Effectiveness of educational intervention and cognitive rehearsal on perceived incivility among emergency nurses: a randomized controlled trial

Kousha, Shohreh; Shahrami, Ali; Forouzanfar, Mohammad Mehdi; Sanaie, Neda; Atashzadeh‐Shoorideh, Foroozan

doi:10.1186/s12912-022-00930-1

Cited by 8 publications

(17 citation statements)

References 31 publications

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“…We identified 42 evaluations or descriptions of 42 interventions, all of which sought to address UB in acute healthcare settings. Of the interventions; 30 were conducted in the USA [ 73 , 76 , 78 , 82 , 86 , 88 , 89 , 91 – 93 , 95 , 100 , 101 , 106 , 111 , 116 , 120 , 122 , 125 , 127 , 129 , 137 , 141 , 143 , 156 , 164 , 165 , 172 , 174 , 177 , 178 ]; five in Australia [ 74 , 108 , 126 , 160 , 162 ]; two each in Canada [ 132 , 169 ] and South Korea [ 83 , 94 ]; and one in Turkey [ 144 ], Ireland [ 100 ] and Iran [ 154 ]. Iran and Turkey were the only low- or middle-income countries to report an intervention.…”

Section: Resultsmentioning

confidence: 99%

“…If an intervention relies solely on single sessions (C), then while they may raise awareness and knowledge of skills to tackle UB in an organisation in the moment (O1), any planned behaviour change may not be sustained (O2), because they are intended as a one-time delivery of information or training and may be forgotten (M) CMOC 2. If an intervention relies solely on single sessions (C), then behaviour and sustained culture change may not happen (O), because it relies on individual behaviour change without any parallel organisation-wide approach (M) Multi-session interventions ( n = 11) [ 82 , 94 , 100 , 106 , 125 , 129 , 144 , 154 , 156 , 172 , 177 ] These are similar to single-session interventions but rely on use of multiple workshops or lecture-type sessions over time. Most still draw on education and role-playing type activities CMOC 3.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Interventions to address unprofessional behaviours between staff in acute care: what works for whom and why? A realist review

Maben,

Aunger,

Abrams

et al. 2023

BMC Med

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Background Unprofessional behaviour (UB) between staff encompasses various behaviours, including incivility, microaggressions, harassment, and bullying. UB is pervasive in acute healthcare settings and disproportionately impacts minoritised staff. UB has detrimental effects on staff wellbeing, patient safety and organisational resources. While interventions have been implemented to mitigate UB, there is limited understanding of how and why they may work and for whom. Methods This study utilised a realist review methodology with stakeholder input to improve understanding of these complex context-dependent interventions. Initial programme theories were formulated drawing upon scoping searches and reports known to the study team. Purposive systematic searches were conducted to gather grey and published global literature from databases. Documents were selected if relevant to UB in acute care settings while considering rigour and relevance. Data were extracted from these reports, synthesised, and initial theories tested, to produce refined programme theories. Results Of 2977 deduplicated records, 148 full text reports were included with 42 reports describing interventions to address UB in acute healthcare settings. Interventions drew on 13 types of behaviour change strategies and were categorised into five types of intervention (1) single session (i.e. one off); (2) multiple session; (3) single or multiple sessions combined with other actions (e.g. training sessions plus a code of conduct); (4) professional accountability and reporting programmes and; (5) structured culture change interventions. We formulated 55 context-mechanism-outcome configurations to explain how, why, and when these interventions work. We identified twelve key dynamics to consider in intervention design, including importance of addressing systemic contributors, rebuilding trust in managers, and promoting a psychologically safe culture; fifteen implementation principles were identified to address these dynamics. Conclusions Interventions to address UB are still at an early stage of development, and their effectiveness to reduce UB and improve patient safety is unclear. Future interventions should incorporate knowledge from behavioural and implementation science to affect behaviour change; draw on multiple concurrent strategies to address systemic contributors to UB; and consider the undue burden of UB on minoritised groups. Study registration This study was registered on the international database of prospectively registered systematic reviews in health and social care (PROSPERO): https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021255490.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Interventions to address unprofessional behaviours between staff in acute care: what works for whom and why? A realist review

