What is the importance of confidentiality in the relationship between the nurse and the client?

Confidentiality means respecting someone’s privacy, and abstaining from sharing personal or potentially sensitive information about an individual, especially if that information has been shared in confidence.

In the context of health and social care, patient confidentiality is an important principle of providing good care which medical professionals and care practitioners should follow. It means not disclosing information about a patient or client to anyone who should not know or does not strictly need to know, unless consent has been given.

It is of course vital to protect the rights of client where appropriate, but health and social care workers and clients alike should bear in mind that a carer’s duty to share information – where required – is of equal importance.

Confidentiality legislation in health and social care

Health and social care providers are given extensive training regarding what is appropriate in regards to confidentiality, but to outsiders, it can be difficult to know what legislation is in place and how it is implemented.

There are five rules of confidentiality in health and social care:

1. All confidential information about a client should be treated respectfully and their rights to confidentiality should be respected at all times
2. Confidential information about a client should be shared by a care team only when it is necessary for the safety and wellbeing of the client
3. Any confidential information shared for the benefit of a community should remain anonymous
4. An individual has the right to object to their confidential information being shared. This right should always be respected
5. It is an organisation’s responsibility to implement confidentiality policies with any procedures necessary to ensure this confidentiality

The 2013 HSCIC Guide to Confidentiality provides detailed information on navigating the complexities of confidentiality legislation as a health and social care worker.

How is confidentiality maintained in health and social care

Confidentiality in health and social care is essential because it helps patients and clients have confidence that they can share information, and this can be extremely important in ensuring they get the care they need. Maintaining confidentiality is therefore vital for medical professionals and care staff so that they can do their important work.

Maintaining confidentiality in medical and social care settings can involve simple practical measures such as positioning computer screens so that information isn’t accidentally seen by third parties, as well as following official guidelines in sensitive and complex situations. Those working in the health and social care sector have legal and professional responsibilities to uphold confidentiality, and will have to undergo significant training on the subject. Day to day maintaining of confidentiality means:

• Ensuring that sensitive conversations are only held in private spaces
• Recording and accessing only necessary and relevant information
• Changing log-ins and passwords necessary and keeping security measures and programs up to date for IT systems
• Reporting any possible data breaches immediately
• Always alerting patients or clients when their information needs to be shared, and obtain consent where necessary

When can you break confidentiality in health and social care?

There is no absolute confidentiality in health and social care. This is due to the fact that breaking confidentiality is sometimes in the best interests of the client, or in the best interests of another party whose needs are more important than those of the client in the present situation.

For example, health and social care practitioners may need to discuss a client’s symptoms with a fellow practitioner in order to ensure that they receive optimum support. This includes referring a client to another service that may be better suited to their needs.

Care workers can also break confidentiality if they suspect an individual is going to seriously harm themselves or someone else. This does not generally include self-harm or drug use unless the practitioner thinks that the client might harm themselves in a life-threatening way by mistake, or the client does not have full mental capacity.

Another situation in which it is appropriate for a care worker to break confidentiality is if they suspect that their client is going to commit a criminal act – this is a rule of health and social care practice with which many people are familiar. Again, this does not typically refer to drug use unless the individual in question is supplying.

In extreme situations, a health and social care worker may also need to reveal information about their client in court if called upon to do so.

At ENA our team are experts in confidentiality in health and social care. If you need any help or advice on matters of confidentiality, or about our specialist care services, please get in touch and we’ll be happy to advise you.

Confidentiality and privacy in aged care are crucial aspects of ensuring the comfort, confidence, reassurance and dignity of both patients and loved ones.

Whether it is enforced based on aged care regulation or further company policies, controlling the disclosure of private and personal information is critical in managing patient privacy and maintaining ethical business practice.

This is particularly true given the vulnerability that can often come with the process of seeking aged care services.

The process might involve initial requirements of examination and discussion, or later quality of life services and aiding in everyday tasks – regardless, carers and patients often form an intimate personal relationship that involves personal health information in providing appropriate care.

