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The maintenance of confidentiality in primary care: a survey of policies and procedures.

机译：维持初级保健的机密性：对政策和程序的调查。

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摘要

We investigated policies and procedures for the maintenance of confidentiality in primary care by means of a postal survey of 109 general practices in a large non-metropolitan urban health authority in England. The response rate was 61%. Practices believed a variety of staff should be informed if a patient was HIV-positive, ranging from 'patient's own GP' (100%) to 'clerical staff' (8%). In 88% of practices receptionists occasionally or normally asked patients why they wished to see a doctor, although in 76% such conversations were audible to other patients. Ninety-nine per cent claimed to have a policy on confidentiality, although it existed in writing in 62% and was publicized in only 27%. In 88% of practices non-clinical staff had access to written patient records. Ninety-three per cent provided staff training in confidentiality, but in 34% it was confined to induction. Almost all practices had taken some steps to safeguard confidentiality, but few had explicit, formal confidentiality policies. Information sharing and non-clinical staff access to medical records were extensive, and few practices communicated their arrangements to patients. Practices need to review their policies and procedures for the maintenance of confidentiality.
机译：我们通过对英国一家大型非都市卫生部门的109种常规做法进行的邮政调查，调查了维护初级保健机密性的政策和程序。回应率为61％。实践认为，如果患者是艾滋病毒阳性，应告知各种工作人员，范围从“患者自己的全科医生”（100％）到“文书人员”（8％）。在88％的实践中，接待员偶尔或通常询问患者为什么希望去看医生，尽管在76％的对话中，其他患者可以听到。 99％的人声称有保密政策，尽管它以书面形式存在的比例为62％，仅以27％的比例公开。在88％的实践中，非临床人员可以访问患者的书面记录。 93％的工作人员接受了保密培训，但34％的工作仅限于上岗培训。几乎所有实践都采取了一些措施来保护机密性，但是很少有明确的，正式的机密性政策。信息共享和非临床工作人员可以访问医疗记录，而且很少有实践向患者传达其安排。实践需要审查其维护机密的政策和程序。

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