictograms

Nine pictograms will be utilized in identifying hazards of ALL chemicals Each chemical will have AT LEAST one pictogram, often multiple pictograms - to visually convey the hazards associated with it We need to be familiar with the meaning(s) of each pictogram Labels and safety data sheets will not always include that information, understanding these is critical Radiological & Environmental Management (REM) will provide pictogram reference cards to post in work areas for future reference

Important HIPAA Terminology;Notice of Privacy Practice

Notice of Privacy Practice [NPP]- a notice given to patients concerning the use and disclosure of their Protected Health Information [PHI]

What are the breach notification requirements?

Notification is required to the affected individuals, the government and in certain cases the media [if the breach involves more than 500 people] in the event of a breach of "Unsecured Protected Health Information". These breach requirements are applicable to both Covered Entities [CE] and their Business Associates. If the Covered Entities Business Associate has a breach, they must report it within 60 days. The snail mail requirement states that the healthcare organization must send out a first class letter to any patients that might have been affected by the breach. [Electronic mail is allowed given the patient agreed to receive electronic notices]

What must a covered entity do to be in compliance with HIPAA?

Notify patients about their privacy rights and how their information can be used. Adopt and implement privacy procedures. Train employees so they understand the privacy procedures. Designate a Privacy Officer. Secure patient records containing Protected Health Information [PHI].

OSHA Hazard CommunicationUpdate

OSHA has adopted Globally Harmonized System of Classification and Labeling of Chemicals (GHS)

Static Electricity

Occurs when static electrical charges accumulate from friction between dissimilar materials. Discharge of static electricity causes a mild shock A good example of static electricity is the balloon in the hair trick. My younger son has medium length hair. When I rub a balloon on his head his hair starts to stand up. He is now "charged" with static electricity. He then does his part to discharge that electricity by touching me, his brother, the cat, the dog, whatever is near. This discharge of static electricity is what causes the mild shock he thinks is so funny. He is the live condutor and whatever he touches ends up being his conducting object bridging the gap between him and ground.

Who enforces medical privacy regulations?

Office for Civil Rights A patient may complain to the Privacy Officer in a hospital or; The Director of Health and Human Services [HHS]

Palliative Care

Palliative care works to achieve one of the primary goals of healthcare—relief of symptoms. Palliative care is an option for patients who are seriously or terminally ill. It focuses on achieving the best possible quality of life for a patient by emphasizing total and comprehensive care for all a patient's needs: pain and symptom management, spiritual, social, psychological, and emotional well being. Palliative care is similar to that of hospice care. However, palliative care is not restricted to patients near the end of life and can be used in both acute and long term care settings. One striking similarity between hospice and palliative care is the use of an interdisciplinary team of professionals including doctors, nurses, social workers, psychologists, chaplains, and others to provide comprehensive care.

WHAT ARE THE HIPAA RULES AND REGULATIONS THAT PROTECT THESE RIGHTS?THE JOINT COMMISSION STANDARDS

Patient's rights: Patients have a right to confidentiality of all information that is provided to the healthcare professional and institution. Health care professionals ensure that patient information is secured at all times and if there are any complaints, those complaints will be resolved in a timely manner.

Labels - Hazard Statements

Phrases that describe the nature of the hazard: Examples: Highly flammable liquid and vapor May cause liver and kidney damage Fatal if swallowed

HOW DO I PROTECT MY PATIENT'S PRIVACY?SAFEGUARDS

Physical Safeguards Computer terminals are not placed in public areas. Technical Safeguards Every associate must keep his/her password confidential. No photographs or recordings of any type are to be taken of patients in the clinical setting. No cameras, tablets, cell phones or any electronic devices with photography capabilities are permitted in the clinical environment Administrative Safeguards Policy and procedure for release of patient information

Labels Are Required to have:

Pictograms Signal Words Hazard Statement Precautionary Statements Product Identifier Supplier Identification Supplemental Information (as required)

Important HIPAA definitions

Privacy - state of being concealed; secret Confidentiality - containing private information (Ex. Medical Record). Authorization - to give permission for; to grant power to. Breach Confidentiality - to break an agreement, to violate a promise. Disclosure - means the release, transfer, provision of access to, or divulging of information outside the entity holding the information. Use - means the sharing, employment, application, utilization, examination, or analysis of individually identifiable information within an entity. Protected Health Information [PHI] - is information that is created or received by a covered entity that: Relates to the past, present, or future physical or mental health of an individual. Identifies the individual or contains reasonable information that can be used to identify the individual(s). Examples of Protected Health Information: Name, address, telephone, fax, email, social security number, medical diagnoses, medical records, account numbers and photographs or images.

