HORIZONTAL VIOLENCE IN NURSING By JB R Kagabo
HORIZONTAL VIOLENCE IN NURSING By JB R. Kagabo
LEARNING OBJECTIVES Defining horizontal violence Relevance to nursing Relevant theories Identify 3 factors that lead to Horizontal violence Identify 3 implications to health care Identify 3 recommendation on how to improve safety and quality of care
WHAT IS HORIZONTAL VIOLANCE? “Hostile, aggressive, and harmful behavior by a nurse or group of nurses toward a coworker or group of nurses via attitudes, actions, words and/or behaviors” What are behaviors seen in horizontal violence? • Demeaning behaviors • disrespectful • language outburst of anger • Throwing objects • undermining confidence • refusing to assist • Intimidation • public humiliation • blaming (Thobaben, 2007, p 82), (Longo & Smith, 2011, p. 346), (Becher & Visovsky, 2012, p. 210)
RELEVANCE TO NURSING Affect the work environment negatively Affect the well being of nurses Affect the quality and safety of patients (Becher & Visovsky, 2012, p. 210)
RELEVANT THEORIES Maslow's hierarchy of needs Conti-O’Hare’s Healer Theory of the Nurse as Wounded
MASLOW'S HIERARCHY OF NEEDS • Using Maslows’s hierarchy of needs to assess healthcare environment • Providing an environment nurses can realize their needs • Using Maslows hierarchy of needs to educate employees on how to foster a healthy working environment for all.
CONTI-O’HARE’S THEORY OF THE NURSE AS WOUNDED HEALER
ASSESSMENT OF HEALTHCARE ENVIRONMENT Policy Zero tolerance of horizontal violence in nursing Resources Education Interdisciplinary collaboration Support for victims and perpetrators Quality and Safety Assessing the work environment Addressing safety for all Implementing strategies suggested by The Joint Commission (TJC) and professional organizations Lachman, 2015, Brooks, Polis & Phillips 2014
ROOT CAUSE ANALYSIS Structural empowerment Lack of leadership support Lack of education Gender differences Low selfesteem Displaced frustration Oppression Lachman 2014, Longo 2010 Horizontal violence
INFERENCES & IMPLICATIONS/CONSEQUENCES • UNSAFE WORK ENVIRONMENT • EMPLOYEE RETENTION ISSUES • FINANCIAL LOSS • BREAKDOWN IN COMMUNICATION • SAFETY AND QUALITY OF CARE OF PATIENT COMPROMISED
RECOMMENDATIONS FOR QUALITY AND SAFETY IMPROVEMENT Address existing horizontal violence Practice of zero tolerance Develop a code of conduct describing behaviors that constitute horizontal violence Enforcing the code of conduct at all times. Determining channels for reporting horizontal violence Maintain privacy https: //www. youtube. com/watch? v=h. Px. B 2 Zln 6 Rw Longo 2010
ANA Standards and QSEN COMPETENCIES ANA standards Communication Leadership Collaboration QSEN competencies Education Teamwork and collaboration Safety
QUESTIONS?
REFERENCES American Nurses Association (2010). Nursing: Scope and standards of practice, 2 nd Edition. Sliver Spring, MD: Nursesbooks. org Becher J. , & Visovsky C. Horizontal Violence in Nursing. MEDSURG Nursing [serial online]. July 2012; 21(4): 210 -214. Available from: CINAHL, Ipswich, MA. Accessed June 4, 2015. Brooks, A. T. , Polis, N. , & Phillips, E. (2014). The New Healthcare Landscape: Disruptive Behaviors Influence Work Environment, Safety, and Clinical Outcomes. Nurse Leader, 12(1), 39 -44. doi: 10. 1016/j. mnl. 2013. 11. 006 Christie, W. , & Jones, S. (2014). Lateral Violence in Nursing and the Theory of the Nurse as Wounded Healer. Online Journal Of Issues In Nursing, 18(4), 1. doi: 10. 3912/OJIN. Vol 19 No 01 PPT 01
REFERENCE CONTD Lachman, V. D. (2015). Ethical Issues in the Disruptive Behaviors of Incivility, Bullying, And Horizontal/Lateral Violence. Urologic Nursing, 35(1), 39 -42. Longo, J. (2010). Combating disruptive behaviors: strategies to promote a healthy work environment. Online Journal Of Issues In Nursing, 15(1), 3. Paris, L. G. , & Terhaar, M. (2011). Using Maslow's Pyramid and the National Database of Nursing Quality Indicators to Attain a Healthier Work Environment. Online Journal of Issues In Nursing, 16(1), 1. doi: 10. 3912/OJIN. Vol 16 No 01 PPT 05 http: //qsen. org/competencies/pre-licensure-ksas/ Thobaben, M. (2007). Horizontal workplace violence. Home Health Care Management and Practice, 20(1), 82 -83
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