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Nursing Research And Evidence Based Practice

Nursing Research And Evidence Based Practice

Nursing Research And Evidence Based Practice

The role of Nurse Leaders in resolving Lateral Workplace violence.



Capstone Project

Submitted to Grantham University

Graduate Faculty of the School of Nursing

in Partial Fulfillment of the

Requirements for the Degree of


Master of Nursing

(Management and Organizational Leadership Track)










Lenexa, Kansas





The role of Nurse Leaders in resolving Lateral Workplace Violence.














Approved by:




_______________________________________________ ________________

Faculty: Name, degree and credentials Date






Certified by:



_______________________________________________ ________________

School Dean: Name, degree and credentials Date








In a health care setting, lateral workplace violence exists. It is an inappropriate and disruptive behavior that is mainly demonstrated by one employee or another, either having a lesser or an equal position. When this occurs, it can be openly displayed and occur in a repetitive nature, escalating over time. Although the acts may appear harmless, they tend to affect nurses by making them uncomfortable in their jobs.  Comment by Darcy Nelson: You need to provide a resource here.

Lateral violence affects nurses by decreasing their sense of well-being and affecting their physical health. This makes them depressed and may reassign with time if nothing is done to solve the issue. This causes a shortage of nurses, which causes the remaining nurses to be overloaded with more tasks. This causes a corresponding burnout and fatigue among them, which affects the patient-an increase in the tasks may lead to reduction in the quality of care, which causes increased dissatisfaction among patients, and later an increase in complications among them Comment by Darcy Nelson: Add citation or resource How do you know that this makes them depressed Comment by Darcy Nelson: Repetitive Comment by Darcy Nelson: Present an overview of why this project is currently of interest. Focus on an area of interest, briefly laying the groundwork for what has been done in the area and why the area is of important social or practical concern, or of theoretical interest. Include appropriate, recent, scholarly sources to support each assertion. Comment by Darcy Nelson: Your task is to provide a thumbnail sketch of what has happened to date during their collective inquiry efforts that can provide an intellectual context for your project, identify territory that has not been explored, and tell the reader how previous research on your project will influence your work. You will fill in this sketch during the literature review.

Statement of the Problem

In my current organization (long-term Care/retirement), there are numerous conflicts among staff members caused by lateral violence presence. This has resulted in poor health care services and increased turnover among them. Therefore, there is need to resolve the issue to mitigate chaos that could later lead to health complications among patients and victims. Comment by Darcy Nelson: Cannot use my we, you I etc in this project.


Describe the situation that needs improvement _______________. Comment by Darcy Nelson: You must answer these 4 questions.

What is happening that should not be happening______________?

What ill effects does this problem create_______________?

What is the evidence of this problem minimum of 2 research articles?

Purpose Comment by Darcy Nelson: What will you do about this problem? That is your purpose to do something about the problem.

With the increase in lateral violence in nursing workplace, there is a need to reduce the behaviors. There are numerous effects associated with the issues, and affects nurses negatively especially when nurse leaders fail to solve them. This project aims at mitigating the negative effects associated with lateral violence among nursing practice. If such issues are not addressed, it affects the performance of Nurses and may later lead to nurses resigning their jobs as a result of having no job satisfaction. and will cause a situation of constant shortage of nurses in most workplaces eventually as most nurses facing these situations tend to quit their jobs in pursuit of a more therapeutic environment to work. when this occurs the few nurses who are left in such organization begin to feel the aftermath effect, in that they begin to assign more patient ratio than expected, all these will lead to stress and nurse burnout, ultimately leading to poor care services by these nurses. Comment by Darcy Nelson: What behaviors? Comment by Darcy Nelson: What are these effects? Comment by Darcy Nelson: What do you mean? What does this look like? Comment by Darcy Nelson: What performance, define performance Comment by Darcy Nelson: Delete.

