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Saturday, October 31, 2009: 3:15 PM
Learning Objective 1: view a dynamic model of leadership initiatives that effectively reduced lateral violence scope and degree in the healthcare workplace.
Learning Objective 2: utilize a multiphasic, multi-pathway lateral violence reduction model in clinical practice to positively affect retention, nurse satisfaction levels.
Introduction: Lateral violence, or nurse to nurse violence, has received increased attention in the past few years and is acknowledged to be a continued source of stress facing the profession. Silence surrounding this disturbing phenomenon endangers patient safety and increases the vulnerability of an already fragmented profession.
Methods: This study used a descriptive mixed methods approach within a hospital-based cohort to examine a three phased leadership intervention initiative to reduce LV. A prospective mixed method quasi experimental design included pre and post-test examination of the degree ofLV present in the unit.
A nursing leadership team offered multi-level, multifaceted interventions to reduce lateral violence levels. A peer-reviewed questionnaire facilitated semi-structured interviews and focus groups on LV. Organizational climate assessment was embedded in the instrument. Qualitative analysis of focus groups and interviews revealed five major themes: 1) LV creates a toxic work environment; 2)LV varies in degree and effect from day to day; 3) LV equates with professional disrespect; 4) LV deleteriously effects teamwork and 5) fear of retaliation.
Results: Nurse recognition of LV effect on teamwork was strongly associated with recognition of LV. Negative associations between LV degree and RN satisfaction level and retention and a positive relationship with recognition of effect on teamwork were present. Retention and staff satisfaction levels increased, and temporary staff levels were reduced to zero following implementation of interventions. Qualitative data revealed improved levels of satisfaction, enhanced interpersonal relationships, and increased collaboration between team members. Episodes ofLV decreased, unit morale trended toward hopeful and positive. As bullying decreased, staff participation levels in staff development activities increased.
Conclusion: This paper has identified a multi-level leadership model to reduceLV in a critical care unit. A multifaceted, multi-level, evidence based leadership pathway reduced high LV levels and positively affected retention and nurse satisfaction.
Methods: This study used a descriptive mixed methods approach within a hospital-based cohort to examine a three phased leadership intervention initiative to reduce LV. A prospective mixed method quasi experimental design included pre and post-test examination of the degree of
A nursing leadership team offered multi-level, multifaceted interventions to reduce lateral violence levels. A peer-reviewed questionnaire facilitated semi-structured interviews and focus groups on LV. Organizational climate assessment was embedded in the instrument. Qualitative analysis of focus groups and interviews revealed five major themes: 1) LV creates a toxic work environment; 2)
Results: Nurse recognition of LV effect on teamwork was strongly associated with recognition of LV. Negative associations between LV degree and RN satisfaction level and retention and a positive relationship with recognition of effect on teamwork were present. Retention and staff satisfaction levels increased, and temporary staff levels were reduced to zero following implementation of interventions. Qualitative data revealed improved levels of satisfaction, enhanced interpersonal relationships, and increased collaboration between team members. Episodes of
Conclusion: This paper has identified a multi-level leadership model to reduce