Organisational antecedents, policy and horizontal violence among nurses: An integrative review

To explore the organisational antecedents related to horizontal violence among nurses and the extent to which policy initiatives reduce its incidence.

Organisational re-engineering initiatives affect registered nurse roles, adding complexity to organisational antecedents related to horizontal violence and policy. No previous systematic review has examined the role of organisational policies in reducing horizontal violence among nurses.

An integrative review was undertaken, beginning with a search through 18 electronic databases and reference lists of key articles. The studies included were quality appraised.

1,423 abstracts were screened, resulting in 22 studies being included. Emergent themes were the influence of working conditions, relational aspects of teams and leadership, organisational culture, climate and role of structural processes, leadership role and decision-making authority, and the relationship of organisational structures to anti-horizontal violence policy.

Further research exploring historical health care organisational hierarchies that inadvertently propagate oppressive nursing work conditions is needed.

If nurse managers understand the impacts of organisational antecedents and climate on registered nurse roles, they can advocate for the breakdown of hierarchies and power inequalities that keep registered nurses in oppressed positions. This awareness and advocacy could facilitate a new understanding of horizontal violence inclusive of organisational roles and the creation of effective anti-horizontal violence policies.