Overcurrent Devices...

Protect circuit from excessive heating by opening the circuit automatically in event of excessive current flow from accidental ground, short circuit, or overload. Examples include fuses and circuit breakers.

P.A.S.S. for Fire Extinguisher Use...

Pull the pin Aim at base of the fire Squeeze the handles together Sweep from side to side the pin needs to be pulled to be able to activate the handle. If you are holding the fire extinguisher by the handle you are pressing the handle against the pin and it will be "pinned " in place. Place the fire extinguisher on the ground, steady it from the top and pull the pin. After the pin is freed, lift the fire extinguisher and go through the steps of P.A.S.S.

Plan for Fire Emergencies...

Read & understand the fire evacuation plan for your area Know the location of at least two (2) emergency exits Know the location of fire alarm pull stations and fire extinguishers Take part in fire drills

In Case of Fire...

Remain calm. Don't panic or cause confusion. NEVER shout fire. Proceed safely to nearest fire exit Feel surfaces of doors before opening Crawl to exit if smoke is present in area Follow instructions of Fire Department Remember R.A.C.E. and P.A.S.S. Remember to stay calm, the patients will look to the staff and you to know what is going on. If you remain calm they will be less likely to break into hysterics. It will be all about your bearing and demeanor in an emergency situation.

What are the HIPAA rules and regulations that protect these rights?Request for amendment

Request for Amendment is a patient's right to request, in writing, to have health information or a record about the patient amended. The Covered Entity does not have to agree to the amendment, however if the CE does agree, the request to amend will become a part of the patients medical record.

What are the HIPAA rules and regulations that protect these rights?Request for restrictions

Request for Restrictions is a patient's right to request, in writing, a restriction or limitation on the health information that a Covered Entity uses or disclosures. The Covered Entity is not required to agree to the restriction.

R.A.C.E. for Fire Safety...

Rescue anyone in immediate danger. Activate the fire alarm pull station Contain the fire Extinguish the fire, if your safety can be assured Remember RACE but also know that the E may be for extinguish or evacuate. Do not try to extinguish a fire that is more than you can easily contain, that is what the professionals are for.

WHAT ARE A PATIENT'S RIGHTS UNDER HIPAA?

Right to written Notice of Privacy Practices [NPP] that informs consumers how Protected Health Information [PHI] will be used and to whom it is disclosed Right of timely access to see and copy records for a reasonable fee Right to an amendment of records Right to restrict access and use Right to an accounting of disclosures Right to revoke authorization

No Smoking Policy..

Smoking by anyone, which includes patients, visitors, medical staff, associates, and visitors is prohibited inside the buildings.

IMPORTANT TIPS

Take training seriously Avoid taking shortcuts Report unsafe conditions Know emergency procedures

ARE THERE OTHER LAWS THAT PROTECT PATIENT PRIVACY?TEXAS MEDICAL PRIVACY ACT [TMPA]

Texas Medical Privacy Act [TMPA] is as strict as HIPAA specifically on Texas medical and dental providers. A training is required as in HIPAA and the information is to be included. This training is required once every two years for providers. This training is an exact photocopy of HIPAA. Since EPCC is considered a hybrid entity [School and Clinic] then we are bound to train our health care personnel, faculty and students about The Texas Medical Privacy Act [TMPA].

What are the HIPAA rules and regulations that protect these rights?Privacy Rule

The Privacy Rule: Establishes a Federal floor of safeguards to protect the confidentiality of medical information. Allows patients to make informed choices when seeking care and reimbursement for care based on how personal health information may be used. This rule is used to protect Protected Health Information [PHI] This rule took effect on April 14, 2003. YOU MAY NOT RETALIATE AGAINST OR INTIMIDATE AN EMPLOYEE WHO FILES A HIPAA COMPLAINT.

6 Environment of Care (EOC) PLANS......The Joint Commission

The hospital provides a safe, accessible, effective, and efficient environment consistent with its mission, services, law, and regulation. EC.02.01.01 Safety Management EC.02.01.01 Security Management EC.02.02.01 Hazardous Materials and Waste Management EC.02.03.01 Fire Safety Management EC.02.04.01 Medical Equipment Management EC.02.05.01 Utilities Management

What are the consequences of not complying with hitech?

