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This study sought to explore the prevalence of workplace stress, gender differences, and the relationship of workplace incivility to the experience of stress. Effects of stress on performance have been explored for many years. Work stress has been at the root of many physical and psychological problems and has even been linked to medical errors and suboptimal patient outcomes. In this study, 617 respondents completed a Provider Conflict Questionnaire (PCQ) as well as a ten-item stress survey. Work was the main stressor according to 78.2% of respondents. The stress index was moderately high, ranging between 10 and 48 (mean = 25.5). Females demonstrated a higher stress index. Disruptive behavior showed a significant positive correlation with increased stress. This study concludes that employees of institutions with less disruptive behavior exhibited lower stress levels. This finding is important in improving employee satisfaction and reducing medical errors. It is difficult to retain experienced nurses, and stress is a significant contributor to job dissatisfaction. Moreover, workplace conflict and its correlation to increased stress levels must be managed as a strategy to reduce medical errors and increase job satisfaction.

The Evaluation of the Effectiveness of a Structured Educational Program on Nurses' Assessment Ratings in an Epilepsy Monitoring Unit Mona Baran Stecker Background: There has been little published about nursing care on an epilepsy monitoring unit (EMU). Patients with epileptic and non-epileptic events require close monitoring and thorough assessments. In addition, it is especially important that these patients are provided a safe environment. Purpose: The purpose of this project was to evaluate the impact of a structured educational program for nurses on an EMU in the assessment of patients with clinical events by quantitatively measuring nursing assessments before and after the program. Objectives: There were two objectives for this project. The first objective was to measure nurses' assessments of patients on the EMU in a quantifiable form. The second objective was to evaluate the effectiveness of an educational program on the scores on the Nursing Assessment Rating Scale. Design: The study used a before and after design to evaluate the effectiveness of an educational program on nurse assessment ratings. Nurses on the EMU attended one multi-modal educational session consisting of reinforcement of existing protocols and didactic lectures one of which used case-based scenarios with interactive participation. Subjects: Twenty-Five nurses working on the EMU participated in the study. Results: Nurses' assessments were quantified using a criterion based rating scale with seven primary quality indicators. The indicators were characterized as Superior (3 points), Good (2 points), Satisfactory (1 point) and Unsatisfactory(0 points). Prior to the education, the mean scores on the rating scale were 14.5 points (SD 2.1). Post education, there was a statistical difference in scores 16. (SD1.6) (p<.01). Conclusions: Three primary conclusions were reache. First, the Nurse Assessment Rating Scale was able to transform a qualitative measure of nursing assessment into a quantitative indicator that could be compared pre-and post-education. By assigning a numeric value to the rating of superior, good, satisfactory, or unsatisfactory, a quantitative score was compared to ascertain whether the education did improve scores. Second, the data indicated that the education significantly improved the assessment scores. With education, the original protocols were reinforced and assessments became more consistent resulting in improved scores. Third using a multimodal education format targeted aspects of performance such as respect and compassion.

Background:Patient safety is a top priority of healthcare organizations. The Joint Commission (TJC) is now requiring that healthcare organizations promulgate polices to investigate and resolve disruptive behavior among employees.Methods:Our aims in this investigation utilizing the Provider Conflict Questionnaire (PCQ: Appendix A) included; determining what conflicts exist among a large sample of healthcare providers, how to assess the extent and frequency of disruptive behaviors, and what types of consequences result from these conflicts. The PCQ was distributed utilizing electronic postings, and predetermined e-mail lists to nurses and physicians across the US.Results:The convenience sample included 617 respondents to the questionnaire. All incomplete responses (failure to answer all 17 items on the questionnaire) were excluded from data analysis. Our major finding was that disruptive behavior was the greatest problem observed in 82% of organizations; 74% personally witnessed these behaviors, while 5% personally experienced these behaviors. Friedman analysis of variance (ANOVA) analyses demonstrated that the difference between these three estimates were significant (χ2 = 207.8 df = 2, P < 0.0001).Conclusion:Healthcare organizations in the US are bound by TJC regulations to develop leadership standards that address disruptive behavior. These organizations can no longer stand by and ignore behaviors that threaten not only the bottom line of the institution, but also most critically, patient safety. As more attention is being paid to recommendations and mandates from the TJC and the Institute of Medicine (IOM), we will need more data, like those provided from this study, to better document how to address, resolve, and prevent future “misbehaviors”.