Evaluating the Work Environment: Development of a Horizontal Violence Scale

Longo, Joy

Saturday, April 13, 2013: 3:50 PM

Joy Longo, PhD, RN
David Newman, PhD
Duangporn Piyakong, RN
Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL

Learning Objective 1: describe a theoretical model of horizontal violence.

Learning Objective 2: identify steps of developing a tool to measure horizontal violence in the practice setting.

Background: Recently the behaviors of healthcare workers have come under scrutiny due to their potential negative impact on patient care and safety. Inappropriate behaviors such as intimidation, yelling, ignoring, and physical threats can lead to a breakdown in communication and collaboration both hallmarks of a healthy work environment. When the behaviors occur among nurses it is known as horizontal violence. Nurses need to be supportive of each other so that quality patient care can be delivered.

Purpose: Horizontal violence can be defined as physical, verbal, and emotional inappropriate behaviors display among colleagues that may be overt or covert. In order to address horizontal violence in nursing, we must accurately measure the extent of the problem and develop effective interventions that specifically address nurse-to-nurse violence. The purpose of this research was to develop a theoretically-based instrument to measure horizontal violence in the clinical setting and to test the reliability and validity.

Methods: The Horizontal Violence Scale (HVS) was created in stages. First, items were developed based on the theoretical model of Horizontal Violence. Once the items were created they were given to 3 expert judges to assess content validity. An item was retained if at least two of the reviewers rated the item as a score of 3 (quite relevant) or a 4 (very relevant). This resulted in the final 23-item tool. In the second stage data on the HV instrument collected on over 300 clinical managers. A Confirmatory Factor Analysis (CFA) was then conducted on this data to test if the items created do reflect the underlying theoretical constructs. Reliability was assessed using Chronbach’s Alpha and Item Response Theory.

Results: The Confirmatory Factor Analysis showed a good model fit. The HVS can be used in the practice to help in creating healthy work environments.

See more of: CLINICAL SESSION: Healthy Work Environment Collaborations
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