Workplace bullying and its impact on the quality of healthcare and patient safety

Abstract

BackgroundWorkplace bullying (WPB) is a physical or emotional harm that may negatively affect healthcare services. The aim of this study was to determine to what extent healthcare practitioners in Saudi Arabia worry about WPB and whether it affects the quality of care and patient safety from their perception.MethodsA cross-sectional study was conducted in 2018. An online survey was distributed among all practitioners at a multi-regional healthcare facility. A previously validated tool was sourced from an integrative literature review by Houck and Colbert. Responses to 15 themes were rated on a 5-point Likert scale, converted to percentage mean scores (PMS) and compared across participants’ characteristics using bivariate and regression analyses.ResultsA total of 1074/1350 (79.5%) completed the questionnaire. The overall median [interquartile range] score of worrying about WPB was 81.7 [35.0]. Participants were mainly worried about the effect of WPB on their stress, work performance, and communication between staff members. A significant negative relationship developed between the quality of care and worrying about WPB, P < 0.001. More educated practitioners were 1.7 times more likely to be worried about WPB compared with their counter group, adj.P = 0.034. Junior practitioners were 1.6 times more likely to be worried about WPB, adj.P = 0.017. The group who has not been trained in handling WPB (1.7 times), and those who had been exposed to WPB (2.2 times) were both more likely to be worried about WPB compared with their counter groups, adj.P = 0.026 and adj.P < 0.001 respectively.ConclusionsMost healthcare practitioners worry about WPB, especially its negative impact on the quality of care and patient safety. A greater proportion of practitioners with higher levels of education and their less experienced counterparts were more worried about WPB. Previous exposure to a WPB incident amplifies the practitioners’ worry, but being trained on how to counteract bullying incidents makes them less likely to be worried.

Workplace harassment: The leadership factor

“…For nurses, in particular, who are with patients 24 hours a day 7 d/wk, increased infection rates of central lines, 33 medical errors, 34 and suboptimal standards of practice resulted. 36 Porath and Pearson found that 66% of workers admitted that their own performance in the workplace had declined significantly, 37 38% intentionally decreased their quality of work, and 48% intentionally decreased their work effort; others just lost interest. 36,38,39 Workplace bullying compromised nurse safety, well-being, and patient-centred safe work practices.…”

“…36 Porath and Pearson found that 66% of workers admitted that their own performance in the workplace had declined significantly, 37 38% intentionally decreased their quality of work, and 48% intentionally decreased their work effort; others just lost interest. 36,38,39 Workplace bullying compromised nurse safety, well-being, and patient-centred safe work practices. 40 Physicians, also compromised patient safety due to their low morale, 41 threw bloody instruments at nurses in the Operating Room (OR), as well as shamed, humiliated, and spread malicious rumours about colleague nurses.…”

Work place bullying: the characteristics of victims and perpetrators at a Middle Eastern health care facility

“…WPB negatively affects patients' safety and quality of care [13]. Studies found that the intimidating and disruptive behaviors associated with WPB fuel medical errors and lead to adverse outcomes [13,14].…”

“…WPB negatively affects patients' safety and quality of care [13]. Studies found that the intimidating and disruptive behaviors associated with WPB fuel medical errors and lead to adverse outcomes [13,14]. In addition to being a dramatic threat to patient safety [15], WPB declines staff morale and increases absenteeism, leading to a high turnover rate of qualified staff [16].…”

“…For instance in Saudi Arabia, studies on WPB are few which leaves numerous gaps in the body of knowledge [13]. The Saudi Arabian community is distinctive compared to Western settings, in terms of race and ethnicity, with deeply rooted traditions framed by tribal bounds and religious constraints.…”