Results from ISMP Survey on Workplace Intimidation

Click here to view article "Intimidation: Practitioners speak up about this unresolved problem (Part I)"
Click here to view article "Intimidation: Mapping a plan for cultural change in healthcare (Part II)"

Total: 2095

(1) Please tell us how frequently in the past year you've encountered potentially intimidating behaviors.
Key: Often = more than 10 times this year; Sometimes = 3-10 times this year; Rarely = 1-2 times this year; Never = no occurrences.
Potentially Intimidating Behaviors
By Physicians/Prescribers
By Others
(e.g., pharmacist, nurse, supervisor)
Often Sometimes Rarely Never Often Sometimes Rarely Never
a. Reluctance or refusal to answer your questions, return phone calls or pages 20% 40% 28% 13% 8% 22% 41% 29%
b. Condescending language or voice intonation 28% 39% 25% 7% 14% 32% 36% 18%
c. Impatience with questions 25% 41% 26% 7% 12% 32% 38% 19%
d. Strong verbal abuse 6% 16% 34% 44% 3% 10% 26% 60%
e. Negative or threatening body language 5% 15% 29% 51% 4% 10% 23% 63%
f. Reporting you to your manager (actual or threat) 4% 11% 27% 59% 3% 10% 24% 63%
g. "Just give what I/the attending ordered." 12% 25% 33% 31% 3% 10% 21% 66%
h. Physical abuse 0% 0% 4% 95% 0% 1% 2% 97%

(2) If you answered "Sometimes" or "Often" to any item in question #1, how many different individuals committed the potentially intimidating behaviors? Please select NA if the question does not apply. 1-2 3-5 More than 5 NA
  34% 38% 19% 9%

(3) Please tell us how frequently in the past year you've experienced the following potential effects of intimidation.
Key: Often = more than 10 times this year; Sometimes = 3-10 times this year; Rarely = 1-2 times this year; Never = no occurrences.

Potential Effects of Intimidation

Often Sometimes Rarely Never

a. Despite concern (even if vague), I've assumed that a medication order is correct and safe rather than interact with a particular prescriber.

2% 11% 26% 61%

b. Despite concern (even if vague), I've assumed that a medication order is correct and safe because of the stellar reputation of the prescriber.

2% 11% 21% 66%

c. I've asked colleagues to help me interpret an order or validate its safety so that I do not have to interact with a particular prescriber.

16% 31% 27% 25%

d. I've refrained from contacting a prescriber and attempted to clarify the safety of an order by researching the topic myself.

13% 28% 26% 33%

e. I've asked another professional to talk to the prescriber (or other professional) about the safety of an order if it involves a particularly intimidating person.

4% 12% 24% 61%

f. I've asked/suggested/allowed a physician to give a medication himself despite concerns (even if vague) about its safety.

1% 5% 24% 69%

g. I've felt pressured to accept an order, dispense a product, or administer a medication despite concerns (even if vague) about its safety.

3% 14% 32% 51%

(4) Please respond "Yes" or "No" to the following statements related to intimidation in the workplace.
Statements
Yes
No
a. Past experiences with intimidation have altered the way I handle order clarification or questions about medication orders. 49% 51%
b. My organization has clearly defined an effective process for handling disagreements with the safety of an order. 60% 40%
c. The process for handling clinical disagreements allows me to bypass the prescriber or my supervisor if necessary. 33% 67%
d. My organization deals effectively with intimidating behavior. 39% 61%
e. My organization/manager would support me if I reported intimidating behavior by another professional. 70% 30%
f. I've been involved in a medication error in the past year where intimidation played a role. 7% 93%



