Impact of workplace mistreatment on patient safety risk and nurse-assessed patient outcomes

J Nurs Adm. 2014 May;44(5):284-90. doi: 10.1097/NNA.0000000000000068.


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 = 0.03-0.06) and perceptions of patient care quality (R = 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Bullying / psychology*
  • Female
  • Humans
  • Interprofessional Relations*
  • Male
  • Middle Aged
  • Models, Psychological
  • Nursing Evaluation Research
  • Nursing Methodology Research
  • Nursing Staff, Hospital / psychology*
  • Nursing Staff, Hospital / statistics & numerical data
  • Ontario
  • Patient Safety*
  • Quality of Health Care
  • Risk Assessment
  • Surveys and Questionnaires
  • Workplace / psychology