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Nurse Jobs in Moscow, ID

Registered nurse (rn).

Clearwater Health and Rehabilitation of Cascadia Healthcare

Nurse Job 39 miles from Moscow

Part-time Registered Nurse

Ivy Correctional Medicine

Nurse Job 22 miles from Moscow

RN (Registered Nurse) - Catheterization Laboratory (Cath Lab)

Licensed Practical Nurse - LPN

Maternal child health nurse (lpn considered).

Marimn Health

Nurse Job 42 miles from Moscow

Travel Nurse RN - PCU - $2,350 per week in Clarkston, WA

Travel nurse rn - cath lab - $1,880 per week in lewiston, id, travel nurse rn - pcu in clarkston, wa.

Remede Group

Travel Nurse RN - Cardiac Cath Lab - $2,204 per week

Travel nurse rn - skilled nursing - $2,309 per week.

Nurse Job 34 miles from Moscow

Travel Nurse RN - Cardiac Cath Lab - $2,380 per week

Nationwide Therapy Group

Travel Nurse RN - Cardiac Cath Lab - $2,210 per week

Planet Healthcare

Travel Nurse RN - PCU - Progressive Care Unit - $2,355 per week

Summit Medical Staffing Nursing

Travel Nurse RN - Dialysis - $2,020 per week

Travel nurse rn - cardiac cath lab - $2,331 per week, travel nurse rn - cardiac cath lab - $2,462 per week, travel nurse rn - med surg - $2,530 per week, travel nurse rn - cardiac cath lab - $2,402 per week, travel nurse rn - med surg - $1,789 per week, learn more about nurse jobs, how much does a nurse earn in moscow, id.

The average nurse in Moscow, ID earns between $38,000 and $72,000 annually. This compares to the national average nurse range of $38,000 to $86,000.

Average Nurse Salary In Moscow, ID

What are the biggest employers of Nurses in Moscow, ID?

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Nursing Jobs in Moscow, Idaho

Licensed Practical Nurse - LPN

(#5 of 5) CNA - MedSurg

Prn cardiac stress test technician - cnas are welcome to apply, full-time registered nurse in the new acute rehab unit in lewiston idaho.

RN/LPN Pulmonology - Full Time

Float rn - multiple clinics.

Lead Caregiver- Guaranteed 40 hours!

Ma/lpn/rn behavioral health clinic, registered nurse - float pool - nights, new graduate rn - float pool, prn cna - pcu (8hr evening shift), prn cna - pcu (8hr night shift), new graduate rn - obgyn, new graduate rn - pcu, prn cna - pcu (12hr night shift), rn, emergency - prn, registered nurse - icu - nights, cna - medsurg in lewiston idaho, rn, sssu per diem, rn/lpn/certified medical assistant- family practice & internal medicine, rn-house supervisor - per diem.

Practical Nurse - PACT

Registered nurse - icu - days.

CAREGIVER/HOME HEALTH AIDE

Rn/lpn/cma-clearwater medical clinic, rn, medical/surgery unit- full time, cardiac stress test technician - cnas are welcome to apply.

Staff RN | PAT

Rn, urogyn/ general surgery.

JOIN OUR NURSING TEAM! (RN, LPN, CMA, & CNA)

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Care Manager RN - OB\/Maternity - 100% Remote

Senior/Country Approval Specialist

Patient Services Specialist (Pharmacy Technician)

Medical Specialist - MBRU

Analyst, SOX

Flu Vaccinator/Nurse Wellness Worker - North Central Region

Virtual Primary Care Physician - Overnight Shifts (TX Licensure)

Clinical pharmacist, pharmacy benefits, proj mgr, clinical supplies (sr/apm), director, ambulatory pharmacy & hgs implementations, manager, sourcing, virtual primary care physician - overnight shifts (il licensure), clinical pharmacist - hybrid, (associate) medical director - psychiatry or neurology, emea, senior manager, regional pharmacies (west), support coord, remote pediatric care manager, internship for pharmacy students/ pharmazeut im praktikum (phip) - 6 months internship.

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Mental Health Worker - Virtual Interview Day – 8.29.2024

Experience the Essence of Who We Are,

Person-Center Care Is at Our Core

Over a century ago, NewYork-Presbyterian/Westchester Behavioral Health Center introduced the world to moral, humanistic psychiatric care. We blazed the way for use of the Planetree model and are the first behavioral health facility to be recognized as a Planetree Designated Patient-Centered Hospital with Distinction. Our hospital is also a recipient of Magnet from American Nurses Credentialing Center (ANCC). It’s a progressive environment—and a premier opportunity for your career. Join a Culture that Supports Excellence in Quality and Patient Satisfaction.

At NewYork-Presbyterian, Per Diem Mental Health Worker is a life-changing career journey focused on amazing patient outcomes every step of the way. Each of our team member dares to be truly excellent – thriving in a compassionate culture of care and caring. Together, we improve the health of patients and their families, making our communities – and the world – stronger. You’ll work with the brightest minds in healthcare to make tomorrow better for countless human beings. Now, you have the opportunity to join us.

Mental Health Worker - Virtual Interview Day – 8.29.2024

Be the eyes and ears of our expert clinical team as a Mental Health Worker. In this role, you'll observe and document patients' physical, emotional, and social behavior, reporting as necessary to the nursing team. Maintain a therapeutic relationship with patients, expertly intervening in times of anxiousness and assisting them with their daily activities. Record vital signs and other important clinical information, as an important resource for the multidisciplinary team. Many of our Mental Health Workers go on to become leaders in Social Work, Occupational Therapy, and other areas. Pursue this extraordinary opportunity to gain valuable frontline experience in mental health patient management.

The Per Diem MHW works all shifts at NYP/Westchester Behavioral Health Center.

How will the event work?   All interviews will be completed through live video. Come prepared to tell us about yourself, and speak personally with leadership from some of our Psychiatric Units at NYP. You will also meet with a representative from our Talent Acquisition team. This is your chance to make a lasting impression on our hiring team.

Who is invited to this event? Qualified candidates will have a High School Diploma or GED and Basic Life Support (BLS)/AHA certification. Ideal candidates aspire to careers or degrees in social work or psychiatry or a college degree and at least one year of psychiatry-related experience

What happens next? This event will be held on Thursday, August 29th, 2024 between 10:30 am and 1:30 pm. Once you are registered for the event, you will receive an email confirmation with details from the NYP Talent Acquisition team.

We look forward to meeting you!

**Please note: this event is not an open interview day. Qualified candidates will receive a confirmation of their registration for the event.*

Join a healthcare system where employee engagement is at an all-time high. Here we foster a culture of respect, diversity, and inclusion. Enjoy comprehensive and competitive benefits that support you and your family in every aspect of life. Start your life-changing journey today. __________________

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Public Health Nursing Consultant - BH

• REMOTE OPTIONS

Arizona Health Care Cost Containment System Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Courage, Teamwork The Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid agency, is driven by its mission to deliver comprehensive, cost-effective health care to Arizonans in need. AHCCCS is a nationally acclaimed model among Medicaid programs and a recipient of multiple awards for excellence in workplace effectiveness and flexibility. AHCCCS employees are passionate about their work, committed to high performance, and dedicated to serving the citizens of Arizona. Among government agencies, AHCCCS is recognized for high employee engagement and satisfaction, supportive leadership, and flexible work environments, including remote work opportunities. With career paths for seasoned professionals in a variety of fields, entry-level positions, and internship opportunities, AHCCCS offers meaningful career opportunities in a competitive industry. Come join our dynamic and dedicated team.

Public health nursing consultant, division of fee for service management (dfsm), address:  801 e. jefferson street, phoenix, az 85034, this position may offer the ability to work remotely within arizona based upon the department's needs and continual meeting of expected performance measures and at the discretion of leadership. , salary: $71,032 , closing date: open until filled .

The Division of Fee For Service Management (DFSM) is looking for a highly motivated individual to join our team as an Public Health Nursing Consultant. This position will provide monitoring and technical assistance to ensure compliance with contractual, regulatory, and statutory obligations for FFS members’ physical/acute care services and behavioral health needs. Monitor over and under utilization, conduct reviews, provide oversight and technical assistance, gather, plan, organize and evaluate information from multiple sources, including utilization data, case file reviews and audits. Coordinate care with external and internal stakeholders as needed, make referrals as necessary, participate in clinical staffing as needed, serve as a resource for medically necessary covered services.

