HospitalInspections.org

Based on review of policies, procedures, medical record, patient and staff interviews, the Critical Access Hospital (CAH) administrative staff failed to ensure staff followed policies and procedures regarding photographing 1 of 1 patient. The CAH administrative staff failed to ensure staff followed the Iowa Administrative Code 481 51.6(135B) Patient Rights and Responsibilities to protect patient rights. (Patient #1)

Failure to ensure staff followed the Iowa Administrative Code 481 51.6(135B) and CAH policies/procedures to protect patient rights resulted in 1 of 1 Registered Nurse (RN) E used her personal cell phone to photograph Patient #1 resulted in an infringement of the patient's right to privacy.

Findings include:

1. Review of the Iowa Administrative Code 481 51.6(135B) Patient Rights and Responsibilities included in part, "...The statement of principles regarding patient rights shall, at a minimum, address: b. Preservation of individual dignity and protection of personal privacy in receipt of care..."

2. Review of procedure titled, "Patient Rights and Responsibilities", no date included in part, "...You may have your personal and physical privacy maintained..."

Review of policy/procedure titled, "Cellular Telephones: Use of at BCHC and Electromagnetic Interference, 2 Way Radios, etc.", dated 8/26/2014, included in part, "... Purpose: To maintain the privacy of our patients...Policy: Taking pictures with camera phones is not allowed in the facility..."

Review of policy/procedure titled, "Consent to Photograph", dated 7/16/2013, included in part, "...Purpose: The purpose of the policy is to outline the process for obtaining a signed consent prior to photographing or videotaping for medical purposes...Policy: It is the policy of Buchanan County Health Center to take photographs and/or film or video tape in an effort to assist educational efforts, treatment practices, and to document certain physical conditions when it may be of benefit to the plan of care and treatment. All photographs, films and/or videotape will be utilized with the express permission and consent of the patient/resident or his or other legally authorized representative for the purposes listed above. . . Procedures: . . .The patient or their legal representative shall sign a 'Consent to Photograph for Medical Purposes' if picture is taken for this purpose..."

2. Review of Patient #1 medical record revealed the lack of evidence of a signed written consent to allow RN E to photograph Patient #1 during the period of 12/15 through 12/21/2015.

3. During an interview on 1/5/2016 at 4:30 PM, Staff E, RN, acknowledged she used her personal cell phone to video tape Patient #1 as the patient walked in the hall on or about 12/17/2015. Staff E confirmed she obtained verbal consent from Patient #1 to video tape her. RN E reported she failed to obtain a written consent from Patient #1.. Staff E reported she showed the video tape of Patient #1 to other CAH staff prior to deleting the video from her personal cell phone.

During an interview on 1/5/2016 at 3:55 PM, Staff D, Certified Nursing Assistant, confirmed Staff E used her personal cell phone to video tape Patient #1 as the patient walked in the hall on an unknown date. Staff D stated Staff E started video taping Patient #1 walking prior to Staff E obtaining a verbal consent from the patient. Staff D verified Staff E showed the video tape of Patient #1 to other CAH staff.

During an interview on 1/5/2016 at 2:55 PM and 1/7/2016 at 11:30 AM, Staff A, Chief Nursing Officer, acknowledged Staff E failed to obtain a written consent for photographing a patient per CAH policy and also violated the CAH's cell phone policy.

During an interview on 1/6/2016 at 1:15 PM, when asked if staff at the CAH took photographs of Patient #1 ambulating in the hall. Patient #1 could not remember if the staff took pictures of her.