Nurses' perception of disruptive behaviors in emergency department healthcare teams: A qualitative study

In an emergency setting, the occurrence of disruptive behaviors hinders team participation and cooperation. Exploring nurses' perception of disruptive behaviors can lead to a better identification of these behaviors in emergency departments and the provision of better recommendations. This study aimed to explore nurses' perception of disruptive behaviors among emergency healthcare teams in hospitals affiliated to the Hamadan University of Medical Sciences, Hamadan, Iran.

The study was carried out using qualitative content analysis in 2018-2019. Twenty participants from emergency departments of five hospitals in Hamadan, Iran, were enrolled using purposive sampling. Data were collected using semi-structured interviews that continued until data saturation. Data analysis was performed using Erlingsson and Brysiewicz's qualitative content analysis approach.

Three main themes emerged including observable disruptive behaviors, hidden disruptive behaviors, and trigger factors. Observable disruptive behaviors consisted of two main categories: violence and incivility. Hidden disruptive behaviors included troubling behaviors, poor communication, and irresponsibility. Finally, the trigger factors of disruptive behaviors involved two categories: professional incompetency and workplace discrimination.

Exploring nurses' perception showed that trigger factors such as professional incompetency and workplace discrimination could cause the occurrence of observable and hidden disruptive behaviors in emergency healthcare teams.