In addition to this privacy of personal information and health records, aged care workers also need to consider the day to day privacy requirements of aged care patients, given close living situations and the extent of care requirements.

In this case, each aspect of aged care is directly related. The difference between disclosure, confidentiality and privacy should be defined as follows:

• Privacy: The right of aged care patients to have privacy to a personal extent, given living situations and extent of care requirements.
• Confidentiality: The right of aged care patients (and other involved persons) to be assured confidentiality in the information that they supply to aged care workers, and control over who sees it.
• Disclosure: The control that aged care patients have over use of their information, as well as the control that aged care companies have over this information based on laws and regulation.

Privacy in Aged Care

When looking at the handling of personal information in aged care, a good place to start is in regard to privacy itself.

What is the definition of privacy?

Privacy refers to a state in which a person or thing is left alone, undisturbed and unobserved – this might mean having your own physical space, being able to go about daily activities alone, and more.

Why privacy is important in aged care

In aged care, both information privacy and privacy as a whole are important.

Protecting patient privacy is something that should be prioritised across all aged care providers – the right approach to privacy is necessary as it ensures that basic moral requirements of patients, family members and all relevant persons are met.

Moreover, privacy is crucial in aged care as a result of the nature of the industry – this is true when considering care providers collecting personal information, the necessity of medical records, the close environments of patients and staff, and the involvement of families and any other relevant third parties.

Australian privacy principles and laws are designed to uphold privacy standards in a way that ensures the comfort and assurance of all aged care stakeholders. This means that aged care centres are required to adhere to strict requirements when they collect personal information, as well as when they disclose health information.

Ultimately, aged care is about providing people with a safe environment to live their final days or years. Thus, it’s important that your loved one has a sense of privacy and control over how they live, what they share, who they share it with, and how much information they disclose to others.

Patient Confidentiality in Aged Care

Now, it is important to have an understanding of confidentiality and the role it plays within the broader topic of privacy.

The Definition of Confidentiality

Confidentiality refers to the idea of keeping information, knowledge or objects secret – within aged care, it means ensuring the prevention of unauthorised access to patient information. Evidently, confidentiality plays a significant part in the upholding of privacy.

What is Confidentiality in Aged Care?

When it comes to confidentiality within the context of aged care, there are a few things to keep in mind.

Firstly, confidentiality is a significant aspect of privacy; more specifically, information privacy is a significant factor in providing aged care, referring to the ability for you to have some control of your personal information, including who sees it, how it is collected, and how it is used.

Secondly, confidentiality will come down to factors that include legal regulation, as well as patient and family requirements and the particular health records in question.

Ultimately, aged care providers should communicate their approaches to confidentiality in an open and transparent way, thus giving patients and loved ones control over what aged care providers do when they collect personal information.

What is Disclosure in Aged Care?

Finally, a crucial part of aged care centre operation is in disclosure – more specifically, when certain people can disclose personal information.

Definition of disclosure

Disclosure refers to how and when information can be shared – often, this information is confidential and kept private.

Why understanding disclosure is important in aged care

Within an aged care setting, understanding rules, regulations and positions surrounding disclosure is crucial for two reasons.

Firstly, it helps to maintain privacy and confidentiality expectations.

Secondly, it allows for the opportunity to ethically disclose personal information and provide critical information to health professionals, often in times of significant need within an individual’s life or in order to protect public health.

The relationship between consent and health information

An important part of understanding disclosure of health information is within the topic of giving consent.

When privacy limitations have been placed on confidential information, being able to determine the information that is confidential and the information that is not is necessary.

Furthermore, aged care patents need to provide access or consent to confidential health information, as well as permissions regarding its use.

Often, the event of disclosure of confidential information will be due to compassionate reasons and medical emergencies regarding a person’s health, disclosing only the necessary amount of health information to doctors, nurses or any health practitioner. Otherwise, a usual approach to disclosure will often mean keeping personal health information confidential.

