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Impact of Workplace Mistreatment on Patient Safety Risk and Nurse-Assessed Patient Outcomes

Laschinger, Heather K. Spence PhD, RN, FAAN, FCAHS

Journal of Nursing Administration: May 2014 - Volume 44 - Issue 5 - p 284–290
doi: 10.1097/NNA.0000000000000068

OBJECTIVE: The aim of this study was to investigate the impact of subtle forms of workplace mistreatment (bullying and incivility) on Canadian nurses’ perceptions of patient safety risk and, ultimately, nurse-assessed quality and prevalence of adverse events.

BACKGROUND: Workplace mistreatment is known to have detrimental effects on job performance and in nursing may threaten patient care quality.

METHODS: A total of 336 nurses from acute care settings across Ontario responded to a questionnaire that was mailed to their home address in early 2013, with a response rate of 52%.

RESULTS: Bullying and incivility from nurses, physicians, and supervisors have significant direct and indirect effects on nurse-assessed adverse events (R 2 = 0.03-0.06) and perceptions of patient care quality (R 2 = 0.04-0.07), primarily through perceptions of increased patient safety risk.

CONCLUSIONS: Bullying and workplace incivility have unfavorable effects on nurse-assessed patient quality through their effect on perceptions of patient safety risk.

Author Affiliations: Distinguished University Professor and Arthur Labatt Family Nursing Research Chair in Health Human Resources Optimization, The University of Western Ontario, London, Ontario, Canada.

Funding was received from the Ministry of Health and Long-Term Care.

The author declares no conflicts of interest.

Correspondence: Dr Laschinger, Health Sciences Addition, Room H41, 1151 Richmond Street, London, Ontario, Canada N6A 5C1 (

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins