Association between nurses' experiences of workplace incivility and the culture of safety of hospitals: A cross-sectional Study.

Abstract

This article examined the association between workplace incivility experiences of nurses and patient safety (PS) culture in hospitals. Workplace incivility, which is characterised by low-intensity behaviours with unclear intention to harm and disruption of workplace ambiance of mutual respect, may threaten the work environment, resulting in an unhealthy and unsafe workplace. Cross-sectional study. This study surveyed 261 nurses in Saudi Arabia from June 2019 to August 2019 using the 'Hospital Survey of Patients' Safety Culture' and the 'Nurse Incivility Scale'. A multiple linear regression was performed with unit- and hospital-level PS culture as the dependent variables. 'Organizational learning-continuous improvement' and 'Teamwork within units' were recognised as PS culture strengths. The nurses reported workplace incivility from patient/visitor as the most frequently experienced (mean=2.27, standard deviation=0.88). Working in Hospital B (ß=0.24, p<.001, 95%CI=0.15, 0.33) and having a baccalaureate degree in nursing (ß=0.13, p=.014, 95%CI=0.03, 0.23) were associated with better perceptions of unit-level PS, whereas working in medical-surgical wards (ß=-0.16, p=.002, 95%CI=-0.26, -0.06) and in intensive care units (ß=-0.19, p=.002, 95%CI=-0.32, -0.07) and experiencing patient/visitor incivility (ß=-0.09, p=.004, 95%CI=-0.15, -0.03) were associated with poor unit-level PS culture perceptions. Experiences of general incivility (ß=-0.24, p<.001, 95%CI=-0.35, -0.13) and supervisor incivility (ß=-0.26, p=.011, 95%CI=-0.46, -0.06) were associated with poor hospital-level PS culture perceptions. Workplace incivility from patients/visitors had a negative association with unit-level PS culture perceptions, whereas experiences on general and supervisor incivilities had an adverse relationship with hospital-level PS culture perceptions. The study emphasises the call to eradicate any form of incivility in healthcare settings to guarantee a PS culture. Hospital and nursing managers should prioritise the creation and implementation of policies aimed at eliminating uncivil behaviours in clinical settings to ensure that unit- and hospital-level PS culture are above standards.