Confidentiality breaches in clinical practice: what happens in hospitals?
Autor
Beltrán Aroca, Cristina María
Girela López, Eloy
Collazo Chao, Eliseo
Montero-Pérez-Barquero, Manuel
Muñoz-Villanueva, María del Carmen
Editor
BMC (Springer)Fecha
2016Materia
Professional ethicsProfessional-patient relationship
Confidentiality
Privacy
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Background: 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.
Methods: 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.
Results: 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.
Conclusions: 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.