Perceived Relationship Between Horizontal Violence and Patient Safety Culture Among Nurses

Despite the value of undertaking patient safety culture, its association with horizontal violence in nursing workplace is still understudied. This study aimed to investigate the association between the perceived patient safety culture and its relationship with horizontal violence among nurses working in Jordan.

A cross-sectional correlational design was used. Nurses working in major governmental hospitals in Jordan were conveniently recruited to complete an online self-administered questionnaire, which included the following tools: Hospital Survey on Patient Safety Culture and Negative Behaviours in Healthcare (NBHC) Survey. The survey was designed to measure attitudes and perceptions on patient safety culture at multiple levels of a healthcare organization with ten dimensions. The Negative Behaviours in Healthcare (NBHC) survey was developed as an adaptation of the Lateral Violence in Nursing Survey (LVNS) with 25 items and two open-ended questions.

A total of 330 nurses responded to the questionnaire. Nurses moderately perceived patient safety culture (HSOPS mean = 3.5, SD = 1.1). Low incidence of horizontal violence was claimed (mean = 2.1, SD = 1.1). However, it was associated with moderate negative correlation with patient safety culture (r = -0.53, p < 0.001). Regression model revealed that patient safety culture explained an additional 53% of the variance of horizontal violence after controlling the effects of age and length of clinical experience (R-square change: 0.560, SE: 19.7, P: 0.001, CI: 1.21-1.57).

Despite its low incidence, patient safety culture was found influential to the horizontal violence based on the perspectives of nurses in Jordan. Patient safety culture can be incorporated with other factors that contribute to the development of horizontal violence in nursing workplace.