Diversity, Patient Rights and Confidentiality

“You have the Right” The Basic Rights all Patients are entitled to while entrusting their care to us.

This module will help you to: Consider the uniqueness of all your patients Understand what skills are necessary to respect a patient while giving care Ensure appropriate communication and confidentiality for all of your patients Identify resources you can use for developing these skills

Imagine yourself Waking in a hospital bed, in a strange room with other patients near by Seeing unfamiliar faces and realizing they all speak a different language than you Having people talk to you and about you with no idea what is being said Seeing looks, smiles, frowns, gestures that you think might be related to you, but you are uncertain Having people approach and touch you without a means to explain Being injected, or washed, or any other private or invasive procedure without being able to ask questions or state your preferences or limitations Hearing discharge instructions and teaching in a foreign language while someone points to a paper for you to sign

If the shoe were on the other foot… Would you feel respected? Would you consider that being treated in a dignified manner? Would you trust your caretakers? How would you know what was wrong and how to get better? Would you feel as though you had rights?

Use that perspective to help you think about and protect your patients’ Basic Rights! “How I would like to be treated ?”

Basic Rights To be treated with respect and dignity To have individual beliefs and values observed in the care environment To have all private and medical information handled confidentially To receive appropriate communication and be able to demonstrate understanding of that communication

Culture – Do you know what this means? The values, beliefs, norms, and practices of a particular group that are learned and shared and that guide thinking, decisions, and actions in a patterned way comprise a Culture

R-E-S-P-E-C-T Find out what it means to YOU! Know yourself – your own attitudes, beliefs, and even prejudices Keep an open mind Acknowledge and celebrate differences –all cultures and groups have strengths and weaknesses Don’t judge anyone because they are different

No Two People are Created Alike What are some of the key cultural differences? Communication – language, patterns, gestures and facial expressions, decision-making Personal Space – how close is too close? Social Organization – how a group mourns, celebrates, learns, lives, etc. Time – past, present, or future orientation Environmental Control – nature versus nurture

How do I become “Culturally Competent?” Resources exist at all hospitals! Know what is available and use them: Cultural Care Guides and books – they provide information about various groups and give practical and immediately usable advice Interpretive Services – know how to access and use Language Services – printed materials, visual aids HIPAA Guidelines – each institution has specific guidelines that ensure confidentiality for patients’ Protected Health Information. All employees, students, and volunteers are responsible for following these guidelines

A Few Words about HIPAA HIPAA (A National Act called the Health Insurance Portability and Accountability Act) is a regulation Congress has developed to protect all patients’ privacy. This law puts very strict limits on who can and cannot view a patient’s health information. We are all required by law to uphold these privacy standards!

A Few More Words about HIPAA To be HIPAA compliant, think “Minimum Necessary”. This means that you are only entitled to the minimum information necessary to perform fantastic patient care. This varies according to situation, unit, patient status, etc. Make sure you are only using the Minimum. !

Communication Barriers Cultural and language differences create unique communication barriers. Legally speaking, both Federal Law and Joint Commission (JCAHO) require hospitals to provide services to those with limited abilities to communicate – this can include sight, hearing, or inability to speak a common language (like English). Patients have the right to appropriate assistance with these barriers.

What is “appropriate assistance?” Each hospital has their own procedure for dealing with language barriers. This may include: live interpreters, telephone interpretive services, printed material in various languages, word cards for assistance with conversation, and steps for documenting the barriers and teaching despite the barriers. All language services are still subject to HIPAA guidelines and a patient’s right to privacy!

Some Basic Tips for Overcoming Initial Cultural or Communication Barriers Greet patients with their name – avoid being too casual or familiar Introduce yourself by pointing to yourself and saying your name Note and observe any hesitations or special requests (ie, no male caregivers for a female patient) Determine understanding by hearing person repeat or demonstrate instructions Do not talk to other staff in patient’s area using a language he/she will not understand Do not make assumptions about eye contact, space, gender issues or any other cultural factor based on your opinions. Seek understanding and resources!

Some Basic Tips for Overcoming Initial Cultural or Communication Barriers Pay special attention to any efforts made by the patient or family to communicate Use an available resource to get a “quick glimpse” into the patient’s culture or language Use available visual aids If language barrier exists that prevents this communication, seek interpretive services – continual attempts will only fail and add to frustration Maintain confidentiality by using “minimum necessary information” even with interpreter Continue to provide non- judgmental care!

Your Responsibility Offer culturally competent care Respect differences Maintain confidentiality Know and use your resources Ensure patient appropriate communication