Respecting the Privacy and Dignity of Clients

Healthcare workers are bound by law to keep the medical records and health information of patients, clients and residents safe and private.

A key part of treating a client with dignity and respect is making sure their privacy is respected. This is reflected in the Aged Care Quality Standards: Aged Care Quality Standard 1 - Consumer Dignity and Choice  and Aged Care Quality Standard 2 - Ongoing Assessment and Planning with Consumers.

There is an inherent vulnerability in seeking healthcare and accessing aged care. A visit to a clinic can involve removing clothing, being prodded, scanned and possibly photographed. In aged care it might mean having another person undress, wash and shower them.

Through all of this, the client trusts that the care worker, nurse, doctor and other healthcare staff have their privacy and dignity in mind. Any breach of this privacy will justifiably upset the client and could result in them taking legal action against you and/or the facility (RCNI 2016).

What Classifies as Health Information?

Health information is any information regarding a person’s health or disability, and any information that relates to a health service they have received or will receive (Better Health Channel 2015).

Consent

When a patient goes into a healthcare facility, they can make the decision to give staff access to their health records, or to withhold them.

They do not have to, but giving healthcare staff their consent to access this information will help staff to provide the best care possible for them. Healthcare workers are required to protect patients’ privacy and confidentiality (Better Health Channel 2015).

Note: a person always maintains a right to access their own medical records.

Are there Exemptions to These Laws?

There are two situations in which a health service may use or share health information without consent. These are:

1. When a person’s health or safety are seriously threatened and the information will help – for example if they are unconscious and the paramedics, doctors and nurses need to know if they are allergic to any medicines.
2. When the information will limit or prevent a serious threat to public health or safety – for instance, if they have a severe contagious illness the public should be warned about.

(Better Health Channel 2015; Health.Vic 2018)

Laws may differ by State and there are certain exemptions that may apply in law enforcement situations and in a court of law. Keep in mind, health information privacy laws only apply rights to people who are living (Better Health Channel 2015).

Person Centred Care

Privacy and dignity are guiding principles of person centred care. The provision of effective, person centred care hinges upon the following:

• Clear respect for client’s values, preferences and expressed needs;
• Coordination and integration of care;
• Information, communication and education;
• Physical comfort;
• Emotional support and attempt to alleviate fear and anxiety;
• Involvement of family, friends and carers;
• Transition and continuity; and
• Access to care.

(SA Health 2014)

Client / Resident Dignity

In this time of vulnerability, even the smallest details in your interactions with clients will impact their perception of how you regard them.

Beyond communication, be mindful of the steps you take to ensure the person’s privacy and modesty are protected, e.g. closing screens, making sure the patient is covered, and keeping your voice level down when discussing private and personal issues (RCNI 2016). In aged care, this means carrying out self-care tasks with sensitivity, tasks such as bathing, dressing and feeding.

Respect for the Values and Preferences of Your Client / Resident

Ways to let the client know that their preferences matter could include:

• Ensure gender accommodation is available, or when not possible, provide clients support and safety needs in a mixed gender environment.
• Introduce yourself and explain your role to the client.
• Ask the client what name they prefer to be called.
• Identify people such as carers, family or friends, in conjunction with the client.
• Show an awareness of the client’s views, beliefs, culture and language.
• Consider the client’s preferences in all decision-making and goal setting for care and treatment.
• Treat clients in an environment that is person centred and focussed on the person as an individual.
• Ensure clients are treated with dignity and respect and show sensitivity towards their cultural values and needs.
• Keep clients informed regarding their medical condition and involve the client, family and/or carer in decision-making.
• Maintain the client’s privacy during consultation and treatment, ensure that curtains, doors and window blinds are closed.
• Be respectful of the client’s religious or faith traditions, ensure that interpreters and cultural, religious or faith supports are available if needed.

(SA Health 2014)

See Ausmed articles on Spiritual and Cultural Considerations in Healthcare

An easy way to ensure a client that their privacy and dignity are primary concerns of yours is to involve them as much as possible in discussions regarding their treatment.

Clients will want to know who is looking after them, when, why and how. Maintain ongoing discussion with your clients during ward rounds and handover (SA Health 2014).

Engage with clients about the following:

• Explain their daily plan of care;
• Use plain language and try to avoid medical jargon;
• Check that the client understands the information;
• Ensure that the client knows and completely understands their rights;
• Respond to client questions, requests, concerns and complaints promptly; and
• Use bed boards to help clients to identify staff and their goals.

(SA Health 2014).

Conclusion

Clients and residents deserve to be treated with utmost dignity and respect during and following the treatment process. Keep in mind that breaching privacy laws could have devastating implications on the lives of you and your patient, and on your career.

Additional Resources

• Aged Care Quality Standards: https://www.myagedcare.gov.au/aged-care-quality-standards
• Health Complaints Commissioner: https://hcc.vic.gov.au/

References

• Better Health Channel 2015, Confidentiality and Privacy in Healthcare, Better Health Channel, viewed 22 August 2019, https://www.betterhealth.vic.gov.au/health/ServicesAndSupport/confidentiality-and-privacy-in-healthcare
• Health Vic 2018, Protecting Patient Privacy in Victoria, Health Vic, viewed 22 August 2019, https://www2.health.vic.gov.au/public-health/infectious-diseases/protecting-patient-privacy
• RCNI 2016, Preserving People’s Dignity, RCNI, viewed 22 August 2019, https://rcni.com/hosted-content/rcn/first-steps/preserving-peoples-dignity
• SA Health 2014, Staff Information on Respecting Patients’ Privacy and Dignity with Patient Centred Care Principles, SA Health, viewed 22 August 2019, https://www.sahealth.sa.gov.au