Secondary Research Report

 This is the first part of my research document. This post includes my literature review, which describes my difficulties I have come across in my research process, it explains the connections I have found between my research, and it directly addresses my main audience, nurses. I have attempted to tie all my research together and find the "conversation" in my research. The second section in my post is my annotated bibliography, giving a description of my sources, and their relevance to my research.

What nurses need to know about HIPPA

            In my studies I have come to find a number of research on the HIPPA 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 HIPPA, 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 HIPPA law.

            Through my research I have noticed the connections. The biggest connection I have noticed is the confusion of HIPPA 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 HIPPA 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 HIPPA 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 HIPPA’s effect on research and future nurses. One author claims HIPPA 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 HIPPA, 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 HIPPA, 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 HIPPA 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 HIPPA, because the main problem is nurses not fully understanding HIPPA.

            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 HIPPA, 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 HIPPA over a ten year time frame, questions on HIPPA’s original intentions, and violations of HIPPA. All are very diverse but point to the main idea that nurses are not aware of every aspect of HIPPA, and that there are numerous situations HIPPA 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 HIPPA is a must have.

            The sources I have come across give me an array of material covering HIPPA. The research allows me to expand on different issues of HIPPA, 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 HIPPA. 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 HIPPA, 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 HIPPA 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 HIPPA 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 HIPPA 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 HIPPA is used to protect their health, and well-being. This source is extremely relevant for my paper because it shows that HIPPA 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 HIPPA.

Dougherty, M. "Health Care Advocate. Creating A Safe, Secure Health Care Environment: Understanding HIPPA & Exploring Its Implications." AWHONN Lifelines 8.1 (2004): 26-28. CINAHL Plus with Full Text. Web. 27 Sept. 2012.

The main argument is that HIPPA 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 HIPPA. Over the years, HIPPA 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 HIPPA 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 HIPPA 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 HIPPA 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 HIPPA, and its implications. It also goes over the changes HIPPA has been through, providing more recent information of HIPPA.

Giacalone, RP, and GG Cacciatore. "HIPPA 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 HIPPA has had on pharmacy practice. The discussions include how pharmacy has had to change its traditional ways to obey the HIPPA law, and the extraneous affects it has had behind the counter. This journal acknowledges HIPPA’s positives, but consistently uses arguments against the positives.  The main points of the article include basics of HIPPA, protected health information, penalties for the violation of HIPPA, 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 HIPPA law has affected pharmacy practice. The source is biased, because it is only looking at HIPPA 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 HIPPA promises the people. The goal of this source is to dive in to HIPPA, understand the rights of the people, and discuss how the law has changed pharmacy practice. The article comes to an end by basically stating HIPPA 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. "HIPPA, 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 HIPPA 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 HIPPA, 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 HIPPA, and how HIPPA 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 HIPPA requires, and the doors that HIPPA 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 HIPPA 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 HIPPA started from its beginning, until 2006. This gives me evidence of how HIPPA 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 HIPPA 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 HIPPA is unfair to minors, and how we can work to change this, and the knowledge that is needed to improve the HIPPA policy. This source helps my research because again, this is another exception to HIPPA. 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 HIPPA has its flaws, and healthcare providers will have to take extra precaution, that HIPPA 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 HIPPA law, but the government is working to make these flaws better in time, so all in all the HIPPA 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 HIPPA, the writer acknowledges that HIPPA 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 HIPPA 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 HIPPA but it gives the positives and how HIPPA 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 HIPPA 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 HIPPA 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 HIPPA law and surface the fact that HIPPA 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; HIPPA has not simplified anything like it was claiming to do in 1996. Many people working for the healthcare industry fear that HIPPA will put us in to a financial downfall because of all the extraneous work needed to be done to protect HIPPA. The goal of this source is to state the issue that HIPPA 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 HIPPA 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 HIPPA is not yet perfected, and how important it is to know the changes of HIPPA 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 HIPPA 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 HIPPA 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 HIPPA 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 HIPPA in only one way, they do not state the positive aspects of HIPPA only why it is negative for their particular case. The goal of this source is to discuss how the HIPPA 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 HIPPA 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 HIPPA 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 HIPPA 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 HIPPA 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 HIPPA 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 HIPPA 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 HIPPA.  The goal of this source is to explain that the HIPPA 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 HIPPA.

"MA: Hospital Employee Violates HIPPA: 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 HIPPA, 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 HIPPA law. The editor’s argument was that Zhu should not have been terminated because it was not the patient reporting HIPPA 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 HIPPA can have, you can be terminated from a hospital position, for making a simple mistake. The topics of this article are violation of HIPPA, the affect violating HIPPA 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 HIPPA 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 HIPPA is to nurses.