HIPAA, Nursing Delegation, and Patient Safety: Key Concepts for Healthcare Professionals

A nurse discusses a patient's diagnosis in an elevator. What is the priority concern?

HIPAA violation due to disclosure of PHI in a public space

A UAP asks about a patient's condition out of curiosity. What should the nurse do?

Do not share information; only those involved in care can access PHI

Which task is appropriate to delegate to a UAP? (assess pain, administer meds, assist with bathing, teach discharge)

Assist with bathing

A nurse logs into the EHR using another nurse's password. What is the issue?

Security breach and HIPAA violation

A nurse leaves a patient chart open at the nurses' station. What principle is violated?

Confidentiality of PHI

A nurse uses AIDET but forgets to explain how long a procedure will take. What component is missing?

Duration

A nurse receives a medication order without a route. What should they do?

Hold and clarify the order

Order: 500 mg; Available: 250 mg tablets. How many tablets should be given?

2 tablets

A nurse writes ".5 mg" on a medication order. What is the issue?

Missing leading zero; should be 0.5 mg

A medication is ordered "q6h PRN pain." What does this mean?

Every 6 hours as needed for pain

A nurse prepares meds and gets interrupted. What should they do?

Restart preparation process

A nurse administers medication without checking ID band. Which right is violated?

Right patient

A patient refuses medication. What is the priority action?

Assess reason for refusal

A medication error occurs. What is the nurse's FIRST action?

Assess the patient

Which order is priority? (routine antibiotic, PRN pain med, STAT epinephrine, daily vitamin)

STAT epinephrine

A nurse documents medication before giving it. What is wrong?

Documentation must occur after administration

A pediatric patient needs medication. What is essential?

Weight-based dosing in kg

An older adult is on multiple medications. What is a priority concern?

Polypharmacy and increased adverse effects

A nurse documents a PRN medication. What must also be included?

Reason given and patient response

A nurse administers medication at the wrong time. Which right is violated?

Right time

A nurse charts inaccurate information. What is the risk?

Legal issue and patient harm

What is the purpose of an incident report?

To improve safety and document unusual events (not part of chart)

A nurse evaluates a website. What indicates reliability?

Credible author and evidence-based sources

Why is standardized terminology used in EHR?

Improves communication and reduces errors

A nurse cannot find patient data in the EHR. What should they do?

Use proper navigation or ask for help

SBAR: What does "B" stand for?

Background

SBAR: What does "R" stand for?

Recommendation

A nurse tells a patient "you'll be fine." What type of communication is this?

Non-therapeutic

A patient says "I'm scared." What is the best response?

"I can see you're scared. Tell me more."

A nurse interrupts a patient while speaking. What is this?

Non-therapeutic communication

A nurse uses silence appropriately. What is the purpose?

Encourage patient expression

A nurse changes the subject when a patient expresses fear. What is this?

Non-therapeutic communication

Which phase involves establishing trust?

Orientation phase

Which phase involves goal setting?

Working phase

A nurse collaborates with a dietitian. Why?

To improve patient outcomes

What is a barrier to collaboration?

Poor communication

A nurse observes crossed arms and no eye contact. What does this indicate?

Closed/non-therapeutic communication

When must soap and water be used instead of sanitizer?

When hands are visibly soiled or with C. diff

A nurse performs hand hygiene before touching a patient. What is this?

Standard precaution

A nurse reaches over a sterile field. What happens?

Field becomes contaminated

A sterile field becomes wet. What should the nurse do?

Consider it contaminated and restart

A nurse drops a sterile item. What should they do?

Discard and replace

A nurse turns away from a sterile field. What is the issue?

Field must remain in view

A nurse experiences a needle stick. What is the FIRST action?

Wash with soap and water

A nurse inserts a catheter without sterile technique. What is the risk?

Infection (CAUTI)

A catheter bag is above bladder level. What is the risk?

Backflow leading to infection

A nurse notices cloudy urine. What does this suggest?

Possible infection

During perineal care, what direction should be used?

Front to back

A nurse performs a bed bath. What is the priority?

Maintain privacy and dignity

CHG wipes should not be used on which area?

Face and genitals (unless ordered)

A nurse encourages a patient to wash themselves. Why?

Promote independence

Redness over bony prominences indicates what?

Pressure injury risk

Before moving a patient, what should the nurse assess?

Mobility and strength

A nurse lifts using their back instead of legs. What is the risk?

Injury

A nurse transfers a patient without help when needed. What is the risk?

Falls and injury

All 4 side rails are raised. What is this considered?

A restraint

A patient is laid flat after eating. What is the risk?

Aspiration

What is the purpose of SCDs?

Prevent DVT

Which side should a cane be used on?

Strong side

A patient becomes dizzy during transfer. What should the nurse do?

Stop and assist to safe position

What is the benefit of a mechanical lift?

Reduces injury risk

PROM is performed for what reason?

Maintain joint mobility

Immobility increases risk for what complications?

DVT, pressure ulcers, pneumonia