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BACKGROUND: In 2008, the Joint Commission issued a sentinel event alert related to the significance of intimidating and disruptive behaviors in healthcare settings. The presence of these behaviors may lead to medical errors (Rosenstein et al., 2005; Institute for Safe Medication Practices: Survey on workplace intimidation, 2003; Gerardi, 2007), poor patient satisfaction (Rosenstein, 2005, Gerardi, 2007), increase costs of care (Gerardi, 2007) and an increase in turnover among qualified clinicians, administrators and managers (Rosenstein et al, 2005; Rosenstein et al, 2002).
PURPOSE: To investigate the time varying effects of disruptive and supportive behaviors targeted at nurses by focusing on consequences pertaining to both the nurse and the patient. It is hypothesized that disruptive and supportive behaviors directly affect the health and well being of nurses, which in turn affects patient safety and satisfaction. The proposed research will follow nurses from the emergency center, various inpatient medical units, and an outpatient short stay setting over a 3 month time period.
GOAL: To identify mechanisms that explain the dynamic effect of disruptive behaviors from peers and supervisors on nurses’ well being and patient safety. Further, to shed new light on when nurses are most vulnerable to the adverse effect of disruptive behaviors.
METHODS: A longitudinal research design will be used to assess the prevalence of disruptive and supportive behaviors through weekly on line surveys. The consequences evaluated and documented are a wide range of disruptive and supportive behaviors on nurses (e.g., emotional well being, turn-over, leave of absences, sick time, staff engagement and staff satisfaction), units (e.g., cohesiveness, cooperation, and attending the units’ goals), and patients (e.g., safety, patient and family satisfaction).
The proposed model seeks to provide a framework for understanding how the individuals’ personal attributes (values, ethnicity, age, tenure on the unit, level of education, and training); situational factors (quality of work environment, psychological climate, social support team dynamics, cohesiveness, supervisor relationships); and the interactions between them might attenuate the prevalence and effects of disruptive behaviors.