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平衡保密性与护理协调:患者隐私面临的挑战

Balancing confidentiality and care coordination: challenges in patient privacy.

作者信息

Ibrahim Ateya Megahed, Abdel-Aziz Hassanat Ramadan, Mohamed Heba Ali Hamed, Zaghamir Donia Elsaid Fathi, Wahba Nadia Mohamed Ibrahim, Hassan Ghada A, Shaban Mostafa, El-Nablaway Mohammad, Aldughmi Ohoud Naif, Aboelola Taghreed Hussien

机构信息

College of Nursing, Prince Sattam Bin Abdulaziz University, Alkarj, Saudi Arabia.

Family and Community Health Nursing Department, Faculty of Nursing, Port Said University, Port Said City, Port Said, 42526, Egypt.

出版信息

BMC Nurs. 2024 Aug 15;23(1):564. doi: 10.1186/s12912-024-02231-1.

Abstract

BACKGROUND

In the digital age, maintaining patient confidentiality while ensuring effective care coordination poses significant challenges for healthcare providers, particularly nurses.

AIM

To investigate the challenges and strategies associated with balancing patient confidentiality and effective care coordination in the digital age.

METHODS

A cross-sectional study was conducted in a general hospital in Egypt to collect data from 150 nurses across various departments with at least six months of experience in patient care. Data were collected using six tools: Demographic Form, HIPAA Compliance Checklist, Privacy Impact Assessment (PIA) Tool, Data Sharing Agreement (DSA) Framework, EHR Privacy and Security Assessment Tool, and NIST Cybersecurity Framework. Validity and Reliability were ensured through pilot testing and factor analysis.

RESULTS

Participants were primarily aged 31-40 years (45%), with 75% female and 60% staff nurses. High compliance was observed in the HIPAA Compliance Checklist, especially in Administrative Safeguards (3.8 ± 0.5), indicating strong management and training processes, with an overall score of 85 ± 10. The PIA Tool showed robust privacy management, with Project Descriptions scoring 4.5 ± 0.3 and a total score of 30 ± 3. The DSA Framework had a mean total score of 20 ± 2, with Data Protection Measures scoring highest at 4.0 ± 0.4. The EHR assessments revealed high scores in Access Controls (4.4 ± 0.3) and Data Integrity Measures (4.3 ± 0.3), with an overall score of 22 ± 1.5. The NIST Cybersecurity Framework had a total score of 18 ± 2, with the highest scores in Protect (3.8) and lower in Detect (3.6). Strong positive correlations were found between HIPAA Compliance and EHR Privacy (r = 0.70, p < 0.05) and NIST Cybersecurity (r = 0.55, p < 0.05), reflecting effective data protection practices.

CONCLUSION

The study suggests that continuous improvement in privacy practices among healthcare providers, through ongoing training and comprehensive privacy frameworks, is vital for enhancing patient confidentiality and supporting effective care coordination.

摘要

背景

在数字时代,医疗服务提供者,尤其是护士,在维护患者隐私的同时确保有效的护理协调面临着重大挑战。

目的

调查数字时代平衡患者隐私与有效护理协调所面临的挑战及策略。

方法

在埃及一家综合医院开展了一项横断面研究,从各科室抽取150名具有至少六个月患者护理经验的护士收集数据。使用六种工具收集数据:人口统计学表格、《健康保险流通与责任法案》合规清单、隐私影响评估(PIA)工具、数据共享协议(DSA)框架、电子健康记录隐私与安全评估工具以及美国国家标准与技术研究院(NIST)网络安全框架。通过预试验和因子分析确保了效度和信度。

结果

参与者主要年龄在31至40岁之间(45%),75%为女性,60%为注册护士。在《健康保险流通与责任法案》合规清单中观察到高度合规,尤其是在行政保障方面(3.8±0.5),表明管理和培训流程强大,总分为85±10。PIA工具显示出强大的隐私管理,项目描述得分4.5±0.3,总分30±3。DSA框架的平均总分为20±2,数据保护措施得分最高,为4.0±0.4。电子健康记录评估显示访问控制(4.4±0.3)和数据完整性措施(4.3±0.3)得分较高,总分为22±1.5。NIST网络安全框架总分为18±2,在“保护”方面得分最高(3.8),在“检测”方面得分较低(3.6)。在《健康保险流通与责任法案》合规性与电子健康记录隐私性之间(r = 0.70,p < 0.05)以及与NIST网络安全之间(r = 0.55,p < 0.05)发现了强正相关,反映了有效的数据保护实践。

结论

该研究表明,通过持续培训和全面的隐私框架,不断改进医疗服务提供者的隐私实践,对于增强患者隐私保护和支持有效的护理协调至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9229/11328515/04accfc40224/12912_2024_2231_Fig1_HTML.jpg

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