Negative behaviours in health care: Prevalence and strategies

• Published in: Journal of nursing management Vol. 27; no. 1; pp. 154 - 160
• Main Authors: Layne, Diana M., Nemeth, Lynne S., Mueller, Martina, Schaffner, Marilyn J., Stanley, Karen M., Martin, Mary M., Wallston, Kenneth A.
• Format: Journal Article
• Language: English
• Published: England Hindawi Limited 01-01-2019
• Subjects: Aggressiveness; bullying; Clinical outcomes; disruptive behaviour; Fear & phobias; Health behavior; Health planning; Health services; horizontal aggression; Interdisciplinary aspects; Medicine; Mental health services; Nurses; Nursing; Nursing administration; Occupational stress; Patient safety; Patients; Physicians; Polls & surveys; Productivity; Professional relationships; Professionalism; Retaliation; Safety behaviour; Safety measures; Strategies; Work environment; United States > US; professionalism; horizontal aggression; bullying; disruptive behaviour
• ISSN: 0966-0429; 1365-2834
• DOI: 10.1111/jonm.12660

Aim
To evaluate the effectiveness of a professionalism taskforce and the prevalence of negative behaviours across interdisciplinary groups at a south‐eastern US academic medical centre.
Background
Negative behaviours within health care organisations may undermine patient safety. These behaviours are associated with decreased productivity, increased turnover, and poor patient and staff outcomes.
Methods
A pre‐post study design using an adapted instrument, the Negative Behaviors in HealthCare (NBHC) survey, assessed perceptions of negative behaviours by physicians, clinical, and managerial staff both before and after a professionalism taskforce was convened in 2012 to identify and promulgate key strategies to improve behaviours.
Results
The 1,980 respondents completed the pre‐survey in January 2012 and 1,423 completed the post‐survey in 2014. Significant reductions in use of lateral aggression (LA) and vertical aggression (VA) (χ2 = 5.65, p < 0.017), observation of LA and VA (χ2 = 4.90, p < 0.027), and experience with contributing factors associated with negative behaviours (χ2 = 9.03, p < 0.003) were identified.
Conclusions
Findings suggest that a professionalism taskforce guiding key strategies to elevate professionalism significantly affected beliefs about lateral and vertical aggression.
Implications for nursing management
Decreasing negative behaviours in health care will require additional strategies and consistent implementation. Additional research addressing fear, retaliation, and job stress, and linking these behaviours to patient safety outcomes, is required.