By the end of this chapter, the learner should be able to:

Handle cross-cultural issues with sensitivity and professionalism
Take steps to ensure client privacy, e.g. knocking before entering a room, asking permission before performing certain tasks, etc.
Determine when it is necessary and appropriate to share information with colleagues.

Ensuring information is kept confidential

Confidentiality is required by law in certain respects; the privacy of client records is a highly important aspect of confidentiality. Failure to maintain privacy of client records is punishable by law and organisations can be sued by the client.

The Privacy Act 1988 comprises of 13 Privacy Principles that legally must be adhered to and also, as explained by the Office of the Australian Information Commissioner (OAIC) website:

“Regulates the collection, storage, use, disclosure, security and disposal of individuals' tax file numbers
Permits the handling of health information for health and medical research purposes in certain circumstances, where researchers are unable to seek individuals' consent
Allows the information commissioner to approve and register enforceable app codes that have been developed by an app code developer, or developed by the information commissioner directly
Permits a small business operator, who would otherwise not be subject to the Australian privacy principles (apps) and any relevant privacy code, to opt-in to being covered by the apps and any relevant app code
Allows for privacy regulations to be made

source: http://www.oaic.gov.au/privacy/privacy-act/the-privacy-act (Links to an external site.)

Ensuring client privacy

Providing clients with as much privacy as possible will have a significant impact on their happiness and self-worth, and make life much more agreeable and attractive; having the privacy and opportunity to do things also encourages and provides levels of independence that clients may not necessarily expect

Tips for ensuring privacy:

Knocking before you enter a room and awaiting an invitation inside will show clients that they have much more autonomy and respect than having them walked in on with no warning.
Closing doors or curtains while treatment is in progress can maintain privacy and dignity. Signs that treatment is in progress can sometimes be used effectively
A care worker asking permission before touching clients when treatment commences e.g. ‘okay so we are all ready now, I just need to apply slight pressure on your back – is that alright?’
Providing clients with a private room where they can take or make phone calls or discuss personal issues.

The following guidelines serve as a good basis for maintaining client confidentiality:

Never discuss client information in social circles
Documented information should only ever relate to service delivery and related factors
Confidential documents must be stored securely, out of reach of the public and unauthorised personnel
Client information should never be disclosed to external agencies that are not part of the client's service delivery system
Names and details of clients should not be disclosed in public forums e.g. meetings, seminars, etc.

There are cases where confidentiality can be broken:

If the person is at serious risk of harm
Where there is an imminent, serious threat to the public or a specific person
Where there is a police request for information under the Police Powers and Responsibilities Act 2000
For use by healthcare professional (as long as a recognised standard of treatment is being delivered).

Issues of confidentiality should never be taken lightly – you should discuss them with your supervisor. Senior staff should always be involved for complex, competing decisions e.g. confidentiality vs. safety.

Sharing information within a team

Even if the client asks that you not share their information with others on your team, it is necessary to do this to ensure service quality is coordinated and of the highest quality. You should inform them of this, explaining that all of the team need to have access to appropriate information to ensure the best outcomes for them. Reassure them that their confidentiality will be maintained outside of a professional context.
The only situation where it may be appropriate to withhold client information from colleagues is when there is a conflict of interest. However, if information isn't shared, it makes team-based care reviews impossible and appropriate decisions are harder to make.