HospitalInspections.org

Based on observation, interview, and record review the facility failed to ensure patient privacy when two staff (K and Q) of two used personal cell phones to text regarding patients care to physicians. This failure potentially allowed for individuals not involved in the patient's care to have access to the patient's medical information. The facility census for Medical/Surgical was four, Swing Bed (post hospital extended care services) was two, and the Intermediate Care Facility (ICF, promotes function and independence) was 12.

Findings included:

1. Record review of the facility's policy titled, "Cell Phone Use," dated 11/2014, showed the directive for facility staff to only operate cell phones during breaks and lunch.

2. During an interview on 03/15/16 at 1:00 PM, Staff K, Licensed Practical Nurse (LPN), stated that there might have been instances that she texted with a physician regarding a patient and used the patient's initials.

During an interview on 03/16/16 at 10:05 AM, Staff Q, Registered Nurse (RN), stated that:
- She had texted physicians to notify them to call the hospital or if a test was back so the physician could review.
- The patient's name or initials were not used.
- The patient's room number was used to identify the patent.
- She texted a physician, that morning, regarding patient care.
- She used the patient's room number, stated that the patient's EKG (a tracing representing electric activity of the heart) was back, the patient was unresponsive, and the telemetry (transmission of cardiac signals to a receiving location where they can be displayed for monitoring) was abnormal.
- She sent a picture of the EKG, with no patient identifiers, and sent the lab values of two lab tests.

During an interview on 03/16/16 at 11:17 AM, Staff G, Chief Nursing Officer (CNO), stated that:
- The facility policy was not to use a personal cell phone while working.
- He did not enforce the policy.
- He had heard of two physicians who preferred nurses texted them over calling.
- He did not want patient care discussions via text.
- Cell phone use was not acceptable under the current policy.

During an interview on 03/16/16 at 12:45 PM, Staff R, Physician, stated that she requested nurses to text when they needed to reach her. Staff R texted with Staff Q that morning and felt it was ok because no patient identifiers were used. She was aware of the facility policy and felt it needed to be changed.

During an interview on 03/17/16 at 12:26 PM, Staff T, Chief of Staff, stated that he requested nurses to text him when they needed to reach him. He would receive messages for him to call or that included patient room numbers and a lab or another test was ready for his review. He did not feel this was an ideal situation.