A multi-center study of horizontal violence in United States military nursing

Recommendations From a Systematic Review of Leadership Development to Support a New Nursing Practice Model

OBJECTIVE

To develop a new nursing practice model for use within the US military, researchers aimed to create evidence-based recommendations for nursing leadership development based on current literature.

BACKGROUND

The role of nursing leadership has many implications, including better nurse and patient outcomes. Therefore, an actionable compilation of recommendations informing how to develop effective nurse leaders could be helpful for current and aspiring nurse leaders.

METHODS

Researchers conducted a systematic literature review of 5 databases searching for relevant articles published from 2001 to 2020.

RESULTS

Seventy-eight articles were synthesized to develop a list of 5 broad yet actionable recommendations for leadership development.

CONCLUSIONS

Leadership development is essential for current and future nurse leaders. The recommendations identified from this review can assist in developing leaders. Leaders can use these recommendations to guide leadership training initiatives, engage in self-development, or begin succession planning.

Social shaming and bullying of mental health staff by patients: A survey in a mental health centre

WHAT IS KNOWN ON THE SUBJECT?: Public shaming, especially by consumers of healthcare, is getting worse and has become a specific case of bullying Despite extensive research on physical and verbal violence directed towards mental health workers, the issue of social shaming and bullying by patients or relatives has not been sufficiently researched WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE: Mental healthcare workers are exposed to the threat of social shaming and bullying on a regular almost weekly basis Abusive behaviours by patients are associated with professional burnout, decreases in professional functioning and even a tendency to leave the workplace among mental health workers WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The stability and strength of the therapeutic alliance between healthcare giver and psychiatric patient are critical to the success of the treatment There is a need to develop a dedicated organizational policy for the prevention, early detection, intervention and support for teams exposed to social shaming and bullying An emphatic response, and effective intervention in a case of social shaming may improve professional functioning and reduce burnout and intention to leave.

ABSTRACT

INTRODUCTION: Social shaming can impair caregivers' performance. The prevalence of shaming experienced by mental health workers and the relationships to their function or burnout is unknown.

AIM

To examine the associations between exposure to social shaming and bullying by patients, the risk appraisal of negative impact of this behaviour, burnout, professional functioning and intention to leave among mental health workers.

METHOD

In this cross-sectional study, 122 workers from a psychiatric hospital completed a questionnaire.

RESULTS

Participants reported exposure to social shaming and bullying by patients on a regular basis. Shaming and bullying were significantly associated with lower professional functioning and higher intention to leave, while burnout may at least partially mediate the association between these variables.

CONCLUSIONS

The phenomenon of shaming and bullying of mental health workers by patients is common and is associated with lower functioning and higher burnout, which have a negative impact on the patient-caregiver interaction.

IMPLICATIONS FOR PRACTICE

There is a need to establish a policy for early detection of shaming of mental health workers in order to prevent burnout or intention to leave. Evidence based interventions, such as the Safewards model, accompanied by assessment of their effectiveness, may help in this effort.

Exploring the relationship between lateral violence and nursing professionalism through the mediating effect of professional identity: A cross‐sectional questionnaire study

AIM

This study aimed to investigate the prevalence of lateral violence (LV) experienced by nursing students during their internship, explore the difference between professional identity and professionalism among nursing students who had or had not experienced LV and analyse the mediating effect of professional identity on the relationship between LV and professionalism.

DESIGN

A cross-sectional survey was used.

METHODS

An online anonymous survey was distributed to nursing students (N = 298) in Jiangsu province, China from June to July 2021. The questionnaire consisted of sections on lateral violence, professional identity and nursing professionalism.

RESULTS

Approximately 49.7% of the nursing students experienced LV behaviour during the internship period. Students who experienced LV had lower professional identity and professionalism than those who did not. Among the students, LV was negatively correlated with professional identity (r = -0.333, p < 0.001) and professionalism (r = -0.418, p < 0.001). The relationship effect of LV on nursing professionalism was partly mediated by professional identity.

CONCLUSION

Nearly half of the nursing students suffered from LV in the workplace, and this condition remarkably influenced nursing professionalism through professional identity. Both quantitative and qualitative studies are needed to investigate the factors that influence LV development in detail.

