Patient Mobile and Recording Devices Management …€¦ · Web viewThis includes the device...

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Canberra Hospital and Health ServicesOperational ProcedurePatient Mobile and Recording Devices: Management and UseContents

Contents...................................................................................................................................1

Purpose.................................................................................................................................... 3

Alerts........................................................................................................................................3

Scope........................................................................................................................................3

Section 1 – Consumers use of mobile devices..........................................................................4

Section 2 – Legislation..............................................................................................................5

1. Consumers’ Rights:...........................................................................................................5

2. CHS Staff Responsibilities:................................................................................................5

3. Legislation:....................................................................................................................... 5

Section 3 – Recording by consumers at CHS Facilities..............................................................6

1. Initial Response:............................................................................................................6

2. Escalation:..................................................................................................................... 6

Section 4 – Recording at Non-CHS facilities..............................................................................8

1. Initial Response:...............................................................................................................8

2. Escalation:........................................................................................................................9

Section 5 – Documentation......................................................................................................9

1. General.............................................................................................................................9

2. Response and Escalation................................................................................................10

3. Conditional Treatment Agreement (CTA).......................................................................10

Implementation......................................................................................................................10

Related Policies, Procedures, Guidelines and Legislation.......................................................11

References..............................................................................................................................11

Definition of Terms.................................................................................................................12

Search Terms..........................................................................................................................12

Attachments...........................................................................................................................12

Attachment 1 – Flow Chart for responding to recording at CHS Facilities..........................14

Attachment 2 – Flow Chart for Home Visits.......................................................................15Doc Number Version Issued Review Date Area Responsible PageCHS18/251 1 18/12/2018> 01/12/2022 Health Policy and

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Do not refer to a paper based copy of this policy document. The most current version can be found on the ACT Health Policy Register

CHHS18/251

Doc Number Version Issued Review Date Area Responsible PageCHS18/251 1 18/12/2018> 01/12/2022 Health Policy and

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Purpose

To outline the acceptable use of mobile and recording devices by consumers accessing a Canberra Health Services (CHS) service in order to: protect the safety and privacy of all consumers and CHS Staff, ensure that consumer’s rights are upheld regarding their use of privately owned mobile

devices, and ensure the safe and proper functioning of medical equipment.

This procedure sets out the appropriate response and escalation process for CHS staff when a consumer creates unauthorised recordings (images, audio or audio-visual) of CHS staff and/or other consumers. Refer to Scope section below for further information.

Alerts

If a consumer is aggressive or violent towards staff, or if the staff at any stage fears for their own well-being, or the well-being of other staff or consumers, they should immediately: Remove themselves from the situation if possible, and Dial “2222” and call a Code Black if on the Hospital campus, or Dial “0-000” in an emergency or from other Canberra Health Service facilities or in the

community, and Activate a personal duress alarm if available.

Scope

This procedure applies to all consumers (patients, relatives and visitors) accessing CHS services, both at CHS facilities and offsite in the community (e.g. in a consumer’s home). Refer to Home Visiting Procedure for further information on care at a person’s private residence.

It relates to the unauthorised recording of other consumers or of CHS staff in their capacity as employees during the normal course of their work duties.

It does not apply to CHS employees or visiting health professionals using devices for clinical purposes. Relevant staff and employees must comply with the Mobile Communications Device: Management and Use Procedure.

Mental Health, Justice Health, Alcohol and Drug Services (MHJHADS) inpatient facilities (Dhulwa Mental Health Unit (DMHU), Adult Mental Health Unit (AMHU), Adult Mental Health Rehabilitation Unit (AMHRU) and Adult Mental Health Day Stay (AMHDS) have specific information relating to the use of personal electronic devices.


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For further information specific for MHJHADS facilities refer to area specific procedures for further information including: DMHU Prohibited and Restricted Items and Items Requiring Approval Procedure, DMHU Searching Policy and Procedure, AMHU Operational Procedure, and Searching on Admission to Brian Hennessy Rehabilitation Centre Procedure.

Back to Table of Contents

Section 1 – Consumers use of mobile devices

Consumers accessing CHS services (including CHS facilities and offsite in the community) are likely to own and have access to mobile devices with the capacity to record audio, images and audio-visual.

