A nurse is enrolled in an orientation program regarding clients' rights, confidentiality, and ethical practices in nursing. Which of the following situations is an example of a breach of confidentiality?

  1. Release of laboratory results to the client via an encrypted electronic email.
  2. Disclosing information for reimbursement of hospital payment.
  3. Disclosing the client's disease prognosis to the estranged spouse.
  4. Using a reference number to replace the client's name in the medical record.
Explanation

Answer: C - A breach of confidentiality is defined as disclosure of information to a third party without the prior consent of the client or by court order. The medium of disclosure is irrelevant, that is why special security measures, such as encryption and password-protected electronic transfer should be used. Under HIPAA (Health Insurance Portability Accountability Act), covered entities are permitted to release information only to facilitate payment and treatment. This act also provides guidelines for safeguarding the client's privacy through the use of reference numbers or codes.

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