Date of Award

2018

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

College

College of Nursing

First Advisor

Lynne S. Nemeth

Second Advisor

Martina Mueller

Third Advisor

Mary Martin

Abstract

Despite extant literature describing the consequences of negative behaviors including adverse patient outcomes, decreased employee satisfaction, reduced employee retention, decreased productivity, increased absenteeism, and decreased engagement the majority of the available research utilizes homogenous groups such as nursing to study these phenomena. Healthcare is provided within the inpatient environment by a cadre of professionals collaborating to deliver care aligned with the Institute of Medicine’s triple aim of improving patient experience, improving overall health, and reducing costs. This dissertation examines instruments which measure negative behaviors among healthcare workers, their psychometric properties, and feasibility of their administration. Both, an exploratory and confirmatory factor analysis were undertaken of the Negative Behaviors in Healthcare Survey with two study samples. Results are reported from an initial study using two cross-sectional administrations of the NBHC Survey, prior and subsequent to a Professionalism Taskforce intervention at an academic medical center in the south eastern United States. The final study examines the presence of negative behaviors across a North Carolina healthcare system, and the relationship of these behaviors with patient safety culture and publicly reported mortality measures.

Rights

All rights reserved. Copyright is held by the author.

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