Horizontal Violence and the Quality and Safety of Patient Care: A Conceptual Model

For many years, nurses in international clinical and academic settings have voiced concern about horizontal violence among nurses and its consequences. However, no known framework exists to guide research on the topic to explain these consequences. This paper presents a conceptual model that was developed from four theories to illustrate how the quality and safety of patient care could be affected by horizontal violence. Research is needed to validate the new model and to gather empirical evidence of the consequences of horizontal violence on which to base recommendations for future research, education, and practice

Job Satisfaction and Horizontal Violence in Hospital Staff Registered Nurses: The Mediating Role of Peer Relationships

Aims and objectives To describe the association between horizontal violence and job satisfaction in hospital staff registered nurses and the degree to which peer relationships mediates the relationship. Additionally, the association between nurse and work characteristics and job satisfaction were determined. Background Horizontal violence is a major predictor of nurses\u27 job satisfaction. Yet, not enough is known about the relationship between these variables. Job satisfaction is an important variable to study because it is a predictor of patient care quality and safety internationally. Peer relationships, a job satisfier for nurses, was identified as a potential mediator in the association between horizontal violence and job satisfaction. Design Cross-sectional mediational model testing. Methods An anonymous four-part survey of a random sample of 175 hospital staff registered nurses working in California provided the data. Data about horizontal violence, peer relationships, job satisfaction, and nurse and work characteristics were collected between March–August 2010. Results A statistically significant negative relationship was found between horizontal violence and peer relationships, job satisfaction and a statistically significant positive relationship was found between peer relationships and job satisfaction. Peer relationships mediated the association between horizontal violence and job satisfaction. Job satisfaction was reported as higher by nurses who worked in teaching hospitals. There were no statistically significant differences in job satisfaction based on gender, ethnicity, basic registered nurse education, highest degree held, size of hospital or clinical area. Conclusions The results suggest that peer relationships can attenuate the negative relationship between horizontal violence and job satisfaction. This adds to the extant literature on the relationship between horizontal violence and job satisfaction. Relevance to clinical practice The findings highlight peer relationships as an important factor when considering effective interventions that foster hospital staff registered nurses\u27 job satisfaction in the presence of horizontal violence

Validity and reliability on three European language versions of the Safety Organizing Scale

Background The Safety Organizing Scale (SOS) offers a reliable snapshot of nurses' engagement in unit-level safety behaviors in hospitals. As no comparable questionnaire exists in German, French and Italian, we explored the psychometric properties of SOS translations into each of those languages. Design and Methods The psychometric properties of the nine-item SOS were tested according to American Educational Research Association guidelines. Subjects and Setting Between October 2009 and June 2010, 1633 registered medical and/or surgical nurses in 35 Swiss hospitals completed translated SOS questionnaires. Results For each translation, psychometric evaluation revealed evidence based on content (scale-content validity index >0.89), response patterns (e.g. average of missing values across all items = 0.80%), internal structure (e.g. comparative fit indices >0.90, root mean square error of approximation 0.79). We differentiated the scale regarding one related concept (implicit rationing of nursing care). Higher SOS scores correlated with supportive leadership and lower nurse-reported medication errors, but not with nurse-reported patient falls. Conclusions The SOS offers a valuable measurement of engagement in safety practices that might influence patient outcomes. Initial evidence regarding the validity and reliability of the translated versions supports their use in German, French and Italian. Concurrent validity will require confirmation via further analysis using more reliable outcome measures (e.g. mortality rates). The translated versions' predictive validity needs to be established in prospective studie

Validity and reliability on three European language versions of the Safety Organizing Scale

Background: The Safety Organizing Scale (SOS) offers a reliable snapshot of nurses' engagement in unit-level safety behaviors in hospitals. As no comparable questionnaire exists in German, French and Italian, we explored the psychometric properties of SOS translations into each of those languages. Design and Methods: The psychometric properties of the nine-item SOS were tested according to American Educational Research Association guidelines. Subjects and Setting: Between October 2009 and June 2010, 1633 registered medical and/or surgical nurses in 35 Swiss hospitals completed translated SOS questionnaires. Results: For each translation, psychometric evaluation revealed evidence based on content (scale-content validity index >0.89), response patterns (e.g. average of missing values across all items = 0.80%), internal structure (e.g. comparative fit indices >0.90, root mean square error of approximation 0.79). We differentiated the scale regarding one related concept (implicit rationing of nursing care). Higher SOS scores correlated with supportive leadership and lower nurse-reported medication errors, but not with nurse-reported patient falls. Conclusions: The SOS offers a valuable measurement of engagement in safety practices that might influence patient outcomes. Initial evidence regarding the validity and reliability of the translated versions supports their use in German, French and Italian. Concurrent validity will require confirmation via further analysis using more reliable outcome measures (e.g. mortality rates). The translated versions' predictive validity needs to be established in prospective studies