Theoretical Framework

The Donabedian model will guide the study. Its process, structure, and outcome are used to evaluate and inform efforts made to ensure improved care among patients. The model proposes using various categories, incorporating process, structure, and outcome to assess healthcare quality effectively. For example, a case of lateral workplace violence is caused by multiple factors, including targets on skilled workers due to increases positive attention from managers and supervisors (Akella, 2016). Others may be experience this violence due to being popular and well-liked by the majority of the organization’s members. Finally, others hold the stereotype that lateral workplace violence in any organization must take place. For this study, the independent and dependent variables will be participants and the effects of lateral workplace violence that affect the process and the outcome. This theory will assume that the causes of lateral workplace violence affects most nurses in various health care facilities. However, the findings will not be generalized to avoid bias. Comment by Darcy Nelson: Citation Describe your theory Comment by Darcy Nelson: Who are the others? Comment by Darcy Nelson: This is not research it is a project. Comment by Darcy Nelson: Theories do not assume. This theory will “support”

Nature of the Project

The overall project will comprise a set of interrelated activities intended as a permanent endeavor. The study will employ personal-centered approach, which is effective in necessitating effective exploration of lateral workplace violence. Similarly, the selected sample of nurses will be required to have faced lateral workplace violence for at least nine months and be subjected to this violence by a colleague or any healthcare worker. Data collection will be collected using open-ended questionnaires, which will allow nurses to explain everything from their own perception and experience. The sampling and sample size will involve selecting approximately twenty-five nurses to avoid the biases associated with selecting too small or big (Meires, 2018). Therefore, it controls the internal and external threats. Essentially, the researcher will aim at collecting detailed descriptions and quotes from the selected sample during the study to provide detailed information to ensure a successful project. Comment by Darcy Nelson: What are these activities? Comment by Darcy Nelson: You can use this in the beginning of your survey. You cannot choose them. Comment by Darcy Nelson: Need a workplace violence questionnaire. You will not be able to get the data you need with an open ended questionnaire.

Significance of the Study

Lateral workplace violence affects the emotional well-being and productivity of nurses, increasing their desire to leave the job. This leads to poor health among patients in the affected health care centers. This project will assist in mitigating lateral workplace violence among nurses by crossing the gap between nurses or nurses and other health care workers. Also, it will give nurses a chance to address their widespread problems, where they will do so using open-ended questionnaires that covers all the affected areas. The project will assist in deepening and consolidating the practical skills and theoretical knowledge acquired in class. Comment by Darcy Nelson: What do you mean by this? Comment by Darcy Nelson: Reword for clarity

Similarly, the collected data will assist in solving problems in practice and make an outstanding contribution to the nursing field (Polit, 2017). This is by adding knowledge and materials that align with other researchers’ previously done works in the field. The work will also include the limitations that may be faced during the study and provide recommendations that future researchers can utilize to make perfect studies. Finally, reviewing literature by other scholars within the field assists in recognizing and appreciating their outstanding contributions to nursing research. Comment by Darcy Nelson: This project aims to provide additional …..


There are various terms that the research paper will incorporate throughout. Such terms include but are not limited to, workplace, process, outcome, and structure. Lateral workplace violence, in this case, refers to repeated and unwanted harmful actions that the doers intend to humiliate, cause distress, and offend their recipients (Meires, 2018). The model that guides the study entails process, structure, and outcome. Structure refers to the qualifications of the provider and the workplace in which the care services occurs. The process will refer to the components that make up the efforts to give and receive care among nurses and patients. Moreover, outcomes focus on the overall patients’ recovery, survival, and functions restoration. Finally, the Healthcare workplace will refer to where healthcare workers such as doctors and nurses gather to share skills, experiences, and goals to work hard towards community health. The terms will be used interchangeably, where outcomes will be used when exploring lateral workplace violence, its effects on nurses’ operations, and the patients’ health.


The nursing practice is dedicated to helping patients who require health care services. Over the years, nurses have been facing situations of lateral workplace violence, which originates from nurses to nurses, healthcare workers, or nurses to leaders. With the adverse environment that this violence causes, the paper addresses in detail the problems associated with it. The researcher selects a sample of nurses to make the study successful on the effects of Lateral workplace violence and later finds strategies to overcome them. The research utilizes a conceptual framework that the Donabedian model guides. This model focuses on improved healthcare among the people- reducing Lateral workplace violence will ensure that nurses do not leave their jobs, which will increase the quality of care rendered to patients. The study utilizes a qualitative, descriptive approach that provides a successful project. Ultimately, the sample size is selected while maintaining internal and external validity control for the data to be collected. Utilizing the highlighted tactics will make the project successful.


