Effects of hospital nurses' internalized dominant values, organizational silence, horizontal violence, and organizational communication on patient safety

Abstract

Recent studies have identified common problems with patient safety in hospitals and medical institutions have responded, prioritizing service quality and performance, including patient safety. However, the factors influencing safety for hospital patients are still being examined and clarified. We aimed to investigate how hospital nurses' internalized dominant values, organizational silence, horizontal violence, and organizational communication satisfaction can affect patient safety and to construct and verify a hypothetical model describing the relationships between these factors. The participant sample included 301 hospital nurses from four large (≥500 beds) general hospitals in Gyeonggi‐do, South Korea. Data were collected through questionnaires from October to November 2018 and analyzed using SPSS 25.0 and AMOS 22.0. Factors that had direct effects on patient safety were organizational silence (β = −.130, p < .05) and organizational communication satisfaction (β = .209, p < .001). Factors that had indirect effects on patient safety were internalized dominant values and horizontal violence. The explanatory power of these variables for patient safety was 7.9%. The results indicate that organizational silence, horizontal violence, and organizational communication satisfaction fully mediated the relationship between nurses' internalized dominant values and patient safety. Our findings may be useful to hospital administrators and managers in identifying and analyzing these organizational characteristics in their institutions. Further, the model described in the results may be used to inform the development of educational programs and strategies to improve patient safety by reducing organizational silence and horizontal violence and improving organizational communication.

Exploring the relationship between nurses’ communication satisfaction and patient safety culture

“…This is in accordance with another finding which stated that job satisfaction is influenced by communication satisfaction in an organization, which continues to increase in more professional staff along with rise in age. 18 The length of time a person has worked in a hospital and certain units indicates their ability to possess more experience working as nurses. Experience influences communication satisfaction, which supports the quality of speech.…”

Effects of horizontal violence among nurses on patient safety: Mediation of organisational communication satisfaction and moderated mediation of organisational silence

“…Purpora (2010) reported that horizontal violence among nurses affects patient safety via peer relationships. Doo and Kim (2020) suggested that the internalized predominant values of nurses affect patient safety with organisational silence, horizontal violence and organisational communication satisfaction being mediator variables.…”

“…It refers to intimidating behaviours among peers (Kaiser, 2017). Horizontal violence among nurses negatively affects relationships among nurses, job satisfaction (Purpora et al., 2015) and patient safety (Doo & Kim, 2020; Purpora, 2010). The most frequent perpetrators were staff nurses (Hopkinson et al., 2020).…”

“…Several studies have been conducted on the factors that affect patient safety. In a study on Korean nurses, Doo and Kim (2020) reported that horizontal violence among nurses indirectly affects patient safety via organisational communication satisfaction. However, conflicting results – horizontal violence directly affecting patient safety – have been reported in precedent studies (Lee & Kim, 2018; Purpora et al., 2015).…”

Creating Respectful Workplaces for Nurses in Regional Acute Care Settings: Protocol for a Sequential Explanatory Mixed Methods Study (Preprint)

“…Although negative workplace behavior entails the actions of an individual or a group, organizational culture, workloads, and leadership styles have all been shown to affect its occurrence [10]. It has been suggested that organizations seeking to mitigate negative workplace behaviors should aim to improve organizational processes that inform the management of bullying, implement skills-based training in communication and conflict management, and aim to promote accountability, transparency, and respectful peer alliances [11,12]. In the literature, there is little evidence of effective strategies that have been implemented in acute care settings to address negative workplace behavior experienced by nurses [2,13].…”