Breaking the Silence of Lateral Violence in Nursing: A Change Model for Nursing Leadership

2.50
Hdl Handle:
http://hdl.handle.net/10755/148429
Type:
Presentation
Title:
Breaking the Silence of Lateral Violence in Nursing: A Change Model for Nursing Leadership
Abstract:
Breaking the Silence of Lateral Violence in Nursing: A Change Model for Nursing Leadership
Conference Sponsor:Sigma Theta Tau International
Conference Year:2009
Author:Melwak, Mary Alice, PhD, CPNP, CNS, CCRN
P.I. Institution Name:UCLA Healthcare, David Geffen School of Medicine
Title:Nurse Practitioner
[Scientific Session Presentation] Introduction: Lateral violence, or nurse to nurse violence, has received increased attention in the past few years and is acknowledged to be a continued source of stress facing the profession.  Silence surrounding this disturbing phenomenon endangers patient safety and increases the vulnerability of an already fragmented profession.Methods: This study used a descriptive mixed methods approach within a hospital-based cohort to examine a three phased leadership intervention initiative to reduce LV. A prospective mixed method quasi experimental design included pre and post-test examination of the degree of LV present in the unit. A nursing leadership team offered  multi-level, multifaceted interventions to reduce lateral violence levels.  A peer-reviewed questionnaire facilitated semi-structured interviews and focus groups on LV.  Organizational climate assessment was embedded in the instrument.  Qualitative analysis of focus groups and interviews revealed five major themes: 1) LV creates a toxic work environment; 2) LV varies in degree and effect from day to day; 3) LV equates with professional disrespect; 4)  LV deleteriously effects teamwork and 5) fear of retaliation. Results:  Nurse recognition of LV effect on teamwork was strongly associated with recognition of LV. Negative associations between LV degree and RN satisfaction level and retention and a positive relationship with recognition of effect on teamwork were present. Retention and staff satisfaction levels increased, and temporary staff levels were reduced to zero following implementation of interventions.  Qualitative data revealed improved levels of satisfaction, enhanced interpersonal relationships, and increased collaboration between team members.  Episodes of LV decreased, unit morale trended toward hopeful and positive.  As bullying decreased, staff participation levels in staff development activities increased.Conclusion: This paper has identified a multi-level leadership model to reduce LV in a critical care unit. A multifaceted, multi-level, evidence based leadership pathway reduced high LV levels and positively affected retention and nurse satisfaction.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleBreaking the Silence of Lateral Violence in Nursing: A Change Model for Nursing Leadershipen_GB
dc.identifier.urihttp://hdl.handle.net/10755/148429-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Breaking the Silence of Lateral Violence in Nursing:&nbsp;A Change Model for Nursing Leadership</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Melwak, Mary Alice, PhD, CPNP, CNS, CCRN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">UCLA Healthcare, David Geffen School of Medicine</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Nurse Practitioner</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">mmelwak@mednet.ucla.edu</td></tr><tr><td colspan="2" class="item-abstract">[Scientific Session Presentation] Introduction: Lateral violence, or nurse to nurse violence, has received increased attention in the past few years and is acknowledged to be a continued source of stress facing the profession.&nbsp; Silence surrounding this disturbing phenomenon endangers patient safety and increases the vulnerability of an already fragmented profession.Methods: This study used a descriptive mixed methods approach within a hospital-based cohort to examine a three phased leadership intervention initiative to reduce LV. A prospective mixed method quasi experimental design included pre and post-test examination of the degree of LV present in the unit. A nursing leadership team offered&nbsp; multi-level, multifaceted interventions to reduce lateral violence levels.&nbsp; A peer-reviewed questionnaire facilitated semi-structured interviews and focus groups on LV. &nbsp;Organizational climate assessment was embedded in the instrument.&nbsp; Qualitative analysis of focus groups and interviews revealed five major themes: 1) LV creates a toxic work environment; 2) LV varies in degree and effect&nbsp;from day to day;&nbsp;3) LV equates with professional disrespect;&nbsp;4)&nbsp; LV deleteriously effects teamwork and 5) fear of retaliation. Results: &nbsp;Nurse recognition of LV effect on teamwork was strongly associated with recognition of LV. Negative associations between LV degree and RN satisfaction level and retention and a positive relationship with recognition of effect on teamwork were present. Retention and staff satisfaction levels increased, and temporary staff levels were reduced to zero following&nbsp;implementation of interventions.&nbsp; Qualitative data revealed improved levels of satisfaction,&nbsp;enhanced&nbsp;interpersonal relationships, and increased collaboration between team members.&nbsp; Episodes of LV decreased, unit morale trended toward hopeful and positive.&nbsp; As bullying decreased, staff participation levels in staff development activities&nbsp;increased.Conclusion: This paper has identified a multi-level leadership&nbsp;model to reduce LV in a critical care unit. A multifaceted, multi-level, evidence based leadership pathway reduced high LV levels and positively affected retention and nurse satisfaction.</td></tr></table>en_GB
dc.date.available2011-10-26T09:45:01Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T09:45:01Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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