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| ST LUKE'S DES PERES HOSPITAL | 2345 DOUGHERTY FERRY ROAD SAINT LOUIS, MO 63122 | Sept. 12, 2018 |
| VIOLATION: PATIENT RIGHTS: PERSONAL PRIVACY | Tag No: A0143 | |
| Based on interview, record review and policy review, the facility failed to respect the right to privacy and dignity for one patient (#11) of one patient reviewed, when patient care staff reviewed an online video (recorded prior to the patient's admission) of the patient drunk and fighting, where other patients and/or visitors could view it. The facility also failed to educate patient care staff that the video review violated facility policy, after facility leadership were made aware that staff had viewed the video. This failure had the potential to affect all patients admitted to the facility with respect to their privacy and dignity. The facility census was 24. Findings included: Review of the facility's policy titled, "Personal Communications," revised 12/2016 showed employees were expected to limit the use of personal cell phones to breaks, lunch, or off-duty time. Personal phones should never be used while working in a patient care area. Electronic media such as internet was to be used for facility business purposes only. Review of the facility's policy titled, "Patient Rights and Responsibilities," revised 01/2016 showed that the purpose was to assure patients and their families' received appropriate respect and dignity during their treatment. Patient's had the right to reasonable access to care which respected their individual dignity. Even though requested, the facility failed to provide a patient privacy policy. During an interview on 09/11/18 at 9:22 AM, Staff N, Registered Nurse (RN) stated that she was aware of a recent incident when staff watched an online video of someone who was drunk and fighting others. Staff N stated that she overheard a patient (the same person who was recorded drunk and fighting in the video) showed it to a nurse, and that nurse then shared it with other staff members. Review of Patient #11's medical record showed: - He had a history of Schizoaffective disorder (a disorder characterized by psychotic symptoms [false ideas about what is taking place or who one is] and mood disturbance [a prominent and persistent disturbance in mood]), anxiety and depression; - He lived in an assisted living facility; and - A history of alcohol and drug abuse. The patient's history showed that he was a vulnerable individual (person in need of special protection because of disability). Review of facility document titled, "Event Details," dated 07/28/18 showed the following documentation by Staff K, Tele Medical (constant monitoring of heart rhythms and electrical activity) Director: - The event was related to privacy and confidentiality, with reference to patient rights and dignity. - An RN had shared with other staff and a physician, a video of Patient #11 being beaten up while he was drunk and acting out. Multiple staff members looked at the video and laughed about it. - The patient had multiple psychiatric issues, and when staff reviewed the video, it was unprofessional and unethical. - There was no immediate action taken. During an interview on 09/11/18 at 10:15 AM, Staff K, stated that: - A staff member had reported that Staff L, RN had viewed an online video of Patient #11 with other staff members. - She interviewed Staff L who admitted that she had viewed the online video, but denied that she shared the video with other staff. - Staff were educated during morning huddle (informal daily meetings between leadership and patient care staff), that review of the video was inappropriate. - She documented this education in her huddle notes. Although requested, no documentation of the huddle notes was provided. During an interview on 09/11/18 at 2:20 PM, Staff L, RN stated that: - She provided care for Patient #11, who was a ward of the state (when a person is legally assigned to make decisions for someone's well-being, when they cannot make decisions on their own due to disability) due to his mental health. - Patient #11 told her he was famous and told her to look online for a video of him, by searching for "drunk guy hits car." - She went to the nurses station and viewed the video with Staff U, RN, Staff V, RN, Charge Nurse, and the patient's physician. - She was not educated that the video review did not follow facility policy, or that it violated the patient's dignity. During an interview on 09/11/18 at 2:40 PM, Staff U, RN stated that: - She reviewed the video of Patient #11 on her cell phone, while at work. - Staff K, Tele Medical Director questioned her about the video. - She was not educated that the video review did not follow facility policy, or that it violated the patient's dignity. During an interview on 09/11/18 at 3:15 PM, Staff V, RN, Charge Nurse stated that: - She was at the nursing station when Staff L, RN, showed Staff U, RN and a physician the video of Patient #11 on Staff L's cell phone; - Staff V stated that she did not watch the video, but Staff L, Staff U and the physician were all "laughing" at it. - She never received education that that the video review did not follow facility policy, or that it violated the patient's dignity. During an interview on 09/11/18 at 12:40 PM, Staff T, Patient Safety/Risk Management and Staff C, Chief Nursing Officer (CNO), stated they were aware of the video incident related to Patient #11, and that it was "poor judgement" for staff to actually follow through and view it. The facility failed to recognize that even though the patient gave his consent for the staff to view the video, the staff failed to respect the patient's right to privacy and dignity when they viewed it at the nursing station where other patients and/or visitors could have also viewed it. The facility also failed to educate all direct care staff that it was against facility policy and a dignity issue. |
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