Lessons learned from a lateral violence and team-building intervention.
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.


OBJECTIVE
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.
Barrett
Ann
A
The Miriam Hospital, Providence, Rhode Island 02906, USA. abarrett@lifespan.org
Piatek
Carolyn
C
Korber
Susan
S
Padula
Cynthia
C
D000328:Adult; D017598:Efficiency, Organizational; D005260:Female; D006126:Group Processes; D019538:Health Care Surveys; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D009718:Nurse Administrators; D009746:Nursing, Team; D015279:Organizational Culture; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D017064:Process Assessment, Health Care; D016730:Program Development; D011594:Psychometrics; D036301:Qualitative Research; D011787:Quality of Health Care; D012237:Rhode Island; D017749:Total Quality Management; D014754:Violence / Q000517:prevention & control*