There are serious penalties for non-compliance, ranging from fines of $100 to $50,000 per violation, capped at $25,000 to $1.5 million per violation of the same standard. Criminal penalties of 1 to 10 years in jail for gross negligence. HITECH also created new methods for enforcement, allowing state attorney generals to enforce HIPAA regulations.

Safety Data Sheets (SDS)

These are chemical fact sheets that contain all the information an employee would need to know about a hazardous chemical Keep current MSDS available until new SDS are received. Archive old MSDS as new SDS are collected. Each SDS is broken down into 16 universal sections Sections 1 - 11 will be of most concern

Globally Harmonized System of Classification and Labeling of Chemicals (GHS); What is it...or is Not?

This is not a new Occupational Safety and Health Administration (OSHA) standard It's a revision to the existing OSHA Hazard Communications Standard/Right-To-Know Law The United Nations system of labeling classification of chemicals Implemented to improve worker understanding of labels and safety data sheets By December 1, 2015 all chemical manufacturers had to comply with the new 16 label elements. Manufacturers, employers and end users work to meet the new requirements of the revised standard

Health Care Advance Directive

This is the generic term that is used for any document that give instructions about your health care. It can also appoint someone to make medical decisions for you if you cannot make decisions for yourself. A Living Will and a Durable Power of Attorney are two types of Health Care Advance Directives. Hospitals are required to ask every patient if they have an advance directive , or if they would like to have someone talk to them about putting one in place. An advance directive is a legal document that provides instructions to the physician, health care agent, and family about your end of life wishes.

Important HIPAA terminology;Treatment, Payment and Health Care Operations

Treatment, Payment and Health Care Operations [TPO] - are common uses of Protected Health Information [PHI] for which HIPAA does not require an authorization.

Code Strong

Violence or Potential Violence Code Strong....means assistance is needed and available help should assist...may include combative patient, visitors, theft or staff disturbances....

Electrical Safety Rules...

Visually inspect all equipment for damage prior to use Do not use extension cords for permanent wiring Unplug equipment by pulling on the plug and not the cord Damaged or defective biomedical/electrical equipment must be removed from service and reported to appropriate authority for repair Keep fluids, chemicals, and heat away from equipment, cords, and cables Maintain sufficient access around equipment & panels for operations/maintenance Do not touch energized/conductive surfaces with one hand while touching the patient with the other Know the function of each control prior to using equipment

Legalities in Providing Care

We live in a very litigious society today. We must all be aware of the impact negligence cases have had in the way we provide care & how we document the care we provide. When we don't function in the same manner that an average, reasonable, & prudent professional would, negligence can occur. Negligence can result from omission or commission of an act based on standards of care regarding policies & procedures. A breech can result in harm to the patient. Some common causes of negligence and the resulting law suits are: 1. Human Error: Medication errors, assessment errors, & documentation errors fall into this category. 2. Equipment Failure or Misuse: Always check equipment before you attach it to a patient. Always make sure you are thoroughly educated on equipment before you use it. Patient Falls: Often the issue is not that the patient fell but whether or not the care provider evaluated the patient's needs & implemented safety precautions. 4. Patient Teaching Issues: Make sure teaching is complete & in the language the patient & their family & significant others understand. Start early. Check for understanding & comprehension. 5. Remember the patient defines what quality care is for them. Use your communication skills to find this out. Set it as part of your patient care goals.

GHS - What will Not Change

We still have to keep chemical inventories We still have to maintain safety data sheets We still have to train new people on the potential hazards of what they will be working with We still have to maintain our records for 30 years, per OSHA

What is done after patient privacy has been compromised?HITECH act

What is the HITECH act? As a result of the American Recovery and Reinvestment Act of 2009, legislation passed the Health Information Technology for Economic and Clinical Health Care Act which places additional privacy and security requirements. This requires any entity that handles Protected Health Information [PHI] to report breaches, whether in paper or electronic form within timeframe that HITECH requires. HITECH applies to all business entities associated with healthcare organizations such as banks, claims, clearing houses, billing firms, health information exchanges and software companies.

YOUR ATTITUDE --- AND ACTIONS --- COUNT!

You must want to do your job safely and you must understand and use safe practices and methods. That's what being part of an effective safety team is all about!