Major duties and responsibilities include, but are not limited to: • Review clinical documentation to monitor, evaluate and authorize healthcare services. Review for medical necessity, appropriateness of services, quality of care, and compliance with contractual State and Federal obligations governing the provision of covered behavioral and physical healthcare services. • Obtain, review, analyze, and discuss report and data findings in order to identify, monitor, and evaluate specialized intervention strategies and outcomes for member populations, including SMI, and TRBHA. • Collaborate with AHCCCS providers including SMI clinic, TRBHA, Medical Home or other treatment team members in order to provide technical assistance, training, & consultation on As needed, provides backup for the responsibilities held by the BH Prior Authorization/Utilization Review unit & other CMSU functions as needed. • Coordinate with internal and external customers as needed, make referrals as necessary, participate in clinical staffing as needed, serve as a FFS health plan subject matter expert. • Assist in the development of policies and procedures as required for delivery of covered behavioral health services.

Knowledge of: • Service Authorization concepts, principles, and strategies. • General knowledge of behavioral health service delivery system and the needs of individuals designated as SMI. • Principles of behavioral health and medical nursing management and assessment. • Individual service planning process and substance abuse treatment. • HCPCS codes Levels I & II and, knowledge of International Classification of Diseases, DSM IV/V coding and medical billing guidelines. • Medical technology, computer data retrieval and input, including EHR, HIE, etc. • Medicaid and Medicare Federal Regulations, State Statute, Rules, and Policies applicable to AHCCCS programs. • AHCCCS program design and implementation, prior authorization functions and responsibilities, provider network, and funding source. • Familiarity with American Indian Tribes, programs and policy. Skill in: • Problem solving identification, evaluation, and imitation of appropriate action, nursing, and case management assessment. • Excellent verbal/written communication skills, with FFS Providers. • Organizational skills to coordinate, monitor and report on multiple cases simultaneously. • Analytical skills to identify and correlate specific patterns, initiate investigations, submit findings and recommendations. • Strong interpersonal skills in working with people of diverse cultures and socioeconomic backgrounds. • Documentation and reporting of data and trends. Ability to: • Strong ability to collaborate with others for mutually beneficial outcomes. • Interpret clinical information and assess implications for treatment. • Read, interpret, and apply complex rules and regulations. • Independent decision making yet knowing when to elevate the decision. • Drive long distances when required. • Work Virtual Office (VO), Telecommute or both.

Minimum: • Possession of a current license to practice as a registered nurse in the State of Arizona. • Three (3) years of relevant experience. Preferred: • Professional experience in the Healthcare Industry; Specifically experience in Prior Authorization, Concurrent Review, Retrospective Review, and Utilization Management.

• Successfully complete the Electronic Employment Eligibility Verification Program (E-Verify), applicable to all newly hired State employees. • Successfully pass fingerprint background check, prior employment verifications and reference checks; employment is contingent upon completion of the above-mentioned process and the agency’s ability to reasonably accommodate any restrictions. • Travel may be required for State business. Employees who drive on state business must complete any required driver training (see Arizona Administrative Code R2-10-207.12.) AND have an acceptable driving record for the last 39 months including no DUI, suspension or revocations and less than 8 points on your license. If an Out of State Driver License was held within the last 39 months, a copy of your MVR (Motor Vehicle Record) is required prior to driving for State Business. Employees may be required to use their own transportation as well as maintaining valid motor vehicle insurance and current Arizona vehicle registration; however, mileage will be reimbursed.

Among the many benefits of a career with the State of Arizona, there are: • 10 paid holidays per year. • Paid Vacation and Sick time off (13 and 12 days per year respectively) - start earning it your 1st day (prorated for part-time employees). • Paid Parental Leave-Up to 12 weeks per year paid leave for newborn or newly-placed foster/adopted child (pilot program). • Other Leaves - Bereavement, civic duty, and military. • A top-ranked retirement program with lifetime pension benefits. • A robust and affordable insurance plan, including medical, dental, life, and disability insurance. • Participation eligibility in the Public Service Loan Forgiveness Program (must meet qualifications). • RideShare and Public Transit Subsidy. • A variety of learning and career development opportunities.

Learn more about the Paid Parental Leave pilot program  here . For a complete list of benefits provided by The State of Arizona, please visit our benefits page

Lifetime Pension Benefit Program. • Administered through the Arizona State Retirement System (ASRS) • Defined benefit plan that provides for life-long income upon retirement. • Required participation for Long-Term Disability (LTD) and ASRS Retirement plan. • Pre-taxed payroll contributions begin after a 27-week waiting period (prior contributions may waive the waiting period). Deferred Retirement Compensation Program. • Voluntary participation. • Program administered through Nationwide. • Tax-deferred retirement investments through payroll deductions.

Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by emailing [email protected]. Requests should be made as early as possible to allow time to arrange the accommodation. The State of Arizona is an Equal Opportunity/Reasonable Accommodation Employer.

ARIZONA MANAGEMENT SYSTEM (AMS)

All Arizona state employees operate within the Arizona Management System (AMS), an intentional, results-driven approach for doing the work of state government whereby every employee reflects on performance, reduces waste, and commits to continuous improvement with sustainable progress.  Through AMS, every state employee seeks to understand customer needs, identify problems, improve processes, and measure results.   State employees are highly engaged, collaborative and embrace a culture of public service.

The State of Arizona is an Equal Opportunity/Reasonable Accommodation Employer.

If this position requires driving or the use of a vehicle as an essential function of the job to conduct State business, then the following requirements apply: Driver’s License Requirements

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© 2024 The University of Texas MD Anderson Cancer Center

• Open access
• Published: 15 August 2024

Balancing confidentiality and care coordination: challenges in patient privacy

• Ateya Megahed Ibrahim 1 , 2 ,
• Hassanat Ramadan Abdel-Aziz 1 , 3 ,
• Heba Ali Hamed Mohamed 4 ,
• Donia Elsaid Fathi Zaghamir 1 , 5 ,
• Nadia Mohamed Ibrahim Wahba 1 , 6 ,
• Ghada. A. Hassan 7 ,
• Mostafa Shaban 8 ,
• Mohammad EL-Nablaway 9 ,
• Ohoud Naif Aldughmi 10 &
• Taghreed Hussien Aboelola 11  

BMC Nursing volume  23 , Article number:  564 ( 2024 ) Cite this article

114 Accesses

Metrics details

In the digital age, maintaining patient confidentiality while ensuring effective care coordination poses significant challenges for healthcare providers, particularly nurses.

To investigate the challenges and strategies associated with balancing patient confidentiality and effective care coordination in the digital age.

A cross-sectional study was conducted in a general hospital in Egypt to collect data from 150 nurses across various departments with at least six months of experience in patient care. Data were collected using six tools: Demographic Form, HIPAA Compliance Checklist, Privacy Impact Assessment (PIA) Tool, Data Sharing Agreement (DSA) Framework, EHR Privacy and Security Assessment Tool, and NIST Cybersecurity Framework. Validity and Reliability were ensured through pilot testing and factor analysis.

Participants were primarily aged 31–40 years (45%), with 75% female and 60% staff nurses. High compliance was observed in the HIPAA Compliance Checklist, especially in Administrative Safeguards (3.8 ± 0.5), indicating strong management and training processes, with an overall score of 85 ± 10. The PIA Tool showed robust privacy management, with Project Descriptions scoring 4.5 ± 0.3 and a total score of 30 ± 3. The DSA Framework had a mean total score of 20 ± 2, with Data Protection Measures scoring highest at 4.0 ± 0.4. The EHR assessments revealed high scores in Access Controls (4.4 ± 0.3) and Data Integrity Measures (4.3 ± 0.3), with an overall score of 22 ± 1.5. The NIST Cybersecurity Framework had a total score of 18 ± 2, with the highest scores in Protect (3.8) and lower in Detect (3.6). Strong positive correlations were found between HIPAA Compliance and EHR Privacy ( r  = 0.70, p  < 0.05) and NIST Cybersecurity ( r  = 0.55, p  < 0.05), reflecting effective data protection practices.

The study suggests that continuous improvement in privacy practices among healthcare providers, through ongoing training and comprehensive privacy frameworks, is vital for enhancing patient confidentiality and supporting effective care coordination.

