This is my literature review, where I started to critically analyze my sources and think about what the author said and what I wanted to say.
What nurses need to know about HIPAA
In my studies I have come to find a number of research on
the HIPAA law. I have gone back and forth with many research questions, but
when I started really diving in to my research the immediate issue came to me.
There are so many articles with confusion on HIPAA, how they dislike it and it
has made healthcare complicated, how it has changed, and how nurses are
supposed to work around the law to complete their daily duties. Through my
research I have seen many connections, and many complaints, and worries that
have been left unanswered. I am piecing these connections together to make my
research document stronger, and to help nurses have a piece of research they
need to better their understanding, and clear up any confusion that they once
had with the HIPAA law.
Through my
research I have noticed the connections. The biggest connection I have noticed
is the confusion of HIPAA between nurses, nurses asking questions concerning
privacy with their patients. There is a lot of information being given in small
pieces, about certain aspects of the HIPAA law, and my goal is to piece them
all together to make one big research document covering the various issues. I
also noticed there is a lot of negative feedback about the HIPAA law, wanting
to know why the law is the way it is, wanting to know how to better understand
their problem to make it easier. One interesting aspect of the research
exercise is I have found some articles that offer a solution to certain
problems, this lets me know that there are people out there trying to build
further on the research.
One conversation
that came to mind was concerning HIPAA’s effect on research and future nurses.
One author claims HIPAA has only made research and recruiting incoming nurses
more difficult, and costly (Wipke-Tevis). Another author responded by raising
the topic that it may be difficult to get the research you need, but it is
surprisingly more accessible than people seem to think (Bova). The only
difference is you must take extra precaution when it comes to protecting the
patient’s information. This is one of the “conversations” I found when
researching, it offered a solution to the problem. The thing that ties the
whole of the research together is they are giving bits and pieces of
information on HIPAA, no one has pieced them together, or tried to answer the
questions of nurses in a whole, which is what I plan to do.
The loudest
speakers are the nurses, which is no surprise considering nurses are always on
the front line when it comes to the patients and their medical information.
Nurses complain about not knowing HIPAA, ask questions about what is right and
not right, how to go about the media, family members, and law enforcement
asking for patients information (Nebraska Nurse). They are the ones needing the
information the most. I believe these issues arise because there must be lack
of communication in hospitals, and health related atmospheres. When the HIPAA
law changes there should be immediate notification to all hospitals, and the
leaders of the establishment should make sure all staff is aware of this
change. If this would happen I believe there would be less complaints, and less
violations of HIPAA, because the main problem is nurses not fully understanding
HIPAA.
I honestly
believe that my sources are equally important, because my main goals were to
bring many different ideas together to make one. Each of my sources bring a new
idea to the table for me to tie the conversation together.
The big
comparison between my research articles is confusion with HIPAA, not knowing
what to do, and wanting it to change. However, each article is different in its
own way, there are direct questions, there are articles on child abuse,
pharmacy practice, research issues, changes of HIPAA over a ten year time
frame, questions on HIPAA’s original intentions, and violations of HIPAA. All
are very diverse but point to the main idea that nurses are not aware of every
aspect of HIPAA, and that there are numerous situations HIPAA relates to.
When I
first started this research I went in to it with my specific research question,
and by the end of gathering numerous amounts of research, reading through many
articles, I found where the real need for research was, and who it needed to be
communicated to. My original audience was society as a whole, a patient’s
standpoint, but the ones who need this research most are nurses. To perform
their duties correctly, and maintain their job, knowledge of HIPAA is a must
have.
The sources
I have come across give me an array of material covering HIPAA. The research
allows me to expand on different issues of HIPAA, answer questions, and
hopefully solve problems. The pieces I have found directly point to my issue
because they give me different situations for me to piece together in one big
document of information communicating how nurses can handle issues, how to
perform when put in certain situations. The sources themselves do not chunk the
information together, they are like puzzle pieces and my job is to fit all the
parts together so nurses receive the big picture.
When I
first began this project I knew I wanted to research HIPAA. I have changed my
question two times in total during the procedure but I think I have finally
come to the right one. The way I refined my search, and came to my final
research question was through piecing together what the research was asking
for. Nurses needed information, a big piece of information that touches on many
different issues of HIPAA, not just one. So when I knew what the need was I
started expanding on that, and looking at ways to piece the research together to
communicate my findings with the nursing community.
"Policy Statement--Child
Abuse, Confidentiality, And The Health Insurance Portability And Accountability
Act." Pediatrics 125.1 (2010):
197-201. CINAHL Plus with Full Text.
Web. 27 Sept. 2012.
