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An Organizational Assessment of Disruptive Clinician Behavior: Findings and Implications

Walrath, Jo M. PhD, RN; Dang, Deborah PhD, RN, NEA-BC; Nyberg, Dorothy MS, RN

doi: 10.1097/NCQ.0b013e318270d2ba

This study investigated registered nurses' (RNs) and physicians' (MD) experiences with disruptive behavior, triggers, responses, and impacts on clinicians, patients, and the organization. Using the Disruptive Clinician Behavior Survey for Hospital Settings, it was found that RNs experienced a significantly higher frequency of disruptive behaviors and triggers than MDs; MDs (45% of 295) and RNs (37% of 689) reported that their peer's disruptive behavior affected them most negatively. The most frequently occurring trigger was pressure from high census, volume, and patient flow; 189 incidences of harm to patients as a result of disruptive behavior were reported. Findings provide organizational leaders with evidence to customize interventions to strengthen the culture of safety.

Johns Hopkins University School of Nursing (Dr Walrath) and Department of Nursing, Johns Hopkins Hospital (Dr Dang and Ms Nyberg), Baltimore, Maryland.

Correspondence: Jo M. Walrath, PhD, RN, Johns Hopkins University School of Nursing, 525 N Wolfe St, Baltimore, MD 21205 (

This study was funded by the State of Maryland Health Services Cost Review Commission Nurse Support Program I grant.

The authors declare no conflict of interest.

Accepted for publication: August 24, 2012

Published online before print: October 15, 2012

© 2013 Lippincott Williams & Wilkins, Inc.