Peer Review reports

Digital technology has significantly transformed healthcare, enhancing care coordination and improving patient outcomes. However, this transformation brings forth critical challenges, particularly in balancing the imperatives of confidentiality and efficient care coordination [ 1 ]. The intersection of these essential elements, patient privacy and the seamless sharing of information among healthcare providers requires a nuanced approach to ensure ethical and legal compliance while optimising patient care [ 2 ].

Confidentiality in healthcare is foundational, rooted in bioethics principles and protected by laws such as the Health Insurance Portability and Accountability Act (HIPAA) in the United States [ 3 ]. HIPAA establishes national standards to safeguard individuals' medical records and other personal health information, emphasising the importance of privacy in the digital age [ 4 ]. As digital technologies become more embedded in healthcare practices, ensuring compliance with these standards while facilitating the necessary flow of information for care coordination becomes increasingly complex [ 5 ]. Care coordination, defined as the deliberate organisation of patient care activities to facilitate the appropriate delivery of health services, is essential for achieving high-quality healthcare [ 6 ]. Effective care coordination requires timely and accurate sharing of patient information among various healthcare providers, which can be challenging when strict confidentiality rules are in place [ 7 , 8 ].

Nurses are responsible for ensuring patient information is shared accurately and promptly with other healthcare team members to facilitate effective care coordination [ 9 ]. However, they must also strictly adhere to confidentiality protocols to protect patient privacy. This dual responsibility can create significant tension and complexity in their daily practice. Nurses must navigate varying levels of digital literacy, differing institutional policies on information sharing, and the ever-present risk of data breaches or inadvertent disclosures [ 10 ]. Furthermore, the pressure to use electronic health records (EHRs) efficiently while maintaining patient trust and confidentiality adds to the complexity of their role [ 11 ]. These challenges highlight the need for robust training, clear guidelines, and support systems to help nurses effectively manage the delicate balance between confidentiality and care coordination.

Introduction

Electronic Health Records (EHRs) are central to enhancing care coordination by providing comprehensive, real-time access to patient health information, facilitating more informed decision-making and continuity of care [ 12 ]. However, digitising health records also raises significant privacy concerns, increasing the risk of unauthorised access and data breaches [ 13 ]. Thus, healthcare providers must implement robust security measures to protect patient data while ensuring it is accessible to authorised personnel when needed [ 14 ].

Although telehealth offers significant benefits in terms of accessibility and convenience, particularly for patients in remote or underserved areas, it further complicates the balance between confidentiality and care coordination [ 15 , 16 ]. It introduces challenges in maintaining patient privacy, preventing breaches, and safeguarding patient data [ 17 ]. Additionally, there is a critical issue concerning who has access to this information, which raises justice concerns about equitable access and safeguarding patient data. Addressing these concerns involves implementing robust access controls and consistently applying privacy measures across all telehealth platforms [ 18 ]. Patient consent is another critical factor for maintaining patient trust and ensuring that individuals know how their information will be used and shared [ 19 ]. However, the complexity of digital health systems can make it difficult for patients to fully understand the implications of consent, particularly regarding sharing their data across multiple platforms and providers [ 20 , 21 , 22 ].

Nurses play a pivotal role in balancing confidentiality and care coordination in the digital age, acting as guardians of patient privacy and key facilitators of information sharing. Their unique position on the front lines of patient care requires them to navigate complex ethical and practical challenges. Nurses are often responsible for inputting and accessing data within EHRs, making their adherence to privacy protocols crucial for protecting patient information [ 23 ]. Additionally, they serve as critical links in the care coordination chain, ensuring that relevant health information is accurately communicated among various healthcare providers to support comprehensive patient care [ 24 ]. As the healthcare landscape becomes increasingly digital, ongoing education and training for nurses in the technological aspects of EHRs and the ethical implications of data handling are essential [ 25 ].

Healthcare institutions must adopt comprehensive policies and technological solutions to manage the dual imperatives of confidentiality and care coordination [ 26 ] to help mitigate the risks associated with data breaches and unauthorised access [ 27 ]. Interoperability between different healthcare systems is another significant challenge, and efforts to develop and implement interoperable systems are essential for balancing the need for information sharing with protecting patient privacy [ 28 , 29 ] ensuring that patient welfare remains the primary focus [ 30 ]. In addition, empowering patients to take an active role is crucial, and education and communication strategies are essential for helping patients understand their rights and measures to protect their privacy [ 31 ].

Healthcare institutions must adopt comprehensive policies and frameworks to manage the dual imperatives of confidentiality and care coordination. These policies should include guidelines for data security, patient consent, and the ethical use of health information [ 26 ]. Technological solutions such as encryption, anonymisation, and secure access controls are crucial for protecting patient data in digital systems. These technologies help mitigate the risks associated with data breaches and unauthorised access, ensuring that sensitive information remains secure while being accessible to those who need it for patient care [ 27 ].

Interoperability between different healthcare systems is another significant challenge. The lack of standardised protocols for data exchange can hinder effective care coordination and increase the risk of privacy breaches [ 28 ]. Efforts to develop and implement interoperable systems are essential for balancing the need for information sharing with the protection of patient privacy [ 29 ]. Ethical frameworks must account for the potential benefits and harms of information sharing, ensuring that patient welfare remains the primary focus [ 30 ].

Patient engagement is also crucial in this context. Empowering patients to take an active role in their healthcare, including decisions about their information, can enhance trust and improve outcomes. Education and communication strategies are essential for helping patients understand their rights and the measures in place to protect their privacy [ 31 ].

In conclusion, balancing confidentiality and care coordination in the digital age is a complex but essential task for modern healthcare. Ensuring patient privacy while facilitating the necessary flow of information for care coordination requires a multifaceted approach that includes robust technological solutions, comprehensive policies, ongoing education and training, and active patient engagement. By addressing these challenges, healthcare providers can improve patient outcomes and maintain public trust in the healthcare system.

Significance of the study

This study is significant as it addresses the critical intersection of confidentiality and care coordination in the rapidly evolving digital healthcare landscape. By examining the practices and perceptions of healthcare professionals, particularly nurses, the research sheds light on how effectively these individuals face challenges posed by digital technologies while ensuring patient privacy. Understanding the dynamics of confidentiality and care coordination informs best practices and enhances the development of training programs and institutional policies to improve patient outcomes.

The findings of this study have several practical applications. Institutions can design targeted training programs focusing on both technical skills and ethical considerations to educate nurses on safeguarding patient information while ensuring efficient care coordination. Insights can inform the creation or revision of data security and patient consent guidelines, ensuring staff understand the importance of maintaining patient privacy and secure data sharing. Additionally, the study promotes integrating advanced security features in Electronic Health Record (EHR) systems, balancing data protection with necessary access for care coordination. This research can build patient trust by highlighting best practices and effective strategies for balancing confidentiality and care coordination, leading to better cooperation and health outcomes. Furthermore, these findings can support the development of standardised protocols for telehealth services, ensuring consistent privacy measures across platforms and improving equitable access to care.

Aim of the study:

Research questions:.

What are healthcare providers' primary challenges in maintaining patient confidentiality while utilising digital health technologies for care coordination?

How do different privacy assessment tools and frameworks impact the balance between patient confidentiality and the efficiency of care coordination in digital healthcare environments?

What best practices can be implemented to maintain patient privacy without compromising care coordination in the digital age?

Theoretical framework

The theoretical framework for this study incorporates several key theories to understand the balance between confidentiality and care coordination in the context of digital health technologies.

Privacy Regulation Theory, proposed by Westin32, emphasises that privacy is a fundamental human right involving control over the extent, timing, and circumstances of sharing oneself with others. This theory is crucial for understanding the importance of maintaining patient confidentiality in healthcare settings. It underscores the need for stringent privacy measures to build and maintain trust between patients and healthcare providers. Using this theory, the study addresses the first research question concerning healthcare providers' challenges in maintaining patient confidentiality. It offers a conceptual foundation for exploring the importance of privacy in patient-provider relationships and the implications of privacy breaches in digital health environments.

Health Information Technology (HIT) Adoption Framework, as described by Venkatesh et al.33, examines factors influencing the adoption of health information systems, such as perceived usefulness, ease of use, and institutional support. This framework is relevant for understanding how healthcare professionals, particularly nurses, adopt and utilise digital technologies while managing patient privacy. It addresses the second research question about how privacy assessment tools and frameworks impact the balance between patient confidentiality and care coordination. The framework provides insights into the factors that facilitate or hinder the adoption of digital health technologies, which is essential for effective care coordination.

