Ensuring Workplace Safety: Evidence Supporting Interventions for Nurse Administrators.

Healthcare workplace violence is a growing concern among nurses; however, nurse administrators and managers may not be fully aware of the level, frequency, or extent of the trauma that staff nurses experience. This information gap is influenced by nurses' failure to report violent incidents, their belief that they are expected to care for violent/assaultive patients, time required for extensive documentation about these incidents, and perceptions that minimal follow-up to mitigate future episodes will occur. This article describes the evidence-based structures, processes, and practices supported to minimize organizational risk and protect nurses and other staff from being physically or emotionally injured and/or traumatized in the workplace.

Psychiatric Inpatient Bedside Handoff: Implementation of a Quality Improvement Project and Nurses' Responses.

Psychiatric inpatient unit nurses implemented a quality improvement project to explore strategies to enhance the effectiveness of the change of shift communication between nurses and patients and obtain goals of care information. Three nurses championed a 6-month project to implement more efficient, patient-centered communication; influence patient outcomes; and assess nurses' perceptions about patient satisfaction. A survey established the level of nurse satisfaction regarding the length of time spent at change of shift obtaining patient information. Following a literature review, nurses used a standardized approach for their change of shift report, which they called patient bedside handoff. Nurses reported increased satisfaction with the length of time spent with the patient bedside handoff from a pre-implementation average score of 5.7 (somewhat satisfied) to a post-implementation score of 8.3 (very satisfied). This nurse-led quality improvement project helped illuminate perceived barriers to the implementation of patient bedside handoff and the changes in nurses' perceptions over time. [Journal of Psychosocial Nursing and Mental Health Services, 54(7), 33-37.].

Preparing New Graduates for Interprofessional Teamwork: Effectiveness of a Nurse Residency Program.

The purpose of this project was to determine whether a nurse residency program was effective in improving satisfaction with new graduates' performance competence in interprofessional collaboration. This was a cross-sectional survey design, comparing the satisfaction ratings of nurse leaders and staff nurses at a mid-western academic medical center to national benchmark data obtained from the 2007 Nursing Practice Readiness Tool. The sample consisted of 149 nurses who worked in inpatient units where new graduates practice. Thirty-five had 1 year or less of experience in nursing and 114 had at least 2 years of experience. Managers, experienced nurses, and new graduate nurses varied in their satisfaction ratings regarding interprofessional collaboration. Satisfaction of new graduates' competencies by nurse managers and staff nurses were rated higher in each category, compared with the national study, with 63% of nurse leaders satisfied with new graduates' ability to communicate with the interprofessional team, compared with the national average of 38%. Participants reported 56% satisfaction in the ability to work as a team, compared with 37% reported in the national study.

A multilevel analysis of the effects of the Practice Environment Scale of the Nursing Work Index on nurse outcomes.

Few researchers have examined how the components of the Practice Environment Scale of the Nursing Work Index (PES-NWI) relate to nurses' well-being at multiple organizational levels. The objective of the study was to perform a multilevel assessment of the relationships of the PES-NWI subscales with three nurse outcomes: job satisfaction, emotional exhaustion, and turnover intentions. Additionally, we tested the multilevel factor structure of the PES-NWI. In a sample of 699 full-time registered nurses in 79 units and 9 branches of a hospital system, relationships of the NWI with nurse outcomes were fairly consistent across levels of analysis. However, subscales contributed differently to the three outcomes, demonstrating the complexity of environmental influences on nurses' work experience.

Examining the factor structure of the Pain Catastrophizing Scale (PCS) as a measure of victim response to the psychological pain of subtle workplace bullying.

BACKGROUND AND PURPOSE: Literature addressing victim-bully dynamics suggests that subtle bullying is prevalent in health care, both in practice and educational settings. The complex dynamics of workplace bullying complicate its assessment. The purpose was to investigate the factor structure of the Pain Catastrophizing Scale (PCS) for modeling victim responses to subtle workplace bullying. METHODS: Nursing faculty members from multiple Midwestern universities (N = 116) completed the PCS online. RESULTS: The 3-factor PCS structure (i.e., Rumination, Helplessness, Magnification) developed to describe victim response to chronic physical pain was useful in describing victim response to the chronic psychological pain of bullying via confirmatory factor analysis (CFA). CONCLUSIONS: With minor modifications, the PCS represented the construct of victim response to bullying's psychological pain.

The effect of manager exclusion on nurse turnover intention and care quality.

Little is known about how exclusionary practices (i.e., ignored, ostracized) by managers differ across demographics and influence nursing outcomes. This study examines whether managerial exclusion varies by generation, race, and gender, and the extent to which these variables, in turn, relate to turnover intention and perceived patient care among a sample of 747 nurses working in hospitals in a midwestern health system. Exclusion did not differ across most demographic groups, though men reported less exclusion than women. Younger nurses of the Millennial generation, those feeling excluded, and those with fewer years of experience reported lower quality patient care. Managerial exclusion, being a nurse of color, and less experience were associated with stronger intentions to leave. Nursing leaders should attend to factors that may contribute to racial minorities seeking other jobs, diminish younger nurses' ability to provide high-quality care, and minimize practices that might lead nurses to feel excluded.

Speaking of workplace bullying.

Despite the increasing frequency of its reported incidence, especially in health care practice and education settings, workplace bullying seems to defy victims' clear understanding of its effects on them personally and to challenge their ability to provide cogent explanations about those effects to others. Especially, when it is subtle, as is the case in much of workplace bullying, the experience is emotionally confusing to its victims, and its inherent behaviors often seem absurd to those who have not lived through them firsthand. Moreover, the outwardly innocuous behaviors of subtle workplace bullying can yield long-term disorder for victims' coworkers and for employing organizations. Aptly capturing the mechanism of operation of workplace bullying, the concept of catastrophization may provide language to support understanding of victims' personal experiences of subtle workplace bullying and support administrators in recognizing bullying's paradoxical and long-term effects.