Decision-making processes of a nurse working in mental health, regarding disclosure of confidential personal health information of a patient assessed as posing a risk

Journal article


Conlon, Darren, Raeburn, Toby and Wand, Timothy. (2021). Decision-making processes of a nurse working in mental health, regarding disclosure of confidential personal health information of a patient assessed as posing a risk. Collegian: The Australian Journal of Nursing Practice, Scholarship and Research. 28(3), pp. 261-267. https://doi.org/10.1016/j.colegn.2020.08.010
AuthorsConlon, Darren, Raeburn, Toby and Wand, Timothy
Abstract

Background: Nurses working in mental health routinely face difficult decisions regarding confidentiality and disclosure of patient information. There is public interest in protecting patient confidentiality, and there is a competing public interest in disclosing relevant confidential information to protect the patient or others from harm. However, inappropriate disclosures may constitute a breach of confidentiality. Despite the gravity of this situation, there is a paucity of literature to guide nurses’ decision-making processes regarding confidentiality and disclosure.

Aim: To examine decision-making processes of a nurse working in mental health, regarding disclosure of personal health information of a patient assessed as posing a risk.

Methods: Qualitative interpretivist approach using thematic analysis of data derived from an instrumental case study of NK v Northern Sydney Central Coast Area Health Service 2010, a Civil and Administrative Tribunal matter in New South Wales, Australia.

Findings: Three important legal concerns relevant to nurses’ decision-making processes are illuminated. Firstly, for risk assessment there was an emphasis on a static notion of dangerousness. Secondly, rules of confidentiality and disclosure were not adequately observed. Thirdly, confidential information was disclosed without valid justification.

Discussion: Inappropriate decision-making processes that may lead to a breach of patient confidentiality were evident in the findings. Gaps in understanding nurses’ decision-making processes pertaining to confidentiality and disclosure of patient information that may be addressed by future research were also revealed.

Conclusion: Future research that addresses gaps in understanding nurses’ decision-making processes identified by this instrumental case study would provide greater guidance for nurses when making decisions regarding confidentiality and disclosure related to risk.

KeywordsAggression; Confidentiality; Mental health nursing; Public interest disclosure; Risk assessment; Self-injurious behaviour
Year01 Jan 2021
JournalCollegian: The Australian Journal of Nursing Practice, Scholarship and Research
Journal citation28 (3), pp. 261-267
PublisherElsevier Science BV
ISSN1322-7696
Digital Object Identifier (DOI)https://doi.org/10.1016/j.colegn.2020.08.010
Scopus EID1-s2.0-S1322769621X00042
Web address (URL)https://www.sciencedirect.com/science/article/pii/S1322769620301141?via%3Dihub
Research or scholarlyResearch
Page range261-267
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
PrintJun 2021
Publication process dates
Accepted23 Aug 2020
Deposited12 Mar 2024
Additional information

© 2020 Australian College of Nursing Ltd. Published by Elsevier Ltd.

Place of publicationNetherlands
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