Hostile clinician behaviours in the nursing work environment and implications for patient care: a mixed-methods systematic review

BMC Nursing

Debra Jackson¹  Marie Hutchinson² 

[1] Faculty of Health, University of Technology, PO Box 123, Broadway Sydney, Australia;School of Health and Human Sciences, Southern Cross University, PO Box 157, Lismore 2780, Australia

关键词: Systematic review;    Work environment;    Nurse-physician relations;    Teamwork;    Quality of care;    Disruptive behaviour;    Workplace bullying;   

Others  :  1091544
DOI  :  10.1186/1472-6955-12-25

 received in 2013-05-15, accepted in 2013-09-24,  发布年份 2013

【 摘 要 】

Background

Although there is a sizeable body of evidence regarding the nature of hostile behaviours among clinicians in the nursing workplace, what is less clear is the nature of the relationship between these behaviours and patient care. To inform the development of appropriate intervention strategies we examine the level of evidence detailing the relationships between hostile clinician behaviours and patient care.

Methods

Published qualitative and quantitative studies that examined hostile clinician behaviours and patient care were included. Quality assessment, data extraction and analysis were undertaken on all included studies. The search strategy was undertaken in July and August 2011 and comprised eight electronic databases (CINAHL, Health Collection (Informit), Medline (Ovid), Ovid Nursing Full Text, Proquest Health and Medicine, PsycInfo, Pubmed and Cochrane library) as well as hand searching of reference lists.

Results

The search strategy yielded 30 appropriate publications. Employing content analysis four themes were refined: physician-nurse relations and patient care, nurse-nurse bullying, intimidation andpatient care, reduced nurse performance related to exposure to hostile clinician behaviours,and nurses and physicians directly implicating patients in hostile clinician behaviours.

Conclusions

Our results document evidence of various forms of hostile clinician behaviours which implicate nursing care and patient care. By identifying the place of nurse-nurse hostility in undermining patient care, we focus attention upon the limitations of policy and intervention strategies that have to date largely focused upon the disruptive behaviour of physicians. We conclude that the paucity of robustly designed studies indicates the problem is a comparatively under researched area warranting further examination.

【 授权许可】

   
2013 Hutchinson and Jackson; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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