Analyzing Published Research of Nurse Incivility and Its Impacts on Performance

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Analyzing Published Research of Nurse Incivility and Its Impacts on Performance

Clinical Question

Problem
            For patient care and its optimal outcome, working environment for nurses should be empowering. Unfortunately, the empowering working environment is destroyed by negative behaviors by their co-workers called “incivility”. Incivility is any rude and disrespectful acts toward others with or without a negative intent (ANA, n.d.). These acts are, for examples, eye-rolling, sarcastic comments, taunting, racial/ethnic slurs, intimidation, and physical violence (Stokowski, 2011). Some of these acts are used daily basis among people. The prevalence rate of incivility in the workplace is varied, but the study shows as high as up to 75% (Laschinger, Wong, Cummings, & Grau, 2014).
Significance of problem in terms of outcomes or statistics
In the workplace, many nurses experienced incivility from other nurses. These behaviors have a negative impact on patient care, nursing productivity (Laschinger et al., 2014). Also, it contributes to burnout, job turnover, and intent to leave the profession (Fida, Laschinger, & Leiter, 2018).
Purpose
            The purpose of this paper is to address how incivility is affected by positive leadership approaches and interventions and the impact this has on their performance. In this paper, the two most relevant research articles will be interpreted to introduce how these researches were studied to find answers to the current problem. The Matrix Table is used below to show the concepts, methods, participants, instruments, and major finding to the research.
Description of Findings
Summary

Article

Reference
Purpose
Hypothesis
Study Question
Variables
Independent(I)
Dependent(D)
Study Design
Sample
Size and Selection
Data Collection
Methods
Major Findings
1
Laschinger, H. S., Wong, C. A., Cummings, G. G., & Grau, A. L. (2014). Resonant Leadershipand Workplace Empowerment: The Value of Positive Organizational Cultures in Reducing Workplace Incivility. Nursing Economic$, 32(1), 5-44.
To test a positive leadership approach and workplace empowerment to workplace incivility
D-Workplace incivility

I-positive leadership and workplace empowerment
Quantitative, but select qualitative explanations for quantitative data
N-3,600
Convenience sample-selected from nine participating provinces in Canada
Survey
The role of positive leadership approaches that empower nurses and discourage workplace incivility and burnout in nursing work environments.
2
Lasater, K., Mood, L., Buchwach, D., & Dieckmann, N. F. (2015). Reducing incivility in the workplace: Results of a three-part educational intervention. The Journal of Continuing Education in Nursing, 46(1), 15-24.doi:http://dx.doi.org.chamberlainuniversity.idm.oclc.org/10.3928/00220124-20141224-01
To experiment a three-part educational intervention enhance the work environment
D-Workplace incivility

I-educational intervention
Quantitative, but select qualitative explanations for quantitative data
N-94
(Unit A = 63) (Unit B = 31)

Convenience sample- selected from two units of a major health sciences hospital.
Interview after intervention.
It was effective in decreasing incivility and increasing self-efficacy with a three-part educational intervention.

Description
The first study presented by Laschinger et al. (2014) is to test a positive leadership approach and workplace empowerment to workplace incivility. A total sample of 3,600 nurses working in direct patient care positions was selected. A survey was sent to at their home addresses using the Dillman Total Design Methodology which helps to enhance collection rates. Laschinger et al. (2014) utilizes various instruments such as Resonant leadership behaviors of the current supervisor were measured by using the 10-item Resonant Leadership Scare, workplace empowerment by the two-item Global Empowerment Scale, Employees’ self-reported exposure to co-worker incivility by the Workplace incivility Scale, the core component of burnout, emotional exhaustion by the Maslach Burnout Inventory-General Survey, and job satisfaction by a four-item global measure of work satisfaction. Among the various instruments, the two-item Global Empowerment Scale demonstrated reliability and validity for workplace empowerment. Social Sciences (SPSS) version 20.0 statistical software program was used to conduct descriptive, inferential and reliability analyses of the demographic and major study variables. The author describes its successful outcome that the positive leadership approach empowers workplace and discourages incivility which had to do with the purpose of the paper. But the authors emphasize several methodological limitations that may impact interpretation of the research. Keeping the limitations in mind, reviewing the questions that the participants received for the survey is needed to better understand the data and help guide the group’s work.
The second article is by Lasater, Mood, Buchwach, & Dieckmann, (2015) and they used a three-part educational intervention hypothesis to test how this intervention can improve the work environment in two units of a major health sciences hospital. The quantitative findings of the study were used, but select qualitative explanations are also used for the quantitative data. 63 from Unit A and 31 from Unit B participated for the study, and eight volunteer participants were interviewed after the intervention. The three-part educational intervention conducted during a six month period. The first part of the study had one-hour presentation and discussion on incivility to raise awareness of this incidence and to gather specific data of their units to set the state for the next two parts. Approximately 30 days after the part one, the 4-hour second part occurred and included a lecture, discussion, and role-play to address uncivil acts in the workplace. The 2-hour simulation part three occurred approximately 30 days after part two. There were four quantitative instruments such as Nurse Incivility Scale (NIS), New General Self-Efficacy Scale (NGSE), Workplace Collective Efficacy Scale (WCES), and National Database for Nursing Quality Indicators (NDNQI) to address the study questions and examine the change on each unit. NGSE is to measure individual efficacy beliefs and it demonstrated the good content validity and high reliability. This research provides evidence of the effectiveness of the intervention that decreased acts of incivility for both units which enhance the workplace. However, the article states that persistence of successful outcome without refresher course still in question. In order to help guide the group’s work, more research is needed, as well as ascertaining if there has been any further research on this subject.  
Conclusion
            The purpose of analyzing researched articles for current problems is to determine whether a result can be trusted. Trustable research articles have key components such as validity and reliability. To measure reliability and validity, specific instruments are used in the research, such as the two-item Global Empowerment Scale for workplace empowerment and Nurse Incivility Scale (NIS). Although both articles support a relationship between nurse incivility and its impacts on performance, there are limitations in methodology and persistency of successful outcome. In order to help guide the group’s work, understanding both limitations and further research are needed.  

         
References
Fida, R., Laschinger, H. K. S., & Leiter, M. P. (2018). The protective role of self-efficacy against workplace incivility and burnout in nursing: A time-lagged study. Health care management review, 43(1), 21-29.
Incivility, Bullying, and Workplace Violence. (n.d.). Retrieved February 03, 2018, from            http://www.nursingworld.org/Bullying-Workplace-Violence
Lasater, K., Mood, L., Buchwach, D., & Dieckmann, N. F. (2015). Reducing incivility in the workplace: Results of a three-part educational intervention.The Journal of Continuing Education in Nursing, 46(1), 15-24.            doi:http://dx.doi.org.chamberlainuniversity.idm.oclc.org/10.3928/00220124-20141224-01
Laschinger, H. S., Wong, C. A., Cummings, G. G., & Grau, A. L. (2014). Resonant Leadership and Workplace Empowerment: The Value of Positive Organizational Cultures in Reducing Workplace Incivility. Nursing Economic$, 32(1), 5-44.
Stokowski, L. (2011). The Continuum of Incivility in Nursing. Retrieved January 20, 2018, from        https://www.medscape.com/viewarticle/739328_2