Incivility among intensive care nurses: the effects of an educational intervention

Abstract

Background: Incivility is a significant problem in nurse satisfaction and nurse retention and can be detrimental to a patient's outcome; therefore, it would be beneficial to educate nurses on ways to improve incivility in clinical practice.

Objectives: To determine if a nursing education program, utilizing case studies and discussion of the nurses' experiences would increase awareness of incivility and impact the number of perceived incidences by (1) assessing nurses' experience of incivility along with discerning the perceived source of the incivility and (2) educating the nurses, thus determining if the in-service education decreases the incidence of incivility in the adult intensive care unit.

Methods: This is a quantitative pilot study that utilized a 1-group preintervention and postintervention test design. The intervention was a 60-minute educational program. Twenty-one nurses completed the survey that assesses prevalence of incivility by specific sources, such as nurses, physicians, supervisors, general (other hospital employees), and patients before and after participation in the education intervention. Descriptive statistics of the 5 dimensions of civility and a total dimension score of civility were used.

Results: A total of 21 nurses completed all parts of this study. The postintervention score had a higher mean than the preintervention score in each of the dimensions. Higher scores indicate incivility; thus, lower scores indicate civility. Therefore, more instances of incivility were identified after intervention to increase awareness of incivility. In addition, nurses perceived greater amounts of incivility from patients and families, whereas the direct supervisor (team leaders) showed the greatest amount of civility. A hierarchical regression revealed that race had the largest negative impact, followed by nurses practicing for more than 5 years, part-time status, and younger age, respectively.

Discussion: The outcomes in this pilot study contradict much of the research on incivility in nursing, which previously found that supervisors are more uncivil toward their staff nurses than the rest of the staff. The results of the current study found that incivility perceptions were higher in the postintervention survey; these findings suggest that the education was effective, thus creating more awareness of incivility. This could be a positive cultural turning point in nursing as it decreases incivility, which in turn will help to decrease medical errors, attrition rates, and the financial burden on hospitals.