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ANAHEIM GLOBAL MEDICAL CENTER
PROTECTING PATIENT RECORDS
Tag No.: A0441
Based on observation and interview, the hospital failed to ensure the patient medical records were secured and confidential at all times. This had the potential for unauthorized individuals to gain access to the medical records.
Findings:
On 11/7/18 at 1000 hours, during a tour of the BHU Unit 6 accompanied by the Director of MCH, Director of Radiology, and the Unit 6 Charge RN, the examination room was inspected. The door to the examination room was not locked. Behind the door were two 4-drawer metal file cabinets that were not locked. Inside the file cabinets were patients' progress notes, medication records, and transfer records. The Director of MCH and Unit 6 Charge RN acknowledged the cabinets should be locked for patients' confidentiality.