Ethical and nursing informatics practice standards within the context of healthcare delivery.

Analyze ethical and nursing informatics practice standards within the context of healthcare delivery.

Scenario
You are a nursing manager of the education and innovations department at a large nonprofit academic medical center. You do work at the flagship hospital, but there are three additional campuses and several affiliated facilities throughout three additional states. Therefore, technology is heavily relied upon for consistent and reliable communication for interdisciplinary care. Recently, the CNO sent you a patient satisfaction survey highlighting how impressed this patient was with their nurse’s timeliness of answering their questions. The patient continued to share that the nurse used their personal cell phone to reach out to the patient’s provider to get clarification of the patient’s discharge instructions. The patient loved their quick response and wanted to highlight this as a best practice for all healthcare professionals.

Instructions
You have just completed a technology usage assessment of the healthcare staff across departments, and it has come to your attention that several nurses occasionally communicate with medical providers through text on their personal cell phones, using their phone’s messaging service. The nurses found that they are able to meet their patient needs more quickly. Your assessment also discovered that a nurse used their personal cell phone to take a picture of a patient’s foot ulcer. The picture was posted on social media as a reminder to diabetics the importance of managing their blood sugars. As the nursing education manager it is your responsibility to ensure staff are following the hospital polices and your technology assessment has highlighted that the staff is in urgent need of HIPAA training and Smart Phone use.

Using the scenario above create a mandatory training for all staff using PowerPoint:
1. Voice over- recording of the PowerPoint.
2. Graphics- pictures
3. Bullet Point
4. Speaker Note: this is the information you will discuss from your bullet points.

The education including the following:
• Thoroughly examine personal Smart Phone (this is your phone, not the hospital phone) use and its implications in Healthcare
• Identify and explain a minimum of 3 unethical uses of Smartphones in healthcare (including text messaging and pictures)
• Discuss potential benefits to appropriate Smartphone use in healthcare
• Thoroughly examine judicious use of Social Media and its implications in Healthcare
• Potential benefits to appropriate use of Social Media in healthcare
• Identify a minimum of 3 unethical uses of Social Media (as reviewed by NCSBN)
• Thoroughly describe regulatory bodies and Ethical Frameworks used to protect Personal Health Information (PHI)
• Investigate the role of HIPAA, HITECH, and Nursing Code of Ethics
• Determine the legal consequences associated with unethical or illegal Smart Phone and Social Media use.

Sample Answer

This scenario highlights critical breaches in privacy, security, and professional conduct stemming from the misuse of personal technology in a healthcare setting. As the Nursing Education and Innovations Manager, your mandatory training must be comprehensive, clear, and strongly emphasize legal and ethical boundaries.

Here is the outline for the mandatory staff training PowerPoint presentation, including slide content, speaker notes, and graphic prompts.

Slide 2: Personal Smart Phone Use in Healthcare

Element	Content	Graphic
Title	Personal Smart Phone Use: High Risk, High Reward
Bullet Points	* Smart Phones are NOT secure or compliant for Protected Health Information (PHI).
	* Implication 1: PHI Breach Risk: Personal devices lack institutional encryption, firewalls, and audit trails.
	* Implication 2: Unprofessional Conduct: Blurring personal and professional lines can damage patient trust.
	* Hospital Policy: All clinical communication regarding patient care must occur through approved, secure, hospital-provided platforms (e.g., Vocera, secured messaging apps, EMR).
Speaker Note	The convenience of your personal device is understandable, as seen in the survey. However, that convenience introduces unacceptable risk. Your personal phone does not meet PHI security standards. If you text a provider about a patient, that PHI is now unencrypted and discoverable on a non-secure device. This is a direct violation of policy and federal law.

3. Slide 3: 🛑 Unethical Uses of Smart Phones in Clinical Practice

Element	Content	Graphic
Title	Unethical and Non-Compliant Smart Phone Use
Bullet Points	* 1. Texting PHI (The Scenario Breach): Using personal SMS to communicate patient details (names, labs, discharge needs) to providers. This is non-secure transmission and constitutes a breach.
	* 2. Unauthorized Patient Imaging (The Scenario Breach): Taking pictures/videos of patient wounds, X-rays, or personal characteristics without formal, documented consent for the purpose of medical record documentation on a personal device.
	* 3. Accessing Non-Clinical Material: Browsing personal social media or checking personal emails during direct patient care. Violates the Nursing Code of Ethics duty of primary commitment to the patient.
Speaker Note	Let's review the two breaches from our scenario. First: Texting a provider on a personal cell phone. This is a clear breach. Second: Taking a picture of a patient's foot ulcer on a personal phone. This is an immediate violation; the photo is now outside the EMR's security. All clinical imaging must be done using hospital-approved devices that upload directly to the EMR.

4. Slide 4: ✅ Benefits of Appropriate Smart Phone Use

Element	Content	Graphic
Title	Benefits of Appropriate Smart Phone Use
Bullet Points	* Quick Reference: Utilizing secure, vetted clinical apps (e.g., drug guides, medical calculators, lab value interpreters).
	* Point-of-Care Education: Accessing approved internal hospital resources and patient education materials.
	* Improved Time Management: Using approved hospital-provided secure messaging applications for internal team coordination (e.g., paging, internal chats).
Speaker Note	We recognize the value of smart devices as tools. When used appropriately—for non-PHI related tasks and clinical reference—they enhance care. The key is using institutionally vetted, secure applications and resources, never the native messaging or camera roll for PHI.

5. Slide 5: Judicious Use of Social Media

Element	Content	Graphic
Title	Social Media: Professional Boundary & PHI Protection
Bullet Points	* Social Media Implication: Any information shared is permanently public, easily searchable, and instantly shareable.
	* Professional Boundaries: Comments about work, colleagues, or patients can violate professional conduct standards and damage the hospital's reputation.