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 = 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.