However, sometimes there are specific situations whereby the use of mobile and recording devices by consumers may interfere with the safe and proper function of medical equipment, or may pose risk to CHS employees and other consumers who may be recorded without providing their consent.

The ACT Government does not accept any liability for damage to any device owned by a consumer, including loss or damage to data and applications, which is brought on to a CHS site. This includes the device itself, device case, charger, keyboard, docking station, Bluetooth attachment, stylus and/or any other related equipment.

Consumers are increasingly using their mobile technologies to enhance the interaction they have with their clinical team and support themselves in their ongoing health journey – we support this. It is an important tool which can support consumers to follow their own treatment plan, improved self-management and recovery and the interactions they have with their health care team.

Consumers should gain permission from the Clinical Nurse/Midwife Consultant (CN/MC) or Manager to use mobile and recording devices in patient care areas. Where use is permitted, the device should be used a minimum distance of two metres from all electronic medical equipment whilst the mobile and recording device is switched on. Consumers should comply with signs which state that mobile communication devices (or mobile phones) must be switched off. Patients and visitors should switch off these devices or put into "flight mode" within ward areas of the hospital to prevent radio frequency (RF) transmission. CHS staff should request that such devices are switched off, or removed from the area if interference with clinical equipment occurs.



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Section 2 – Legislation

1. Consumers’ Rights:CHS aims to operate in accordance with Australian Charter of Healthcare Rights. Consumers accessing CHS services have a right to: access safe, high quality health care, be treated with respect, dignity and consideration, be properly informed and included in decisions about healthcare and be able to provide

feedback that is responded to, and privacy and confidentiality.

All CHS staff will consider these rights when applying this procedure, and ensure that consumers’ rights are upheld.

2. CHS Staff Responsibilities:CHS and its staff have several duties of care while carrying out their clinical work. These include: Duty of a health care provider – duty to administer reasonable treatment and care to a

person accessing health services Duty of an occupier of a premises – duty to exercise reasonable care for the safety of

those on the premises Duty of an employer of staff or colleagues – duty to do everything reasonably practicable

to minimise or eliminate risks to health and safety of any person, including employees, patients and visitors.

3. Legislation: Under the Health Records (Privacy and Access) Act 1997, any recording of a healthcare consumer is classified as a health record. Recordings made without permission by someone in the course of their work duties as a health service provider constitute a breach of that patient’s privacy under the Act, however private individuals are not bound by these principles.

Recording a private conversation (both audio and audio-visual, but not video alone) without the consent of all parties is an offence under the Listening Devices Act 1992, unless the recording is made when the recorder believes it is “necessary for the protection of (...their...) lawful interest”. For this reason, it may be difficult to prosecute a consumer who uses this defence, however, the escalation procedures outlined in Section 4 should still be followed if the person being recorded did not provide consent.

The Criminal Code Act 1995 prohibits the use of a carriage service (i.e. broadcasting and telecommunications) to menace, harass, or cause offence. If the CHS staff member fears that an unauthorised recording may be used to distribute in a way that they would find harassing or offensive, it may be referred to ACT Policing.


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Within a private residence, there is currently no legislation which prohibits a person filming another individual in their own home, even if that person is providing a health service. There are principles contained in the Information Privacy Act 2014 and the Privacy Act 1988 which regulate the collection of personal information, however, private individuals are not bound to comply with these principles.


Section 3 – Recording by consumers at CHS Facilities

The use of technology to enhance a consumer’s health care experience is encouraged. Recordings (audio, visual or audio-visual) can be a useful tool for consumers to keep track of their progress or document required actions in relation to their care. A consumer (or their relative/visitor with consent from the consumer) may create recordings relating to their own care as long as: No other consumer is included in the recording No CHS staff member is included in the recording without their consent The consumer has been authorised to use their mobile device in the relevant care area

by the area Manager or CN/MC as per section 1.

If the consumer records a staff member with their consent as part of this process, this should be documented in the consumer’s clinical record. The staff member being recorded should also give their consent at the beginning of the recording and should state their name, the date of recording and the purpose of the recording (e.g. to demonstrate changing a wound dressing). This is to ensure that the consumer also has a record of the consent.

