title: Bullying among nursing staff: relationship with psychological/behavioral responses of nurses and medical errors.
abstract: OBJECTIVE
  The aim of this article is to examine the relationship between three types of bullying (person-related, work-related, and physically intimidating) with two types of outcomes (psychological/behavioral responses of nurses and medical errors). In addition, it investigates if the three types of bullying behaviors vary with age or gender of nurses and if the extent of bullying varies across different facilities in an institution.
  
  
  BACKGROUND
  Nurses play an integral role in achieving safe and effective health care. To ensure nurses are functioning at their optimal level, health care organizations need to reduce negative components that impact nurses' job performance and their mental and physical health. Mitigating bullying from the workplace may be necessary to create and maintain a high-performing, caring, and safe hospital culture.
  
  
  METHODS
  Using an internal e-mail system, an e-mail requesting the participants to complete the questionnaire on Survey Monkey was sent to a sample of 1,078 nurses employed across three facilities at a university hospital system in the Midwest. Two hundred forty-one completed questionnaires were received with a response rate of 23%. Bullying was measured utilizing the Negative Acts Questionnaire-Revised (NAQ-R). Outcomes (psychological/behavioral responses of nurses and medical errors) were measured using Rosenstein and O'Daniel's (2008) modified scales.
  
  
  RESULTS
  Person-related bullying showed significant positive relationships with psychological/behavioral responses and medical errors. Work-related bullying showed a significant positive relationship with psychological/behavioral responses, but not with medical errors. Physically intimidating bullying did not show a significant relationship to either outcome. Whereas person-related bullying was found to be negatively associated with age of nurses, physically intimidating bullying was positively associated with age. Male nurses experienced higher work-related bullying than female nurses.
  
  
  CONCLUSIONS
  Findings from this study suggest that bullying behaviors exist and affect psychological/behavioral responses of nurses such as stress and anxiety and medical errors. Health care organizations should identify bullying behaviors and implement bullying prevention strategies to reduce those behaviors and the adverse effects that they may have on psychological/behavioral responses of nurses and medical errors.
authors.affiliation: Whitney Wright, MHA, is Business Manager, Therapy Services, University of Missouri Hospital & Clinics, Columbia. Naresh Khatri, PhD, is Associate Professor, Department of Health Management and Informatics, University of Missouri, Columbia. E-mail: kahtrin@health.missouri.edu.
authors.forename: Whitney
authors.initials: W
authors.lastname: Wright
authors.forename: Naresh
authors.initials: N
authors.lastname: Khatri
mesh_terms: D000328:Adult; D058445:Bullying / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D019300:Medical Errors / Q000523:psychology / Q000706:statistics & numerical data; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000523:psychology* / Q000706:statistics & numerical data; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology; D011795:Surveys and Questionnaires; D055815:Young Adult