Center for Improvement in Healthcare Quality Newsletter
October 2021

CIHQ-ARS Article

Patients Right to Personal Privacy

By: Ann Martin
Do you sometimes wonder during the busiest of days whether the patient’s personal privacy is compromised? Do you feel that staff are doing whatever they can to protect patients’ dignity and respect during personal care?
Especially today, staff are overwhelmed with high census, very sick patients, multiple tasks, and understaffing. It may be easy to forget to close the door or curtain while providing personal care. This can cause embarrassment, loss of dignity, and cause a lack of respect for the caregiver. Personal care activities are a vital service we provide to patients. While it may be easy to forget, and to view these services as routine tasks of the job, it is important to remember that this may violate a patient’s right to personal privacy.
Although “Patient Right to Physical Privacy” is a CMS regulation (§482.13(c)(1) “Privacy must be provided when personal care is being performed”), we as healthcare workers have an obligation to our patients to make their environment welcoming, safe, respectful, and comforting during their routine personal care and treatments.
A few simple tasks that you can do to ensure your patient’s privacy is protected during personal cares/treatments:
  • Provide enough space for them to feel comfortable in their care setting
  • Pull the curtains and close the doors
  • Provide a bathrobe or covering while walking them to the bathroom
  • Allow them privacy while in the bathroom, if appropriate to patient safety assessment and ability to be alone
  • Cover private areas during bathing, only exposing what is needed
  • Have visitors step out during care/treatments unless patient has given permission for them to stay
  • Place a sign or other signal on the patient door that personal care is in progress alerting visitors or other staff they should not enter or knock first
Here is an example of respect and dignity during personal care: You are about to give a bed bath to a patient. Start by gathering all necessary supplies, explain what you are doing to the patient and what you are planning so they can participate in care (if applicable), close the door, draw the curtain. While giving the bed bath make sure to only expose the area you are bathing. This allows the patient to feel more comfortable and not exposed during the entire bath.
What about audio/video monitoring? Is this a violation of patient rights to privacy? Under CMS’ regulations, this would not be considered violating the patient’s privacy if there is a clinical need, the patient/patient’s representative is aware of the monitoring, and the video/audio is not visible or audible where other patient’s, visitors or public are present. Consent of the patient or patient representative is required for video/audio monitoring.
What steps can you take to ensure patients privacy is protected during video/audio monitoring?
  • Ensure consent is signed prior to initiation
  • If caregivers are present in the room providing personal care, pause the monitoring device and restart once care is completed. This allows dignity for the patient.
  • If audio is used, ensure the volume is adequately heard by caregivers but not by public
  • Utilize a private room where the staff who are monitoring the patient are behind closed doors without public access/viewing.
Although we may make every effort to protect a patient’s personal privacy, there may be some situations that are unavoidable. For example, a suicidal patient is being continuously observed while in restraint or seclusion that puts the patient at immediate risk of harm. These patients may be in an emergency department which makes it difficult at times to protect their personal privacy; protecting them from harm is the highest priority. Documentation of such events is important to assure that an accurate picture and account of events are clearly stated in the electronic health record.
Hospitals should have a policy and a clear process in place that addresses the patient’s right to privacy and safety. In addition, training of all staff on hire and periodically to ensure they are educated on patient rights related to personal privacy, dignity and respect is required.

References

Centers for Medicare and Medicaid Services, (2020). State Operations Manual, Appendix A – Survey Protocol, Regulations and Interpretive Guidelines for Hospitals. Retrieved from cms.gov