Confidentiality breaches in clinical practice: what happens in hospitals?
Confidentiality breaches in clinical practice: what happens in hospitals?
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DOI：
10.1186/s12910-016-0136-y
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发表时间：
2016-09-02
影响因子：
2.7
通讯作者：
Muñoz-Villanueva MC
中科院分区：
文献类型：
--
作者：
Beltran-Aroca CM;Girela-Lopez E;Collazo-Chao E;Montero-Pérez-Barquero M;Muñoz-Villanueva MC
尊重保密对于保障患者的福祉和确保社会对医患关系的信心至关重要。我们研究的目的是通过临床实践中的直接观察来检查违反保密性的真实的情况。通过直接观察，我们的研究探讨了真实的情况下，有一个在三级医院违反保密。为了观察和收集这些情况的数据，我们招募了科尔多瓦大学医学学位课程的学生。观察员在不同科室的临床实习期间在标准化模板上记录了他们的条目：内科;妇产科;儿科;急诊医学;普通和消化外科;颌面外科;整形外科;骨科和创伤学;消化;皮肤科;流变学;精神卫生;肾脏科;神经科;眼科。经过7138天和33157小时的观察，我们发现估计的频率指数为每62.5小时发生一次违约。关于观察到的违规行为的类型，最常见的（54.6%）与向不参与患者临床护理的医务人员以及医院外部人员咨询和/或披露临床和/或个人数据有关。就严重程度而言，严重违规事件最为频繁，占所有事件的46.7%。大多数报告的事件发生在公共区域（37.9%），如走廊，电梯，自助餐厅，楼梯和更衣室。除了与医院组织或基础设施相关的方面外，我们还发现，所有医疗保健人员都涉及违反保密规定的行为，尤其是医生。虽然大多数是无意中犯下的，但不可忽略的数字是严重的，重复的违规行为（9.5%），因此表明一定的疏忽，也许是由于对某些可能危及患者机密性的行为的无知。本文的在线版本（doi：10.1186/s12910-016-0136-y）包含补充材料，可供授权用户使用。
Respect for confidentiality is important to safeguard the well-being of patients and ensure the confidence of society in the doctor-patient relationship. The aim of our study is to examine real situations in which there has been a breach of confidentiality, by means of direct observation in clinical practice. By means of direct observation, our study examines real situations in which there has been a breach of confidentiality in a tertiary hospital. To observe and collect data on these situations, we recruited students enrolled in the Medical Degree Program at the University of Cordoba. The observers recorded their entries on standardized templates during clinical internships in different departments: Internal Medicine; Gynecology and Obstetrics; Pediatrics; Emergency Medicine; General and Digestive Surgery; Maxillofacial Surgery; Plastic Surgery; Orthopedics and Traumatology; Digestive; Dermatology; Rheumatology; Mental Health; Nephrology; Pneumology; Neurology; and Ophthalmology. Following 7138 days and 33157 h of observation, we found an estimated Frequency Index of one breach per 62.5 h. As regards the typology of the observed breaches, the most frequent (54,6 %) were related to the consultation and/or disclosure of clinical and/or personal data to medical personnel not involved in the patient’s clinical care, as well as people external to the hospital. As regards their severity, severe breaches were the most frequent, accounting for 46.7 % of all incidents. Most of the reported incidents were observed in public areas (37.9 %), such as corridors, elevators, the cafeteria, stairs, and locker rooms. In addition to aspects related to hospital organization or infrastructure, we have shown that all healthcare personnel are involved in confidentiality breaches, especially physicians. While most are committed unintentionally, a non-negligible number are severe, repeated breaches (9.5 %), thus suggesting a certain carelessness, perhaps through ignorance about certain behaviors that can jeopardize patient confidentiality. The online version of this article (doi:10.1186/s12910-016-0136-y) contains supplementary material, which is available to authorized users.
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