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Clinical Resource Practice Scenarios to Mitigate Bullying

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Clinical Resource Practice Scenarios to Mitigate Bullying Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2019 Clinical Resource Practice Scenarios to Mitigate Bullying Sabrina Renea Brown-Oliver Walden University Follow this and additional works at: https://scholarworks.waldenu.edu/dissertations Part of the Nursing Commons This Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks. For more information, please contact [email protected]. Walden University College of Health Sciences This is to certify that the doctoral study by Sabrina Brown-Oliver has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Eric Anderson, Committee Chairperson, Nursing Faculty Dr. Sophia Brown, Committee Member, Nursing Faculty Dr. Faisal Aboul-Enein, University Reviewer, Nursing Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Walden University 2019 Abstract Clinical Resource Practice Scenarios to Mitigate Bullying by Sabrina R. Brown-Oliver MS, University of Medicine and Dentistry New Jersey, 2005 BSN, Rutgers University, 2003 Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University November 2019 Abstract Workplace bullying is repeated, aggressive action towards a victim, which especially affects new graduate nurses and can inhibit growth and lead to nursing burnout and staff turnover. The purpose of this Doctor of Nursing Practice project was to develop a clinical resource educational module. The case scenarios were developed using literature on workplace bullying and lateral violence. Clegg’s circuits of power theory was applied to frame the organizational authoritative nursing power struggles that exist as a circular flow between different nursing group members, and the American Nurses Association (ANA) Practice Standards and Code of Ethics guided the assertive communication. The case scenarios consisted of 3 vignettes, terms and definitions, a summary of the ANA practice and code of ethical standards, the Appraisal of Guidelines Research and Evaluation (AGREE) II instrument, Workplace Bullying Inventory, Organizational Predictors and Consequences of Bullying Scale, flip cards, and content readability evaluation forms. The AGREE II instrument is a 7-point Likert scale for evaluating clinical guidelines with a threshold standard of 70%. The results of advisory committee members’ rigor scores (mean = 50.8, median = 31, SD = 3.03) were compared with the scores of nurse evaluators (mean = 50, median = 31, SD = 4). The AGREE II reliability score is 0.93, with similar results found for the advisory members (0.939) and the nurse evaluators (0.941). The overall findings suggest that the AGREE II is a viable instrument for evaluating case scenarios, which can be used to improve the workplace environment for nurses by addressing workplace bullying. Clinical Resource Practice Scenarios to Mitigate Bullying by Sabrina R. Brown-Oliver MS, University of Medicine and Dentistry New Jersey, 2005 BSN, Rutgers University, 2003 Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University November 2019 Dedication I dedicate this paper to my family: Mom, Diane, Dad, Charles, my son Jordan, and my grandchild. Thank you for your support throughout this journey. I am truly blessed to have you in my life. Special thanks to Dr. Jennings Sanders, Dr. Anderson, and Dr. Brown for your support and understanding during the project. I would also like to thank Dr. Lorraine Steefel for helping me edit this paper. Acknowledgments I would like to thank my fellow nursing colleagues, who continually encouraged me. It was a very long, hard road, but it was worth the struggle. I would also like to thank HPAE for giving me the opportunity to complete this project. Thank you to all the advisory committee members and the nurse evaluators who participated in this project. Special thanks to my Local for all their encouragement throughout this hugely significant period in my professional development. God, without your infinite wisdom, I would not have made my dream come true. Thank you for carrying me when I doubted myself. Table of Contents List of Tables .......................................................................................................................v Section 1: Nature of the Project ...........................................................................................1 Introduction ....................................................................................................................1 Problem Statement .........................................................................................................2 Purpose Statement ..........................................................................................................4 Project Objectives ................................................................................................... 6 Practice-Focused Questions .................................................................................... 6 Nature of the Doctoral Study .........................................................................................7 Significance..................................................................................................................10 Summary ......................................................................................................................12 Section 2: Background and Context ..................................................................................13 Introduction ..................................................................................................................13 Concepts, Models, and Theories ..................................................................................14 Circuits of Power .................................................................................................. 14 Definition of Terms............................................................................................... 17 Relevance to Nursing Practice .....................................................................................19 Local Background and Context ...................................................................................19 Psychological Effects of Bullying ........................................................................ 21 Intention-to-Leave................................................................................................. 22 Role of the Doctor of Nursing Practice Student ..........................................................24 Student Context ..................................................................................................... 24 i Role of the Project Team ...................................................................................... 24 Summary ......................................................................................................................25 Section 3: Collection and Analysis of Evidence ................................................................27 Introduction ..................................................................................................................27 Sources of Evidence .....................................................................................................28 Literature Search ................................................................................................... 28 Assembling an Expert Panel ................................................................................. 31 Literature Related to Workplace Bullying ............................................................ 32 Analysis and Synthesis ................................................................................................38 Data Analysis Evaluation Tool ............................................................................. 39 Relationship Development with Institutional Stakeholders .................................. 40 Ethical Protection of Participants.......................................................................... 40 Evaluation of the Plan ........................................................................................... 41 Summary ......................................................................................................................42 Section 4: Findings and Recommendations .......................................................................44 Introduction ..................................................................................................................44 Practice-Focused Question 1: What Content Must Be Included in the Practice Scenarios Module? ...................................................................... 44 Practice-Focused Question 2: What Educational Strategies Have Been Demonstrated Effective in Current Evidence-Based Literature? .............. 45 Practice-Focused Question 3: Do the Educational Activities Align with Current Evidence-Based Practice? ............................................................ 47 ii Practice-Focused Question 4: Does the Educational Content Meet the Content Requirements Derived from the Experts’ Review? ..................... 47
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