Client Rights (Nursing)

00:02 Hi, I'm Jessica Spellman and I'm going to be reviewing client rights today.

00:07 The objectives of this course are to help you educate patients regarding their rights and responsibilities about their healthcare and to also differentiate between the Patient Self Determination Act, the HIPAA Act and the Patient Bill of Rights. Nurses are aware that there are legal and ethical obligations in our practice, but it's always good to review principles that influence client rights regarding their care so that we can function within those parameters.

00:38 So there are specific rights that govern clients and what they expect from their healthcare.

00:43 The first one is the Patient Self Determination Act of 1990, also known as PSDA.

00:50 The second the Health Insurance Portability and Accountability Act, also abbreviated HIPAA.

00:57 And the Patient Bill of Rights. I will be reviewing these documents with you.

01:01 Let's start with the Patient Self Determination Act of 1990.

01:05 The purpose of this Act was to inform patients of their right to make decisions about their healthcare and it granted them the right that they can make determinations about the future of their healthcare in case they become incapacitated.

01:20 So specifically, there are five rights that we need to be aware of when we talk about PSDA. The right to participate in and decide on their own healthcare decisions and plan of care. The right to accept or refuse medical or surgical treatment.

01:39 It gives patients the right to prepare an advanced directive and/or designate the durable power of attorney for their healthcare decisions.

01:48 It also gives them the right to providers' policies and procedures, so it gives the patients the right to receive information about their rights in the hospital.

02:04 And, lastly, it gives them the right not to be discriminated against based upon their healthcare choices and decisions that they make. So the role of the nurse.

02:15 When we're discussing the PSDA is to make sure that the client is knowledgeable about what their options are.

02:22 The nurse needs to be able to educate them on advanced directives and assist them with the creation of those documents if they designate to do so.

02:31 And to recognize and respect the rights of patients and any decision that they make but especially when they refuse treatment. The next document I'd like to go over is the Health Insurance Portability and Accountability Act, also known as HIPPA.

02:48 It was approved in 1996 and revised in 2003, and it created a set of national standards for the protection of protected health information, or PHI. Under HIPPA, clients have the right to receive a copy of the Notice of Privacy Act for the institution or physicians office that they are attending. Second, they should expect confidentiality of all of their protected health information.

03:15 There are a few exclusions to this, and that is information that they need for billing purposes, for treatment or for the operations of the facility. The third right that they have under HIPPA is that they have access to their medical records and can obtain copies of them if they are requested. The fourth is to be notified of a breach of confidentiality.

03:41 So, as nurses, the way that we protect our clients under HIPPA is that we should protect all patient health information in the strictest of confidence and only use it for authorized purposes.

03:57 Second, we should only look at the protected health information for the minimum amount necessary to do our jobs. Don't access health records of clients for which you are not assigned. Don't share protected health information with anyone unless you are sure they are authorized to receive such information.

04:18 I think a great example of how this is difficult is if a family member comes up to you during a hospital admission and asks you to make a copy of the patient's labs so that they can take them to the doctor's office on the next visit. Unless the patient specifically signs a release that that family member can have that specific information, you are not able to print those off and give them to the family member.

04:47 It's important to keep documents containing protected health information in a safe place, and don't ever remove the protected health information from the facility in which you work. Also, if you do print off information from a computer with patient information on it, you need to destroy those documents as designated by the facility in which you work.

05:07 The next document I want to discuss is the Patient Bill of Rights. It's a statement that identifies the rights of clients, but it also identifies the responsibility of clients.

05:20 The topics covered in the Patient Bill of Rights are: the information disclosure, and that is that clients have the right to receive easy to understand information about their healthcare plan, about their healthcare professionals, and about the healthcare facility in which they are being taken care of.

05:38 Second, they have a choice in their providers and plans. The third item in the Patient Bill of Rights is that patients have access to emergency services.

05:52 They should receive emergency healthcare without having to wait for insurance to be cleared or to find out if that facility is going to get paid.

06:01 They have the right to access emergency services. If they're brought to the hospital in an emergency situation, they shouldn't have to wait for healthcare or receive a penalty if there's a problem with insurance coverage of that facility.

06:16 They are allowed to participate and are expected to participate in treatment decisions.

06:22 That means they can accept or refuse the treatment options that are being presented to them.

06:29 They should expect confidentiality of their health information.

06:33 They have a right to consult with healthcare professionals. And when they do so and they share their health information, they should expect that to remain confidential and protected.

06:46 They also have the right to complain and to write an appeal. They have the right to file a complaint against the hospital, a healthcare worker, a professional, a health plan, and expect an expedient unbiased review of that complaint. And also, the client has the responsibility to disclose accurate information about their past medical history, their medications, and other information as requested by the physician in order to prescribe appropriate treatment. So the role of nurses in the Patient Bill of Rights.

07:20 Our responsibility is to educate clients and families about the rights that they are entitled to and provide them copies of those rights on their admission.

07:30 It is our responsibility to make sure clients have access to that information and not hide it from them.

07:38 And be aware that they have these rights and can decide and participate in their care accordingly.

07:45 So in summary, there are several documents that help protect client's rights in the healthcare setting. First is the Patient Self Determination Act of 1990, or the PSDA. The second is the Health Information Portability and Accountability Act, or HIPAA.

08:03 And the third is the Patient Bill of Rights. Nurses are required to be knowledgeable about those documents and be able to provide that information to the clients both in written and verbal form.

08:16 Thank you. This is Jessica Spellman for Client Rights.