The argument in this article is for the protection of
children in an abusive situation. In many child abuse cases, the child is
unwilling to disclose information of their case. This article is arguing that
in these abuse cases it is necessary to go against the child’s wishes to
protect their health and well-being.
This source is labeled as an academic journal. The point of this article
is to point out that HIPAA has leniency in extreme situations such as child
abuse; it gives supporting evidence why this leniency is relevant in protecting
a child’s health. The topics that are covered in this article include protected
health information, public health authority, patient/parent rights to
confidentiality, specific exceptions to HIPAA regulations related to child abuse,
child abuse reports and investigation, disclosing information when the
pediatrician is not the child abuse reporter, disclosing protected health
information beyond reporting and investigating child abuse, issues specific to
child abuse, child rights/media exposure, and effect of HIPAA on pediatric
practice. I do not believe this source is biased; it is more on a factual level
than an argument level, written by the committee on child abuse and neglect.
The goal of this article is to discuss the rights of children, and how HIPAA is
used to protect their health, and well-being. This source is extremely relevant
for my paper because it shows that HIPAA has exceptions to certain cases
including child abuse. This allows me to inform nurses on child abuse, so if
they ever come across a situation where child abuse is a factor, they know how
to go about it while complying with HIPAA.
Dougherty, M. "Health Care
Advocate. Creating A Safe, Secure Health Care Environment: Understanding HIPAA
& Exploring Its Implications." AWHONN
Lifelines 8.1 (2004): 26-28. CINAHL
Plus with Full Text. Web. 27 Sept. 2012.
The main argument is that HIPAA is positive, it is vital to
keep to the medical environment private for the sake of the patient. This
source is labeled as an academic journal. The point of this article is to
convey the rules of HIPAA. Over the years, HIPAA has been revised, and has been
changing its rules and regulations so it is somewhat difficult to understand
the law since it keeps changing. This article makes it a point to give the
proper rules and regulations of HIPAA to nurses, since nurses are the primary
people visiting patients, dealing with their medical history, and transferring
their information to appropriate people. So what this article does is explain
the new rights of patients, and what you can do as a nurse to protect this
information. The topics that are covered in this article include understanding
the new HIPAA rule, protecting patient privacy, helping patients understand
their rights, and consequences of noncompliance. The source seems biased
because the beginning of the article is stating that the HIPAA law is good, it
is inferring there is no bad regarding this law, also this article is written
by a Registered Health Information Administrator, so it is only looked at from
this particular point of view, not an entire medical staff as a whole. The goal
of this source is to communicate the rights of the patient, how nurses can
protect these rights, and how violating these rights can affect you. This source
can be relevant in my research because just like the title states, it is an
article used to understand HIPAA, and its implications. It also goes over the
changes HIPAA has been through, providing more recent information of HIPAA.
Giacalone, RP, and GG Cacciatore. "HIPAA And Its Impact
On Pharmacy Practice." American
Journal Of Health-System Pharmacy 60.5 (2003): 433-445. CINAHL Plus with Full Text. Web. 27
Sept. 2012.
This article is discussing the affects HIPAA has had on
pharmacy practice. The discussions include how pharmacy has had to change its
traditional ways to obey the HIPAA law, and the extraneous affects it has had
behind the counter. This journal acknowledges HIPAA’s positives, but
consistently uses arguments against the positives. The main points of the article include basics
of HIPAA, protected health information, penalties for the violation of HIPAA,
uses and disclosure of PHI, consent, notice and written acknowledgement,
authorization, and rights of individuals. Each of these topics is discussed in
a thorough manner, pointing out the difficulties the pharmacy has had to face
with each of these topics. This source is labeled as an academic journal. The
point of the overall article was to discuss how the HIPAA law has affected
pharmacy practice. The source is biased, because it is only looking at HIPAA
from a pharmacist’s standpoint, it fails to look in to the other perspectives
of people like the patients. The article mostly gives negatives however it does
point out some positive points like the rights that HIPAA promises the people.
The goal of this source is to dive in to HIPAA, understand the rights of the
people, and discuss how the law has changed pharmacy practice. The article
comes to an end by basically stating HIPAA has its positives in society, but
these positives are going to come with a big price tag. Overall this article seems like it will be a
valuable piece of research in my final paper. It is focused towards pharmacies
but I believe it to be relevant because nurses work side by side with
pharmacists, so it is important for them to know how it affects others in their
field.
Conn, J. "HIPAA, 10 Years
After." Modern Healthcare 36.31
(2006): 26-28. CINAHL Plus with Full
Text. Web. 26 Sept. 2012.
