Patient Safety and Confidentiality in Nursing: A Comprehensive Report

This report provides a comprehensive overview of patient safety and confidentiality within the nursing profession. It begins by defining patient safety, emphasizing the importance of minimizing risks and ensuring a safe healthcare environment. The report explores safety concerns related to medication administration, highlighting the significance of the 'rights' of medication administration and potential errors in the medication process. It also addresses safety concerns arising from mental illnesses, emphasizing the need for nurses to be aware of potential risks posed by these patients. Furthermore, the report discusses the global recognition of patient safety issues and the efforts being made worldwide to address them, including the growing problem of healthcare-associated infections. The report then shifts to the concept of confidentiality in nursing, defining it as the patient's right to have their information protected. It explores the legal and ethical implications of maintaining confidentiality, including dilemmas nurses face when balancing confidentiality with other ethical principles, such as the need to prevent harm. The report provides examples of such dilemmas and discusses the legal obligations nurses have to maintain patient confidentiality, referencing relevant legislation like the Personal Health Information Protection Act. The report also covers the consequences of breaching confidentiality, both legally and ethically, emphasizing the importance of maintaining trust between patients and nurses. It concludes by highlighting the significance of confidentiality in providing the highest standard of patient care.

Running Head: PATIENT SAEFTY AND CONFIDENTIALITY IN NURSING 1
PATIENT SAFETY AND CONFIDENTIALITY IN NURSING
Name
Institution Affiliation

PATIENT SAEFTY AND CONFIDENTIALITY IN NURSING 2
MODULE ONE
SAFETY IN HEALTH CARE
Safety in health care is the process of minimizing risks for patients and healthcare
providers to acceptable levels. Nurses play a big role in enhancing the safety of patients. It is the
process of avoidance of any unexpected or unintended harm to individuals in the course of
healthcare provision. Healthcare organizations are mandated to ensure that patients are treated in
an environment that is safe and free from any harm (Moumtzoglou, 2012). They also play a role
in enhancing the quality of healthcare and safety of patients. Patient’s safety is considered in
various aspects of healthcare provision.
First Safety is considered in the medication administration process. Patients have various
rights touching on the medication process which include the right to the right dose, right time,
right routine and right drug. These rights ensure that patients are not harmed through the
medication process. Nurses have a critical role in ensuring that a patient’s medication rights are
observed to avoid any adverse effects on them. Medication process includes transcription,
prescription, dispensing, administration and monitoring processes. Errors can occur in any of
these processes. For example, errors can occur in the prescription stage which may include the
prescription of the wrong dose or wrong drugs. Such errors can arise as a result of wrong
labelling, wrong storage, wrong patient information or communication breakdown. In the event
that these errors occur the safety of the patient can be at risk. An overdose for example can have
adverse effects on a patient, which may include even death (Rudd, Aleshire, Zibbell & Gladden,
2016).

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Secondly, Safety concerns may arise as a result of mental illnesses. Mental health
patients pose risks not only to themselves but also other patients and healthcare providers alike.
Such patients may contemplate on committing suicide and self-harm, become violent or
aggressive. Their aggressive behaviour may compel them to harm other people within the
healthcare set up. To enhance the safety of such patients and other people within the clinical
setting, nurses need to be aware of such factors to maintain safety for patients and other parties
likely to be affected (Dewa et al., 2018).
The issue of safety has become a serious issue in global healthcare set up For some
reasons. This growing recognition has led to more than 140 countries worldwide to work
relentlessly to solve issues associated with unsafe care (Mitchell, 2008). In developed countries,
research has estimated the number of patients likely to be harmed while receiving health care to
be one out of 10 patients. This harm may arise as a result of adverse effects at the hospital as
well as other errors. There is also a worrying trend of the increased infections among admitted
patients. The number of patients who acquire such infections is 7 out of 100 in developed
countries and 10 out of 100 in developing countries. Every year millions of such cases are
reported globally. Inappropriate hand hygiene is one of the causes of associated healthcare
infections. Partnerships at the hospital can play a major role in improving the safety of patients
within the healthcare set up. These partnerships can provide learning opportunities on aspects of
patient safety and facilitate a collaborative effort in the development of solutions to safety
concerns (Healthstream.com, 2018).
Module Two: CONFIDENTIALITY
What is Confidentiality?

