Background/Significance of Problem. Nurse-to-nurse lateral violence (NNLV) has been internationally reported for greater than two decades and results in new nurse turnover and serious negative outcomes. Clinical Question/Project Objective. Will NNLV and cognitive rehearsal (CR) education result in a decrease in perceived nurse-to-nurse lateral violence in a critical access hospital (CAH)? The scope of this project was to determine perceived extent and increase awareness of NNLV through an educational project about NNLV and CR. Clinical Appraisal of Literature/Best Evidence. Trends of NNLV were assessed through an extensive literature review from Health Source, CINAHL, ProQuest Health, and Medical Complete. An educational forum about NNLV with CR was advocated for newly licensed nurses and current nurses (potential perpetrators of NNLV) with the goal of liberation of oppressed individuals. Integration into Practice/Discussion of Results. An interventional study with one group and pre-/postintervention was used to determine NNLV and CR education on perceived levels of lateral violence. Evidence-based measurement occurred through use of the Nurse Workplace Scale and the Silencing the Self-Work Scale. Outcomes were analyzed quantitatively through independent t-tests. Awareness of NNLV was increased. Evaluation of Evidence-Based Practice/Implications. Organizations must learn to eliminate NNLV. With increased levels of awareness of NNLV, nurses requested additional assistance in dealing with inappropriate behavior. 1. Introduction Up to 90% of nurses experience lateral violence [1, 2]. Extensively and globally reported in the literature, nurse-to-nurse lateral violence (NNLV) or nurse aggression profoundly increases occupational stress with psychological, physical, and organizational consequences [3]. The pervasiveness of nursing workplace violence is of major concern for nursing as evidenced by the multiple position statements developed in response to NNLV [4]. A conservative estimate of the annual cost of nursing workplace violence is $4.3 billion dollars or nearly $250,000 per incident [5]. Nearly 60% of new nurses leave their initial employer within the first six months due to NNLV perpetrated in the workplace [6–8]. Each percentage point of nurse turnover results in an annual cost to an average hospital of nearly $300,000 and $3.6 million in poorly performing hospitals [9]. Utilizing effective evidence-based interventions can positively affect nurse-to-nurse interactions which in turn impact retention, recruitment, and a disenfranchised nursing work
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