Assessing potential threats to the confidentiality of employee health information in occupational health nursing practice in Manitoba

Abstract

This descriptive cross-sectional survey examined potential threats to the confidentiality of employee health information in occupational health nursing practice in Manitoba. Nurses' perception of a problem maintaining confidentiality was probed. Objective measures of the difficulty of maintaining confidentiality included sources and frequency of inappropriate requests for information and methods of occupation health records handling. Factors related to the nurse or his/her working environment which may affect ethical decision-making were explored. Data were collected using a self-administered mail questionnaire developed by the researcher. Ninety-four nurses were surveyed. An 86.2% response rate was achieved. Over half of the nurses surveyed indicated that they perceived maintaining confidentiality of employee health information to be a problem. Those who perceived this to be a problem were more likely to receive requests, particularly inappropriate requests, from employers. Subjects identified remedies for improving the protection of privacy. Resources used by nurses when making difficult ethical decisions were identified. Most respondents tended toward a patient advocacy role conception rather than a bureaucratic role conception in ethical decision-making. Other factors which may affect ethical decisions such as colleague support, decision-making authority, confidence, education, experience, and powerlessness were explored. Based on this study's findings, recommendations for nursing practice and further nursing research are suggested.