Disruptive behavior in obstetrics: a hidden threat to patient safety.

OBJECTIVE

This study was to determine the frequency of disruptive behavior on labor and delivery units, its effect on work performance, and its contribution to adverse outcomes.

STUDY DESIGN

One hundred questionnaires were sent to nurse managers of labor and delivery units in selected hospitals in Washington, Oregon, and California regarding the occurrence of disruptive behavior and the consequences of this behavior with respect to patient safety.

RESULTS

Fifty-six percent of questionnaires were returned. Disruptive behavior was currently occurring on 60.7% of the units. Multiple professionals demonstrated the behavior. Nurses had left the unit and there were reported adverse outcomes as a consequence of this behavior.

CONCLUSION

Disruptive behavior occurs frequently on labor and delivery units on the West Coast. This behavior contributed to the nursing shortage, near misses, and adverse occurrences, and was exhibited by a broad range of professionals. The behavior was not always effectively managed by the organization.