Lateral violence is a common phenomenon in a nursing workplace. It mainly manifest through physiological harassment that result in hostility, mainly caused by one nurse or another. This issue is opposed to physical aggression, and the harassments may include intimidations, criticism, intimidations, threats, discouragement, exclusion, disinterest, and verbal abuses, among others. Over years, nurses have faced lateral workplace violence constantly, where they employ an enduring behavior worsened by insults, malicious, and intimidating patterns. This violence results in power abuse, and the victims may feel humiliated, vulnerable, menace, and distress. Comment by Darcy Nelson: Citation Comment by Darcy Nelson: What is it? Comment by Darcy Nelson: Psychological Comment by Darcy Nelson: Restate clarify this statement. Comment by Darcy Nelson: Citation Comment by Darcy Nelson: Citation Comment by Darcy Nelson: Citation

Nurse Managers have an essential role of ensuring that lateral workplace violence does not exist in the workplace. This is by solving the issues and implementing policies and rules that warns employees on the punishments associated with such violence. For instance, they may develop zero-tolerance ratios for any workplace hostility outline, which ensures high quality care, teamwork, improved health outcomes, and advancement due to research in the workplace. Failure to solve the lateral violence may cause serious implications for the institution and the victims. This may have effects such as mental health challenges among the victims, alongside comprised physical health. This may cause long term sickness and unplanned absences. Also, this lateral workplace violence, may lead to high turnover rate due to reduction in job satisfaction and the sense of being committed to the employer. A high turnover rate implies a reduction in the quality of care due to detachment from their jobs. Thus, there is an increasing need to deal with lateral violence to eradicate such effects and ensure quality care in nursing institutions. Comment by Darcy Nelson: Managers solve the issues and implement policies Comment by Darcy Nelson: Citation. Comment by Darcy Nelson: Stop using pronouns to begin your sentences. Please begin with a noun Comment by Darcy Nelson: Citation


Programmatic Outcomes required to be addressed in Chapter 1

Programmatic Outcomes are to be infused throughout the Capstone Project. There is not a specific heading for it, but it must be visible where the outcome is being addressed. As you write, you will be citing where you believe you have achieved these outcomes. You will use the “MSN Programmatic Outcomes with Citation Codes” document to identify the Outcomes by letter and number (ex. E1) for both the Core and Specialty Track Outcomes. Core Outcomes will be found for each chapter and identified as “C1-6”. Each of the four specialization tracks Case Management (M1-5), Nursing Informatics (I1-5), Education (E1-5), Management and Leadership (L1-5) may have specific competencies under different sections. The student will highlight the sentences/paragraphs where the numbers are placed for grading by the faculty during the early phases of the writing. Later the student will transfer the best examples of the outcomes to the PO ID table attached at the end. This will be specified in the assignment. In the 600 level courses where the paper is nearing completion it gets rather long. The instructor may request the student to begin using the Change Matrix for easier identification on new content as well as verification of requested changes. The Change Matrix is attached to this document. The student is encouraged to create a final copy without highlighting for publication and the presentation.



Core Outcomes (C)

· Patient Centered Care (C3)- Design nursing care for a clinical or community-based population with respect to cultural diversity, biophysical, psychosocial, and organizational needs

· Evidence Based Practice (C5)- Combine theory and research-based knowledge from nursing and the sciences as they relate to the interdisciplinary team when designing, coordinating and evaluating quality patient care.

Management and Organizational Leadership (MOL) Specialization Outcomes

· Evidence Based Practice (L1)- Utilize management principles to coordinate health care activities with regard to human, capital, system and community resources

Chapter 2: Literature Review

This research paper aims at identifying the issue of Lateral workplace violence and the role of the nurse leaders in correcting the problems. Failure to address such issues leads to reduced performance among nurses and, later, poor health outcomes among consumers (Blackwood et al., 2017). Also, it leads to increased labor turnover since many providers tend to be willing to work in a more therapeutically environment. Various nursing processes, structure, and outcomes can effectively ensure improved healthcare and reduce lateral workplace violence in workplaces. Following numerous reasons that lead to increased lateral workplace violence, there is a need to carry extensive research and experiments to understand the issues. Comment by Darcy Nelson: This is a project not a research paper. Comment by Darcy Nelson: Support this with research articles Comment by Darcy Nelson: What are the numerous reasons?

This part comprises literature that will be essential in informing the study. The review is conducted using literature searches, Google scholar articles and journals, and various library databases like EBSCO. The review explores the concept of lateral workplace violence, the causes, effects, and role of health care workers and leaders in ensuring reduction in the issue and improved performances among health care practitioners. By conducting searches, the work will assist in understanding workplace lateral workplace violence, the gaps, and the right strategies to utilize in the modern world to ensure health care providers are not exposed to this condition.

