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Research finds disruptive behavior among hospital staff affects patient outcomes

Patient Safety Monitor Alert, January 17, 2005

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New research conducted by VHA Inc. in Irving, TX, finds that disruptive behavior between physicians and nurses occurs often and affects patient outcomes, according to PR Newswire.

"The findings of this new research are alarming and yet not new," said Diana Mason, RN, PhD, FAAN, editor-in-chief of the American Journal of Nursing. "A VHA study conducted in 2002 uncovered disturbing physician behavior towards nurses; however, this new study intensifies the urgency of this issue by revealing what happens to patients, which is sobering and distressing."

The study, "Disruptive Behavior & Clinical Outcomes: Perceptions of Nurses & Physicians," was conducted by Alan H. Rosenstein, MD, vice president and medical director at VHA and Michelle O'Daniel, director of member relations for VHA. As part of the study, surveys were distributed to 50 VHA member hospitals in more than 12 states. The team evaluated results from more than 1,500 participants.

The survey found that 94% of respondents believe disruptive behavior impacts adverse events, medical errors, patient safety, patient mortality, quality of care, and patient satisfaction. About 60% of participants said they were aware of potential adverse events that may have occurred from disruptive behavior.

"The survey suggets a serious problem within and across disciplines," said Rosenstein. "Disruptive behavior needs to be addressed at the organizational level."

Rosenstein suggested that hospitals invest time and resources in performing self-assessments, increasing staff awareness, opening communication lines, and boosting collaboration between peers.

"The comments we captured from respondents were incredible and they define the issue," said O'Daniel. Comments included:

• "I have caught myself in the middle of mislabeling specimens after confrontations that have been upsetting."
• "Delay in patients receiving medications because RN was afraid to call MD."
• "Communication between obstetrician and delivery nurse was hampered because of physician behavior. Resulted in poor outcome in newborn."
• "RNs did not want to call MD after the IV ran out. No antibiotic therapy for four days. RN afraid to call MD. Patient expired."

Nursing Management and the American Journal of Nursing will publish this study.

For more information, visit VHA or the American Journal of Nursing.

To read the PR Newswire press release, click here.

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