Lessons learned from a lateral violence and team-building intervention

Nurs Adm Q. 2009 Oct-Dec;33(4):342-51. 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Efficiency, Organizational*
  • Female
  • Group Processes
  • Health Care Surveys
  • Humans
  • Job Satisfaction*
  • Male
  • Middle Aged
  • Nurse Administrators*
  • Nursing, Team*
  • Organizational Culture
  • Patient Satisfaction / statistics & numerical data
  • Process Assessment, Health Care
  • Program Development
  • Psychometrics
  • Qualitative Research
  • Quality of Health Care
  • Rhode Island
  • Total Quality Management*
  • Violence / prevention & control*