Lateral workplace violence has become established in the modern world. It is an endemic feature of capitalist employment relationships (Hartin et al., 2020). In a workplace setting, the most common type of lateral violence is physical and verbal abuse from patients, relatives, and nurse leaders (Polit, 2017). Thus, the nursing profession is not spared from this violence despite being built based on following solid codes of ethics and ensuring compassionate care to all (Kang & Lee, 2016). From research by Anusiewic et al., lateral violence is inherent in the nursing working environment (Blackwood et al., 2017). Health practitioners sometimes like to oppress others if they are new in the organization, abuse power in the workplace, and if the work occasions, it must take place (Akella, 2016). This tends to emotionally and mentally influence nurses, which affects their output (Wolf et al., 2018). Therefore, organizations should support new nurses and manage nursing work environment relational attributes. Comment by Darcy Nelson: You need to break the chapter into themes. For example Lateral Workplace Violence, Violence in healthcare etc.

Furthermore, this lateral workplace violence, involves repeating acts that do not favor nurses, which harm them due to a hostile working environment (Meires, 2018, Al-Ghabeesh, 2019)). Also, this violence may be in terms of overloading nurses, neglecting their application for leaves, flaunting one’s power and status, and overruling the victim’s decision (Butler et al., 2018). This affects nurses and may lead to health issues, reduced loyalty for their organization, and lowered morale.

Most cases of Nursing shortage in most organizations are caused by as a result of lateral workplace violence. Lateral violence in any workplace is most times prohibited, but it does not seem to end. Employees have the right to protect themselves and safeguard their interests (Kang & Lee, 2016, De Cieri, 2019). They need to organize themselves to create environments that will be more respected. Essentially, generating awareness is a paramount act to ensure reduced cases of lateral workplace violence (Kang & Lee, 2016). They also need to understand workplace concepts by collectively differentiating this lateral violence and management style. Celebrations can assist in creating lateral workplace violence- free working environments. A study by Koh (2016) reveals that proper awareness provides nurses with an opportunity to celebrate a positive working environment. In addition, it allows them to become pioneers, innovators, and leaders in anti-workplace violence initiatives.

Nurse leaders should ensure that their organization does not report any incidence of Lateral workplace violence. If it occurs, they should resolve them effectively and ensure work continuity. Various strategies can assist in eradicating workplace it(Al-Ghabeesh, 2019) and, for instance, educating nurses on what to do and the strategy to follow when confronted by any lateral workplace violence incidence (Arnetz et al., 2019). Leaders also need to receive education on how to foster and sustain a favorable environment- they should be held accountable for all behavior expectations in the organizations they operate in (Carol, n.d). Finally, leaders should develop a policy to create an environment that treats workers with respect, dignity, and fairness. According to Denise (2017), nurses tend to work harder in an environment where they are respected and treated fairly. Koh (2016) revealed that nurses should be taught to reduce incidences of lateral workplace violence by utilizing positive verbal responses rather than criticizing and intimidating them. However, the use of scripted responses requires multi-level collaboration among hospitals, especially staff members and administrators.

Lateral workplace violence is harmful. It has adverse effects on employees, clients, and the overall organizations they work. From the literature searches, the most affected nurses are new employees. In contrast, others may experience this violence in form of being allocate heavy workloads unjustly, being neglected when requesting something, and oppression by use of power. Nurse employees have the right to mitigate such violence by reporting various instances or creating an environment that ensures they are also respected as individuals.. Moreover, nurse leaders should mitigate lateral workplace violence by educating workers on the right strategies, creating policies against this lateral violence, and collaborating with employees to ensure fairness, dignity, and respect. By doing so, it will vastly reduce possible future incidents of lateral workplace violence.


Programmatic Outcomes required to be addressed in Chapter 2

Core Outcomes (C)

· Evidence Based Practice (C5)- Combine theory and research-based knowledge from nursing and the sciences as they relate to the interdisciplinary team with designing, coordinating and evaluating quality patient care

Management & Organizational Leadership Specialization (L)

· Collaboration & Teamwork (L3)- Apply the theories of leadership to provide a supportive work environment that encourages staff development and promotes a quality health care environment.


Chapter 3: Project Design

[Begin with an introduction and/or restatement of the research problem and purpose. Conclude the introduction with a brief overview of the chapter.]

