Jennifer Brutzki, JB02408, October 18, 2016.Neut.Ftv
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DISCIPLINE COMMITTEE OF THE COLLEGE OF NURSES OF ONTARIO PANEL: Michael Hogard, RPN Chairperson Renate Davidson Public Member Samantha Diceman, RPN Member Karen Laforet, RN Member Devinder Walia Public Member BETWEEN: COLLEGE OF NURSES OF ONTARIO ) ALYSHA SHORE for ) College of Nurses of Ontario - and - ) ) JENNIFER BRUTZKI ) MICHAEL MANDARINO for Registration No. JB02408 ) Jennifer Brutzki ) ) ) ) ) Heard: OCTOBER 18, 2016 DECISION AND REASONS This matter came on for hearing before a panel of the Discipline Committee (the “Panel”) on October 18, 2016 at the College of Nurses of Ontario (“the College”) at Toronto. The Allegations The allegations against Jennifer Brutzki (the “Member”) as stated in the Notice of Hearing dated 18 July, 2016 are as follows. IT IS ALLEGED THAT: 1. You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, and defined in subsection 1(1) of Ontario Regulation 799/93, in that while you were employed as a Registered Practical Nurse at Grand River Hospital in Kitchener, Ontario, you contravened a standard of practice of the profession or failed to meet the standard of practice of the profession with respect to accessing personal health information without consent or other authorization, for one or more of the following clients on or about the dates indicated below: Client Name Date of Access [Client A] March 18, 2014 [Client B] March 18, 2014 [Client C] June 13, 2014 [Client D] June 13, 2014 [Client E] June 15, 2014 [Client F] July 28, 2014 [Client G] July 28, 2014 [Client H] July 28, 2014 [Client I] July 31, 2014 [Client J] October 19, 2014 (20:03 hours) October 19, 2014 (20:39 hours) October 19, 2014 (22:58 hours) October 20, 2014 [Client K] October 20, 2014 [Client L] November 15, 2014 [Client M] November 15, 2014 [Client N] November 15, 2014 November 16, 2014 [Client O] November 16, 2014 [Client P] December 9, 2014 [Client Q] December 30, 2014 [Client R] January 6, 2015 [Client S] January 6, 2015 [Client T] January 6, 2015 [Client U] January 6, 2015 Client Name Date of Access [Client V] January 7, 2015 [Client W] January 7, 2015 [Client X] January 8, 2015 [Client Y] January 16, 2015 and/or; 2. You have committed an act of professional misconduct as provided by subsection 51(1)(c) of the Health Professions Procedural Code of the Nursing Act, 1991, S.O. 1991, c. 32, as amended, and defined in subsection 1(37) of Ontario Regulation 799/93, in that, while you were employed as a Registered Practical Nurse at Grand River Hospital in Kitchener , Ontario, you engaged in conduct or performed an act, relevant to the practice of nursing, that, having regard to all the circumstances, would reasonably be regarded by members of the profession as disgraceful, dishonourable or unprofessional with respect to accessing personal health information without consent or other authorization, for one or more of the following clients on or about the dates indicated below: Client Name Date of Access [Client A] March 18, 2014 [Client B] March 18, 2014 [Client C] June 13, 2014 [Client D] June 13, 2014 [Client E] June 15, 2014 [Client F] July 28, 2014 [Client G] July 28, 2014 [Client H] July 28, 2014 [Client I] July 31, 2014 [Client J] October 19, 2014 (20:03 hours) October 19, 2014 (20:39 hours) October 19, 2014 (22:58 hours) Client Name Date of Access October 20, 2014 [Client K] October 20, 2014 [Client L] November 15, 2014 [Client M] November 15, 2014 [Client N] November 15, 2014 November 16, 2014 [Client O] November 16, 2014 [Client P] December 9, 2014 [Client Q] December 30, 2014 [Client R] January 6, 2015 [Client S] January 6, 2015 [Client T] January 6, 2015 [Client U] January 6, 2015 [Client V] January 7, 2015 [Client W] January 7, 2015 [Client X] January 8, 2015 [Client Y] January 16, 2015 Member’s Plea The Member admitted the allegations set out in paragraphs 1 and 2 in the Notice of Hearing. The Panel received a written plea inquiry which was signed by the Member. The Panel also conducted an oral plea inquiry and was satisfied that the Member’s admission was voluntary, informed and unequivocal. Agreed Statement of Facts Counsel for the College and the Member advised the Panel that agreement had been reached on the facts and introduced an Agreed Statement of Facts, which reads as follows. THE MEMBER 1. Jennifer Brutzki (the “Member”) obtained a diploma in nursing from Conestoga College in 2001. 2. The Member registered with the College of Nurses of Ontario (the “College”) as a Registered Practical Nurse (“RPN”) in February 2002. 