Date of Completion of Thesis/SIP

Spring 5-5-2020

Document Type

Scholarly Inquiry Paper (SIP)

Degree Name

Master of Science in Nursing (MSN)



First Advisor

Kimberly Langer


Incivility among nurses is a problem that affects healthcare at multiple levels. Incivility can lead to intimidation that can distract clinical judgment, putting patient safety in jeopardy. Incivility affects patient safety as it is a “contributing factor to 98,000 deaths each year in acute care settings” (Lesater, Mood, Buchwach, & Dieckmann, 2015 p.17). In addition, incivility impacts healthcare organizations related to nursing turnover rates and can cost hospital organizations up to 125% of a registered nurse’s (RN) annual salary to replace each individual nurse who leaves their job (Stagg, Sheridan, Jones, & Speroni, 2013). The Joint Commission and American Nurses Association recommend zero-tolerance for such disruptive behavior and express goals to improve recognition of incivility and address the behaviors within the nursing profession as well as medical institutions. The purpose of this integrative literature review is to identify a relationship between nursing incivility and nursing turnover intentions as well as identify the impact an educational program has on nurse’s confidence in managing uncivil behaviors when witnessed. Martha Griffin’s (2004) Cognitive Rehearsal Program (CRP) has supporting evidence to manage incivility in nursing and combining this program with The Johns Hopkins Nursing Evidence-Based Practice model can be utilized to integrate positive changes into the nursing culture. The effects of a CRP were studied quantitatively and qualitatively with supportive levels of evidence. The literature reviewed supported a CRP for managing nursing incivility as there was an overall decrease in nursing incivility post intervention and a raised nursing awareness of incivility. Schwarz and Leibold (2017) surveyed nurses using a Likert scale pre and post an online educational intervention and found nurses ability to identify uncivil behaviors statistically improved (p = 0.013). Cognitive rehearsal programs taught nurses to reflect on their own behavior and how they may be perceived by other co-workers. Interestingly, 70% of nurses surveyed reported a positive change in their own behaviors after an educational course on nursing incivility (Stagg et al. 2013). Ultimately, there is a wealth of research to support an evidence based educational intervention to promote a change to prevent nursing incivility in hospital settings.

Included in

Nursing Commons



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