The Prevalence and Outcome of Disruptive Behaviors in Nurses and Physicians: A Descriptive Study in Iranian Health Care Context

Abstract

Background: Disruptive behavior is any inappropriate behavior, verbal-physical abuse, and threats that a therapist performs unprofessionally that leads to a significant negative impact on clinical outcomes of patient care and staff collaboration. Objectives: This study was done to investigate the prevalence of disruptive behavior among nurses and physicians and its effects on the health care context. Methods: In this descriptive cross-sectional study, 248 medical staff in teaching medical centers affiliated with the Isfahan University of Medical Sciences participated. Data were collected employing a questionnaire with convenience sampling and analyzed by SPSS software using descriptive statistics. Results: Data revealed that 85.5% of the participants had experience disruptive behaviors from nurses and physicians. Also, 74 participants stated that the highest prevalence of disruptive behaviors by nurses and physicians were observed weekly, and 87% believed that these behaviors negatively influenced the treatment process. The probability of emerging problems, dangerous events, medical errors, the impaired patients’ safety, and a decrease in treatment quality sometimes occurs, though it often leads to dissatisfaction of the physician, nurse, and patient. In addition, 71% of the participants stated that there is no behavioral statute, and 89.1% believed that even if such a statute exists, there is no executive support. Conclusions: Due to the negative effects of disruptive behaviors and the prevalence of such behaviors among physicians and nurses, it is recommended to have a statute and management system that guarantees its implementation and train all the staff.

Disruptive Behavior and Factors Associated with Patient Safety Climate: A Cross-Sectional Study of Nurses’ and Physicians’ Perceptions

“…When asked about the prevalence of disruptive behaviors by department type, the emergency department and the ICU are the most relevant in our study. However, in terms of specialty, they are more frequent in general surgery, which coincides with the study by Saghaei et al [33]. Tis refects that these services have a context characterized by high demand and a high level of technology where life and death are separated by an instant or an error in care.…”

“…Regarding the undesirable clinical outcomes associated with disruptive behaviors, professionals point out that these directly impact the satisfaction levels of patients and professionals themselves, according to previous research [32][33][34]47]. Tere is also evidence of their relationship with adverse events in clinical practice.…”

“…In the context of Iranian healthcare care, we found two relevant studies. One of them, carried out in health centers afliated with the University of Isfahan, involved 248 professionals, most of them nurses [33]. Te other study was carried out in four emergency departments, with 45 physicians and 110 nurses responding [34].…”

“…Regarding the type of service, several studies have found that emergency and operating room areas are the most signifcant in the manifestation of disruptive behavior [22,23,25,33,35]. Tese two environments are high-stress environments characterized by high communication fow and remarkable concentration.…”

“…According to the perspective of professionals and according to the existing literature, the main factors linked to disruptive behaviors that impact the safety climate include stress and frustration [32][33][34][35][36][37][38][39], poor communication [32], and problems in the nurse-physician relationship [33]. However, nurses report a more negative perception of lost concentration and reduced information transmission than their medical colleagues.…”