Abstract
Incivility is a notorious issue in the nursing profession and has negative consequences for both nurses and patients. Research exists regarding the positive effects of implemented healthy work environment (HWE) initiatives on nurse satisfaction; however, research has not been expanded to evaluate the effect HWE initiatives have on incivility. The purpose of this project is to implement a HWE initiative at a community hospital to mitigate and prevent incivility. The implemented HWE initiative has the potential to positively influence nursing practice and patient outcomes.
Methodology: Selected floors experiencing significant change at a 144-bed community hospital were analyzed to determine the perception of incivility in relation to a HWE. Pre-surveys gathered data on nurses’ perceptions of incivility and a HWE. Results indicated appropriate staffing, true collaboration, and meaningful recognition were important HWE domains needing to be addressed to assist with the presence of incivility within the facility. An electronic virtual smart speaker was uploaded with organizational information for nurses to retrieve nursing skill components, receive meaningful recognition messages and access quality improvement education in a convenient and timely manner. After a nine-week assessment period, the incivility survey was re-released to assess the effects the HWE initiative had on the perceived level of incivility experienced amongst registered nurses.
Results: Analysis of the survey results were inconclusive regarding the effects a HWE initiative had on mitigating incivility. Interestingly, anecdotal evidence confirmed registered nurses accepted, utilized, and appreciated the smart speaker device; however, a larger percentage of survey respondents reported experiencing instances of incivility after the HWE initiative. This data suggested either a HWE initiative increased incivility or other factors were influencing incivility. Significant factors such as a Coronavirus surge associated with the Omicron variant, a new human resources platform affecting nurse scheduling, and additional house-wide education was impacting nursing care at the studied hospital at the same time the post-implementation survey was opened. Overall, the post-implementation survey results raised questions about other factors affecting incivility. Specifically, based upon the literature, further analysis of the demographic factors of the nurses responding to the survey and their tenure at the studied site appears to be warranted.
Implications for Practice: Based upon the nature of the analyzed statistics and the positive acceptance of the communication devices on the implemented units, it was recommended for smart speakers to be deployed to all floors. Additional studies can then be performed on the added and original units, with special attention paid to the identity of study participants. Such additional studies may reveal to what extent variables like tenure, and external factors such as the Coronavirus, may have affected the study and how future HWE initiatives may be better tailored to identify the connection between HWE and incivility. The project sparked many ideas for the growth of the health of a work environment during times of difficult staffing. When individuals are fully engaged in the process of maintaining a HWE, they will realize the benefits to the work environment.
Notes
Presenter notes available in attached slide deck.
References:
American Association of Critical-Care Nurses. (2016). AACN Standards for Assessing and Establishing and Sustaining Healthy Work Environments: A Journey to Excellence (2nd ed.). https://www.aacn.org/WD/HWE/Docs/HWEStandards.pdf American Nurses Association.
American Nurses Association. (2015). American Nurses Association position statement on incivility, bullying, and workplace violence. https://www.nursingworld.org/practicepolicy/nursing-excellence/official-positionstatements/id/incivility-bullying-andworkplace-violence/
Anthony, M., Yastik, J., MacDonald, D. & Marshall, K. (2014). Development and validation of a tool to measure incivility in clinical nursing education. Journal of Professional Nursing, 30(1), 48–55. https://doi.org/10.1016/j.profnurs.2012.12.011
Brunt, B. (2017). Breaking the cycle of horizontal violence. Ohio Nurses Review, 93(3), 27-32. https://www.bluetoad.com/publication/index.php?m=32439&i=504661&p=26
Kile, D., Skarbek, K., & Thurby-Hay, L. (2019). Bullying and lateral incivility: Have you and your patients been affected? Virginia Nurses Today, 26(4), 9. https://d3ms3kxrsap50t.cloudfront.net/uploads/publication/pdf/1759/Virginia_Nurs es_To day_11_18.pdf
Wei, H., Sewell, K. A., Woody, G., & Rose, M. R. (2018). The state of the science of nurse work environments in the United States: A systematic review. International Journal of Nursing Sciences, 5, 287-300. http://doi.org/10.1016/j.ijnss.2018.04.010.
Sigma Membership
Psi Epsilon
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Workplace Incivility, Work Environment, Hospital Personnel, Organizational Behavior, Amazon Echo, Smart Speakers
Recommended Citation
Gilbreth, Angela K., "Incivility, the Impact, and the Ability to Overcome" (2026). Creating Healthy Work Environments (CHWE). 123.
https://www.sigmarepository.org/chwe/2024/presentations_2024/123
Conference Name
Creating Healthy Work Environments
Conference Host
Sigma Theta Tau International
Conference Location
Indianapolis, Indiana, USA
Conference Year
2024
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-03-10
Incivility, the Impact, and the Ability to Overcome
Indianapolis, Indiana, USA
Incivility is a notorious issue in the nursing profession and has negative consequences for both nurses and patients. Research exists regarding the positive effects of implemented healthy work environment (HWE) initiatives on nurse satisfaction; however, research has not been expanded to evaluate the effect HWE initiatives have on incivility. The purpose of this project is to implement a HWE initiative at a community hospital to mitigate and prevent incivility. The implemented HWE initiative has the potential to positively influence nursing practice and patient outcomes.
Methodology: Selected floors experiencing significant change at a 144-bed community hospital were analyzed to determine the perception of incivility in relation to a HWE. Pre-surveys gathered data on nurses’ perceptions of incivility and a HWE. Results indicated appropriate staffing, true collaboration, and meaningful recognition were important HWE domains needing to be addressed to assist with the presence of incivility within the facility. An electronic virtual smart speaker was uploaded with organizational information for nurses to retrieve nursing skill components, receive meaningful recognition messages and access quality improvement education in a convenient and timely manner. After a nine-week assessment period, the incivility survey was re-released to assess the effects the HWE initiative had on the perceived level of incivility experienced amongst registered nurses.
Results: Analysis of the survey results were inconclusive regarding the effects a HWE initiative had on mitigating incivility. Interestingly, anecdotal evidence confirmed registered nurses accepted, utilized, and appreciated the smart speaker device; however, a larger percentage of survey respondents reported experiencing instances of incivility after the HWE initiative. This data suggested either a HWE initiative increased incivility or other factors were influencing incivility. Significant factors such as a Coronavirus surge associated with the Omicron variant, a new human resources platform affecting nurse scheduling, and additional house-wide education was impacting nursing care at the studied hospital at the same time the post-implementation survey was opened. Overall, the post-implementation survey results raised questions about other factors affecting incivility. Specifically, based upon the literature, further analysis of the demographic factors of the nurses responding to the survey and their tenure at the studied site appears to be warranted.
Implications for Practice: Based upon the nature of the analyzed statistics and the positive acceptance of the communication devices on the implemented units, it was recommended for smart speakers to be deployed to all floors. Additional studies can then be performed on the added and original units, with special attention paid to the identity of study participants. Such additional studies may reveal to what extent variables like tenure, and external factors such as the Coronavirus, may have affected the study and how future HWE initiatives may be better tailored to identify the connection between HWE and incivility. The project sparked many ideas for the growth of the health of a work environment during times of difficult staffing. When individuals are fully engaged in the process of maintaining a HWE, they will realize the benefits to the work environment.
Description
Staffing shortages lead to stress, burnout, and decreased patient outcomes. The implementation of the Amazon Echo to timely convey policies, procedures and other pertinent patient care information can support a healthy work environment during times when staff are not present to sustain orientation processes and changes in hospital procedures.