Mlinek E J, Pierce J
University of Nebraska Medical Center, Department of Surgery, Omaha, NE, USA.
Acad Emerg Med. 1997 Dec;4(12):1142-6. doi: 10.1111/j.1553-2712.1997.tb03697.x.
To determine the frequency of visual and auditory confidentiality and privacy breaches in a university ED.
A prospective, observational study of medical personnel behavior was performed using participant and direct observation techniques. Observations were made in a university tertiary referral and trauma center emergency facility. Observers recorded auditory and visual confidentiality and privacy breaches in various patient care areas during 1-hour periods. Information collected included patient name or room number, complaint/diagnosis, diagnostic tests, past medical history, and personal information. It was then determined whether a clear identification of the patient's name or face and/or an association to his or her clinical course could be made.
All members of the health care team committed confidentiality and privacy breaches. Frequency of breaches was dependent on room location and design. Breaches in the triage/waiting area occurred for > 53% of the patients. Breaches near the physician/nursing station ranged from 3 to 24 per hour and 1.5 to 3.4 per patient hour. Other inappropriate comments also were noted. One hundred consecutive patients and family members were interviewed at ED release, with only 2/100 having noticed the status board, although neither could recall any specific details.
Confidentiality and privacy breaches occur in a university ED by all members of the health care team. The ED architecture and floor plan affect patient confidentiality and privacy.
确定大学急诊科视觉和听觉方面违反保密及隐私规定的发生率。
采用参与观察和直接观察技术对医务人员行为进行前瞻性观察研究。观察在一所大学三级转诊和创伤中心的急诊设施中进行。观察者在1小时时间段内记录不同患者护理区域的听觉和视觉保密及隐私违规情况。收集的信息包括患者姓名或房间号、主诉/诊断、诊断检查、既往病史和个人信息。然后确定是否能明确识别患者姓名或面孔以及/或者将其与临床病程联系起来。
医疗团队所有成员均存在违反保密及隐私规定的行为。违规发生率取决于房间位置和设计。分诊/候诊区超过53%的患者存在违规情况。医生/护士站附近的违规情况为每小时3至24次，每位患者每小时1.5至3.4次。还注意到其他不当评论。在急诊科放行时对100名连续的患者及其家属进行了访谈，只有2/100的人注意到了状态板，不过两人都记不起任何具体细节。
大学急诊科中医疗团队所有成员均存在违反保密及隐私规定的行为。急诊科的建筑结构和平面图会影响患者的保密及隐私。