Association between horizontal violence and turnover intention in nurses: A systematic review and meta-analysis

Background

Horizontal violence is common in nurses. Most published studies have focused on horizontal violence and higher turnover rates in nurses; however, it lacks systematic reviews and meta-analyses. The purpose of this review is to quantitatively assess the correlation between horizontal violence and turnover intention in nurses.

Methods

Systematic review and meta-analysis were performed in accordance with PRISMA guidelines. The relationship between horizontal violence and turnover intention in nurses was obtained by systematically searching related literature in four English databases (Cochrane, PubMed, Embase, and CINAHL) and three Chinese databases (SinoMed, CNKI, and Wanfang) (up to 6 March 2022). The relationship between horizontal violence and turnover intention was evaluated using Fisher's z-value, which was then converted to r. STATA 16.0 was used to perform statistical analysis. The random-effects model was performed to synthesize data.

Results

A total of 14 studies with 6,472 nurses were included. A low-positive correlation of horizontal violence with turnover intention was found (pooled r=0.32 [0.29-0.34]). Subgroup analysis showed that sample size and quality were not the source of heterogeneity. Measurement tool was the source of heterogeneity. Although geographic region might not be the source of heterogeneity, further subgroup analysis of the country reveals heterogeneity. The funnel plot and Egger's test showed no publication bias.

Conclusion

Horizontal violence had a low positive correlation with turnover intention in nurses. Nurses who experienced horizontal violence were more likely to leave or change careers than those who did not experience horizontal violence. This finding helps to draw attention to horizontal violence by nursing managers and implement effective interventions for nurses, so as to reduce nurses' turnover.

Creating respectful workplaces for nurses in regional acute care settings: A quasi-experimental design

AIM

To examine self-reported exposure and experiences of negative workplace behaviour and ways of coping of nursing staff before and after educational workshops.

DESIGN

A Quasi-experimental design.

METHOD/SETTING/PARTICIPANTS

Data were collected pre- /postworkshops using a structured questionnaire. Nurses (N = 230) from 12 units in four regional acute care hospitals were invited to complete a pre-intervention survey. Educational workshops were then implemented by the organization at two of the hospitals, after which, follow-up surveys were undertaken.

RESULTS

There were 74 responses in the pre-intervention and 56 responses in the postintervention time period. There were 111 participants who attended the educational intervention, 20% (n = 22) completed the follow-up survey. Participants were more likely exposed to work-related bullying acts and they used problem-focused coping strategies and sought social support as a way of coping when exposed to the negative behaviours. Overall, there was a decrease in both bullying and incivility experienced by participants; however, our findings were unable to establish that a statistically significant difference was made due to the implementation of the intervention.

STUDY REGISTRATION

Australian New Zealand Clinical Trials Registry (Registration No. ACTRN12618002007213; December 14, 2018).

Effects of horizontal violence among nurses on patient safety: Mediation of organisational communication satisfaction and moderated mediation of organisational silence

AIMS

This study aimed to investigate the effect of nurses' horizontal violence on patient safety as mediated by organisational communication satisfaction and to examine the moderated mediation effect of organisational silence.

BACKGROUND

Patient safety is a worldwide concern in health care, but patients still experience adverse events. Among factors affecting patient safety, organisational silence must be examined in relation to organisational communication satisfaction and horizontal violence.

METHOD

A total of 301 nurses working at four general hospitals with over 500 beds in Gyeonggi-do were recruited from October to November 2018. Data were collected through questionnaires and analysed using SPSS 25.0 and SPSS PROCESS macro.

RESULTS

Horizontal violence directly affected patient safety and indirectly affected patient safety via mediation by organisational communication satisfaction. Organisational communication satisfaction had a partial mediation effect, and organisational silence had a significant moderated mediation effect in the path from horizontal violence to organisational communication.

CONCLUSION

To enhance patient safety, educational programmes and strategies that improve organisational silence and organisational communication satisfaction should be developed at an organisational level.

IMPLICATIONS FOR NURSING MANAGEMENT

Hospital administrators should be aware of the pivotal impact of organisational silence among nurses on patient safety.