Recognizing and Responding to the “Toxic” Work Environment: Worker Safety, Patient Safety, and Abuse/Neglect in Nursing Homes

Pickering, Carolyn; Nurenberg, Katie; Schiamberg, Lawrence B.

doi:10.1177/1049732317723889

Cited by 46 publications

(66 citation statements)

References 34 publications

(40 reference statements)

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“…Difficulties in defining abuse in nursing home settings have been found in studies that include staff's perceptions [39,54], where abusive situations are seen as normal in the nursing home culture [17,33,39,55]. However, these studies did not specifically focus on care managers' or leaders' understandings.…”

Section: Discussionmentioning

confidence: 99%

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Elder abuse and neglect: an overlooked patient safety issue. A focus group study of nursing home leaders’ perceptions of elder abuse and neglect

Myhre

Saga

Malmedal

et al. 2020

BMC Health Serv Res

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Background: The definition and understanding of elder abuse and neglect in nursing homes can vary in different jurisdictions as well as among health care staff, researchers, family members and residents themselves. Different understandings of what constitutes abuse and its severity make it difficult to compare findings in the literature on elder abuse in nursing homes and complicate identification, reporting, and managing the problem. Knowledge about nursing home leaders' perceptions of elder abuse and neglect is of particular interest since their understanding of the phenomenon will affect what they signal to staff as important to report and how they investigate adverse events to ensure residents' safety. The aim of the study was to explore nursing home leaders' perceptions of elder abuse and neglect. Methods: A qualitative exploratory study with six focus group interviews with 28 nursing home leaders in the role of care managers was conducted. Nursing home leaders' perceptions of different types of abuse within different situations were explored. The constant comparative method was used to analyse the data. Results: The results of this study indicate that elder abuse and neglect are an overlooked patient safety issue. Three analytical categories emerged from the analyses: 1) Abuse from co-residents: 'A normal part of nursing home life'; resident-to-resident aggression appeared to be so commonplace that care leaders perceived it as normal and had no strategy for handling it; 2) Abuse from relatives: 'A private affair'; relatives with abusive behaviour visiting nursing homes residents was described as difficult and something that should be kept between the resident and the relatives; 3) Abuse from direct-care staff: 'An unthinkable event'; staff-to-resident abuse was considered to be difficult to talk about and viewed as not being in accordance with the leaders' trust in their employees.

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Section: Discussionmentioning

confidence: 99%

“…Good leadership plays a key role in developing staff's understanding of residents' needs [31,32] and creating a strong safety culture of respect, dignity, and quality [6,7,9,33]. The importance of leadership in developing a patient safety culture is highlighted in a report from the National Patient Safety Foundation [10].…”

Section: Introductionmentioning

confidence: 99%

Elder abuse and neglect: an overlooked patient safety issue. A focus group study of nursing home leaders’ perceptions of elder abuse and neglect

Myhre

Saga

Malmedal

et al. 2020

BMC Health Serv Res

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“…The workplace environment can be classified into two major categories: collaborative workplace environment and toxic workplace environment. The collaborative workplace environment yields a sense of happiness, joy, harmony, kindness, politeness, cooperation, and facilitation at the workplace [ 19 , 20 ]. The workplace is toxic when individuals in power are greedy and narcissistic and/or use unfair means to bully, harass, threat, and humiliate others.…”

Section: Literature Reviewmentioning

confidence: 99%

An Empirical Study Analyzing Job Productivity in Toxic Workplace Environments

Anjum

Siddiqi

et al. 2018

IJERPH

108

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Purpose: This empirical study aims to determine the effects of a toxic workplace environment, which can negatively impact the job productivity of an employee. Methodology: Three hundred questionnaires were randomly distributed among the staff members of seven private universities in Pakistan with a final response rate of 89%. For analysis purposes, AMOS 22 was used to study the direct and indirect effects of the toxic workplace environment on job productivity. Confirmatory Factor Analysis (CFA) was conducted to ensure the convergent and discriminant validity of the factors, while the Hayes mediation approach was used to verify the mediating role of job burnout between the four dimensions of toxic workplace environment and job productivity. A toxic workplace with multiple dimensions, such as workplace ostracism, workplace incivility, workplace harassment, and workplace bullying, was used in this study. Findings: By using the multiple statistical tools and techniques, it has been proven that ostracism, incivility, harassment, and bullying have direct negative significant effects on job productivity, while job burnout was shown to be a statistical significant mediator between the dimensions of a toxic workplace environment and job productivity. Finally, we concluded that organizations need to eradicate the factors of toxic workplace environments to ensure their prosperity and success. Practical Implications: This study encourages managers, leaders, and top management to adopt appropriate policies for enhancing employees’ productivity. Limitations: This study was conducted by using a cross-sectional research design. Future research aims to expand the study by using a longitudinal research design.

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“…Disruptions in work can result in decreased patient outcomes through negative state anxiety stress, impaired communication and teamwork, and medical errors. [13,14,[24][25][26][27] In turn, medical errors and poor patient outcomes can generate serious financial burdens for organizations, with projected costs across Western Europe and the United States reaching $383 BN USD by the year 2020. [28] Likewise, a comparative study of the United States, Australia, New Zealand and Canada found turnover costs ranging between $20,561 USD -$48,790 USD.…”

Section: Disruptive Behaviorsmentioning

confidence: 99%

Responding to disruptive behaviors in nursing: One-year follow-up of quasi-experimental research measuring links to turnover, intent to leave, and patient care quality

Sanner-Stiehr

2020

JNEP

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Background and objectives: Disruptive behaviors among nurses are a prevalent problem in health care, contributing to nursing staff turnover and compromising patient care. Newly licensed nurses may be unprepared to respond to disruptive behaviors effectively, negatively impacting them, patients, and organizations. Cognitive rehearsal can increase self-efficacy to respond effectively to disruptive behaviors. The purpose of this study was to determine the longitudinal impact of a cognitive rehearsal intervention delivered to nursing students during the final semester of their pre-licensure program on self-efficacy to respond to disruptive behaviors, turnover and intent to stay in a job, frequency of disruptive behaviors, and perceived impact on patient care.Methods: Design: This study was the second phase in a quasi-experimental, longitudinal project. Participants and Setting: In Phase 1, 129 participants were recruited from three pre-licensure nursing programs in the Midwestern United States. All participants received the intervention. In Phase 2, one year after graduating, 95 remained enrolled. Methods: An electronic survey was used to collect data. Paired t-tests were used to detect changes in self-efficacy; bi-variate correlations were utilized to determine relationships between outcome variables.Results: Multiple measures of self-efficacy to respond remained statistically significantly increased one year after graduating (p < .05). Experiencing (r = .489; p < .000) and witnessing (r = .432; p < .000) disruptive behaviors was significantly linked to patient care.Conclusions: Cognitive rehearsal had a sustained, positive impact on self-efficacy to respond to disruptive behaviors and should be included in pre-licensure curricula.

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Recognizing and Responding to the “Toxic” Work Environment: Worker Safety, Patient Safety, and Abuse/Neglect in Nursing Homes

Cited by 46 publications

References 34 publications

Elder abuse and neglect: an overlooked patient safety issue. A focus group study of nursing home leaders’ perceptions of elder abuse and neglect

Elder abuse and neglect: an overlooked patient safety issue. A focus group study of nursing home leaders’ perceptions of elder abuse and neglect

An Empirical Study Analyzing Job Productivity in Toxic Workplace Environments

Responding to disruptive behaviors in nursing: One-year follow-up of quasi-experimental research measuring links to turnover, intent to leave, and patient care quality

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