The Technology Acceptance Model (TAM), proposed by Davis 34, explains how users accept and use technology, emphasising perceived ease of use as primary determinants. TAM is pertinent for understanding healthcare professionals' attitudes toward digital health technologies and how these attitudes influence their adoption and usage. This model supports the exploration of the third research question regarding best practices for ensuring patient privacy without compromising care coordination. It provides a basis for developing strategies to enhance the acceptance and effective use of digital health technologies among healthcare providers.

Ethical Decision-Making Framework, based on Beauchamp and Childress's principles of biomedical ethics—autonomy, beneficence, non-maleficence, and justice—guides ethical considerations in healthcare [ 35 ]. This framework is integral for evaluating the ethical implications of maintaining confidentiality while promoting care coordination. It helps address the ethical challenges identified in the first research question. It supports the development of best practices outlined in the third research question. This framework ensures that ethical principles guide decisions about information sharing and patient privacy in digital health environments. Additionally, Grady's Ethical Framework for Health Informatics emphasises integrating ethical considerations into the design and use of health information technologies, ensuring that privacy and care coordination are complementary goals [ 36 ].

Diffusion of Innovations Theory, proposed by Rogers [ 37 ], explains how new ideas and technologies spread within a social system, focusing on communication channels, social systems, and the attributes of innovations. This theory is relevant for understanding how digital health innovations are adopted in healthcare settings and their impact on confidentiality and care coordination. It helps explore the challenges of adopting digital health technologies addressed in the first research question. It supports identifying best practices for integrating new technologies into healthcare practice, as addressed in the third research question. The theory provides insights into the adoption process and the factors influencing the successful integration of innovations into healthcare practice.

Conceptual framework

The conceptual framework for this study explores the dynamic interaction between confidentiality, care coordination, and the utilisation of digital health technologies, with insights drawn from several theoretical perspectives. Confidentiality protects patient information from unauthorised access, which is critical for maintaining trust in healthcare settings [ 38 ]. Privacy Regulation Theory emphasises that privacy is a fundamental human right, focusing on controlling the extent, timing, and circumstances of sharing personal information. This theory underlines the necessity of robust privacy measures to ensure patient data security and build trust between patients and healthcare providers [ 32 ].

Care coordination refers to effectively managing and integrating patient care across different healthcare providers and settings. It involves ensuring that care is seamless and that information is shared appropriately among various stakeholders to provide comprehensive and continuous care [ 39 ]. The Health Information Technology (HIT) Adoption Framework sheds light on how factors such as perceived usefulness, ease of use, and institutional support influence the adoption of health information systems. This framework helps us understand how healthcare professionals integrate digital technologies into their workflows while managing patient privacy and enhancing care coordination [ 33 ].

Using digital health technologies includes tools such as electronic health records (EHRs) and telehealth platforms that facilitate communication, information sharing, and care coordination. These technologies are critical for modern healthcare delivery but also raise challenges related to confidentiality [ 1 , 2 ]. The Technology Acceptance Model (TAM) provides a lens through which to examine how perceived ease of use and perceived usefulness affect the acceptance and effective use of these technologies. Understanding healthcare professionals' attitudes towards these tools is crucial for improving their integration and addressing potential barriers to technology adoption, which impacts confidentiality and care coordination [ 34 ].

The Ethical Decision-Making Framework, guided by Beauchamp and Childress's principles—autonomy, beneficence, non-maleficence, and justice—offers a foundation for evaluating the ethical implications of maintaining confidentiality while promoting care coordination. This framework helps ensure that information-sharing decisions respect patient autonomy and adhere to ethical standards, balancing privacy with the need for effective care [ 35 , 36 ].

The Code of Ethics for Nurses further reinforces the importance of privacy by setting ethical guidelines for protecting patient information. This code ensures that nurses' practices align with ethical and legal standards, providing a practical framework for maintaining confidentiality while coordinating care effectively [ 14 , 17 ].

Lastly, Diffusion of Innovations Theory explains how new technologies spread within healthcare systems, emphasising the roles of communication channels, social systems, and the attributes of innovations. This theory helps us understand how digital health innovations are adopted and how they impact the balance between confidentiality and care coordination. It provides insights into the factors influencing the successful integration of new technologies [ 37 ].

The conceptual framework integrates these theories to comprehensively understand how confidentiality, care coordination, and digital health technologies interact. Each theory provides unique insights into the challenges and solutions of maintaining patient privacy while improving care coordination in a digital healthcare environment (Fig.  1 ).

Balancing confidentiality and care coordination in digital health

This cross-sectional study was conducted at General Hospital in Egypt to evaluate the balance between patient confidentiality and care coordination in the digital age. Data was collected from a sample of nurses working in various departments in the hospital. The recruitment process entailed inviting all eligible nurses through internal communication channels, such as email and notice boards, with detailed information about the study and the importance of their participation. A total of 150 nurses were needed to achieve a representative sample, calculated using the formula for sample size estimation for a finite population: n  = z2 * p * (1—p)/e2 [ 40 ], where Z was the Z-value (1.96 for a 95% confidence level), p was the expected prevalence (assumed at 0.5 for maximum sample size), and e was the margin of error (0.05). The inclusion criteria for the study included nurses working at Damietta General Hospital for at least six months, directly involved in patient care, and consented to participate. Nurses on extended leave, such as maternity or sick leave, or those involved in administrative roles without direct patient care responsibilities were excluded from the study.

Data collection tools

Six tools were used for data collection.

Demographic form

The demographic questionnaire for this study was designed following a comprehensive review of relevant literature and studies and included variables such as age, gender, marital status, current job title/position at General Hospital, years of nursing experience, highest nursing qualification attained, training received on patient confidentiality and digital health technologies, and primary language of communication in the workplace. These variables were chosen to provide a comprehensive profile of the participating nurses, enabling a deeper analysis of their perceptions and practices concerning patient confidentiality and care coordination in the digital healthcare environment.

Health insurance portability and cccountability act (HIPAA) compliance checklist

The Health Insurance Portability and Accountability Act (HIPAA) is a regulatory framework enforced by the U.S. Department of Health and Human Services (HHS) to safeguard patient privacy and secure health information [ 41 ]. Healthcare providers use the HIPAA Compliance Checklist to ensure adherence to regulations, protecting patient information from unauthorised access and breaches. The HIPAA Compliance Checklist was chosen for its comprehensive approach to ensuring regulatory compliance and its ability to provide quantifiable data on privacy practices to identify best practices for maintaining patient confidentiality and enhancing care coordination by evaluating how well healthcare facilities implement privacy measures in the context of digital technologies. Components include administrative safeguards, such as security management processes and workforce training; physical safeguards, like facility access controls and workstation security, and technical safeguards including access control and audit controls. The checklist also covers organisational requirements such as business associate contracts and documentation of policies and procedures. The checklist evaluates adherence using a scoring system that rates each component from 0 (non-compliant) to 4 (fully compliant), with a total score ranging from 0 to 100.

Privacy impact assessment (PIA) tool

The Privacy Impact Assessment (PIA) tool, as detailed by Wright and De Hert [ 42 ], is used to identify and mitigate risks and ensure compliance with data protection regulations by thoroughly evaluating how information is collected, used, shared, and stored. The PIA tool typically includes sections on project descriptions, methods of data collection, practices for data usage and sharing practices, data storage and security strategies, identification of potential privacy risks, and methods for mitigating these risks. Each section is scored on a scale from 0 (non-compliant) to 5 (fully compliant), resulting in a total score range from 0 to 35. The PIA tool is chosen to identify and manage privacy risks, which aligns with the study's aim to balance confidentiality and care coordination. It helps evaluate how effectively privacy measures are integrated into new systems, thus ensuring that privacy concerns are proactively addressed and managed.

