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

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.