An evaluation of post-registration neuroscience focused education and neuroscience nurses' perceived educational needs

Background People with complex neurological conditions require co-ordinated care provided by nurses educated in meeting service needs, understanding the pathophysiological processes of disease and the preparation to care for those with complex needs. However, evidence suggests that neuroscience specific education provision is largely unregulated and set outside of a cohesive professional development context. Furthermore, it largely seems to only address the induction phase into working within neurosciences. Objectives To evaluate the nature of post-registration neuroscience focused education across Europe and neuroscience nurses' perceived educational needs. Methods Post qualifying nurses working in the field of neurosciences were invited to complete a self-reported 29-item on-line questionnaire that contained closed and open-ended questions exploring professional background, clinical and educational experience, educational opportunities available to them and their perspectives on their educational needs. Results 154 participants from fourteen countries across Europe completed the survey. 75% (n = 110) of respondents had undertaken neuroscience focused education with the most accessible education opportunities found to be conferences 77% (n = 96) and study days 69% (n = 86). Overall, 52.6% of courses were multidisciplinary in nature, and 47.4% were exclusively nursing. Most identified that their courses were funded by their employer (57%, n = 63) or partly funded by their employer. Results illustrate a significant variance across Europe, highlighting the need for more effective communication between neuroscience nurses across Europe. Implications for future education provision, recruitment/retention, and funding are discussed, resulting in recommendations for the future of neuroscience nursing. Conclusions This study, the largest of its kind to survey neuroscience nurses, illustrates the absence of a cohesive career development pathway for neuroscience nurses in Europe. Nurses need quality assured specialist education to deliver high quality appropriate healthcare

Horizontal Violence and the Quality and Safety of Patient Care: A Conceptual Model

For many years, nurses in international clinical and academic settings have voiced concern about horizontal violence among nurses and its consequences. However, no known framework exists to guide research on the topic to explain these consequences. This paper presents a conceptual model that was developed from four theories to illustrate how the quality and safety of patient care could be affected by horizontal violence. Research is needed to validate the new model and to gather empirical evidence of the consequences of horizontal violence on which to base recommendations for future research, education, and practice

Residential Status and Birth Outcomes: Is the Rural/Urban Distinction Adequate?

In studies comparing the birth outcomes of rural and urban women, residency status is frequently defined dichotomously as either rural or urban. Since residency status appears to be a continuum, however, the usefulness of other categorization systems needs to be explored. The purpose of this study was to compare birth outcomes using a three-level variable for residency status (rural, rural adjacent to urban, and urban). The study population was comprised of women who delivered by cesarean section over an 18-month period (N= 263) at a tertiary care hospital. Data were collected from patient charts, interviews, and the hospital information system. Residency status was determined by county of residence. Birth outcomes examined included gestational age, birthweight, Apgar scores, maternal complications, length of hospital stay, and costs of hospital care. Rural women had worse birth outcomes overall and traveled the greatest distance for delivery. Rural-adjacent women had the best birth outcomes of the three groups, yet were the youngest, least educated, least likely to be married, and the least likely to be privately insured. By using a nondichotomous three-level variable for residency status, two distinct groups of rural women were identified whose maternal health care needs may differ from each other

Power and Bargaining in Authority-Client Relations

This article presents a theory of tactical action designed to analyze the authority- client relationship, i.e., voluntary, noncontractual relation between service-providers and their clients. The focus is on conflicts that arise when authorities refuse requests from clients, and the theory predicts the tactical choices of the clients. Authority-client relationships are seen from an exchange perspective. The theory is structured around power-dependence and integrates legitimacy and attribution notions with previous theories of tactical action. The major predictions indicate that the client’s choice of tactic is a function of an interaction between (1) the client’s attribution of the authority’s reason for refusal and (2) the respective power positions of the client and the authority.Lawler51_Power_and_bargaining.pdf: 65 downloads, before Oct. 1, 2020