Data sharing agreement (DSA) framework

The Data Sharing Agreement (DSA) framework [ 43 ] establishes clear protocols to ensure data privacy and security while facilitating effective care coordination to enhance patient care and comply with legal requirements. Key components of the DSA framework include defining the purpose of data sharing, specifying the types of data to be shared, outlining the roles and responsibilities of involved parties, implementing robust data protection measures, managing consent appropriately, and establishing terms for data use and retention. Regarding compliance evaluation, each section of the DSA framework was assessed on a scale from 0 (indicating non-compliance) to 4 (indicating full compliance), resulting in a total score range from 0 to 24. The DSA framework is chosen for its structured approach to managing data sharing while ensuring privacy and security. It supports the study's aim of balancing confidentiality with effective care coordination by providing a comprehensive system for managing data-sharing agreements.

Electronic health record (EHR) privacy and security assessment tool

The Electronic Health Record (EHR) Privacy and Security Assessment Tool [ 44 ] is critical for evaluating EHR systems' privacy and security features. This tool ensures that EHR systems adhere to regulations and best practices, protecting patient information against unauthorised access and breaches. Key components evaluated by the assessment tool include access controls, encryption methods, audit trail functionalities, measures for maintaining data integrity, and protocols for incident response. In terms of scoring, each component was typically rated on a scale from 0 (indicating non-compliance) to 5 (indicating full compliance), resulting in a total score range from 0 to 25. This assessment tool is chosen for its comprehensive approach to evaluating EHR systems' security and privacy features, aligning with the study's aim of ensuring effective privacy protection while facilitating care coordination.

National institute of standards and technology (NIST) cybersecurity framework

The National Institute of Standards and Technology (NIST) Cybersecurity Framework [ 45 ] is a foundational tool healthcare organisations, including nursing staff, use to enhance and assess their cybersecurity measures. Key components of the NIST Cybersecurity Framework include five core functions: Identify, Protect, Detect, Respond, and Recover. Each function incorporates specific categories and subcategories detailing activities and best practices for cybersecurity. Each core function can be assessed on a scale from 0 (indicating not implemented) to 4 (indicating fully implemented), resulting in a total score range from 0 to 20. This framework is selected for managing cybersecurity risks, aligning with the study's aim of safeguarding patient information while ensuring effective care coordination.

Validation and reliability

In the preliminary phase of this study, a pilot test was conducted involving 10% of the total nurses, equivalent to 10 individuals, using the newly introduced data sharing agreement (DSA) framework, the electronic health record (EHR) privacy and security assessment tool, and the National Institute of Standards and Technology (NIST) Cybersecurity Framework. These participants were excluded from the final sample size to mitigate any potential bias from their prior exposure to the research instruments, ensuring the integrity of the results. During the pilot phase, a crucial step involved implementing factor analysis. This statistical technique was employed to rigorously examine the relevance and accuracy of each component within the research instruments. Following the pilot study, the insights gained from factor analysis informed the decision-making process for the final study. The same factor analysis methodology was applied to the remaining nurses who were not part of the pilot study.

Additionally, content validity was rigorously employed as a methodological approach to validate the measurement instruments used in this study. Specifically, for the data sharing agreement (DSA) framework, electronic health record (EHR) privacy and security assessment tool, and National Institute of Standards and Technology (NIST) Cybersecurity Framework, content validity procedures were implemented to ensure that the items within these instruments accurately and comprehensively captured the intended constructs. Experts possessing considerable knowledge and experience in healthcare data sharing, cybersecurity, and relevant research methodologies critically evaluated the items to ensure that they effectively measured the key dimensions of data sharing protocols, EHR privacy and security features, and cybersecurity practices.

Reliability, a fundamental aspect of measurement accuracy in research, was meticulously assessed for each tool employed in this study. The data sharing agreement (DSA) framework underwent thorough scrutiny, with the calculation of Cronbach's alpha as a robust indicator of its internal consistency. The results revealed an impressive Cronbach's alpha value of 0.87, signifying a high level of Reliability. Similarly, the electronic health record (EHR) privacy and security assessment tool comprehensively evaluated its internal consistency using Cronbach's alpha. The findings were notably robust, with a calculated alpha value of 0.88. This high degree of internal consistency underscores the tool's Reliability in assessing EHR privacy and security features, indicating that it consistently measures these aspects stably and dependably. The Cronbach's alpha value of 0.88 signifies a strong level of agreement among the tool's items, further enhancing the credibility of the data generated from this instrument.

Ethical approval and consideration

This study adhered to stringent ethical standards and received approval from the Research Ethics Committee (REC) at the Faculty of Nursing, Zagazig University, Egypt under the code ID/Zu.Nur.REC#:0067. Nurses were described the study's objectives, methodologies, potential risks, and benefits and provided written, informed consent before participation, signifying their understanding of the study's purpose and their voluntary decision to contribute. Strict confidentiality measures were implemented, ensuring all collected data was anonymised and securely stored to protect participant privacy.

Statistical analysis

Statistical analysis was conducted using SPSS 26. Descriptive statistics, including counts, percentages, mean scores and standard deviations (mean ± SD), were systematically employed to offer a detailed overview of demographic characteristics and the usage status of the Privacy Impact Assessment (PIA) Tool, Data Sharing Agreement (DSA) Framework, Electronic Health Record (EHR) Privacy and Security Assessment Tool, and National Institute of Standards and Technology (NIST) Cybersecurity Framework. These statistical measures provided a nuanced understanding of the respondents' backgrounds, contributing valuable insights into the diverse composition of the sample and the distribution of tools' utilisation among participants. Spearman's rank correlation coefficient (r) was utilised to unveil significant associations among the tools, highlighting the interconnected nature of these critical constructs within the nursing context.

Furthermore, the study integrated inferential statistics, including ANOVA and t-tests, to add depth to the analysis of the tools. These statistical methods uncovered associations and significant differences related to demographic variables, contributing to a holistic understanding of the factors influencing nurses' attitudes and behaviours towards privacy, security, and data-sharing practices. This multifaceted statistical approach, executed with the aid of SPSS 26, captured the distribution of key attributes and explored relationships and patterns across variables pertinent to the tools' implementation and impact.

Table 1 shows the demographic profile of study participants. Most participants were between 31 and 40 (45%), followed by those aged 20–30 (35%). Female participants comprised 75% of the sample, while males comprised 25%. Most participants were married (55%), with 40% being single and 5% divorced or in other categories. Regarding job titles, 60% were staff nurses, 20% were nurse managers, 10% were nurse educators, and 10% were nurse practitioners. Experience-wise, 30% had 0–5 years, 25% had 6–10 years, 20% had 11–15 years, and 25% had over 16 years of nursing experience. Regarding qualifications, 40% held a diploma, 35% a bachelor's degree, 20% a master's degree, and 5% a doctorate. A significant majority had received training on confidentiality (70%), while half had training on digital health technologies. The primary language of communication was Arabic (80%), with English used by 20% of the participants.

Table 2 presents the mean scores and standard deviations for the components of the HIPAA Compliance Checklist. The results indicate that the highest compliance was observed in Administrative Safeguards, with a mean score of 3.8 ± 0.5. Technical Safeguards follow this with a mean score of 3.7 ± 0.6. Physical Safeguards had a mean score of 3.5 ± 0.7. In contrast, Organisational Requirements had a mean score of 3.6 ± 0.8. The overall total score was 85 with a standard deviation of 10, suggesting generally high compliance with some variability among the components.

Table 3 displays the mean scores and standard deviations for each Privacy Impact Assessment (PIA) Tool section. Across all sections, high scores were observed, indicating robust compliance with privacy standards. Project Descriptions received the highest mean score of 4.5 ± 0.3, reflecting clear and comprehensive project documentation. Data Storage and Security Strategies also scored a mean of 4.4 ± 0.4, highlighting strong measures for protecting data integrity and security. The total score of 30 ± 3 underscores overall high adherence to privacy protocols, albeit with some variability across specific assessment criteria.

Table 4 presents the mean scores and standard deviations (mean ± SD) for each Data Sharing Agreement (DSA) Framework component. The assessment reveals solid compliance across all components, with Data Protection Measures achieving the highest mean score of 4.0 and a standard deviation of 0.4, indicating robust safeguards for data security. Purpose of Data Sharing and Roles and Responsibilities both received a mean score of 3.8, demonstrating clarity in defining the objectives and delineating roles in data-sharing activities. Consent Management and Data Use and Retention Terms also scored well, reflecting comprehensive practices in managing consent and outlining data use and retention terms. The total score of 20 with a standard deviation of 2 indicates strong adherence to data-sharing protocols, with minor variability in assessment outcomes.

