Patient perceptions of privacy infringements in an emergency department

Abstract

To identify the nature, severity, impact, frequency and risk factors for patient perceived privacy infringements in the ED of St Vincent's Health Melbourne with 32,000 emergency attendances per annum. Patients 18 years and older attending emergency over a 2-week period were offered a nine-item questionnaire using a Likert scale. A privacy incident was defined as: (i) overhearing medical or personal information; (ii) being overheard; (iii) having private body parts exposed or (iv) seeing others' body parts. Differences between demographic, emergency environment, length of stay and other factors suspected of affecting patient privacy were quantified. From 1169 emergency presentations, 235 patients returned questionnaires, with 105 of these (45%) reporting a total of 159 privacy incidents. Seventy-eight patients (33%, 95% CI 28-36%) reported a definite privacy incident and 81 (35%, 95% CI 29-37%) reported a probable privacy incident. Ninety-six patients (41%, 95% CI 35-47%) reported overhearing other patient's conversations with the staff whereas 36 (15%, 95% CI 11-21%) felt their conversations with staff were overheard by others. Twenty-seven patients (11%, 95% CI 6-14%) experienced or observed inappropriate exposure of private body parts. Ten patients (4%, 95% CI 2-7%) changed or withheld information from staff because they felt others may overhear it and two refused part of their physical examination because they felt they may be seen by inappropriate people. Twenty-four patients (10%, 95% CI 6-14%) did not have their expectations of privacy met. The longer a patient was in emergency the greater the number of privacy incidents they experienced (Spearman correlation P < 0.01). Patients in walled cubicles experienced fewer privacy incidents than those in curtained cubicles (P < 0.05). Patient privacy incidents occur frequently in an ED, risk factors being length of stay and absence of a walled cubicle. Patients who have their conversations overheard are more likely to withhold information from staff and less likely to have had their expectations of privacy met.