NORTHBAY MEDICAL CENTER

Report ID: UGLB11.02, California Department of Public Health

Reported Entity: NORTHBAY MEDICAL CENTER

Issue:

Based on observations and interviews the facility failed to ensure visual and auditory privacy for three out of five patients (Patient 1,2,3) when patients were assessed and treated in the hallway of the emergency room. This failure resulted in other people observing personal medical treatment and hearing personal healthcare information. Findings:During an interview on 2/27/14 at 11:00 a.m., Patient 1 stated that when she was seen in the Emergency Department, she was seated in the hallway. She stated that the Doctor was talking about her information where everyone else could hear. There were no curtains separating the patients. It was a wide open area. "I didn't have any privacy". During an observation on 2/28/14 at 4:15 p.m., a patient was seated in the hallway with a staff member placing a 4X4 (gauze dressing) onto the patients left knee. During an interview on 2/28/14 at 4:50 p.m., Staff A stated if a patient is in the hallway we use a quiet voice for privacy. We ask the patient when they are coming back if they mind sitting in the hallway. We do not put inappropriate patients in the hallway, such as abdominal pain or female issues. The doctor can take the patients to the doctors' room if needed.During an interview on 3/4/14 at 9:15 a.m., Staff B stated that they ask if the patient does not mind sitting in the hallway, if it is a private issue we will put them in a room.During an interview on 3/4/14 at 9:55 a.m., Staff C stated if a patient was in the hallway I would ask if it was OK to talk in the hall. If I had to discuss something in private I would ask to whisper.During an interview on 3/4/14 at 1:05 p.m., Administrative Staff D stated that the facility was working on building another patient care area in the Emergency Department, so that the patients would not have to be seen in the hallway.During an observation on 5/7/14 at 3:10 p.m., the Emergency Department's waiting room has a walled area in place, to separate the waiting room area from the new patient care area. In a concurrent interview Administrative Staff E stated that the facility was waiting for the screens to come in before they can use the walled off area to see patients. Administrative Staff E pointed out that the new patient chairs had come in. The chairs were in the hallway of the emergency room, and a patient was sitting in one of them.During an observation on 5/7/14 at 3:20 p.m., there were patients sitting in the emergency room hallway, in chairs with a label over the chairs identifying each one with a number. There were no screens or dividers separating the patients in the hallway. During an interview on 5/7/14 at 3:25 p.m., Patient 2 stated the doctor saw her in the hallway, and that they tried to draw her blood three times in the hall. Patient 2 complained that she did not have any privacy. "I've never been to a hospital where I was put in the hallway. During an interview on 5/7/14 at 3:30 p.m., Patient 3, who had come to the emergency department for a bladder infection, stated that she was "a little uncomfortable" discussing her symptoms in the hallway and wanted to talk in private but she did not say anything because she wanted the doctor to see her. Patient 3 stated that no one asked her if she would mind sitting in the hallway.During an interview on 5/7/14 at 4:30 p.m., Unlicensed Student F stated that she had brought Patient 3 back into the hallway and had questioned her about her symptoms. Patient 3 had complained of burning upon urination. Unlicensed Student F stated that she had sat next to Patient 3 (sitting in between Patient 3 and Patient 4). While Unlicensed Student F was questioning Patient 3, the woman next to her (Patient 4) asked Unlicensed Student F, "What's wrong with her? Is she contagious?" Unlicensed Student F admitted that she had not asked Patient 3 if she would mind sitting in the Hallway. In a concurrent interview Staff G stated that the Triage Nurse was the one who was to ask patients if they would mind sitting in the hallway.During an interview on 5/7/14 at 4:40 p.m., Staff H stated that she would not always ask patients if they were comfortable sitting in the hallway unless she knew that they would be seen in the hallway.During an interview on 5/27/14 at 11:20 a.m., Administrative Staff I stated that they did not have a written policy and procedure for seating patients in the hallway. We instruct the staff on what to do (when they seat patients in the hallway), but the patients in the hallway are treated like all of the other patients in the Emergency Department.During an interview on 6/2/14 at 4 p.m., Administrative Staff E stated that the only thing the facility has in regards to privacy is in the Standards of Professional Nursing Practice, under Patients' Rights, which talks about patient confidentiality.In a record review labeled "Professional Nursing Practice, Patients' Rights" dated 4/12 indicates that the RN's will ... protect their (patients) right to confidentiality.

Outcome:

Deficiency cited by the California Department of Public Health: Patients' Rights

Related Reports:

The report containing this deficiency also includes information about 1 other violation. Note that these may be related to the same event: UGLB11.01