Disruptive Behavior In Health Care Setting- Reasons, Implications And Remedial Measures

Abstract

Introduction:Disruptive behavior of health care providers is common in most health care settings. It is more commonly observed among junior doctors. Common forms of disruptive behaviour are using abusive language,yelling at patients and colleagues ,indisciplined behavior and at times physical abuse. The present study was carried out to review the literature on disruptive behaviour among health care providers in regards to its nature, incidence, possible reasons, implications and the remedial measures. Methods: An electronic search of 32 published articles in the Medline, Pubmed and Psych Info databases was carried out covering a period from1992 to 2009 using the keywords disruptive behavior among physicians, surgeons,health care provider, nurses, horizontal violence in combination to its incidence, implications and remedial measures. Results: Disruptive behaviors were a common occurrence in the perioperative and emergency care units. These types of behaviors were most prevalent in junior physicians, surgeons and nurses. Disruptive behaviors increased levels of stress and frustration, which impaired concentration, impeded communication flow, and adversely affected staff relationships and team collaboration. These events were considered to increase the likelihood of medical errors and adverse events and to compromise patient safety and quality of care. Conclusions: Disruptive behavior has significant effect on patient care. Organizations need to recognize the prevalence and significance of disruptive behaviors and develop policies to address the issue. Key areas of focus include recognition and awareness, organizationa commitment, implementation of appropriate codes of behavior policies and procedures, and provision of education and training programs to discuss the issue among health care providers.