The Incidence and Impact of Incivility in Pre-Hospital Care

Background: Incivility or rudeness is a relatively mild form of interpersonal aggression. Customers, clients, and patients serve as the primary perpetrators of incivility particularly in high-intensity, service-oriented organizations such as the pre-hospital environment (Flin, 2010). Incivility or rudeness has been shown to have adverse consequences on clinical decision making, diagnostic and procedural performance (Riskin et al. 2015). Rudeness from relatives results in statistically significant poorer team performance from teams under stress. Diagnostic and procedural interventions are worse with incivility and Porath et al. (2013) suggest that 38% of recipients reduce the quality of their work when faced with incivility.There is a dearth of research exploring the incidence of this negative behaviour and, in turn, the effect this has on clinical care. Although the rude behaviours regularly experienced by health care practitioners can seem benign, they may result in patient safety errors with potentially devastating outcomes Aim: To evaluate registered paramedics perception of incivility in clinical practice Method: Study objectives: 1. To conduct semi-structured interviews with registered paramedics to identify the incidence of incivility 2. To explore the paramedic’s understanding of the relationship between decision making, clinical competence and incivility 3. To understand if incivility affects staff wellbeing in the pre-hospital environment Study design: Qualitative, in-depth, semi-structured interviews will be conducted to understand the incidence and impact of incivility on paramedics. Each interview is expected to last for 30-45 minutes and interviews will be undertaken over a 6-week time scale. A convenience sample of registered front line paramedics working for Yorkshire Ambulance Service will be used. The final sample will be identified once data saturation is achieved. Data saturation is achieved when no new themes are identified. Interviews will be audio-recorded, verbatim transcribed and analysed using thematic analysis. Qualitative analysis of interview will be conducted to assess: incidence and impact of incivility in pre-hospital care. All identifiable data will be anonymised. All transcripts will then be checked for accuracy by the PI with initial emergent areas of interest noted. Transcripts will then be analysed using thematic analysis. The study has full ethical approval from University of Hull Faculty of Health Sciences ethics committee. Results: The study is at data collection stage therefore there are no results available at this time Implications for Practice: It is not possible to identify implications for practice until data collection and analysis is complete. However, the critical care / intensive care environment is equally a high intensity area and conclusions from the study will be linked to critical care nursing.