Note: This does not relate to recordings of a consumer by a staff member for clinical purposes. Refer to Photos, Video and Audio: Capture Storage Disposal and Use Procedure.

1. Initial Response:Any staff member who is recorded while carrying out their work duties without their consent, or is notified by a consumer of unauthorised recordings should politely ask the consumer to stop, and request they delete all recorded material.

2. Escalation:Alert:If a consumer is aggressive or violent towards staff, or if the staff at any stage fears for their own well-being, or the well-being of other staff or consumers, they should immediately: Dial “2222” and call a Code Black if on the Hospital campus, or Dial “0-000” in an emergency or from other CHS facilities or in the community, and Activate a personal duress alarm if available.

2.1 If the consumer continues to record without consent or refuses to delete recorded material, the staff member should:


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Escalate to their manager or Clinical Nurse/Midwife Consultant (CN/MC) who will advise the consumer of the provisions under the Listening Devices Act 1992 and Criminal Code Act 1995 as described above.

In some cases, the CN/MC may request that the treating medical team develops a conditional treatment agreement (CTA) with the consumer (see Section 5 – documentation).

2.2 If the consumer is a patient, and fails to comply with direction of the manager or CN/MC:2.2.1 A decision may be made by the Chief Executive Officer (CEO) or delegate to

withhold non-emergency treatment and direct them to leave the hospital. The matter should be escalated in accordance with the procedures outlined in the Violence and Aggression by Patients Consumers or Visitors Policy and Procedure. Consideration will be given as to:

o The seriousness of the patient’s presentationo The urgency of requirement for treatmento An assessment of the patient risk to others, including staff, who are in

the vicinity and are at risk.

Note: The decision to withhold treatment in response to non-compliance with this procedure can only be made by the CEO in consultation with the treating medical team. See Violence and Aggression by Patients Consumers or Visitors Policy and Procedure.

It should be made clear to the consumer that their remaining time on CHS premises and receiving treatment is dependent on their compliance with the direction of staff to cease unauthorised recording/image capture.

A direction to leave can be given by an authorised person according to section 154 of the Crimes Act 1900. The Executive Director, Infrastructure Management and Maintenance, the Director, Client Services, Security and Emergency and the Senior Manager, Protective Services have delegated legislated responsibility to nominate authorised persons. For a full list of authorised persons, contact the Senior Manager, Protective Services. The direction of authorised persons will be enforced by Security staff. If the person refuses to leave after such a direction without reasonable excuse, the matter may be referred to ACT Policing. Further information can be found in the Violence and Aggression by Patients or Consumers Procedure.

2.2.2 Staff may issue a direction that the device either needs to be given into the possession of a family member or friend to remove from the premises, or CHS will take possession of the device for the duration of their stay if: A consumer fails to comply with a direction to cease recording/taking

photographs AND They are either receiving emergency treatment, OR


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The individual circumstances to not justify a direction being given to the consumer to leave CHS premises.

Note: Removing a mobile device should only be considered if no other option is available to ensure the safety and privacy of all consumers and staff. Removing a mobile device may pose an increased risk to consumers, e.g. they are unable to contact their family/friends, they cannot easily contact the CARE escalation phone line.

Staff may offer, or request to take possession of the item, label with the consumer’s identification and store in a designated valuables safe. Staff should contact the manager or CN/MC of the ward or area to identify the appropriate safe if uncertain. All parts of the device/item should be labelled and stored together (e.g. mobile phone and charger).

The item must then be returned to the consumer on discharge. Two members of staff should witness, document and co-sign storage of the

removed item in the clinical record and relevant registers, e.g. consumer’s valuables book. Refer to Protective Security (Patient Valuables and Lost Property) Procedure for more information.

Note: CHS owes a duty of care to the owner of property that has been relinquished. This duty requires staff to exercise reasonable care to avoid damage or loss. Any actions taken regarding requests to hand over personal devices (including circumstances giving rise to the request) and its removal, storage and ultimate return to the patient should be documented in the clinical record.

