115,232 research outputs found

    Horizontal Violence Effect on Nurse Retention

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    Horizontal violence is known by a variety of terms such as lateral violence, bullying, and incivility. Christie and Jones (2014) describe lateral violence as a problem in nursing where a behavior is demonstrated through harmful actions that occur between nurses. Studies have revealed how horizontal violence affects nurse retention. Horizontal violence is a relevant issue in the healthcare community, yet often goes undiscussed. Walrafen (2012) explains that an outcome of horizontal violence in nursing is directly proportional to a decrease in retention of nurses. Sherman (2012) proclaimed that nurses who are subjected to horizontal violence have low self-esteem, depression, excessive sick leave, and poor morale. As Wilson (2011) identified nurses, who witness or experience horizontal violence have an increased desire to leave the organization where the bullying takes place. Horizontal violence is a pervasive source of occupational stress with physical, psychological, and organizational consequences (Hauge, et al, 2010). Roy (2007) describes this as an unkind, discourteous manner in which nurses relate to their colleagues. As nurses seek to perform their daily tasks, other co-workers may embarrass them for their lack of knowledge, tease them as they participate in informal cliques, or demean them for their technique (Bakker, 2012). Creating excuses, taunting, and refusing to share information, nursing education or knowledge are examples of horizontal violence (Ball, 1996)

    Nurses’ Perceptions of Horizontal Violence

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    In this article, I describe a study exploring horizontal violence and nurses’ perceptions of the phenomenon within the context of two 28-bed inpatient hospital units. The purpose of the study was to develop a clearer understanding of horizontal violence, incorporating observation and inquiry to identify the language nurses use to describe their experiences and factors in the nursing work environment that may perpetuate the phenomenon. Observation, review and analysis of policies, and interviews with staff were completed between June and November 2012. Thematic analysis resulted in five themes: (a) behaviors are minimized and not recognized, (b) fear inhibits all reporting, (c) avoidance and isolation are coping strategies, (d) lack of respect and support, and (e) organizational chaos. The findings suggest future interventions must address a range of factors that perpetuate horizontal violence within the nursing work environment with consideration for the embeddedness and complexity of the phenomenon

    Registered Nurses Experience with and Perceived Effects of Horizontal Violence

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    The prevalence of horizontal violence in nursing has been well documented in the past 20 years. Recently the focus of the literature has been on developing strategies to prevent horizontal violence from occurring. The purpose of this exploratory descriptive study was to ascertain how Registered Nurses at one rural North Carolina hospital experienced and perceived horizontal violence. A zero tolerance policy was in place at the time of the study. The Nursing 2011 horizontal violence survey was used to examine a convenience sample of 40 nurses in this facility. The subjects were employed in seven different units throughout the hospital. While there were nurses personally affected by the violence, the majority reported never or only a few times in answer to the questions about this subject. Overall, approximately 67% of the nurses surveyed witnessed or experienced horizontal violence while on the job. This substantial finding reinforces research literature that identifies horizontal violence persistence in nursing as being related to existing workplace cultures

    Hospital Staff Registered Nurses’ Perception of Horizontal Violence, Peer Relationships, and the Quality and Safety of Patient Care

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    Objective: To test hypotheses from a horizontal violence and quality and safety of patient care model: horizontal violence (negative behavior among peers) is inversely related to peer relations, quality of care and it is positively related to errors and adverse events. Additionally, the association between horizontal violence, peer relations, quality of care, errors and adverse events, and nurse and work characteristics were determined. Participants: A random sample (n=175) of hospital staff Registered Nurses working in California. Methods: Nurses participated via survey. Bivariate and multivariate analyses tested the study hypotheses. Results: Hypotheses were supported. Horizontal violence was inversely related to peer relations and quality of care, and positively related to errors and adverse events. Including peer relations in the analyses altered the relationship between horizontal violence and quality of care but not between horizontal violence, errors and adverse events. Nurse and hospital characteristics were not related to other variables. Clinical area contributed significantly in predicting the quality of care, errors and adverse events but not peer relationships. Conclusions: Horizontal violence affects peer relationships and the quality and safety of patient care as perceived by participating nurses. Supportive peer relationships are important to mitigate the impact of horizontal violence on quality of care

    Horizontal Violence Among Hospital Staff Nurses Related to Oppressed Self or Oppressed Group

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    Horizontal violence among nurses is recognized as a major problem in hospitals; however, the origins and effects on patient care have not been studied. This study described the incidence of horizontal violence among hospital staff RNs and tested 2 hypotheses about the social origins of this behavior. A random sample of 175 hospital staff RNs drawn from the California Board of Registered Nursing\u27s mailing list was surveyed. Horizontal violence was reported by 21.1% (n = 37) of participating nurses. Hypotheses were supported. Findings suggested (a) a positive relationship between beliefs consistent with an oppressed self and horizontal violence (r = .434, P \u3c .05) and (b) a positive relationship between beliefs consistent with those of an oppressed group and horizontal violence (r = .453, P \u3c .05). A change in the oppressive social structure of hospitals may be needed to truly address horizontal violence in the best interest of the quality and safety of patient care

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

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    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

