Pavithra Antoinette, Sunderland Neroli, Callen Joanne, Westbrook Johanna
Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
BMC Health Serv Res. 2022 Mar 28;22(1):410. doi: 10.1186/s12913-022-07763-3.
Unprofessional behaviours of healthcare staff have negative impacts on organisational outcomes, patient safety and staff well-being. The objective of this study was to undertake a qualitative analysis of narrative responses from the Longitudinal Investigation of Negative Behaviours survey (LION), to develop a comprehensive understanding of hospital staff experiences of unprofessional behaviours and their impact on staff and patients. The LION survey identified staff experiences and perceptions related to unprofessional behaviours within hospitals.
Two open-ended questions within the LION survey invited descriptions of unprofessional staff behaviours across seven hospitals in three Australian states between December 2017 and November 2018. Respondents were from medical, nursing, allied health, management, and support services roles in the hospitals. Data were qualitatively analysed using Directed Content Analysis (DCA).
From 5178 LION survey responses, 32% (n = 1636) of participants responded to the two open-ended questions exploring staff experiences of unprofessional behaviours across the hospital sites surveyed. Three primary themes and 11 secondary themes were identified spanning, i) individual unprofessional behaviours, ii) negative impacts of unprofessional behaviours on staff well-being, psychological safety, and employee experience, as well as on patient care, well-being, and safety, and iii) organisational factors associated with staff unprofessional behaviours.
Unprofessional behaviours are experienced by hospital staff across all professional groups and functions. Staff conceptualise, perceive and experience unprofessional behaviours in diverse ways. These behaviours can be understood as enactments that either negatively impact other staff, patients or the organisational outcomes of team cohesion, work efficiency and efficacy. A perceived lack of organisational action based on existing reporting and employee feedback appears to erode employee confidence in hospital leaders and their ability to effectively address and mitigate unprofessional behaviours.
医护人员的不专业行为会对组织成果、患者安全和员工福祉产生负面影响。本研究的目的是对负面行为纵向调查（LION）中的叙述性回答进行定性分析，以全面了解医院员工对不专业行为的经历及其对员工和患者的影响。LION调查确定了与医院内不专业行为相关的员工经历和看法。
LION调查中的两个开放式问题邀请受访者描述2017年12月至2018年11月期间澳大利亚三个州七家医院中员工的不专业行为。受访者来自医院的医疗、护理、联合健康、管理和支持服务岗位。使用定向内容分析法（DCA）对数据进行定性分析。
在5178份LION调查回复中，32%（n = 1636）的参与者回答了这两个开放式问题，这些问题探讨了在所调查的医院场所中员工对不专业行为的经历。确定了三个主要主题和11个次要主题，包括：i）个人不专业行为；ii）不专业行为对员工福祉、心理安全、员工体验以及患者护理、福祉和安全的负面影响；iii）与员工不专业行为相关的组织因素。
所有专业群体和职能的医院员工都经历过不专业行为。员工以不同方式概念化、感知和体验不专业行为。这些行为可被理解为对其他员工、患者或团队凝聚力、工作效率和效能等组织成果产生负面影响的行为表现。基于现有报告和员工反馈，人们感觉组织缺乏行动，这似乎削弱了员工对医院领导的信心以及他们有效处理和减轻不专业行为的能力。
