Horizontal hostility: a threat to patient safety

Area of Science:

• Nursing
• Healthcare Management
• Patient Safety

Background:

• Horizontal hostility (HH) in nursing is increasingly recognized.
• Limited understanding exists on how HH influences nurse behaviors impacting patient care.

Purpose of the Study:

• To assess the perceived level of horizontal hostility (HH) in an acute care hospital.
• To determine if HH influences nurse behaviors related to patient safety.

Main Methods:

• A 28-item survey was administered to nearly 500 nurses.
• The survey measured perceived HH and subsequent nurse actions.
• Data was collected over a 2-month period in 2011.

Main Results:

• Nurses experiencing HH reported actions potentially compromising patient safety.
• Examples include failing to clarify orders and performing tasks without assistance.
• Nurses also reported using unfamiliar equipment without clarification.

Conclusions:

• Horizontal hostility poses significant risks to patient safety.
• Recommendations are provided for hospital leadership to manage and address HH.