Politeness and safety in hospitals

Israeli researchers point out that hitherto, little has been understood about the impact of social interactions on iatrogenic harm and lapses in patient safety.Their field-based experience-sampling study of health workers (primarily nurses) in a general hospital explored the impact of rudeness on patient safety performance, state depletion (that is, exhaustion of mental energy for reflective behavior), and team processes (for example, information sharing). Objective measures of performance were compliance with hand hygiene and medication preparation protocols, as well as archival reports of adverse events. Data were analyzed by department shift (480 shifts [15 days] in 16 departments). The study documented 231 “rudeness incidents” over 98 shifts, mostly originating from a patient or family. Compliance with hand hygiene was significantly lower up to 24 hours after rudeness exposure (p = 0.03), and rudeness significantly increased team members’ state depletion (p = 0.002) and decreased information sharing (p = 0.046). Interestingly, episodes of rudeness was not directly associated with adverse events or level of compliance with medication and hand hygiene protocols, but the deleterious indirect effect of a shift’s temporal proximity to rudeness upon poor compliance with medication preparation and team members’ information sharing via state depletion was significant. Remember your mother’s advice – being polite never hurt anyone: it actually appears to have the opposite effect. Refer to the original research here