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

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