Table 5 presents the mean scores and standard deviations for each Electronic Health Record (EHR) Privacy and Security Assessment Tool component. Access Controls received the highest mean score of 4.4, indicating strong implementation of measures to control access to patient information. Encryption Methods and Data Integrity Measures scored 4.3, highlighting robust practices in securing and maintaining the integrity of EHR data. Audit Trail Functionalities and Incident Response Protocols scored 4.2, indicating effective mechanisms for tracking access to records and responding to security incidents. The total score of 22 ± 1.5 suggests high overall compliance with EHR privacy and security requirements, with minimal variability in assessment outcomes.

Table 6 displays the mean scores and standard deviations for each function of the National Institute of Standards and Technology (NIST) Cybersecurity Framework. The framework is designed to enhance cybersecurity practices across healthcare settings, focusing on five core functions: Identify, Protect, Detect, Respond, and Recover. Protect achieved the highest mean score of 3.8, indicating strong implementation of measures to protect against cybersecurity threats. Identify, Respond, and Recover scored similarly at 3.7, highlighting robust capabilities in identifying assets, responding to incidents, and recovering from cybersecurity events. Detect scored slightly lower at 3.6, suggesting areas for potential improvement in detecting and mitigating threats. The total score of 18 ± 2 reflects generally effective cybersecurity practices with moderate variability in implementation across functions.

The correlation matrix (Table  7 ) reveals significant relationships among key frameworks for assessing healthcare data security and privacy measures. These tools include the Health Insurance Portability and Accountability Act (HIPAA) Compliance Checklist, Privacy Impact Assessment (PIA) Tool, Data Sharing Agreement (DSA) Framework, Electronic Health Record (EHR) Privacy and Security Assessment Tool, and the National Institute of Standards and Technology (NIST) Cybersecurity Framework. Strong positive correlations were found between HIPAA Compliance and both EHR Privacy and Security ( r  = 0.70, p  < 0.05) and NIST Cybersecurity Framework ( r  = 0.55, p  < 0.05), indicating that adherence to HIPAA regulations often coincides with robust electronic health record protections and cybersecurity practices. The PIA Tool demonstrated moderate positive correlations with the DSA Framework ( r  = 0.55, p  < 0.05) and EHR Privacy and Security ( r  = 0.60, p  < 0.05), underscoring the alignment between thorough privacy impact assessments and effective data sharing agreements and EHR security measures. These findings highlight the interconnectedness of regulatory compliance and proactive privacy measures in ensuring comprehensive healthcare data protection across organisational settings.

Nurses are pivotal in the healthcare system, and their expertise spans various domains, from clinical practice to administrative roles, influencing the quality and delivery of healthcare services. In recent years, the evolving healthcare landscape has underscored the need for nurses to navigate complex challenges such as patient privacy, data security, and regulatory compliance, are crucial for safeguarding patient information and maintaining trust and integrity within healthcare settings. This study explored the efficacy of several frameworks and tools designed to enhance data privacy and security measures, aiming to empower nurses with comprehensive strategies that align with regulatory standards and promote optimal patient care outcomes [ 46 , 47 ].

The high mean scores in administrative safeguards (mean = 3.8, SD = 0.5) and technical safeguards (mean = 3.7, SD = 0.6) reflected a strong commitment to data privacy and security within the healthcare sector. These findings indicated that some healthcare organisations are implementing measures to secure electronic protected health information (ePHI) and manage access controls effectively. However, there remains variability that needs addressing. The lower scores in physical safeguards (mean = 3.5, SD = 0.7) and organisational requirements (mean = 3.6, SD = 0.8) highlight areas where further attention is needed. The variability in these scores suggests potential challenges in implementing physical security measures and ensuring consistent policy documentation and workforce training. Previous studies highlighted the importance of comprehensive physical security measures and consistent organisational policies in maintaining overall compliance [ 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 ].

Regarding the Privacy impact assessment, high scores in project descriptions (mean = 4.5, SD = 0.3) and data storage and security strategies (mean = 4.4, SD = 0.4) suggested thorough documentation and robust security measures are in place, effectively identifying and mitigating privacy risks associated with new projects and data handling practices. However, the variability in scores across different sections of the PIA Tool indicated a need for continuous improvement in data usage, sharing practices, and risk mitigation methods, where consistent implementation may vary. These findings are consistent with previous studies that emphasised the need for comprehensive project documentation and secure data handling practices [ 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 ].

Concerning the data sharing agreement, the high scores in Data Protection Measures (mean = 4.0, SD = 0.4) indicated robust safeguards for data security. The purpose of data sharing and roles and responsibilities also performed well, reflecting clear definitions of data sharing objectives and roles. However, the moderate score variability indicated challenges in uniformly implementing consent management practices and data use terms. Prior studies also support the critical role of well-defined data-sharing agreements in balancing data utility and privacy protection [ 66 , 67 , 68 , 69 ].

In terms of electronic health record privacy and security assessment, high scores in access controls (mean = 4.4, SD = 0.3), encryption methods, and data integrity measures (mean = 4.3) reflected advancements in technology and policies aimed at enhancing data protection in healthcare settings, highlighting effective implementation of access management protocols. However, the minor variability in scores suggested room for improvement in incident response protocols. These findings were consistent with literature advocating for robust access controls and encryption methods to mitigate risks associated with EHR breaches [ 70 , 71 , 72 , 73 , 74 , 75 ].

With respect to the NIST Cybersecurity Framework , the high scores in the Protect function (mean = 3.8) indicated strong measures to protect healthcare information systems from cybersecurity threats. The identify, respond, and recover functions also scored well (mean = 3.7), highlighting robust capabilities in identifying assets, responding to incidents, and recovering from cyber-attacks. However, the slightly lower score in the detect function (mean = 3.6) suggested areas for improvement in detecting and mitigating cybersecurity threats. These results were supported by research emphasising the effectiveness of the NIST framework in enhancing cybersecurity resilience across various sectors, including healthcare [ 76 , 77 , 78 , 79 , 80 , 81 , 82 ].

Moreover, the current study revealed significant relationships among key frameworks used to assess healthcare data security and privacy measures, underscoring the interconnectedness of regulatory compliance efforts and proactive privacy measures. For instance, strong positive correlations were found between HIPAA Compliance and both EHR Privacy and Security ( r  = 0.70, p  < 0.05) and the NIST Cybersecurity Framework ( r  = 0.55, p  < 0.05), indicating that adherence to HIPAA regulations often coincides with robust electronic health record protections and cybersecurity practices. The PIA Tool demonstrated moderate positive correlations with the DSA Framework ( r  = 0.55, p  < 0.05) and EHR Privacy and Security ( r  = 0.60, p  < 0.05), highlighting the alignment between thorough privacy impact assessments and effective data sharing agreements and EHR security measures. These findings suggested that while certain frameworks complement each other well, there may be specific areas where improvements could enhance overall data security posture [ 83 , 84 , 85 ].

Study Limitations

This study has several notable limitations. Firstly, the cross-sectional design captures data at a single point in time, which may not fully reflect the dynamic nature of digital healthcare environments and evolving privacy challenges. Future research could address this by employing a longitudinal design to track how privacy and care coordination evolve with changes in technology and regulations. Secondly, the study was conducted at a single hospital, which may limit the generalizability of the findings to other healthcare settings with different digital infrastructures and privacy practices. Including multiple healthcare settings with diverse digital systems and privacy practices in future studies could enhance the applicability of the findings.

Additionally, the reliance on self-reported data from nurses introduces potential response bias, as participants may overstate their adherence to privacy and security protocols, resulting in inflated compliance rates. The exclusion of nurses on extended leave or those in administrative roles also limits the study's comprehensiveness. These groups might have unique insights or experiences related to confidentiality and care coordination that are not captured in the current study. Finally, while the study used validated tools, the rapid evolution of digital health technologies means that these tools may quickly become outdated. The changing landscape of technology and privacy standards can affect the relevance and accuracy of the assessment instruments. Addressing these limitations in future studies will provide more comprehensive understanding of privacy and care coordination in digital healthcare environments and improve the relevance and applicability of the findings across different contexts and periods.