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Confidentiality in nursing refers to the right of patients to have their information withheld
from other parties unless if shared with the consent of the patient. This information may include
their medical history or personal information. Patient’s information as mandated by law should
only be availed to the Doctor or a few other insurance and healthcare officials as the need may
arise (Mazqai, 2015). Beyond these parties, it should be kept confidential. Patient’s
confidentiality is one of the most important aspects of healthcare. It is important in maintaining
trust and a strong bond between a patient and the doctor. Also, it is also a sign of moral respect
for the patient.
Implications and Dilemmas legally and ethically
Nurses are faced with multiple challenges in maintaining the confidentiality of their
patients especially in the wake of technological advancements that have hastened the sharing of
information. They are however mandated by law to keep private all the information touching on
their patients and share it only in situations allowed by law or where a patient has consented to
such action. Different governments have enacted laws aimed at protecting the confidentiality of
their citizen’s healthcare information. These legislations are particularly centred on information
relating to mental health and communicable diseases (Price, 2015). Dilemmas surrounding
patient confidentiality arises when the need to maintain patient confidentiality conflicts with
other ethical principles. These principles may include avoidance of harm for other people or the
patient. For example, a mental health patient may reveal details of how he/she is planning to
commit suicide upon leaving the hospital to a nurse. In as much this information is sensitive the
nurse may find themselves in an ethical dilemma on whether to share the information and breach
patient’s confidentiality or conceal the information and keep the safety of the patient at risk.

PATIENT SAEFTY AND CONFIDENTIALITY IN NURSING 5
Nurses have legal and professional obligations to maintain their patient’s confidentiality.
As provided for by the Personal Health Information Protection Act, 2004, disclosure, use and
collection of patient’s information requires their consent, with only a few exceptions. This Act
also gives patients the right to instruct the custodians of their information not to share it with
others (Richler, 2016).
A nurse at XYZ Clinic was working with was working with a patient who was waiting
for his surgery due in a few3 days . In one of their interactions, the patient revealed to the nurse
that he had been depressed and unhappy that he would be having a surgical operation in a few
days. For that reason, the patient said he has been smoking and drinking heavily to forget about
his current depression and urged the Nurse to keep mum. The nurse is aware that this may have
an impact on his patient’s surgery but he also has to protect the confidentiality. The Nurse can
therefore be said to be in a Dilemma (College of Physiotherapists of Ontario, 2014).
What impact does this have and what are the consequences of not maintaining
confidentiality legally and ethically?
Provision of the highest standard of patient care calls for prioritization of patient’s
privacy as a patient who are aware that the information shared will not be revealed to third
parties are more likely to give out all the necessary information. Nurses must, therefore,
understand that they must at all times treat patient’s information confidentially. Legally failure to
maintain patient’s Confidentiality can attract legal suits by patients. The recent past has seen an
increase in legal suits filed by patients whose information has been leaked without their consent.
These have been estimated to cost both parties huge sums of money. The increase in legal suits
attributed to patient confidentiality shows how important confidentiality is. The principle of

PATIENT SAEFTY AND CONFIDENTIALITY IN NURSING 6
confidentiality requires physicians to take the confidentiality of their patients as an integral part
of healthcare. Confidentiality creates a strong bond and trust between the patient and Nurse.
Failure to observe confidentiality would therefore be a breach of the confidentiality principle
(Marsh & Reynard, 2009).

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References
College of Physiotherapists of Ontario. (2014). Ethical Dilemma: Confidentiality [Blog].
Retrieved from
https://www.collegept.org/blog/post/case-of-the-month/2014/01/15/january-2014-ethical-
dilemma-confidentiality
Dewa, L. H., Murray, K., Thibaut, B., Ramtale, S. C., Adam, S., Darzi, A., & Archer, S. (2018).
Identifying research priorities for patient safety in mental health: an international expert
Delphi study. BMJ open, 8(3), e021361.
Healthstream.com. (2018). The Urgent Priority to Keep Each Patient Safe. Retrieved from
https://www.healthstream.com/resources/ebooks/ebooks/2017/04/13/ebook-the-urgent-
priority-to-keep-each-patient-safe
Marsh, H., & Reynard, J. (2009). Patient confidentiality: ethical, legal and regulatory
responsibilities. BJU international, 104(2), 164-167.
Mazqai, M. (2015). Patient confidentiality. Nursing Standard, 29(49), 61-61. doi:
10.7748/ns.29.49.61.s44
Moumtzoglou, A. (Ed.). (2012). E-Health Technologies and Improving Patient Safety: Exploring
Organizational Factors. IGI Global.
Mitchell, P. H. (2008). Defining Patient Safety and Quality Care. Patient Safety and Quality: An
Evidence-Based Handbook for Nurses.
Price, B. (2015). Respecting patient confidentiality. Nursing Standard, 29(22), 50-57. doi:
10.7748/ns.29.22.50.e9579

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Richler, E. (2016). The Personal Health Information Protection Act, 2004: A Guide for
Regulated Health Professionals. Retrieved from http://www.cmto.com/assets/The-
Personal-Health-Information-Protection-Act-2004-2016-Update.pdf
Rudd, R. A., Aleshire, N., Zibbell, J. E., & Gladden, R. M. (2016). Increases in drug and opioid
overdose deaths—United States, 2000–2014. American Journal of Transplantation,
16(4), 1323-1327.