The main arguments of this journal were really how HIPAA has
affected health care negatively and positively from when it was first started
in 1995. Listed in the journal were the pros and cons of HIPAA, and what they
think should be changed about it. The genre of this source is an academic
journal. The point of this article was to get information and feedback from
professionals in the health care field on their views of HIPPAA, and how HIPAA has influenced the health care world over the past ten years. Negative and
positive effects were given in this journal. Topics that were covered are the
effort of the medical staff to protect patient’s privacy, the work HIPAA
requires, and the doors that HIPAA has opened for IT. The source is in a way
biased because the information and feedback that is given in this article is
strictly people from the medical field, there are no patients, or people from
society giving their feedback. The main goal of this source is to point out
where HIPAA has come in the past ten years, how it has affected the world of
health care, negatively, and positively. This source gives me a look at what
the law is doing in the medical field; it also shows me how HIPAA started from
its beginning, until 2006. This gives me evidence of how HIPAA has changed, and
continues to change.
Maradiegue, A. "From Research
To Policy In Pediatric Nursing. The Health Insurance Portability And
Accountability Act And Adolescents." Pediatric
Nursing 28.4 (2002): 417-420. CINAHL
Plus with Full Text. Web. 28 Sept. 2012.
The main argument of this article is that the HIPAA law
affects adolescents in a negative way, by allowing parents to have access to
the medical documentation of their children. This resource is an academic
journal. The point of this article is “… the minors' rights and HIPAA
regulations regarding Standards for Privacy of Identifiable Health Information
(PHI)” (417). Topics that are covered in this article include public policy
problem to be solved, government objectives, the political issues and influences,
relevant actions, ethical principles, impact on nursing practice, and knowledge
needed to improve policy. This source is written by a woman who holds a PhD,
and an RN degree so it is apparent she has done research on the issue, but the
source could possibly be biased because she is looking at the issue from a
medical profession standpoint, not a standpoint of an adolescent, or parent of
an adolescent. The goal of this source
is to describe how HIPAA is unfair to minors, and how we can work to change this,
and the knowledge that is needed to improve the HIPAA policy. This source helps
my research because again, this is another exception to HIPAA. This gives me
information on what rights parents have to their child’s medical records.
Frimpong, JA, and PA Rivers.
"Health Insurance Portability And Accountability Act: Blessing Or
Curse?." Journal Of Health Care
Finance 33.1 (2006): 31-39. CINAHL
Plus with Full Text. Web. 28 Sept. 2012.
The main argument of this article is that even though HIPAA
has its flaws, and healthcare providers will have to take extra precaution,
that HIPAA is an overall positive aspect to our society. The genre of this
article is labeled academic journal. The point of this article is to show the
reader that there are indeed flaws of the HIPAA law, but the government is
working to make these flaws better in time, so all in all the HIPAA law will be
positive to our society. Topics that are covered in this article are HIPAA on
research, privacy, administration simplification, practice, costs of HIPAA
compliance, technological investment, and costly changes to office procedures.
This source seems to be objective because it is not simply looking at a
positive standpoint of HIPAA, the writer acknowledges that HIPAA is not
perfect, but that there is work being done to perfect the law as best as
possible. The goal of this source is to provide positive, encouraging feedback
about the HIPAA law, encouraging that it may not be perfect as of right now,
but it could eventually get there. This information is relevant for my research
because it shows the negatives of HIPAA but it gives the positives and how
HIPAA is trying to take the negative aspects and make them positive, but it
will take time.
Banks, DL. "The Health
Insurance Portability And Accountability Act: Does It Live Up To The
Promise?." Journal Of Medical
Systems 30.1 (2006): 45-50. CINAHL
Plus with Full Text. Web. 27 Sept. 2012.
The main argument of this article is that the HIPAA law has
not lived up to its promise. In 1996 when HIPPA was formed, one of its promises
was to make the healthcare administrative process easier than it currently was.
This article argues against the HIPAA law claiming that the law has not made
the healthcare administrative process easier, but it has made it much more
extraneous, and extremely costly. This resource is labeled as an academic
journal. The point of this article is to
argue against the HIPAA law and surface the fact that HIPAA could become a
financial burden to the healthcare industry. Topics that are covered in this
article are the challenge of standardization, healthcare claims or coordination
of benefits, he Administrative Simplification Compliance Act, the promise of cost
savings, and the status of HIPAA compliance. This source does not appear to be
biased because it is factual; HIPAA has not simplified anything like it was
claiming to do in 1996. Many people working for the healthcare industry fear
that HIPAA will put us in to a financial downfall because of all the extraneous
work needed to be done to protect HIPAA. The goal of this source is to state
the issue that HIPAA did not keep its promise in simplifying the healthcare
administrative process, and that it could potentially financially harm the
healthcare industry. This article shows what HIPAA has said it was supposed to
do to help make the healthcare administrative process easier, and how it has
failed to do so. This is another source I can use to show nurses that HIPAA is
not yet perfected, and how important it is to know the changes of HIPAA from
the law of today and the law of 1996.
