Peer Accountability Program to Combat Nurse Incivility

Abstract

Incivility within the nursing profession is a topic of serious concern and requires immediate interventions. This quality improvement project utilized an evidenced-based approach to implement a program directed at nurse led incivility. The Professional Accountability Program (PAP) was implemented in 26 units in two urban hospitals to empower staff to address uncivil interactions, promote teamwork, and support a shared governance model. The PAP utilized peer coaches to intervene in episodes of low intensity incivility incidents where a nurse is the alleged offender. The project was evaluated utilizing the Clark Workplace Civility Index (CWCI) survey and trending of incidents. The findings included three of the 26 units (12%) increased one civility index measurement after implementation of the program, two units (8%) decreased by one level, and 21 units (80%) remained at baseline. All units scored at “Moderately Civil” or above. Trending analysis demonstrated that Hospital 2 increased reporting >300% during the PAP. Lastly, there were 20 incidents that utilized peer coaching with only one requiring escalation to human resources. The PAP challenges nurses, aided by a peer coach, to alter negative behaviors to support an environment free from incivility. Future work is required to address the stainability and long term effects of the PAP.