Disclosure in the event of a serious and imminent threat

In the event of serious threat, disclosure of health information that is to an extent reasonable and necessary might be appropriate.

Exceptions to confidentiality expectations should be taken very seriously – the wrong approach can result in anticipated legal proceedings, and understanding the fine line between confidentiality and disclosure often requires the involvement of a legal advisor.

For example, in the event that an ambulance must be called, a responsible person disclosing specific relevant health information might be appropriate – especially if this information can help medical practitioners save the life of a patient.

This involvement of an ambulance service is just one example of where a patient can expect disclosure of information, and this situation can even involve public safety concerns.

In many other situations, communicating consent is critical in disclosing private information – ultimately, seriously improper conduct can result in serious legal ramifications.

Social Sustainability in Aged Care Health Services

Privacy, disclosure and confidentiality comprise a broader part of aged care and health services; social sustainability.

The importance of socially sustainable health service

When it comes to privacy and the use of personal information within aged care, it is important to consider the broader idea of socially sustainable aged care and health service. In addition to privacy and confidentiality, this involves environmental costs, broader social costs, and investment in preventative care.

These things are crucial in reducing the overall negative social and environmental impacts of health care, and reducing the extent to which health care is necessary in the first place.

Aged Care Workers and Duty of Care

Within aged care, workers have a duty of care – this is similar to any worker within a care role.

What is duty of care?

This means that workers need to be able to manage privacy, comfort and general care given to patients, assess health status, identify any serious threat, and be able to utilise health information to the extent reasonable.

One way in which duty of care is upheld is with an aged care assessment team. This is a team of allied health professionals (medical, nursing, etc) that assesses health status and a number of needs of elderly people, in order to help both them and their carers in maximising quality of life.

These needs include:

• Physical
• Cultural
• Social
• Medical
• Restorative
• Psychological

Frequently Asked Questions About Aged Care Information Usage

How do you maintain privacy and confidentiality in aged care?

Privacy and confidentiality in aged care can be maintained by ensuring clarity and transparency in how personal information is collected and used, as well as by following privacy laws and regulations set in legislation such as the privacy act.

Why is it important to maintain privacy and confidentiality in aged care?

Maintaining privacy and confidentiality is crucial in building trust between aged care patients and workers, where the personal lives and situations of patients are acknowledged and information can flow freely between clients and carers.

When can you disclose confidential information in aged care?

In aged care, a patients confidential health information may be disclosed if the aged care facility is required to by law, if doing so will lessen or prevent significant injury or worse, if public safety is threatened, or if the facility can successfully obtain consent.

If you suspect unlawful activity in regard to personal information and privacy in aged care, the affected persons are able to contact the relevant enforcement body to ensure that reasonable steps are taken.

How to Maintain Patient Confidentiality and Privacy in Aged Care

When it comes to the enforcement and maintaining of personal information control and use within aged care, there are a number of processes that are often utilised:

• Regular training and awareness
• Thorough confidentiality agreements and policies
• Extension of all privacy and confidentiality policies to partners and other stakeholders
• Implementation of appropriate information storage mediums and security measures.
• Restrictions on usage of mobile phones
• Thoughtful layout of rooms and overall facility
• Asking before touching patients in any way
• Demonstrating politeness within everyday tasks
• Privacy and confidentiality laws and regulations
• Giving patients control over their personal space, belongings, and rooms.
• Transparency around involvement of healthcare professionals and other health providers

Conclusion

Ultimately, there are a number of different aged care facility types, from retirement villages and independent living units to nursing homes.

Whatever kind of aged care centre someone lives in, it is important that they feel comfortable and safe in regard to their privacy and the use of their information.

As a result, it is important to consider the confidentiality, privacy and disclosure requirements that should be met in an aged care setting, as well as aged care worker duty of care more broadly.

Understanding how aged care homes are required to carry out their care roles in regard to the collection of an individual’s personal information and operation in a confidential manner is critical in providing a well rounded approach to aged care as a health service, and even in upholding public health.