Rural nurses' perceptions of disruptive behavior and clinical outcomes : a replication-extension study

Abstract

Disruptive behavior in the healthcare setting is considered a major threat to patient safety, patient outcomes, patient satisfaction, and interdisciplinary relationships. The Institution of Medicine estimated that over 44,000 to 98,000 people die related to medical errors (2000). The Joint Commission suggests that disruptive behavior is one of the leading causes of adverse events in the healthcare setting (2008). The purpose of this study was to evaluate Montana nurses perceptions of disruptive behavior and its impacts on interdisciplinary relationships, patient safety, and patient outcomes while working in rural hospitals. This study was a replication-extension study based on Rosenstein & O'Daniel's research in 2008. Rosenstein's survey was used to assess perceptions of disruptive behavior in the healthcare environment. This survey was sent out to 120 rural nurses in Montana. Fifty-nine participants completed the survey resulting in a 49% response rate. One hundred percent of nurses indicated that disruptive behavior could have a potential negative effect on patient outcomes. Over 45% of nurses indicated that they were personally aware of an adverse event that occurred from disruptive behavior and 82.2% of nurses indicated this event could have been prevented. Nurse indicated that both nurse and physician disruptive behavior was prevalent in the rural healthcare setting. Also, participants indicated that disruptive behavior could be linked to increased stress, frustration, loss of concentration, reduced team collaboration, frustration, reduced information transfer, reduced communication, and impaired RN/MD relationships. Results from this survey demonstrated that disruptive behavior can lead to adverse events, compromises in patient safety and quality, and finally decrease overall interdisciplinary relationships. These findings have important implications for patient safety and effective interdisciplinary relationships and support the development of effective policy implementation to address and mange such behavior.