2.3 If the consumer is a visitor or relative of a patient, and does not comply with the direction of CHS staff: As stated above, a direction to leave can be given by an authorised person according

to section 154 of the Crimes Act 1900. Authorised persons at CHS include EDs, DDGs or DG, and their direction will be enforced by Security staff. Other CHS staff (e.g. manager or CN/MC) may ask the consumer to leave the premises, though without mentioning the Crimes Act. If the person refuses to leave after such a direction without reasonable excuse, the matter may be referred to ACT Policing. Further information can be found in the Violence and Aggression by Patients or Consumers Procedure.

Refer to attachment 1 for a flow chart which summarises the escalation process in the case of unauthorised recording.



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Section 4 – Recording at Non-CHS facilities

1. Initial Response:Any staff member who is recorded while carrying out their work duties without their consent, or is notified by a consumer of unauthorised recordings should politely ask the consumer to stop, and request they delete all recorded material. 2. Escalation:Alert:If a consumer is aggressive or violent towards staff, or if the staff at any stage fears for their own well-being, or the well-being of other staff or consumers, they should immediately: Dial “2222” and call a Code Black if on the Hospital campus, or Dial “0-000” in an emergency or from other CHS facilities or in the community, and Activate a personal duress alarm if available.

2.1 If the consumer continues to record without consent, or refuses to delete the recorded material, the staff member should: Remove themselves from the situation as soon as practicable.

o When the staff member judges no immediate risk or threat of harm, they should continue to provide the planned care before removing themselves.

o If the staff member feels an immediate risk to their safety or believes the recording is being made to be distributed in a way which they would find harassing or offensive (as per the Criminal Code Act 1995), they should remove themselves from the situation immediately.

Escalate to their manager or CNM/C, who should review provision of care based on any risk to staff that may be associated with the unauthorised filming.

For example, if it is decided that the unauthorised filming of staff by consumers during community home visits poses a risk to the mental health or general well-being of the staff member, a decision may be made to consider alternative treatment arrangements, and have the consumer attend a CHS facility, where the principles in section 2 would apply. Refer to Home Visit Procedure for details on risk management.

Refer to attachment 2 for a flow chart which summarises the escalation process in the case of unauthorised recording.



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Section 5 – Documentation

1. GeneralUpon admission to a CHS facility, consumers are required to sign a “General Conditions of Admission” form (available on the Forms Register) which contains a clause stating CHS right to detain personal property if it is considered to pose a threat to the safety of an individual including consumers and staff.

If the consumer records a staff member with their consent as part of this process, this should be documented in the consumer’s clinical record. The staff member being recorded should also give their consent at the beginning of the recording and should state their name, the date of recording and the purpose of the recording (e.g. to demonstrate changing a wound dressing). This is to ensure that the consumer also has a record of the consent.

Signage must be present throughout CHS facilities regarding the use of mobile devices, specifically highlighting acceptable functions of use, and authorised areas of use (i.e. mobile devices are not to be used within certain areas of the hospital such as medical imaging or theatres).

2. Response and EscalationAll conversations related to the unauthorised recording of staff or other consumers should be documented in the clinical record, and in the incident reporting module of Riskman. Any specific threats to staff should be documented in the Staff Accident and Incident Reporting (SAIR) system. Documentation should include: The date and time of the conversation Who was present during the discussion The content of the discussion including:

o Directions to the consumero Advised consequences of non-compliance with the direction, including the possible

effect of not receiving treatment on the person’s treatment regime and personal health circumstances

What the agreed outcomes were Circumstances in which the clinician made a decision to cease providing treatment

(particularly in the community when the Clinician departed the premises) The clinician’s referral of the matter to their CN/MC/manager information and warnings provided to the consumer and the consumer’s responses.

3. Conditional Treatment Agreement (CTA)Consumers receiving a health service may also be asked to develop and sign a conditional treatment agreement (in consultation with their treating medical team), which is documented in their clinical notes (refer to Violence and Aggression by Patients Consumers or Visitors Procedure for further information). This agreement outlines: The roles and responsibilities of both the CHS staff and the consumer; and


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What the implications and possible outcomes are if the consumer fails to comply with the signed agreement.