Project Plan

[Accurately describe the plan for the applied project. This section should be very detailed with every step fully described and supported by the literature. Substantiate the appropriateness of the plan; the strategy for developing the project, engaging stakeholders, providing education, implementing changes, etc. Each step toward researching, designing, and implementing the applied project should be fully elucidated here.]


[Describe the participants in your project and the role they will play in it]


[In this section, include a description of the materials (order sets, teaching plans, windshield surveys, etc.]


[Describe the planned evaluation of the efficacy of the project in detail. Actual evaluation will be presented in Chapter 4. Here, describe what will be done.]

Assumptions and Limitations

[Thoroughly discuss the assumptions about the design and process and what problems may be anticipated to arise given your project and implementation.]

Ethical Assurances

[While applied projects do not involve human subjects thoroughly explore any ethical considerations here.]


[Summarize key points presented in chapter 3 and provide supporting citations for key points.]

Programmatic Outcomes required to be addressed in Chapter 3

Core Outcomes (C)

· Diversity (C1)- Integrate nursing and related sciences into the delivery of advanced nursing care to diverse populations

· Critical Thinking (C2)- Incorporate concepts of advanced practice nursing when making nursing diagnoses and critical thinking decisions about educational and therapeutic interventions

· Collaboration and Teamwork (C4-) Demonstrate high-level communication skills when involved with patients and professionals both within and outside the healthcare field.

Management & Organizational Leadership Specialization Outcomes (L)

· Evidence Based Practice (L1)- Utilize management principles to coordinate health care activities with regard to human, capital, system and community resources.

· Quality Improvement (L2)- Design strategic plans for the development and maintenance of health care environments to insure quality improvement and provide for innovation and change

· Safety (L4)- Demonstrate commitment to adhere to current standards and regulatory agency requirements in the provision of nursing care



Chapter 4: Evaluation

[Begin the discussion with a brief overview of the purpose of the applied project and provide a brief overview of the chapter. Organize the chapter around the actual implementation of the project. Describe each step of the implementation in detail.]


[Once implemented, describe (without analysis) the change.]

Evaluation of Findings

[This section is used to analyze the process change that has been implemented. The discussion will be expanded in Chapter 5. Interpret results in light of the theory (or theories) and/or the conceptual framework(s) you have identified. Describe whether the analysis of the process change was expected given the literature and provide potential explanations for unexpected or conflicting responses.]


[Discussion summarizes key points presented in Chapter 4.]

Programmatic Outcomes required to be addressed in Chapter 4

Core Outcomes (C)


· Evidence Based Practice (C5)- Combine theory and research-based knowledge from nursing and the sciences as they relate to the interdisciplinary team when designing, coordinating and evaluating quality patient care.

Management & Organizational Leadership Specialization Outcomes

· Quality Improvement (L2)- Design strategic plans for the development and maintenance of health care environments to insure quality improvement and provide for innovation and change.

Chapter 5: Implications, Recommendations, and Conclusions

[Begin the discussion with a brief review of the problem statement, purpose, process, and ethical dimensions, and conclude the introduction with a brief overview of the chapter.]



[Present all recommendations for practical applications of the study. Note: support all recommendations with the analysis of the project. Present recommendations for any future changes.]


[In this section, summarize all key points in Chapter 5.]

Programmatic Outcomes required to be addressed in Chapter 5

Core Outcomes (C)


· Professionalism (C6)- Formulate career management strategies, including self-advocacy, to enhance professional growth.

Management & Organizational Leadership Specialization Outcome (L)

· Quality Improvement (L5) – Provide leadership in the delivery of professional nursing practice that is safe, cost-effective and promotes continuity of care across the health care continuum


Reference 1

Reference 2


Reference n…


Instructions: All resources cited in the dissertation must be included in the list of references.


List all references in APA format with the exception noted below. For each reference listed, there must be at least one corresponding citation within the body of the text, and vice-versa.


Formatting: Single space each reference citation, along with a .5 inch hanging indent; double space between consecutive references in the reference list (See the Doctoral Candidacy Resource Guide located in the Dissertation Center for NCU exceptions to APA format).


Tips: Sort in alpha surname/title order. Only capitalize the first word of the title and of the subtitle, if any. Do not bold the title. Know when to italicize and when not to (i.e., periodical/non-periodical/publication versus book/report/paper). Italicize volume (i.e., Journal Name 4, pp. 12-22.). Please refer to the APA Manual, 6th edition and the Writing Center for additional APA guidance.

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