Nursing control over practice and teamwork.

Nurses' control over practice is essential to nursing care quality and fosters teamwork at the point of care delivery. This article describes a study to measure the impact of nurses' control over their practice from the perspective of teamwork. The purpose of this study was to measure the relationship of control over practice to the five following dimensions of teamwork: team structure, leadership, situation monitoring, mutual support, and communication. The study method was a secondary analysis of 456 surveys from registered nurses working in a five-hospital system. Study results demonstrated that the global measure of teamwork correlated with control over practice and nursing experience, but not with teamwork training. All five individual dimensions of teamwork were perceived as better for those who had a high level of control over practice compared to those who did not. In the discussion section, we consider situation monitoring since this dimension demonstrated an interaction effect between teamwork training and control over practice. Nursing control over practice demonstrates a positive relationship with teamwork and should be considered in future education, policy, and research efforts. Further study is needed to understand control over practice as a potential moderator or mediator of other predecessors of effective teamwork.

A leadership challenge: staff nurse perceptions after an organizational TeamSTEPPS initiative.

The purpose of this study was to measure RNs' perceptions of teamwork skills and behaviors in their work environment during a multiphase multisite nursing organizational teamwork development initiative. Teamwork is essential for patient safety in healthcare organizations and nursing teams. Organizational development supporting effective teamwork should include a just culture, engaged leadership, and teamwork training. A cross-sectional survey study of bedside RNs was conducted in one 5-hospital healthcare system after a TeamSTEPPS teamwork training initiative. TeamSTEPPS teamwork training related to improved RN perceptions of leadership. Initiatives to align the perspectives and teamwork efforts of leaders and bedside nurses are indicated and should involve charge nurses in the design.

Strengthening communication to overcome lateral violence.

AIM: This quality improvement project aims to reduce nurse-to-nurse lateral violence and create a more respectful workplace culture through a series of workshops. BACKGROUND: Lateral violence is common and pervasive in nursing, with detrimental physical, psychological and organizational consequences. METHODS: This project describes the organization-wide pre- and post-intervention survey of registered nurses' perception of lateral violence and turnover. RESULTS: After the workshop series, nurses who reported experiencing verbal abuse fell from 90 to 76%. A greater percentage of nurses perceived a workplace that was respectful to others and in which it was safe to express opinions. After the workshop series, a greater percentage of nurses felt determined to solve the problem after an incident of lateral violence, while a smaller percentage felt powerless. Nursing turnover and vacancy rates dropped. CONCLUSIONS: Educational workshops that enhanced awareness of lateral violence and improved assertive communication resulted in a better working environment, reduction in turnover and vacancy rates, and reduced incidence of lateral violence. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers must raise awareness of lateral violence with individual and organizational consequences. Nursing leadership can effect organizational change to lesson lateral violence and enhance a healthy workplace culture by replicating our intervention or components of our workshops.