    Relationship between Horizontal Violence among Registered Nurses and Falls

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    Background: Horizontal violence is a manifestation of oppressed group behavior leading to low self-esteem and feelings of worthlessness among nurses. Horizontal violence leads to the creation of a hostile, unsafe work environment preventing nurses from performing at their highest potentials. A hostile work environment leads to a culture of unsafe patient care which may result in increased harm to patients. An understanding of why horizontal violence occurs and the implications of this phenomenon are the first steps in addressing this destructive behavior as well as protecting patients from harm. Health care environments must support nurses to perform at their best in order to provide safe high quality patient care. Methodology: This was a correlation descriptive study of the relationship between nurses\u27 responses to an online questionnaire regarding prevalence of horizontal violence and NDNQI data submission of the number of unit falls, with and without injury. Data was analyzed and correlated at the individual and group levels but was not simultaneously correlated to demonstrate individual responses as predictors of group outcomes. Simultaneous analysis of hierarchical subjects would require more complex analytical methods outside the scope of this study. Results: A majority of the responses to the survey on prevalence of horizontal violence among registered nurses indicated exposure to at least one of these behaviors. Only 42 out of 168 respondents (25%) gave the response never to all four items. At least one horizontal violence behavior was experienced by 126 out of 168 respondents (75%) over a six-month period. Individual response (n=168) to the prevalence of horizontal did not positively correlate to the number of unit falls with and without injury. The mean of individual responses per unit (n=6) did not positively correlate to the number of falls with and without injury. No statistical significance was obtained regarding the relationship between prevalence of horizontal violence among registered nurses and falls. Conclusions: While this study did not demonstrate a positive relationship between the prevalence of horizontal violence and falls, undesirable patient outcomes have been shown in the literature to result from care provided in an environment of poor communication and lack of team work. In the presence of increased numbers of poor patient outcomes, including falls, it is strongly recommended that the work environment be assessed for the presence of horizontal violence

    Assessment of Horizontal Violence and Healthy Work Environments of two Nursing Units

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    PURPOSE: Horizontal Violence plagues the health of nursing work environments. In order to diminish this phenomenon and establish healthy work environments as established by the AACN, assessments must be completed to identify strengths and weaknesses and determine the proper interventions to employ. However, there is a lack of evidence in actionable interventions. The purpose of this project was to assess healthy work environments of two nursing units by examining horizontal violence, civility, teamwork, and satisfaction, and identify interventions to strengthen the health of the work environment. METHODS: This study was a descriptive study using an electronic survey of two nursing units at University of Kentucky Healthcare. The survey was composed from three existing tools: Nursing Teamwork Survey, Horizontal Violence Survey, and VA Civility Scale. The target population consisted of 90 nurses on the Intensive Care unit and 48 nurses on the Acute/Progressive unit. RESULTS: On average, participants in the acute/progressive unit are neutral with their current role (M 3.5, SD=1.2) and satisfied with the level of teamwork (M 4.0, SD=1.0). ICU participants are dissatisfied with their current role (M 2.0, SD=1.7) and teamwork on the unit (M 2.67, SD 1.2). The frequency of horizontal violence was reported as experienced 25% of the time for both units. The acute/progressive unit reports higher ratings of teamwork (M 3.67) and civility (M 4.21) amongst the team, compared to the ICU unit (Teamwork M 3.2, civility M 3.33). CONCLUSION: Communication, teamwork, and satisfaction amongst nurses play an important role in the health of a work environment. Although both environments assessed in this project reported a frequency of horizontal violence 25% of the time, the health of the acute/progressive unit is higher considering communication, teamwork, and satisfaction. Evidence-based interventions are lacking, however recommendations to strengthen the work environment were provided from the literature. These interventions include identifying horizontal violence, educating staff on horizontal violence, taking a stance against horizontal violence through organization policies, such as zero tolerance policies, and enhancing communication skills

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

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    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

    Horizontal Violence in the Nursing Work Environment: Beyond Oppressed Group Behavior

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    The United States has been experiencing a nursing shortage since the mid-1990s. The shortage is expected to deepen as the provisions of the 2010 Patient Protection and Affordable Care Act are enacted. Horizontal violence is a negative phenomenon in the nursing workplace that contributes to difficulty in recruiting and retaining nurses in hospitals. Horizontal violence has been described as a form of mistreatment, spoken or unspoken, that is threatening, humiliating, disrespectful or accusatory towards a peer. The effects of this nurse on nurse aggression can be devastating for the nurse involved and also for the patients under the nurse\u27s care. Nursing and social science literature have advanced oppressed‐group behaviors as a motivating factor driving this phenomenon in nursing. Workplace stress has also been implicated in these negative behaviors. This study used a grounded theory approach to examine how nurses explain, through semi‐structured and open ended interviews, the phenomenon of horizontal violence in the nursing workplace. The primary outcome of this study was a small scale theory focused specifically on horizontal violence in the nursing work environment. The theory that emerged from this analysis was that horizontal violence can be influenced by other environmental factors beyond oppression theory. The results from the data indicated that these behaviors, described as horizontal violence, may be employed as a method of manipulating the care environment in an effort to enhance patient outcomes while maintaining group or individual perception of security through a sense of environmental control
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