Maben,

Aunger,

Abrams

et al. 2023

BMC Med

View full text Add to dashboard Cite

show abstract

“…This noble profession encompasses not only the administration of treatments and medications but also the provision of emotional support and education to patients and their families [ 3 , 4 ]. Nurses are often the primary point of contact for patients, which makes their role crucial in shaping patient experiences and outcomes [ 5 ]. The diverse responsibilities, from bedside care to patient advocacy, emphasize the multifaceted nature of nursing and its critical impact on the delivery of healthcare [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…Such research is essential not only to transform current anecdotal and observational understandings into data-driven insights but also to develop effective strategies to mitigate the negative impacts of incivility [ 47 , 48 ]. These insights are vital to promoting a healthier, more respectful, and efficient healthcare environment, ultimately enhancing nurses’ well-being and patient care quality [ 3 , 5 ]. The primary objective of this study was to investigate the impact of nursing incivility on critical aspects of healthcare care delivery.…”

Section: Introductionmentioning

confidence: 99%

From incivility to outcomes: tracing the effects of nursing incivility on nurse well-being, patient engagement, and health outcomes

Alsadaan,

Ramadan,

Alqahtani

2024

BMC Nurs

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Background Nursing incivility, defined as disrespectful behaviour toward nurses, is increasingly recognized as a pressing issue that affects nurses’ well-being and quality of care. However, research on the pathways linking incivility to outcomes is limited, especially in Saudi hospitals. Methods: This cross-sectional study examined relationships between perceived nursing incivility, nurse stress, patient engagement, and health outcomes in four Saudi hospitals. Using validated scales, 289 nurses and 512 patients completed surveys on exposure to incivility, stress levels, activation, and medication adherence. The outcomes included readmissions at 30 days and satisfaction. Results: More than two-thirds of nurses reported experiencing moderate to severe workplace incivility. Correlation and regression analyzes revealed that nursing incivility was positively associated with nursing stress. An inverse relationship was found between stress and patient participation. Serial mediation analysis illuminated a detrimental cascade, incivility contributing to increased nurse stress, subsequently diminishing patient engagement, ultimately worsening care quality. Conclusions The findings present robust evidence that nursing incivility has adverse ripple effects, directly impacting nurse well-being while indirectly affecting patient outcomes through reduced care involvement. Practical implications advocate for systemic interventions focused on constructive nursing cultures and patient empowerment to improve both healthcare provider conditions and quality of care. This study provides compelling information to inform policies and strategies to mitigate workplace mistreatment and encourage participation among nurses and patients to improve health outcomes.

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“…Among those studied, CREW entails a series of workshops and training sessions over a period of weeks or months that focus on social interactions and (un)civil communication, but this intervention has demonstrated weak or inconclusive results [ 24 ]. More recent interventions have tended to focus on education and cognitive rehearsal techniques to teach HCWs (primarily nurses) how to respond to acts of incivility and build resilience [ 25 ] with some success. However, these cognitive interventions put the burden on the target of incivility rather than addressing ways to reduce incivility in the system.…”

Section: Introductionmentioning

confidence: 99%

Eyes on incivility in surgical teams: Teamwork, well-being, and an intervention

Ostroff,

Benincasa,

Rae

et al. 2023

PLoS ONE

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Incivility in surgery is prevalent and negatively impacts effectiveness and staff well-being. The purpose of this study was to a) examine relationships between incivility, team dynamics, and well-being outcomes, and b) explore a low-cost intervention of ‘eye’ signage in operating theater areas to reduce incivility in surgical teams. A mixed methods design was used in an orthopedic hospital. Surveys of incivility, teamwork, and well-being were administered three months apart in a small private hospital. An intervention of signage with eyes was placed in the theater area after administration of the first survey, using a pretest-posttest design. Participants also responded to an open-ended question about suggestions for improvements at the end of the survey which was then thematically analyzed. At the individual level (n = 74), incivility was statistically significantly related to team dynamics which in turn was significantly related to burnout, stress, and job attitudes. At the aggregate level, reported incivility was statistically significantly lower after the ‘eye’ sign intervention. Thematic analysis identified core issues of management behaviors, employee appreciation, communication, and work practices. Incivility in surgical teams has significant detrimental associations with burnout, stress, and job attitudes, which occurs through its impact on decreased team dynamics and communication. A simple intervention that evokes perceptions of being observed, such as signage of eyes in theater areas, has the potential to decrease incivility at least in the short term, demonstrating that incivility is amenable to being modified. Additional research on targeted interventions to address incivility are needed to improve teamwork and staff well-being.

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Effectiveness of educational intervention and cognitive rehearsal on perceived incivility among emergency nurses: a randomized controlled trial

Cited by 8 publications

References 31 publications

Interventions to address unprofessional behaviours between staff in acute care: what works for whom and why? A realist review

Interventions to address unprofessional behaviours between staff in acute care: what works for whom and why? A realist review

From incivility to outcomes: tracing the effects of nursing incivility on nurse well-being, patient engagement, and health outcomes

Eyes on incivility in surgical teams: Teamwork, well-being, and an intervention

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