Security: Privacy and Informatics

Every question here, with the answer

1. A nurse finishes documenting in a patient’s electronic health record on a computer in the patient’s room. Which action best protects the patient’s PHI before the nurse leaves?

   1. Ask a family member to watch the screen while the nurse steps out.
   2. Leave the record open in case the nurse needs to return quickly.
   3. Log off after completing the interaction.
   4. Discuss the patient’s test results at the nurses’ station if the area is busy.

   Answer: Log off after completing the interaction.

   Logging off after each interaction is a specific measure identified for protecting patient information. Leaving the record open, allowing others near the screen, or discussing PHI where it may be overheard increases the risk of unauthorized access or disclosure.

2. A patient tells the nurse, “I’m worried about what happens to my information when you put it into the computer.” Which nursing responses are appropriate? Select all that apply.

   1. Reassure the patient that information is only accessed on a need-to-know basis.
   2. Tell the patient that technology systems have no security risks.
   3. Acknowledge the patient’s concern and ask what specifically worries them.
   4. Ask whether the patient has additional questions and offer resources about technology policies.
   5. Explain facility policies and procedures for protecting patient privacy.

   Answer: Reassure the patient that information is only accessed on a need-to-know basis., Acknowledge the patient’s concern and ask what specifically worries them., Ask whether the patient has additional questions and offer resources about technology policies., Explain facility policies and procedures for protecting patient privacy.

   The nurse should explore the patient’s specific concerns, explain privacy and security measures, reassure the patient about need-to-know access, and offer further resources. Saying technology has no security risks is inappropriate because the section states technology can increase risks and nurses must understand and respond to them.

3. A family member calls the hospital unit requesting an update on a patient’s condition. The facility uses the admission code-word process described in the section. What should the nurse do first?

   1. Provide the update if the caller states they are a close family member.
   2. Share only general information because it is not detailed PHI.
   3. Transfer the call to another nurse so the information can be confirmed later.
   4. Ask the caller to provide the assigned code word before sharing information.

   Answer: Ask the caller to provide the assigned code word before sharing information.

   The section describes the code word as a best-practice method to help protect PHI when loved ones or family members call for updates. The nurse should request the assigned code word before giving information rather than relying on the caller’s stated relationship or sharing general status information.

4. A nurse is preparing to provide care through telehealth for patients who cannot easily come to the clinic. Which nursing actions or competencies are consistent with telehealth delivery? Select all that apply.

   1. Use communication and patient education skills to support safe, patient-centered care.
   2. Be knowledgeable about the technology and equipment being used.
   3. Understand legal and ethical issues related to remote healthcare delivery.
   4. Provide triage, assessment, education, and care coordination remotely.
   5. Rely on telehealth only for patients who live in urban centers.

   Answer: Use communication and patient education skills to support safe, patient-centered care., Be knowledgeable about the technology and equipment being used., Understand legal and ethical issues related to remote healthcare delivery., Provide triage, assessment, education, and care coordination remotely.

   Telehealth nursing includes triage, assessment, education, and care coordination, and requires knowledge of equipment plus legal and ethical issues. It is especially described as improving access in rural settings, so limiting it to urban patients is inconsistent with the section.

5. A nurse performs point-of-care testing at the bedside. Which action is most important to support safe and accurate results?

   1. Use the test only when a centralized laboratory is unavailable.
   2. Avoid using point-of-care testing for monitoring patients.
   3. Document only abnormal results from the bedside test.
   4. Receive training in the test and follow appropriate quality control measures.

   Answer: Receive training in the test and follow appropriate quality control measures.

   The section emphasizes that POCT can be beneficial, but nurses must be trained and follow quality control measures to ensure accuracy. The other options either add restrictions not stated in the section or conflict with safe documentation and monitoring practices.

6. A unit is implementing assistive clinical decision-making tools. Which teaching points should the nurse educator include? Select all that apply.

   1. Clinicians should be trained in using the tools and understand their limitations.
   2. These tools analyze patient data and provide recommendations to clinicians.
   3. Once implemented, these tools remove the need for clinician decision-making.
   4. The tools should be integrated into workflows without disrupting care delivery.
   5. These tools can improve accuracy and efficiency and reduce the risk of errors.

   Answer: Clinicians should be trained in using the tools and understand their limitations., These tools analyze patient data and provide recommendations to clinicians., The tools should be integrated into workflows without disrupting care delivery., These tools can improve accuracy and efficiency and reduce the risk of errors.

   Assistive clinical decision-making tools support clinicians by analyzing data and providing recommendations; they may improve accuracy, efficiency, and outcomes. The section also stresses training, understanding limitations, and integrating tools into workflow without adding burdens; it does not say they replace clinician decision-making.