下列哪項護理師的行為可能違反《健康保險隱私及責任法案》（HIPAA）？
Which action by the nurse is a potential violation of the Health Insurance Portability and Accountability Act (HIPAA)?
- ADiscussing a client's condition with the physical therapist involved in the client's care.與參與該病人照護的物理治療師討論病人狀況
- BSharing a client's lab results with a nurse from another unit who is curious about the case.✓ 正解將病人的檢驗結果分享給其他單位對該病例好奇的護理師
- CGiving a change-of-shift report at the client's bedside with the curtain closed.在拉上簾子的情況下於病床邊進行交班報告
- DReviewing the medical record of a client assigned to the nurse's care for the day.檢視當日指派給該護理師照護之病人的病歷
HIPAA 的核心原則是『知其所需（Need to Know）』。醫療資訊只能分享給直接參與該病人照護的醫療團隊成員。選項 B 中，另一單位的護理師並未參與照護，僅因好奇而詢問，這屬於未經授權的資訊披露，嚴重違反隱私法規。選項 A 是合法的，因為物理治療師屬於照護團隊的一員，需要資訊來規劃復健。選項 C 的床邊交班是推廣的標準實務（Bedside Report），只要採取了適當的隱私保護措施（如拉簾、低聲說話），即被認為是合理的。選項 D 是護理師執行職務所必需的，完全合法。在護理管理中，保護病人隱私不僅是法律義務，也是建立護病信任的基礎。護理師必須警覺任何可能導致資訊外洩的行為，包括在電梯討論病情、隨意翻閱非負責病人的病歷或將含病名資料隨意丟棄於一般垃圾桶。
The core HIPAA principle is 'need to know.' Medical information may only be shared with team members directly involved in care. In option B, a nurse from another unit not involved in care is asking out of curiosity, which is unauthorized disclosure and a serious privacy violation. Option A is legal because the physical therapist is on the care team. Option C (bedside reporting) is standard practice when privacy measures (curtains, soft voice) are used. Option D is required for the nurse to perform duties and is legal. Nurses must guard against any information leakage, including discussions in elevators, browsing non-assigned charts, or improper disposal of identifying documents.
美國 HIPAA 對個人隱私的保護極為嚴苛，違規可能導致巨額罰款甚至吊銷執照；台灣雖有《個人資料保護法》及《醫療法》，但在實務中，家屬詢問病人病情通常被視為理所當然，護理師在台灣需在保護隱私與符合在地文化（家屬參與度高）之間取得平衡。