Responding to disruptive behaviors in nursing: One-year follow-up of quasi-experimental research measuring links to turnover, intent to leave, and patient care quality

Ericka Sanner-Stiehr


Background and objectives: Disruptive behaviors among nurses are a prevalent problem in health care, contributing to nursing staff turnover and compromising patient care. Newly licensed nurses may be unprepared to respond to disruptive behaviors effectively, negatively impacting them, patients, and organizations. Cognitive rehearsal can increase self-efficacy to respond effectively to disruptive behaviors. The purpose of this study was to determine the longitudinal impact of a cognitive rehearsal intervention delivered to nursing students during the final semester of their pre-licensure program on self-efficacy to respond to disruptive behaviors, turnover and intent to stay in a job, frequency of disruptive behaviors, and perceived impact on patient care.

Methods: Design: This study was the second phase in a quasi-experimental, longitudinal project. Participants and Setting: In Phase 1, 129 participants were recruited from three pre-licensure nursing programs in the Midwestern United States. All participants received the intervention. In Phase 2, one year after graduating, 95 remained enrolled. Methods: An electronic survey was used to collect data. Paired t-tests were used to detect changes in self-efficacy; bi-variate correlations were utilized to determine relationships between outcome variables.

Results: Multiple measures of self-efficacy to respond remained statistically significantly increased one year after graduating (p < .05). Experiencing (r = .489; p < .000) and witnessing (r = .432; p < .000) disruptive behaviors was significantly linked to patient care.

Conclusions: Cognitive rehearsal had a sustained, positive impact on self-efficacy to respond to disruptive behaviors and should be included in pre-licensure curricula.

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Journal of Nursing Education and Practice

ISSN 1925-4040 (Print)   ISSN 1925-4059 (Online)

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