Wolf Lisa A, Perhats Cydne, Clark Paul R, Moon Michael D, Zavotsky Kathleen Evanovich
Institute for Emergency Nursing Research, Emergency Nurses Association, Des Plaines, IL, United States.
Institute for Emergency Nursing Research, Emergency Nurses Association, Des Plaines, IL, United States.
Int Emerg Nurs. 2018 Jul;39:33-39. doi: 10.1016/j.ienj.2017.09.002. Epub 2017 Sep 22.
The Institute of Medicine recognizes that the workplace environment is a crucial factor in the ability of nurses to provide safe and effective care, and thus interactions that affect the quality and safety of the work environment require exploration.
The purpose of this study was to use situational analysis to develop a grounded theory of workplace bullying as it manifests specifically in the emergency care setting.
This study used a grounded theory methodology called situational analysis. 44 emergency RNs were recruited to participate in one of 4 focus group sessions, which were transcribed in their entirety, and, along with field notes, served as the dataset.
This grounded theory describes the characteristics of human actors and their reactions to conditions in the practice environment that lead to greater or lesser levels of bullying, and the responses to bullying as it occurs in U.S. emergency departments.
Workplace bullying is a significant factor in the dynamics of patient care, nursing work culture, and nursing retention. The impact on patient care cannot be overestimated, both in terms of errors, substandard care, and the negative effects of high turnover of experienced RNs who leave, compounded by the inexperience of newly hired RNs. An assessment of hospital work environments should include nurse perceptions of workplace bullying, and interventions should focus on effective managerial processes for handling workplace bullying. Future research should include testing of the theoretical coherence of the model, and the testing of bullying interventions to determine the effect on workplace environment, nursing intent to leave/retention, and patient outcomes.
医学研究所认识到工作场所环境是护士提供安全有效护理能力的关键因素，因此需要探索影响工作环境质量和安全的互动关系。
本研究的目的是运用情境分析方法，构建一个关于工作场所欺凌行为的扎根理论，该理论具体体现于急诊护理环境中。
本研究采用一种名为情境分析的扎根理论方法。招募了44名急诊室注册护士参与4个焦点小组讨论中的一个，所有讨论内容均被完整转录，并与现场记录一起作为数据集。
该扎根理论描述了参与人员的特征以及他们对实践环境中导致不同程度欺凌行为的状况的反应，以及美国急诊科发生欺凌行为时的应对措施。
工作场所欺凌是患者护理、护理工作文化和护理人员留任意愿等动态过程中的一个重要因素。其对患者护理的影响无论在错误、不合格护理方面，还是在经验丰富的注册护士高离职率所带来的负面影响（新入职注册护士经验不足加剧了这种影响）方面，都不可高估。对医院工作环境的评估应包括护士对工作场所欺凌行为的看法，干预措施应侧重于处理工作场所欺凌行为的有效管理流程。未来的研究应包括对该模型理论连贯性的测试，以及对欺凌干预措施的测试，以确定其对工作场所环境、护士离职意愿/留任意愿以及患者结局的影响。
