UNH Nursing Transcultural Trip to Mexico 2010Becca Knowles, Mellissa Cadime, Jenn Pawson, Ashley Brown, Diana Bartash, Briana Terrill

Patient Privacy and Implementation in Mexico

ObjectivesEmerge in a transcultural nursing experience

Observe nursing care in a different culture

Recognize a problem or need

Research using evidence based practice

Create a plan of improvement

Implement the plan of improvement

Evaluate the plan of improvement

The Problem?a lack of patient privacyand dignity in thehospital was observedby the Americanstudents

What Exactly are “Privacy” &“Dignity”?

“In simple terms privacy can be defined as freedom of intrusion and dignity can be defined as being worthy of respect” (PPD, 42)

Observations of Lack of Privacy:Medical Records

Breeched Patient Privacy

Disorganization of charts

Lack of communication between health

care team

Misplaced charts

Unattended charts

Other Observations ofLack of Privacy

Close proximity to other patients

Open ward

No Curtains Drawn

OR doors left open

Community bathroom

7University of Wisconsin-Extension, Program Development and Evaluation

Goal: To promote dignity through patient privacy in a hospital setting

What we do

Who we

reachWhat results

INPUTS OUTPUTSActivities

Participation

OUTCOMESShort term Long term

PowerPoint teachingSurveys & QuestionnairesVideo visual

ParticipantsPatientsSatisfactionDecision-makers

Awareness of importance of patient privacy.Confidential patient conversationsUtilizing resources to maintain privacy

Less stressful environmentSocial expectations of privacy while in the hospitalization (standardization)Possibility of HIPPA (in Mexico) or equivalent

What we

invest

TimeResources AvailableTechnologyMaterialsStudentsStaff

Why is it important?Helps patients feel...

In control

Valued

Respected

Comfortable

According to the Code of Ethics,Patients Deserve…

AUTONOMY

BENEFICENCE

DIGNITYVERACITY

JUSTICE

NON MALEFICENCE

“It is clear that some patients even have quite low expectations of privacy, being accustomed to the low standards offered in much health care. When we direct patients to use bathrooms, toilets,

commodes, and other facilities, we must also ask what would we want for ourselves, and our relatives, in the same situation.”

(Johnson, 2005)

Why Is Dignity IMPORTANT In Health Care Settings?

It facilitates nurse-patient relationship so we must encourage high standards

Four Aspects Of Privacy & Dignity

(Johnson, 2005)

bodily privacy: patients felt that having their body exposed and being treated as an object were threats to their dignity and that this “embarrassment” leads to a patient’s embarrassment and lack of confidence in the healthcare team

space privacy: patients reported that pulling the curtains maintained the privacy of their space, as well as their body

information privacy: keeping medical records and medical information confidential helps to increase patients dignity

privacy of individual behavior: ensuring privacy of patients’ intimate social relations with relatives, friends, and others

Patient Dignity is at the of what nurses do!

How Can Nurses and Other Health Care Providers Promote Dignity???Label a patient with a name, not a

diagnosisPulling a curtain for privacy

Help patient feel comfortable & confident with their care

Allow patients to have a voice in their care

Keep medical records confidential

Provide a non-threatening, safe environment

An Example of Care That PromotesPatient Privacy & Dignity

INSERT LINK TO VIDEO HERE!

Privacy Survey For PatientsNEVER RARELY SOMETIMES OFTEN ALWAYS

Did your HCP close the curtains?Were you treated with dignity throughout

your stay?

Do you feel that all the aspects of your care were kept confidential?

Did you feel anxious related to close proximity to other patients?

Did you feel you were informed about the care you were receiving?

Did you feel exposed at any time during your stay? If so please describe: _______________ _______________________ _______________________

Did you overhear information about other patients’’ care?

Privacy Survey For Health Care Providers

1. Do you feel you have a better understanding of the importance of patient privacy and dignity?

2. Do you feel you will implement these privacy measures in your practice?

3. Do you feel your peers could benefit from this, as well?

4. Can you anticipate any barriers to implementing patient privacy? Explain ___

5. Do you believe this will improve patient/provider therapeutic relationships?

WHAT HAVE YOU LEARNED???

You should close the curtain when…a. Cleaning a patientb. Examining the patientc. Discussing patient care and treatmentd. All of the above

WHAT HAVE YOU LEARNED???

As a health care provider, what are three ways that you can protect the privacy of your patients?

WHAT HAVE YOU LEARNED???

SCENARIO #1

A male patient is in a room with 6 other patients. His nurse is discussing his condition (AIDS) with him and everyone in the room can see and hear the conversation.

1. Is the nurse promoting patient privacy?2. If not, what can be done to promote

patient privacy in this situation?3. How would you feel if you were in this

situation?

WHAT HAVE YOU LEARNED???

SCENARIO #2Nurse Betty likes to leave the charts open at the end of her patients’ beds because this saves the time of shuffling through charts to record new information. When nurse Betty finishes charting her patients vitals, she leaves all charts open at the end of the patient’s beds.

1. Is this nurse promoting patient privacy?2. If not, what can be done to promote patient privacy in

this situation?3. How would you feel if you were one of the patients in

this situation?

WHAT HAVE YOU LEARNED???SCENARIO #3

Nurse Lisa enters a post-partum room full of 8 female patients. None of the curtains are drawn between the patients. All of the patients’ medical records are open and at the end of their beds. Another nurse, nurse Paula, is examining the patients for edema and leaving each women uncovered when she is done with her examinations.

1. Which nurse is displaying behavior that does NOT promote patient privacy and dignity?

2. What should nurse Lisa do in this situation to promote patient privacy and dignity?

3. How can nurse Lisa make sure that nurse Paula understands the importance of patient privacy and dignity?