Conclusion and recommendations

In conclusion, this study underscores the crucial role of nurses in ensuring robust data privacy and security within healthcare settings. The findings reveal high compliance with HIPAA regulations, particularly in administrative and technical safeguards, and strong performance in project descriptions and data storage strategies. The adherence to data privacy and sharing protocols, effective EHR security measures, and alignment with the NIST Cybersecurity Framework reflect a comprehensive approach to data protection. However, the variability in certain areas, such as physical safeguards, organisational requirements, and detection measures, highlights the need to continuously enhance data security practices to maintain the integrity and trust essential in healthcare. Investing in continuous training programs for nurses is crucial. Healthcare organisations should provide regular, specialised training addressing emerging privacy regulations, cybersecurity threats, and best practices. Upgrading physical security measures, such as access controls and surveillance, and ensuring that all organisational policies and procedures are up-to-date with current regulations will help achieve comprehensive HIPAA compliance.

Another key recommendation is to standardise and enhance consent management practices and data use terms. Organisations should develop clear, standardised consent forms and data use agreements, implement automated systems for tracking and managing consent, and regularly review and update these policies to reflect regulation changes. Additionally, conducting regular audits and updating detection measures is vital for improving overall cybersecurity posture. Lastly, fostering a culture of continuous improvement and proactive privacy management within healthcare organisations is essential. Encouraging open communication about privacy and security concerns, rewarding compliance and proactive measures, and engaging staff in regular discussions about privacy and security initiatives will contribute to a robust privacy management culture.

Study Implications

The findings of this study offer several actionable insights for healthcare practice, policy, and future research.

Healthcare Practice: The study highlights the critical need for continuous and comprehensive training for nurses on digital health privacy and security protocols. Specific recommendations include developing targeted training programs that address emerging privacy threats and technologies. Additionally, integrating privacy and security training into onboarding processes for new staff can ensure that all personnel are up-to-date with best practices from the start.

Policy: Policymakers should prioritise the development of detailed guidelines that address the specific challenges posed by these technologies, such as data sharing and electronic health records. Recommendations include establishing clear standards for data encryption, access controls, and consent management. Regular policy reviews and updates are necessary to keep pace with technological advancements and ensure ongoing protection of patient confidentiality.

Future Research: Longitudinal studies are needed to assess how implementing digital health technologies impacts patient privacy and care coordination over time. Future studies could also focus on developing and validating new assessment tools that reflect the latest technological advancements and privacy challenges. Investigating the role of interdisciplinary approaches, combining insights from cybersecurity experts and healthcare practitioners, could further enhance privacy and security measures in digital health environments.

Availability of data and materials

Data sharing is not applicable to this article as no datasets were generated or analysed during the current study.

Data availability

No datasets were generated or analysed during the current study.

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Acknowledgements

The authors thank all the nurses who participated in our study. This study is supported via funding from Prince Sattam bin Abdulaziz University project number (PSAU/2024/R/1445). Also; The authors would like to thank Al-Maarefa University, Riydah, Saudi Arabia for supporting this research.

This study is supported via funding from Prince Sattam bin Abdulaziz University project number (PSAU/2024/R/1445).

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Ibrahim, A.M., Abdel-Aziz, H.R., Mohamed, H.A.H. et al. Balancing confidentiality and care coordination: challenges in patient privacy. BMC Nurs 23 , 564 (2024). https://doi.org/10.1186/s12912-024-02231-1

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What happened in the Kolkata rape case that triggered doctors’ protests?

Activists and doctors in India demand better safeguarding of women and medical professionals after a trainee medic was raped and murdered in Kolkata.

Activists and doctors across India continued to protest on Wednesday to demand justice for a female doctor, who was raped and murdered while on duty in a hospital in the eastern city of Kolkata.

Feminist groups rallied on the streets in protests titled “Reclaim the Night” in Kolkata overnight on Wednesday – on the eve of India’s independence day – in solidarity with the victim, demanding the principal of RG Kar Medical College resign. Some feminist protesters also marched well beyond Kolkata, including in the capital Delhi.

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While the protests were largely peaceful, a small mob of men stormed the medical college and vandalised property. This group was dispersed by the police.

This comes after two days of nationwide protests by doctors following the incident at RG Kar Medical College in West Bengal’s capital city. “Sit-in demonstrations and agitation in the hospital campus will continue,” one of the protesting doctors, identified as Dr Mridul, told Al Jazeera.

Services in some medical centres were halted indefinitely, and marches and vigils shed light on issues of sexual violence, as well as doctors’ safety in the world’s most populous nation.

What happened to the doctor in Kolkata?

A 31-year-old trainee doctor’s dead body, bearing multiple injuries, was found on August 9 in a government teaching hospital in Kolkata.

The parents of the victim were initially told “by hospital authorities that their daughter had committed suicide,” lawyer and women’s rights activist Vrinda Grover told Al Jazeera. But an autopsy confirmed that the victim was raped and killed.

Grover has appeared for victims in sexual violence cases in India in the past, including Bilkis Bano , a Muslim woman who was gang-raped during the 2002 Gujarat riots, and Soni Sori, a tribal activist based in Chhattisgarh state.

Thousands of doctors marched in Kolkata on Monday, demanding better security measures and justice for the victim.

On Tuesday, the Kolkata High Court transferred the case to the Central Bureau of Investigation (CBI).

The Federation of Resident Doctors Association (FORDA) called for a nationwide halting of elective services in hospitals starting on Monday. Elective services are medical treatments that can be deferred or are not deemed medically necessary.

On Tuesday, FORDA announced on its X account that it is calling off the strike after Health Minister Jagat Prakash Nadda accepted protest demands.

One of these demands was solidifying the Central Protection Act, intended to be a central law to protect medical professionals from violence, which was proposed in the parliament’s lower house in 2022, but has not yet been enacted.

FORDA said that the ministry would begin working on the Act within 15 days of the news release, and that a written statement from the ministry was expected to be released soon.

Press release regarding call off of strike. In our fight for the sad incident at R G Kar, the demands raised by us have been met in full by the @OfficeofJPNadda , with concrete steps in place, and not just verbal assurances. Central Healthcare Protection Act ratification… pic.twitter.com/OXdSZgM1Jc — FORDA INDIA (@FordaIndia) August 13, 2024

Why are some Indian doctors continuing to protest?

However, other doctors’ federations and hospitals have said they will not back down on the strike until a concrete solution is found, including a central law to curb attacks on doctors.

Those continuing to strike included the Federation of All India Medical Associations (FAIMA), Delhi-based All India Institute Of Medical Sciences (AIIMS) and Indira Gandhi Hospital, local media reported.

Ragunandan Dixit, the general secretary of the AIIMS Resident Doctors’ Association, said that the indefinite strike will continue until their demands are met, including a written guarantee of the implementation of the Central Protection Act.

Medical professionals in India want a central law that makes violence against doctors a non-bailable, punishable offence, in hopes that it deters such violent crimes against doctors in the future.

Those continuing to protest also call for the dismissal of the principal of the college, who was transferred. “We’re demanding his termination, not just transfer,” Dr Abdul Waqim Khan, a protesting doctor told ANI news agency. “We’re also demanding a death penalty for the criminal,” he added.

“Calling off the strike now would mean that female resident doctors might never receive justice,” Dr Dhruv Chauhan, member of the National Council of the Indian Medical Association’s Junior Doctors’ Network told local news agency Press Trust of India (PTI).

Which states in India saw doctors’ protests?

While the protests started in West Bengal’s Kolkata on Monday, they spread across the country on Tuesday.

The capital New Delhi, union territory Chandigarh, Uttar Pradesh capital Lucknow and city Prayagraj, Bihar capital Patna and southern state Goa also saw doctors’ protests.

Who is the suspect in the Kolkata rape case?

Local media reported that the police arrested suspect Sanjoy Roy, a civic volunteer who would visit the hospital often. He has unrestricted access to the ward and the police found compelling evidence against him.

The parents of the victim told the court that they suspect that it was a case of gang rape, local media reported.

Why is sexual violence on the rise in India?

Sexual violence is rampant in India, where 90 rapes were reported on average every day in 2022.

Laws against sexual violence were made stricter following a rape case in 2012, when a 22-year-old physiotherapy intern was brutally gang-raped and murdered on a bus in Delhi. Four men were hanged for the gang rape, which had triggered a nationwide protests.

But despite new laws in place, “the graph of sexual violence in India continues to spiral unabated,” said Grover.

She added that in her experience at most workplaces, scant attention is paid to diligent and rigorous enforcement of the laws.

