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Lessons Learned From a Lateral Violence and Team-Building Intervention

Barrett, Ann MBA, RN, NE-BC; Piatek, Carolyn MA, RN; Korber, Susan MS, RN, OCN, NE-BC; Padula, Cynthia PhD, RN

doi: 10.1097/NAQ.0b013e3181b9de0b

Background Lateral violence is likely to exist in settings characterized by poor leadership and lack of clearly articulated roles, expectations, and processes that guide behavior.

Objectives The purposes of this process improvement project were to (1) identify and improve baseline levels of nurse satisfaction and group cohesion through planned unit-based interventions, (2) determine the effect of a team-building intervention on factors that impact cohesive team functioning, and (3) determine the effect of lateral violence training and communication style differences in improving team cohesion.

Methods The sample consisted of registered nurses (RNs) from 4 diverse patient care areas, chosen on the basis of low scores on the National Database of Nursing Quality Indicators (NDNQI) RN-RN interaction subscale. A quasi-experimental pre–post intervention design without a control group was employed. The intervention focused on lateral violence and team building. A qualitative component focused on the impact of the intervention on overall group dynamics and processes.

Results RN scores on the Group Cohesion Scale (P = .037) and the RN-RN interaction scores improved postintervention. Group sessions focused on building trust, identifying and clarifying roles, engaging staff in decision making, role-modeling positive interactions, and holding each other accountable.

Conclusions Key to a cohesive environment is an effective nurse manager able to drive and sustain change.

The Miriam Hospital (Mss Barrett and Korber and Dr Padula) and Human Resources, Lifespan (Ms Piatek), Providence, Rhode Island.

Corresponding Author: Ann Barrett, MBA, RN, NE-BC, Nursing Resource Management, The Miriam Hospital, 164 Summit Ave, Providence, RI 02906 (

The authors thank the staff nurses and nursing leaders who participated in the research, as well as Rebecca Burke, MS, RN, chief operating officer/chief nursing officer, for her support throughout the project and her commitment to maintaining a Magnet environment for nursing, one that is conducive to excellence in nursing practice and research. This project was supported by the Creating Cohesion Fund, The University of Rhode Island, College of Nursing.

© 2009 Lippincott Williams & Wilkins, Inc.