3. The Member was employed at Grand River Hospital (the “Facility”) on the Kitchener- Waterloo campus as a full-time staff nurse on the [Unit] from November 2002 to March 2015, when she was terminated as a result of the incidents described below. The Member grieved her termination from the Hospital, and that matter was resolved by way of a mutually agreeable settlement. THE FACILITY 4. The Facility is located in Kitchener, Ontario. 5. The Member initially worked on the complex continuing care unit when she was first hired at the Facility. She then moved into the [Unit] and worked on that unit for the last seven to eight years of her employment at the Facility. 6. The [Unit] had 65 beds that were divided into a north and south end. It was “U”-shaped with clients’ rooms around the “U”. 7. At the time of the incidents, eight nurses were assigned to each end of the unit. It was not uncommon for the nurses on the unit to work as a team and help each other out. 8. If the unit’s census was low, staff would occasionally be reassigned to float on other units. The Facility’s Electronic Records System 9. The Facility used an electronic health records system. Each staff member had an individualized access ID and password that allowed them to log into the system. 10. When a staff member logged into the system on the [Unit], the census for the unit appears, allowing staff to access the clients in their circle of care with ease. In order to access other client records, staff would need to search for clients by name or medical record number, or they could also select a different census to view. 11. Staff were expected to log out of the system when they were finished using the electronic records system. However, the system would automatically log an individual out after 15 minutes of inactivity. 12. Staff could self-report an accidental access, which was kept on a database that could be referred to when the Facility conducted an audit. Facility Policies on Accessing Client Records 13. The Facility had several policies in force at the time regarding the protection of personal health information that made it clear that staff were not to access personal health information of clients unless required to provide client care or carry out their duties. Privacy, Confidentiality and Security Policy 14. The Facility’s “Privacy, Confidentiality and Security” Policy was issued in March 2004 and last reviewed in May 2004. The policy indicated that “[Personal Health Information] will not be used or disclosed for purposes other than those for which it was collected, except with the consent of the individual or as required by law.” 15. The policy further stated that “[a]ccess to [Personal Health Information] will be limited to only those employees/agents with a need to know such information for their job purposes (the “need to know” rule). Authorization is required before accessing, collecting, using, or disclosing [Personal Health Information]. If an employee is unsure of whether they have authorization to access, use or disclose [Personal Health Information], they will seek clarification from the Manager/Supervisor or Chief Privacy Officer.” 16. The policy warned against improper access or use of personal health information, stating that “[a]ny individual who collects, uses or discloses [Personal Health Information] under the custody and control of [Grand River Hospital] can be the subject of a question, complaint or breach of this policy.” The policy goes on to indicate that breaches are taken very seriously and dealt with swiftly. Audits of Health Information Systems Policy 17. The Facility’s “Audits of Health Information Systems” Policy was last reviewed in July 2006. It indicated that a breach of confidentiality occurs “when an individual accesses [Personal Health Information] when they are not required to do so in order to perform their job functions. Access to [Personal Health Information] is based on the ‘need to know’ rule to provide patient care or to perform one’s duties. Inappropriate access includes accessing patient information for personal interests including accessing a family member’s chart or your own records.” Breach of Confidentiality: Staff, Physicians & Affiliates of Grand River Hospital 18. The Facility has a third policy entitled “Breach of Confidentiality: Staff, Physicians & Affiliates of [Grand River Hospital]” that was first issued in December 2006 and last reviewed in November 2012. It reiterated that access to personal health information “is limited to those individuals that need to know such information for performing their duties. Inappropriate collection, access, use or disclosure of information will be considered a breach of confidentiality and may result in disciplinary action.” Electronic Privacy and Confidentiality Course 19. The Member was also required to complete an electronic Privacy and Confidentiality course for the Facility, and pass the test at the end of the course.