OBJECTIVE: To test hypotheses from a horizontal violence and
quality and safety of patient care model: horizontal violence (negative
behavior among peers) is inversely related to peer relations, quality of
care and it is positively related to errors and adverse events.
Additionally, the association between horizontal violence, peer relations,
quality of care, errors and adverse events, and nurse and work
characteristics were determined.
PARTICIPANTS: A random sample (n= 175) of hospital staff Registered
Nurses working in California.
METHODS: Nurses participated via survey. Bivariate and multivariate
analyses tested the study hypotheses.
RESULTS: Hypotheses were supported. Horizontal violence was
inversely related to peer relations and quality of care, and positively
related to errors and adverse events. Including peer relations in the
analyses altered the relationship between horizontal violence and quality of
care but not between horizontal violence, errors and adverse events. Nurse
and hospital characteristics were not related to other variables. Clinical
area contributed significantly in predicting the quality of care, errors and
adverse events but not peer relationships.
CONCLUSIONS: Horizontal violence affects peer relationships and the
quality and safety of patient care as perceived by participating
nurses. Supportive peer relationships are important to mitigate the
impact of horizontal violence on quality of care.
