A nurse is reviewing the medical records of S clients at a local clinic.

The charge nurse reviews the medical records for the 5 clients and notifies the provider of the laboratory reports. Which of the following clients who have communicable diseases should the nurse report as required by law?
Select the 3 clients that the nurse should report.

Rationale:

A. Teaching about a prescribed diet is within the scope of practice of a dietitian or nurse. They can provide instructions on dietary modifications, restrictions, and nutritional counseling, which do not require a social worker’s involvement.

B. Assisting with range-of-motion exercises is part of physical therapy or nursing care. Physical therapists assess and implement mobility and exercise programs to improve function and prevent complications such as pneumonia or deep vein thrombosis.

C. Teaching about home oxygen is typically managed by a nurse or respiratory therapist, who can educate the client and family on safe oxygen use, maintenance of equipment, and monitoring oxygen saturation at home.

D. Arranging financial resources to purchase medications is an appropriate reason to involve a social worker. Social workers help clients identify and access financial assistance programs, insurance benefits, or community resources. They also provide guidance on navigating healthcare systems and overcoming socioeconomic barriers that might affect the client’s adherence to treatment and overall recovery.

Rationale:
A. Discussing the incident with another staff nurse is inappropriate because it spreads information about the breach and does not address the issue directly. Confidentiality violations should be handled professionally and promptly with the individuals involved or through appropriate supervisory channels.

B. Reporting the staff members’ actions to the state board of nursing is excessive as a first step. State boards handle serious violations of nursing practice or legal regulations, but minor breaches of confidentiality are typically managed within the facility through counseling, education, or supervisory intervention first.

C. Counseling the staff members about the breach of confidentiality is the correct first action. The nurse should address the issue promptly by reminding staff of the Health Insurance Portability and Accountability Act (HIPAA) regulations and the organization’s policies on protecting patient information. Immediate corrective action at the unit level helps prevent further breaches and reinforces professional standards.

D. Filing a grievance report is not the first step. Grievances are formal complaints that may be used if counseling or direct intervention fails. Immediate, direct counseling is more appropriate for addressing a specific, observable incident like this.