A qualitative investigation of nurses’ knowledge and practice gaps, regarding confidentiality and risk-actuated public interest disclosure-related decision-making

There is a legal duty of confidentiality on the part of nurses working in mental health care. Nonetheless, it may be necessary to release some information if a patient is assessed as posing a potential credible risk, to protect the patient or others from harm. However, contemporary research literature reveals gaps in nurses' knowledge and practice, with respect to sharing patients' confidential information. The aim of this study was to understand potential causal factors for these knowledge and practice gaps, so they can be addressed. A theoretical thematic analysis of focus-group data was undertaken. Findings indicated nurses had limited knowledge of confidentiality. Additionally, participants described a paucity of support networks nurses could approach for information. Participants also emphasised their perception that health services unrealistically expected them to always identify and manage patient risk. In summarising these findings, recommendations for interventions to address these knowledge and practice gaps are outlined.