Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA.
University of Alabama at Birmingham School of Nursing, Birmingham, Alabama, USA.
Nurs Forum. 2022 Nov;57(6):1059-1068. doi: 10.1111/nuf.12781. Epub 2022 Jul 31.
Bullying may undermine patient safety in healthcare organizations threatening quality improvement and patient outcomes.
To explore the associations between the nursing work environment, nurse-reported workplace bullying, and patient outcomes.
Cross-sectional analysis of nurse survey data (N = 943). The Practice Environment Scale of the nursing work index was used to measure the work environment, nurse-reported bullying was measured with the short negative acts questionnaire, and single items measured care quality and patient safety grade. Random effects logistic regressions were used to determine associations controlling for individual, employment, and organizational factors.
Fourty percent of nurses reported experiencing bullying. A higher work environment composite score was significantly associated with a lower risk of bullying (OR = 0.16 [0.12, 0.22], p < .0001). Nurses experiencing bullying were less likely to report good/excellent quality of care (OR = 0.28 [0.18, 0.44], p < .0001) or a favorable patient safety grade (OR = 0.36 [0.25, 0.51], p < .0001).
The nursing work environment influences the presence of bullying, which can negatively impact patient outcomes. Improving nurse work environments is one mechanism to better address nurse bullying.
欺凌行为可能会破坏医疗保健组织中的患者安全，威胁到质量改进和患者预后。
探讨护理工作环境、护士报告的工作场所欺凌与患者结局之间的关系。
对护士调查数据（N=943）进行横断面分析。使用护理工作指数的实践环境量表来衡量工作环境，使用简短的负面行为问卷衡量护士报告的欺凌行为，使用单项衡量护理质量和患者安全等级。采用随机效应逻辑回归来确定在控制个体、就业和组织因素的情况下的关联。
40%的护士报告经历过欺凌。较高的工作环境综合评分与较低的欺凌风险显著相关（OR=0.16[0.12,0.22]，p<0.0001）。经历过欺凌的护士报告护理质量较好/优秀的可能性较小（OR=0.28[0.18,0.44]，p<0.0001）或患者安全等级较好的可能性较小（OR=0.36[0.25,0.51]，p<0.0001）。
护理工作环境会影响欺凌行为的发生，从而对患者结局产生负面影响。改善护士工作环境是解决护士欺凌问题的一种机制。
