Outcomes of a Proximal Workplace Intervention Against Workplace Bullying and Harassment: A Protocol for a Cluster Randomized Controlled Trial Among Norwegian Industrial Workers.

Background: Workplace bullying is an important and prevalent risk factors for health impairment, reduced workability and lowered efficiency among both targets and observers. Development and tests of effective organizational intervention strategies are therefore highly important. The present study describes the background, design, and protocol of a cluster randomized controlled trial evaluating the effectiveness of an organization-wide intervention on preventing workplace bullying with a focus on promoting active and constructive bystander behavior. The main overarching goal is to develop an easy to use and standardized organizational intervention based on theory and research in the role of bystanders in bullying situations with the potential of reducing the prevalence of workplace bullying. The theoretical framework of the study is theory of planned behavior (TPB; Ajzen, 1991).Methods/Design: Using a full randomized control trial (RCT) design, this project will empirically test the outcomes of an intervention program targeting bullying and harassment as the main distal outcomes and perceived behavioral control and helping behavior among bystanders as the main proximal outcome. A 1-year cluster randomized controlled design will be utilized, in which controls will also receive the intervention. About 1,500 workers from two different locations of a Norwegian industrial company will be randomized into one intervention group and two control groups with at least 400 workers in each group. A survey will be conducted electronically. With a total of three assessments over 10­12 months, the time interval between the measurement times will be 4 months. Thus, the data collection will take place at baseline, completion of the intervention and at 4 months follow-up.Discussion: This study primarily aims to develop, implement, and evaluate an intervention based on the abovementioned features with the ultimate aim of reducing the prevalence of workplace bullying, by awareness raising and training of bystanders. Manager involvement and involvement of the union representative and the elected health and safety representatives is an important feature of the program. Results of the intervention study will provide important information regarding the effectiveness of preventive interventions against workplace bullying when focusing on bystanders, particularly so regarding the role of bystander awareness, bystander self-efficacy, and bystander behavioral control on the one hand and the prevalence of bullying and harassment on the other.

The art of oral handovers: A participant observational study by undergraduate students in a hospital setting.

AIMS AND OBJECTIVES: To explore the conditions for oral handovers between shifts in a hospital setting, and how these impact patient safety and quality of care. BACKGROUND: Oral handovers transfer patient information and nursing responsibilities between shifts. Short written summaries of patients can complement an oral handover. How to find the balance between a standardised protocol for handovers and tailoring variations to specific patients and situations is debated in the literature. Oral handovers provide time for discussion, debriefing and problem solving, which can lead to increased team cohesiveness. DESIGN: This study used a participant observation design. METHOD: Fifty-two undergraduate nursing students conducted 1100 hr of participant observation in seven different units in a hospital in Western Norway from 2014-2015. Field notes were analysed using qualitative content analysis. RESULTS: Six themes emerged from the data: (i) content and structure of the handover, (ii) awareness of nurses' attitudes during oral handover, (iii) verbal and nonverbal communication, (iv) distractions, (v) relaying key information accurately, (vi) ensuring quality through oral handovers. CONCLUSION: Developing a familiar structure for oral handovers and minimising the use of abbreviations and unfamiliar medical terms promote clarity and understanding. Limiting disturbances during handovers helps nurses focus on the content of the report. Awareness of one's attitudes and the use of verbal and nonverbal communication can enhance the quality of a handover. Time allocated for an oral handover should allow for professional discussions and student supervision. Involving nurse leaders in promoting the quality of oral handovers can impact the quality of care. CLINICAL IMPLICATIONS: Oral handovers serve many purposes, such as the safe transfer of patient information between shifts and staff education and debriefing, which enhance team cohesiveness.