Because of the role nursing students play in the provision of healthcare, the HIPAA guidelines for nursing students are straightforward. Nonetheless, there have been cases in which nursing students have unintentionally violated HIPAA regulations due to a lack of appropriate HIPAA training – suggesting more than mandated HIPAA training may be necessary.
When nursing students start on the path to becoming a Registered Nurse, there is a lot to absorb. Depending on the path being taken (ADN or BSN) there is either two years or four years of coursework to complete, during which time they have to develop all the knowledge and skills required to enter the healthcare industry as full-time professionals.
During their education, nursing students are frequently exposed to Protected Health Information (PHI) during clinical rotations. Therefore, it is important nursing students understand at an early stage of their education what the HIPAA guidelines for nursing students are to avoid unintentional violations of HIPAA regulations that could impact their future nursing careers.
What are the HIPAA Guidelines for Nursing Students?
The HIPAA Privacy Rule doesn´t differentiate between nursing students and other members of a Covered Entity´s workforce – defining workforces as “employees, volunteers, trainees, and other persons whose conduct, in the performance of work for a Covered Entity, is under the direct control of such Covered Entity, whether or not they are paid by the Covered Entity”.
Consequently, the HIPAA guidelines for nursing students are the same as for other members of a Covered Entity´s workforce inasmuch as nursing students must be trained on policies and procedures with respect to PHI as necessary and appropriate to carry out their functions compliantly, and are subject to sanctions for failing to comply with the policies and procedures.
The initial HIPAA training for nursing students must be provided within a within a reasonable period of a nursing student joining a Covered Entity´s workforce, and further training provided when a material change affects the Covered Entity´s policies and procedures, when a risk assessment identifies a need for training, or when training is a requirement of an OCR corrective action plan.
What Further HIPAA Training Should be Provided?
In addition to the Privacy Rule HIPAA guidelines for nursing students, Covered Entities are required by the Security Rule to implement a security awareness and training program for all members of the workforce to ensure the confidentiality, integrity, and availability of electronic PHI (ePHI). The content of the training program should be determined by a risk analysis.
However, for nursing students to best understand security awareness training – and comply with the policies and procedures implemented to control access to ePHI – it is important they have an understanding of HIPAA basics such as what constitutes PHI/ePHI, when can PHI/ePHI be used or disclosed without authorization, and the Minimum Necessary Standard when PHI/ePHI is disclosed.
These topics are not necessarily covered in Privacy Rule HIPAA training, so it is important nursing students are taught the basics of the HIPAA Rule early in their education to prevent unintentional HIPAA violations. In addition, refresher training should be provided on an annual basis to ensure students´ knowledge of HIPAA is maintained as they continue on the path towards qualification.
The Importance of Annual HIPAA Refresher Training
In addition to the risk of unintentional HIPAA violations due to a lack of knowledge or information overload, nursing students can be exposed to non-compliant workplace cultures, conflicting information provided by different nurse educators, and clinical situations in which their lack of experience results in responses that do not align with the Covered Entity´s policies and procedures.
Because of these influences, nursing students can adopt poor HIPAA practices which may result in HIPAA violations – not only potentially impacting their future nursing careers, but also the privacy of patients whose PHI has been exposed. There could also be consequences for the Covered Entity if a violation or patient compliant is investigated by the HHS´ Office for Civil Rights (OCR).
Annual HIPAA refresher training mitigates the risk of HIPAA violations attributable to a lack of knowledge, information overload, or negative influences by delivering training in bite-sized modules that can be taken online at a convenient time. It is also a cost-effective way for Covered Entities to improve their compliance posture in the event of an OCR investigation.
Whose Responsibility is it to Provide HIPAA Training for Nursing Students?
Because they provide healthcare, counselling, and/or assessment services, most post-secondary institutions are classified as “hybrid entities” under HIPAA (the exception being academic medical centers). This means only the care component of the institution´s activities is subject to HIPAA and the institution is not responsible for providing HIPAA training for nursing students.
Only colleges and universities that offer ADN and BSN courses AND involve nursing students in on-campus clinical rotations are classified as Covered Entities for the purposes of providing HIPAA training. Otherwise, the healthcare facilities at which clinical rotations occur have the responsibility for providing HIPAA training to nursing students.
This means, in the majority of circumstances, that the healthcare facility is the Covered Entity who has “direct control” of nursing students. Consequently, the healthcare facility has the responsibility to provide nursing students with all HIPAA-mandated training, “material change”, risk assessment, and corrective action training, and annual refresher training to avoid unintentional HIPAA violations attributable to a lack of knowledge, information overload, or negative influences.
HIPAA Guidelines for Nursing Students: Notes
- In some jurisdictions, state law preempts HIPAA, and this may impact responsibility for providing training. For example, in Texas, all post-secondary institutions are classified as Covered Entities under the Texas Medical Records Privacy Act.
- Under 45 CFR §164.530, all training must be documented along with the reason why it was provided. The documentation must be retained for a minimum of six years (longer in some states) in case of an audit or investigation by the OCR.
- This case study provides an example of how nursing students can unintentionally violate HIPAA regulations and what the consequences can be. It also demonstrates how annual refresher training can avoid such scenarios – and additional work for compliance personnel.