Critical Care Nurses' Perceptions and Knowledge of Patient Confidentiality

The perceptions that critical care nurses express regarding patient confidentiality may yield insight to what information this population of nurses' value as protected health information, their knowledge of confidentiality law and bio-ethics and what information they communicate with patients' family members and others visitors. The purpose of this study was to explore critical care nurses' perceptions and knowledge of patient confidentiality. In an effort to explore this, 12 respondents were asked (a) what knowledge of legislation and ethics critical care nurses have related to confidentiality (b) how critical care nurses describe their roles regarding patient confidentiality and its application in their work environment, and (c) how critical care nurses describe their roles regarding confidentiality in the intensive care unit (ICU)? For this qualitative study, a naturalistic inquiry methodology was employed using semi-structured interviews and two structured scenarios that elicited participants' feelings and probable actions related to the scenarios. Participants were recruited via snowballing. Interviews were audio-recorded, and transcripts were analyzed using content analysis, within case and cross-case. The synthesizing framework, Therapeutic Jurisprudence provided structure for the study, allowing assessment of the actors (nurses) and the application of rules (legislation) in relation to the outcomes of application of the rules to individual practice (therapeutic vs. antitherapeutic). Critical care nurses were knowledgeable about federal confidentiality law, the role of the Board of Nursing and resources available regarding confidentiality. Further education for critical care nurses about specific state legislation as well as organizational policy is needed. Nurses employed their knowledge and values regarding confidentiality in the interaction and communication with their patients, family members and visitors. Nurses' application of ethical principles exemplifies their concern regarding the communication they should provide and the information they desired to provide to patient families and significant others. Nurses indicated that while the legislation is therapeutic, there is still work needed to prevent breach of confidentiality. Understanding the critical care nurse's perception and knowledge may lead to adjustments in decision making regarding the protection of health information. Reexamination of health care policy at all levels may be better operationalized for nurses in the critical care field of practice.Doctor of Philosoph