Wipke-Tevis, DD, and MA Pickett.
"Impact Of The Health Insurance Portability And Accountability Act On
Participant Recruitment And Retention." Western Journal Of Nursing Research 30.1 (2008): 39-53. CINAHL Plus with Full Text. Web. 27
Sept. 2012.
The argument of this article is that HIPAA has affected
research in a negative way, by limiting access to research, which in returns
limits the education of nursing students when studying clinical research. This
source is an academic journal. The point of this article is to acknowledge the
fact that HIPAA has changed the way we teach healthcare to students, and how it
has affected participant recruitment and retention when relating to clinical
studies. This article points out how the HIPAA law has made researching more
difficult, costly, and how one must attempt to go around this law in a legal
way to avoid breaking the law. Topics that are covered in this article include
preparatory research, initial contact of participants, prescreening potential
participants, the consent process, long-term follow up patients, recruitment
for future studies, and training of research staff. This sourced is biased because the authors
are looking at HIPAA in only one way, they do not state the positive aspects of
HIPAA only why it is negative for their particular case. The goal of this
source is to discuss how the HIPAA law has hindered learning because of limited
access to certain documents, it has made learning the field of healthcare much more
expensive, and an extensive amount of work must be done to avoid breaking this
law. This is a good reference for my research because it gives me evidence of
how HIPAA will affect clinicals, and how nurses must go about teaching to
nursing recruits.
Bova, C, D Drexler, and S
Sullivan-Bolyai. "Reframing The Influence Of The Health Insurance
Portability And Accountability Act On Research." Chest 141.3 (2012): 782-786. CINAHL
Plus with Full Text. Web. 27 Sept. 2012.
The main argument of this article is that just because the
HIPAA law takes an extensive amount of effort, and paperwork does not make it a
negative law. This article brings up the point that there has been much talk
about how HIPAA is negative because it requires extra effort from the medical
staff, it is a burden, and it is too costly to hospitals, this article is to
argue that HIPAA is positive, but extra work will need to be performed by
researchers to gain access to certain sources. The genre of this source is
academic journal. The point of this article is to inform people that the HIPAA
law is not going anywhere, so people need to appreciate it, and learn to
appreciate the rights of patients. The writer wants people to know that just
because HIPAA make certain things more difficult does not mean it is not
important. The writer acknowledges the fact that protected health information
is very accessible, but the researcher will have to take extra precaution to
protect the privacy of patients. Topics that are covered in this article
include Health Insurance Portability and Accountability Act, HIPAA and the
Common Rule, and working with HIPAA’s privacy and security requirements. This
source does not appear to be biased considering the authors of this article hold
doctorate degrees, and nursing degrees, so they work directly with the
hospital, and HIPAA. The goal of this
source is to explain that the HIPAA law is positive, and that researchers
should be willing to take extra precaution to protect the medical information
of patients. This source helps my argument because it shows how someone must
take an extensive route to gain the research they need because of HIPAA.
"MA: Hospital Employee
Violates HIPAA: Suspension And Termination Upheld By Court. (Hospital Law
Decisions Of Note)." Hospital Laws
Regan Report 51.12 (2011): CINAHL
Plus with Full Text. Web. 27 Sept. 2012.
This is a court case of Jing Zhu v. General Hospital
Corporation. Zhu was an office assistant at Massachusetts General Hospital, she
is charged for the violation of HIP
aA, she released medical information to a
patient’s mother assuming the mother already knew of her daughter’s medical
condition. There are two different arguments for this article the first is that
of the courts. The argument the court gave is that terminating Zhu from her
position was necessary because of her violation of the HIPAA law. The editor’s
argument was that Zhu should not have been terminated because it was not the
patient reporting HIPAA violation, it was the mother and the mother is not in a
position to complain about another person’s medical disclosure. This article is
labeled as an academic journal. The point of this article is to describe the
affects that violating HIPAA can have, you can be terminated from a hospital position,
for making a simple mistake. The topics of this article are violation of HIPAA,
the affect violating HIPAA can have, and the rights of the patient. I believe
this source to be objective because the writer is giving the facts of the
situation, stating the court’s view of the violation, and then finally stating
his own personal opinion of the situation. This source is a great reference to
my research because it gives me a case of how violating HIPAA can directly
affect them. This shows that even a simple slip up can cause a nurse to lose
her job. This gives me a reference of how important knowledge of HIPAA is to
nurses.