College of Nursing and Health S
ciences PhD Doctoral Dissertation Defense - Nicholas DiGiovine MSN\, RN\,
NEA-BC\, CCRN
TITLE: The Influence of Identity\, Organizational F
actors\, and Assault on Nursing Personnel on Nurse Informal Power
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br>ZOOM: https://umassd.zoom.us/j/96376257911?pwd=A3QYgTGFaBq1iISAeEEsfGIy
YObyG3.1
Passcode: 389659
COMMITTEE:
\nAbstract
\nTitle : The Influence of Identity\, Organizational Factors\, and Assault on Nurs ing Personnel on Nursing Informal Power
\nBackground: Assaults on nursing personnel are a widespread issue across healthcare globally. This form of violence has consequences for patient care\, nurse outcomes\, and organizational operations and reputation. Despite numerous studies evaluat ing risk factors\, risk screening\, consequences\, and interventions to pr omote safety\, there continues to be a gap evaluating the role of various identity factors beyond binary sex and age on the experience of this viole nce. While studies have evaluated the role of structural empowerment as a protective factor\, individual clinician informal power has not been evalu ated as an outcome variable. Informal power reflects the social connection s of a person and the influence these connections have on the surrounding environment.
\nAim: The purpose of this investigation was to evaluat e the role of identity\, organizational factors\, and violence on staff in formal power while also clarifying population-specific needs for victims o f this violence.
\nTheoretical Framework: Intersectionality and a th eoretical synthesis (Theory of Respect in Interpersonal Relations [TRIR]) framed this study. The synthesis blended the Dual Pathway Model and the Th eory of Humanistic Communication in Nursing.
\nMethods: A simultaneo us convergent mixed methods study using cross-sectional\, quantitative des criptive and qualitative descriptive designs. Nurses (n=153) who had exper ienced patient violence completed an online survey. The survey included a demographic questionnaire and three instruments. The relationship between identity\, organizational factors\, violence and informal power was explor ed. A hierarchical regression model determined significant predictors. Qua litative data was coded and analyzed using standard content analysis techn iques.
\nFindings: The following identity factors were found to ha ve a significant relationship with informal power: age (r[151] = .170\, CI [.007\, .324]\, p = .036) and years of experience (r[151] = .255\, CI [.0 96\, .402]\, p = .001. There was a significant relationship between inform al power and unionization (t[151] = -3.015\, p = .003\, d = .67)\, working in a Magnet recognized organization (t[151] = -2.786\, p = .006\, d = .50 )\, working in an academic medical center (t[151] = -2.972\, p = .003)\, a nd hospital size (F[2\,150] = 3.881\, p = .023\, h2 = .049 [CI 0.000\, 0.1 23)]). Local transformational leadership (r[151] = .478 CI [.341\, .595]\, p<.001) and authentic leadership (r[151] = .541\, CI [.414\, .647]\, p<.0 01) also influenced staff informal power. Exposure to verbal violence (t[1 51] = -2.121\, p = .036\, d = .58) and psychological violence (t[151] = -2 .493\, p = .014\, d = .48) were correlated with staff power. Finally\, the re was a relationship between informal power and frequency of verbal viole nce (r[136] = .203\, CI [.032\, .363]\, p = .017). When these variables we re entered into a hierarchical regression model\, a significant model was found (F[9\,128] = 7.873\, p<.001\, R2 = .311). Local authentic leadership ([ALI] b = .368\, p = .007)\, unionization (b = .192\, p = .018)\, and ve rbal violence frequency (b = .151\, p = .043) were significant predictors and explained 31.1% of the variance in informal power. Three themes were i dentified from qualitative data analysis: “Healthcare environments have significant impact on power during and after violent events”\; “Identi ty may influence violence but is not a major driver of power”\; and “W here does one go from here?”.
\nImplications: Environment has a si gnificant influence on informal power and affected outcomes after nurses e xperienced patient violence. Relationality between nurses and local leader s was a significant predictor of power and may be protective of staff. Whe n violence was not responded to effectively by an organization\, nurses re ported less power. Classification of violence may not accurately illustrat e the complexity of violence presentations. Findings suggest nurses develo p tolerance to violence or grit as an adaptive response to patient violenc e. Although quantitative findings were not significant\, qualitative conte nt analysis suggests Hispanic and LGBTQ nurses may require additional supp ort after experiencing violence.
\nConclusion: Although identity was not a major driver of power\, exposure to violence and organizational des ign impacted staff informal power after experiencing violence. These findi ngs support the need for organizations to meaningfully respond to these ev ents to promote the safety and well-being of nurses.
Event page: https://www.umassd.edu/events/cms/11-12-26-phd-docto
ral-dissertation-defense---nicho.php
Event link: https://
umassd.zoom.us/j/96376257911?pwd=A3QYgTGFaBq1iISAeEEsfGIyYObyG3.1