Impact of workplace mistreatment on patient safety risk and nurse-assessed patient outcomes.

Objective: The aim of this study was to investigate the impact of subtle forms of workplace mistreatment (bullying and incivility) on Canadian nurses' perceptions of patient safety risk and, ultimately, nurse-assessed quality and prevalence of adverse events.

Background: Workplace mistreatment is known to have detrimental effects on job performance and in nursing may threaten patient care quality.

Methods: A total of 336 nurses from acute care settings across Ontario responded to a questionnaire that was mailed to their home address in early 2013, with a response rate of 52%.

Results: Bullying and incivility from nurses, physicians, and supervisors have significant direct and indirect effects on nurse-assessed adverse events (R = 0.03-0.06) and perceptions of patient care quality (R = 0.04-0.07), primarily through perceptions of increased patient safety risk.

Conclusions: Bullying and workplace incivility have unfavorable effects on nurse-assessed patient quality through their effect on perceptions of patient safety risk.