Social Media and Nursing: Guidelines for Protecting Patient Privacy Online

Social media connects billions of people around the world, supporting relationships of all kinds. Nurses can use social media as a tool to connect with colleagues, follow industry leaders, and grow their networks. However, because nurses have access to sensitive information about patients, they must understand the Health Insurance Portability and Accountability Act (HIPAA) guidelines governing their social media activity.

Chapter 1: How Nurses Use Social Media

Social media offers many benefits unique to nurses, such as facilitating quick and convenient communication to better serve their patients. However, nurses’ social media usage varies widely.

Benefits of Social Media for Nurses

Social media allows nurses to:

• Foster professional connections
• Communicate with patients and family members in a timely manner
• Express feelings about their careers or workdays, reflect, and seek support [NCSBN]
• Overcome barriers in delivering health care to patients [NCBI]
• Follow conference highlights and health care agency alerts [PLOS]
• Engage with other nurses around the world [Healthy Nurse]

Social Media Usage Among Health Care Workers

• A 2017 survey of 366 health care workers in Texas found:
  • 97% of respondents owned an electronic device.
  • 88% of nurses used social media.
  • Health care workers averaged one hour on social media per day.
    • Less than 30 minutes per day: 32%
    • 31-60 minutes per day: 35.4%
    • 61-90 minutes per day: 16.8%
    • 91-120 minutes per day: 8.1%
    • More than two hours per day: 7.8%
  • Only 38.2% of nurses were aware of their hospital’s social media policies.
  • 5% spent less than 10% of their time on social media for work-related activities.
  • 7% indicated their social media usage was mostly work-related.
  • 3% said their use of social media was a waste of time. [NCBI]
• A 2018 survey of over 1,600 health care practitioners found:
  • 41% of nurses used social media for educational purposes.
  • 85% agreed that social media could be an effective educational tool.
  • Facebook was the most commonly used social media platform for any purpose:
    • Facebook: 27.7%
    • Pinterest: 17.38%
    • Instagram: 16.59%
    • Snapchat: 13.30%
    • LinkedIn: 9.68%
    • Twitter: 8.81%
  • Twitter users followed:
    • Conference highlights: 51%
    • Health agency alerts: 48%
    • Journal article alerts: 46%
  • 25% of Facebook users reported educational use.
  • Less than 10% used social media for research collaborations. [PLOS]

Chapter 2: HIPAA Guidelines for Social Media and Nursing

To avoid violating HIPAA regulations, nurses must be aware of how the law restricts their social media activity.

HIPAA Guidelines for Social Media Usage Among Nurses

• The HIPAA Privacy Rule prohibits:
  • Posting images or videos that could identify a patient
  • Posting text about specific patients
  • Posting protected health information (PHI) without the patient’s written consent
• Social media channels may be used to share:
  • Health tips
  • Event information
  • New medical research
  • Staff bios
  • Marketing messages [HIPAA Journal]

Common Social Media HIPAA Violations

• Posting gossip about patients
• Sharing photos or videos in which patients or PHI is visible
• Sharing photos, videos, or text containing PHI within a private group without patient consent
• Posting information that could potentially identify a patient [HIPAA Journal]

HIPAA Social Media Guidelines for Health Care Organizations

• Develop policies governing staff social media usage and ensure all employees are aware of how they relate to HIPAA.
• Offer training to teach staff how to use social media in compliance with HIPAA.
• Give examples of acceptable and unacceptable behavior on social media platforms.
• Communicate the penalties of violating social media policy.
• Review and update policies regularly.
• Require individuals to keep their personal and corporate social media accounts separate.
• Encourage staff to report potential HIPAA violations. [HIPAA Journal]

Chapter 3: How Nurses’ Social Media Behavior Impacts Patients

Social media misuse by nurses not only affects their patients but could also bring negative consequences to their employers.

The Effects and Consequences of Nurses’ Social Media Misuse

• A negative comment posted on social media about a co-worker may:
  • Affect their performance and team unity
    • Lead to poor quality care
  • Be constituted as lateral violence or cyberbullying
    • Lead to disciplinary action
  • Social media misuse may violate state and federal laws and lead to:
    • Employment consequences, including termination
    • Damage to the reputation of the nurse’s employer
    • A lawsuit or regulatory consequences directed at the organization
    • Civil and criminal penalties, including fines and jail time
    • A civil lawsuit filed against the nurse for defamation, invasion of privacy, or harassment [NCSBN]

5 Myths About Nurses’ Social Media Behavior

• Myth # 1: Privately shared posts and comments about patients will stay private.
  • Truth: Information shared on social media can be widely disseminated if someone takes a screenshot and posts the image to a public website.
• Myth #2: If content is deleted, it can no longer be viewed.
  • Truth: Even if the post or comment is removed, it will continue to exist on a server and could still be discoverable by a court of law.
• Myth #3: Only the intended recipient will access a private message that contains PHI.
  • Truth: Disclosing any PHI to unauthorized individuals is a breach of confidentiality.
• Myth #4: It’s OK to discuss or refer to patients using a nickname, room number, diagnosis, or condition.
  • Truth: Patients can easily be identified using this information.
• Myth #5: If patients disclose certain personal information about themselves, nurses can disclose that information as well.
  • Truth: Nurses must obtain written consent before they can share patients’ PHI with anyone outside of the care team. [NCSBN]

Tips for HIPAA-Compliant Social Media Usage

• Recognize your ethical and legal obligation to maintain patient privacy.
• Maintain professional boundaries when communicating with patients online.
• Avoid sharing, posting, or making any comments about patients on social media.
• Avoid identifying patients by name or posting information that may identify them.
• Never refer to patients in a disparaging manner, even if you are not discussing a specific patient.
• Never take photos or videos of patients on personal devices; only use employer-provided devices as directed.
• Report any social media misconduct or breach of patient confidentiality or privacy. [NCSBN]

Conclusion:

Health care organizations can protect patient privacy by implementing a strong social media policy to govern nurses’ activities on social media platforms. Proper and effective social media use among nurses has the potential to bring many benefits — to patients, nurses, and health care organizations.

Sources

https://www.hipaajournal.com/hipaa-social-media/
https://www.ncsbn.org/NCSBN_SocialMedia.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5708107/
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0228372
https://engage.healthynursehealthynation.org/blogs/8/1507