“It is regrettable that government and institutions respond only after the woman has already suffered sexual assault and often succumbed to death in the incident,” she added, saying preventive measures are not taken.

In many rape cases in India, perpetrators have not been held accountable. In 2002, Bano was raped by 11 men, who were sentenced to life imprisonment. In 2022, the government of Prime Minister Narendra Modi authorised the release of the men, who were greeted with applause and garlands upon their release.

However, their remission was overruled and the Supreme Court sent the rapists back to jail after public outcry.

Grover believes that the death penalty will not deter rapists until India addresses the deeply entrenched problem of sexual violence. “For any change, India as a society will have to confront and challenge, patriarchy, discrimination and inequality that is embedded in our homes, families, cultural practices, social norms and religious traditions”.

What makes this case particularly prominent is that it happened in Kolkata, Sandip Roy, a freelance contributor to NPR, told Al Jazeera. “Kolkata actually prided itself for a long time on being really low in the case of violence against women and being relatively safe for women.”

A National Crime Records Bureau (NCRB) report said that Kolkata had the lowest number of rape cases in 2021 among 19 metropolitan cities, with 11 cases in the whole year. In comparison, New Delhi was reported to have recorded 1, 226 cases that year.

Prime Minister Modi’s governing Bharatiya Janata Party (BJP) has called for dismissing the government in West Bengal, where Kolkata is located, led by Mamata Banerjee of All India Trinamool Congress (AITC). Banerjee’s party is part of the opposition alliance.

Rahul Gandhi, the leader of the opposition in parliament, also called for justice for the victim.

“The attempt to save the accused instead of providing justice to the victim raises serious questions on the hospital and the local administration,” he posted on X on Wednesday.

Roy spoke about the politicisation of the case since an opposition party governs West Bengal. “The local government’s opposition will try to make this an issue of women’s safety in the state,” he said.

Have doctors in India protested before?

Roy explained to Al Jazeera that this case is an overlap of two kinds of violence, the violence against a woman, as well as violence against “an overworked medical professional”.

Doctors in India do not have sufficient workplace security, and attacks on doctors have started protests in India before.

In 2019, two junior doctors were physically assaulted in Kolkata’s Nil Ratan Sircar Medical College and Hospital (NRSMCH) by a mob of people after a 75-year-old patient passed away in the hospital.

Those attacks set off doctors’ protests in Kolkata, and senior doctors in West Bengal offered to resign from their positions to express solidarity with the junior doctors who were attacked.

More than 75 percent of Indian doctors have faced some form of violence, according to a survey by the Indian Medical Association in 2015.

What happens next?

The case will now be handled by the CBI, which sent a team to the hospital premises to inspect the crime scene on Wednesday morning, local media reported.

According to Indian law, the investigation into a case of rape or gang rape is to be completed within two months from the date of lodging of the First Information Report (police complaint), according to Grover, the lawyer.

The highest court in West Bengal, which transferred the case from the local police to the CBI on Tuesday, has directed the central investigating agency to file periodic status reports regarding the progress of the investigation.

The FIR was filed on August 9, which means the investigation is expected to be completed by October 9.

Bengal women will create history with a night long protest in various major locations in the state for at 11.55pm on 14th of August’24,the night that’ll mark our 78th year as an independent country. The campaign, 'Women, Reclaim the Night: The Night is Ours', is aimed at seeking… pic.twitter.com/Si9fd6YGNb — purpleready (@epicnephrin_e) August 13, 2024

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Biggest Questions Left On Georgia's Roster

Brooks austin | 5 hours ago.

The Georgia Bulldogs are just 12 days away from the start of their 2024 college football seasons. Classes are underway in Athens, and the preparation for Clemson has begun. Thus, the fall camp portion of the season has concluded and it's time to put the final touches on the gameplan for their season opener.

Though Fall Camp has come to a conclusion, they still have two weeks worth of practice to answer the remaining questions on their roster.

Who Will Start at Corner? Based on everything we've learned from sources this fall camp, it's been an intense battle between Julian Humphrey and Daniel Harris opposite of Daylen Everrette with freshman Ellis Robinson showing obvious signs of needing playing time. Sources have indicated that both Humphrey and Harris have been rotating days in which they are the "starter" and there's been no sign of a chosen direction yet for this coaching staff. It's possible their could be a rotation against Clemson to see who the "gamer" is of the group.

Just How Healthy Will They Be? Center Jared Wilson returned to action this weekend per sources, though they've been without the likes of Colbie Young, Warren Brinson, Roderick Robinson, Jordan Hall, and as of late Xavier McLeod. The good news for Georgia is that apart from the defensive line, they haven't had a position group suffer multiple injuries this fall camp. The Defensive Tackle position is rather banged up at the moment, just how healthy can they get over the next 12 days?

Who Are THE Targets? Georgia has a plethora of talented options at the wide receiver and tight end positions. The question for Georgia isn't going to be whether or not they have enough targets, it's which of their targets are the most dynamic, explosive, and perhaps most importantly, consistent. Dominic Lovett, Dillon Bell, and Oscar Delp seem to be known answers in this department... who else can they add to that discussion for certainty this fall?

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This latest generation fulfilment centre utilises advanced technology across three floors of Amazon Robotics to stow, pick and ship customer orders. Amazon consistently invests in its workplaces to provide the most modern, engaging and safe environment for employees.

The building is located in close proximity to an Amazon delivery station and an Amazon Robotics sortation centre, and less than ten miles from the Wakefield fulfilment centre which started operations in October 2022.

James Mason, West & North Yorkshire Chamber of Commerce Chief Executive, said: “This further, significant investment from Amazon is a confirmation of our strategic location for the logistics industry as a whole, and a ringing endorsement for the strength and skillset of the workforce in our region.

“We at the Chamber welcome the job creation, a significant boost for the region’s economy.”

Richard Thompson, Amazon’s Regional Director, said: “West Yorkshire is an important region for Amazon, with more than 3,800 small- and medium-sized enterprise selling partners, and I am delighted to confirm our ongoing commitment with this £500 million investment in a new, state-of-the-art fulfilment centre in Leeds. This new site will create more than 2,000 new jobs, taking our total workforce in the region to more than 4,000 full and part-time roles, and our investment in the region to more than £1.5 billion since 2010.

“Amazon continues to invest in our buildings and innovative technology to provide our people with some of the most advanced workplaces of their kind in the world, ensuring their wellbeing while delivering for our customers.”

Mandy Ridyard, Business Advisor to the Mayor of West Yorkshire, said: “Amazon’s multi-million pound investment in Leeds is a fantastic vote of confidence in our region and supports our ambition to drive economic growth.

“I’m delighted that thousands more new jobs will be created for people throughout our communities, as we work to build a stronger, brighter West Yorkshire that works for all.”

Energy efficiency is a top priority in the operation of the new fulfilment centre, which features specialist building management systems including solar roof panels which will ensure a comfortable working environment for employees at the same time as reducing unnecessary energy consumption. Amazon is the world’s largest corporate purchaser of renewable energy, and last year matched 100% of the power required for our global operations with renewable energy sources – seven years ahead of our original target.Amazon has invested over £56 billion in the UK since 2010 to provide convenience, selection and value to UK consumers, while helping to digitally empower hundreds of thousands of small businesses and content creators.

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NOTES TO EDITORS

Amazon employees receive competitive pay and comprehensive benefits. Pay starts at a minimum of £12.30 or £13 per hour depending on location and employees are offered a comprehensive benefits package, including private medical insurance, life assurance, income protection and an employee discount as well as a company pension plan.

Amazon also offers employees Career Choice, an innovative programme which pre-pays 95% of tuition for courses in high-demand fields, up to £8,000 over four years, regardless of whether the skills are relevant to a career at Amazon.

To find out more about a career with Amazon, visit Amazon Jobs .

For further information please contact:

Amazon UK Press Office Email: [email protected]

About Amazon Amazon is guided by four principles: customer obsession rather than competitor focus, passion for invention, commitment to operational excellence, and long-term thinking. Customer reviews, 1-Click shopping, personalized recommendations, Prime, Fulfilment by Amazon, AWS, Kindle Direct Publishing, Kindle, Fire tablets, Fire TV, Amazon Echo, and Alexa are some of the products and services pioneered by Amazon. For more information, visit aboutamazon.co.uk and follow @AmazonNewsUK .