Documenting the conversation in this way ensures that the conversation is clear and transparent, and that the CHS employee has done everything as appropriate to de-escalate and resolve the situation before resorting to a withdrawal of treatment as outlined in section 3, above.


Implementation

Managers, supervisors and team leaders are responsible for advising staff of the process for ensuring the safe and acceptable use of mobile devices by consumers. Consumers are informed of this through the CHS Inpatient Guide and on the General Conditions of Admission form.

Signage to be implemented throughout CHS facilities advising of areas not suitable for mobile device use.


Related Policies, Procedures, Guidelines and Legislation

Legislation Health Records ( Privacy and Access) Act 1997 Listening Devices Act 1992 Workplace Privacy Act 2011 Criminal Code Act 1995 Crimes Act 1900 Human Rights Act 2004 Information Privacy Act 2014 Privacy Act 1988 Mental Health Act 2015

Policies ACTPS – Use of Recording Devices Policy ACT Government Social Media Policy DMHU Searching Policy Violence and Aggression by Patients Consumers or Visitors Policy

Procedures: Mobile Communication Devices – Management and Use Procedure Photos Video and Audio Capture Storage Disposal and Use Procedure Violence and Aggression by Patients Consumers or Visitors Procedure DMHU Prohibited and Restricted Items and Items Requiring Approval Procedure


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DMHU Searching Procedure AMHU Operational Procedure Searching on Admission to Brian Hennessy Rehabilitation Centre Procedure

Standards Australian Charter of Health Care Rights (2008) Australian Council of Healthcare Standards, National Safety and Quality Health Service

Standards: 1 (Governance) & 2 (Partnering with Consumers), (2013) Australian Privacy Principles (2014) Privacy Policy, APHRA (2014)


References

1. Irnich, W. & Tobisch, R. (1999). Mobile phones in hospitals. Biomed Instrum Technol, vol 33, pp 28 – 34.

2. Lawrentschuk, N. & Bolton, D. (2004). Mobile phone interference with medical equipment and its clinical relevance: A systematic review. MJA, vol 181, no 3, pp 145 – 149.

3. Rodriguez, M., Morrow, J. & Seifi, A. (2015). Ethical implications of patients and families secretly recording conversations with physicians. Journal of the American Medical Association, vol 313, no 16, pp 1615 – 1616.

4. Tsulukidze, M., Grande, S., Thompson, R., Rudd, K. & Elwyn, G. (2015). Patients covertly recording clinical encounters: Threat or opportunity? A qualitative analysis of online texts. PLoS ONE, vol 10, no 5.

5. Wright, J. (2015). Mobile phone policy. Clinical Governance Directorate, NSLHD. Sydney.


Definition of Terms

Emergency Treatment: Treatment provided to prevent significant morbidity or mortality, where the withdrawal of such treatment could reasonable cause serious harm, injury, disability or death to the individual.

Consumer: Any person accessing an CHS service, including patients, relatives and visitors.

Mobile and recording devices: Any personal electronic device, or device capable of creating an audio or visual recording. Including, but not limited to, mobile telephones, smart phones, iPads, iPhones, tablet computers, laptop computers and small handheld devices.


Search Terms


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Mobile, recording, devices, device, film, filming, video, image, consent, record, photo, photograph, iPad, tablet.


Attachments

Attachment 1 – Flow Chart for Responding to Recording at CHS FacilitiesAttachment 2 – Flow Chart for Home Visits Responding to Recording at CHS Facilities

Disclaimer: This document has been developed by Canberra Health Services specifically for its own use. Use of this document and any reliance on the information contained therein by any third party is at his or her own risk and Canberra Health Services assumes no responsibility whatsoever.

Policy Team ONLY to complete the following:Date Amended Section Amended Divisional Approval Final Approval

This document supersedes the following: Document Number Document Name


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Attachment 1 – Flow Chart for responding to recording at CHS Facilities


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Attachment 2 – Flow Chart for Home Visits


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Patient Mobile and Recording Devices Management …€¦ · Web viewThis includes the device...

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