Experiencing and witnessing disruptive behaviors toward nurses in COVID‐19 teams, patient safety, and errors in care

Abstract

BackgroundNurse managers and team co‐workers' disruptive behaviors (DBs) are negatively associated with a perceived safe climate. Moreover, DBs are a risk factor for patients' safety. Yet, it remains unknown whether and to what extent these effects were prevalent in COVID‐19 wards and among witnesses of DBs.DesignA cross‐sectional study.MethodsA questionnaire was distributed on social networks and completed by nurses in various Israeli healthcare organizations using snowball sampling between October and December 2021. The questionnaire included seven previously published measures and a question checking whether the participants had worked in a COVID‐19 ward. The minimal sample size for any analysis was 236. Hypotheses were tested with correlations and structural equation modeling.ResultsDBs of nurse managers and team co‐workers toward nurses were higher in COVID‐19 teams. As hypothesized, DBs were negatively correlated with a safe climate and positively with patient safety (fewer errors). The data were consistent with a model suggesting that a safe climate is related to fewer DBs and DBs largely mediate the effects of safe climate on errors. Surprisingly and importantly, the strongest predictor of errors, including preventable mortality, is witnessing DBs and not being a victim of DBs.ConclusionsDBs may impede open communication and collaboration among co‐workers, particularly in COVID‐19 teams. This study shows the links between nurse shaping of a safe climate, DBs toward nurses, and patient safety.Clinical relevanceNurse managers who create a safe climate and show zero tolerance for DBs could reduce the risk of errors in care.

Patient Safety Climate, Quality of Care, and Intention of Nursing Professionals to Remain in Their Job During the COVID-19 Pandemic

“…1 Healthcare professionals working in an environment with inadequate staff, equipment, and personal protective measures can experience negative emotions, such as tension and anxiety among healthcare professionals, as they struggle to provide care under challenging circumstances. 9 In a previous study, higher disruptive 12 The variable quality of care showed a strong correlation with the dimensions of overall emphasis on patient safety and organizational resources for safety. There was a moderate correlation between quality of care with the dimensions of unit safety norms, senior managers' engagement, unit managers' support, collective learning, psychological safety, and unit recognition and support for safety efforts.…”

“…Healthcare professionals working in an environment with inadequate staff, equipment, and personal protective measures can experience negative emotions, such as tension and anxiety among healthcare professionals, as they struggle to provide care under challenging circumstances 9 . In a previous study, higher disruptive behaviors of nurse managers and coworkers during the COVID-19 pandemic jeopardized open communication and collaboration among coworkers, particularly among healthcare professionals caring for COVID-19 patients 12 …”

“…11 The variables that influenced the perception of patient safety climate during COVID-19 were related to age, length of experience in the profession, burnout, job satisfaction, working condition, and AEs. [1][2][3]7,9,10,12 However, these studies did not address the relationship between patient safety climate, quality of care, and the intention of nursing professionals to remain in their job during the COVID-19 pandemic. Thus, this study aimed to examine that relationship.…”

“…To our knowledge, there is a scarcity of studies that assessed the patient safety climate with the use of the Patient Safety Climate in Health Organizations (PSCHO), considering that this measure was recently validated in our culture 11 . The variables that influenced the perception of patient safety climate during COVID-19 were related to age, length of experience in the profession, burnout, job satisfaction, working condition, and AEs 1–3,7,9,10,12 . However, these studies did not address the relationship between patient safety climate, quality of care, and the intention of nursing professionals to remain in their job during the COVID-19 pandemic.…”

Association of quality of nursing care with violence load, burnout, and listening climate

“…The dysfunctional opposite is defined as destructive [ 38 ]. Studies suggest that the ward’s climate of constructive listening may reduce nurses’ exposure to workplace violence [ 38 , 39 ].…”