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AIM STATEMENT
WHY DOES THIS MATTER?
The AIM of this study is to improve civility in
the workplace through the use of evidence-
based leadership strategies.
WHAT IS THE PROBLEM?
We tested an evidence-based leadership
strategy to improve civility, using
assertiveness training with role-play during
staff meetings.
WHAT DID WE DO?
FINDINGS & CONCLUSIONS
Two Civility Scale items reached statistical
significance (p<.05): cooperation (p=.023)
and anti-discrimination (p=.027). The Civility
Scale mean score showed a trend toward
statistical significance (p=.055). The
leadership strategy had a rapid and
meaningful effect. Civility in the workplace is
everyone’s right and everyone’s
responsibility. This was a cost effective
educational approach to safety
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and equality in your life and relationships (9th ed.). Atascadero,
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Griffin, M. (2004). Teaching cognitive rehearsal as a shield for
lateral violence: An intervention for newly licensed nurses. The
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Joint Commission. (2008). Sentinel event alert: Behaviors that
undermine a culture of safety, Issue 40. Chicago, IL: The Joint
Commission. Retrieved from
http://www.jointcommission.org/SentinelEvents/Sentineleventalert
/sea)_40.htm
Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (Eds.). (2000). To
err is human: Building a safer health system. Washington, DC:
National Academy Press.
Osatuke, K., Moore, S. C., Ward, C., Dyrenforth, S. R., & Belton, L.
(2009). Civility, respect, engagement in the workforce (CREW):
Nationwide organization development intervention at Veterans
Health Administration. The Journal of Applied Behavioral
Science, 45(3), 384-410. doi: 10.1177/00218863093350067
Page, A. (Ed.). (2004). Keeping patients safe: Transforming the
work environment of nurses. Washington, DC: National
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United Nations General Assembly. (1948). The Universal
Declaration of Human Rights. New York, NY: Author. Retrieved
from http://www.un.org/events/humanrights/2007/
ACKNOWLEDGEMENTS VA National Center for Organizational Development (NCOD) for
statistical analysis
Dr. Jan Boller, Dr. Robert T. Rubin, and Dr. Joyce Johnson
Dissertation Committee Members
MH Nursing Administration Team
• The Institute of Medicine (IOM) tells us
that effective communication reduces
patient care errors.
• Incivilities in the workplace, including
ineffective communication, lead to
unnecessary staff distractions and
undermine the culture of safety.
• Workplace incivilities are at one end of a
continuum of violence in the workplace.
• Providing safe care within Mental Health
services requires staff to remain focused
continuously.
• Civility in the workplace conveys respect
and promotes safety.
(RESULTS Continued) METHODS
Annual All Employee Survey (AES) –
Civility scores for 2011 showed a sharp
decline. The Civility Scale measured 8
items:
• Respect
• Conflict resolution
• Cooperation
• Anti-discrimination
• Value differences
• Diversity acceptance
• Personal interest
• Reliability
• This leadership strategy should continue.
• Support for Nurse Manager use of role-
play should be increased.
• Staff should be recognized for their
positive behaviors.
• Results should be compared across
services.
AES - Civility Scale scores 2008 - 2012
Design: Translational research guided by
Neuman Systems Model and Peplau’s
Theory of Interpersonal Relations.
Sample Size: N = 169
Sample: VHA MH Nursing Service
Independent Variables: Working in MH
Nursing service 05/12 and received
assertiveness training with role-play
09/2011 – 05/2012
Dependent Variables: AES-Civility score
Survey Instrument: AES Civility Scale
Data Collection Procedures: AES responses
automatically transmitted to independent
contracted data collection agency and de-
identified.
Data Analysis: T-test for independent
samples and Cohen’s d for effect size
“Our 2011 civility score dropped!”
AES - Civility Scale scores 2008 - 2011
LuAnn Sanderson, DNP, PMHCNS-BC, RN
VA Greater Los Angeles Healthcare System & Western University of Health Sciences
Leading a MH Nursing Team to Improve Civility through Assertiveness Training with Role-play
RESULTS
RECOMMENDATIONS