Total for Female: 1719
(1) Please tell us how frequently in the past year you've encountered potentially intimidating behaviors.
Key: Often = more than 10 times this year; Sometimes = 3-10 times this year; Rarely = 1-2 times this year; Never = no occurrences.
Potentially Intimidating Behaviors
By Physicians/Prescribers
By Others
(e.g., pharmacist, nurse, supervisor)
Often Sometimes Rarely Never Often Sometimes Rarely Never
a. Reluctance or refusal to answer your questions, return phone calls or pages 20% 40% 27% 13% 8% 23% 41% 28%
b. Condescending language or voice intonation 28% 40% 25% 7% 14% 32% 36% 18%
c. Impatience with questions 25% 43% 25% 7% 12% 32% 37% 19%
d. Strong verbal abuse 6% 16% 35% 43% 3% 10% 27% 60%
e. Negative or threatening body language 5% 15% 30% 51% 4% 10% 23% 64%
f. Reporting you to your manager (actual or threat) 4% 11% 27% 59% 3% 9% 23% 65%
g. "Just give what I/the attending ordered." 12% 25% 32% 32% 3% 9% 22% 66%
h. Physical abuse 0% 0% 4% 95% 0% 1% 2% 97%

(2) If you answered "Sometimes" or "Often" to any item in question #1, how many different individuals committed the potentially intimidating behaviors? Please select NA if the question does not apply. 1-2 3-5 More than 5 NA
  35% 37% 19% 9%

(3) Please tell us how frequently in the past year you've experienced the following potential effects of intimidation.
Key: Often = more than 10 times this year; Sometimes = 3-10 times this year; Rarely = 1-2 times this year; Never = no occurrences.

Potential Effects of Intimidation

Often Sometimes Rarely Never

a. Despite concern (even if vague), I've assumed that a medication order is correct and safe rather than interact with a particular prescriber.

2% 10% 25% 63%

b. Despite concern (even if vague), I've assumed that a medication order is correct and safe because of the stellar reputation of the prescriber.

1% 10% 21% 68%

c. I've asked colleagues to help me interpret an order or validate its safety so that I do not have to interact with a particular prescriber.

16% 31% 28% 25%

d. I've refrained from contacting a prescriber and attempted to clarify the safety of an order by researching the topic myself.

12% 29% 27% 33%

e. I've asked another professional to talk to the prescriber (or other professional) about the safety of an order if it involves a particularly intimidating person.

4% 12% 25% 59%

f. I've asked/suggested/allowed a physician to give a medication himself despite concerns (even if vague) about its safety.

1% 5% 24% 69%

g. I've felt pressured to accept an order, dispense a product, or administer a medication despite concerns (even if vague) about its safety.

3% 14% 32% 51%

(4) Please respond "Yes" or "No" to the following statements related to intimidation in the workplace.
Statements
Yes
No
a. Past experiences with intimidation have altered the way I handle order clarification or questions about medication orders. 50% 50%
b. My organization has clearly defined an effective process for handling disagreements with the safety of an order. 60% 40%
c. The process for handling clinical disagreements allows me to bypass the prescriber or my supervisor if necessary. 33% 67%
d. My organization deals effectively with intimidating behavior. 39% 61%
e. My organization/manager would support me if I reported intimidating behavior by another professional. 70% 30%
f. I've been involved in a medication error in the past year where intimidation played a role. 7% 93%



Total for Male: 283
(1) Please tell us how frequently in the past year you've encountered potentially intimidating behaviors.
Key: Often = more than 10 times this year; Sometimes = 3-10 times this year; Rarely = 1-2 times this year; Never = no occurrences.
Potentially Intimidating Behaviors
By Physicians/Prescribers
By Others
(e.g., pharmacist, nurse, supervisor)
Often Sometimes Rarely Never Often Sometimes Rarely Never
a. Reluctance or refusal to answer your questions, return phone calls or pages 19% 38% 31% 12% 9% 19% 46% 26%
b. Condescending language or voice intonation 26% 32% 31% 11% 16% 30% 37% 18%
c. Impatience with questions 24% 32% 35% 10% 12% 31% 41% 16%
d. Strong verbal abuse 5% 16% 31% 48% 6% 13% 24% 57%
e. Negative or threatening body language 6% 14% 26% 55% 5% 12% 24% 58%
f. Reporting you to your manager (actual or threat) 4% 10% 31% 54% 4% 16% 27% 52%
g. "Just give what I/the attending ordered." 13% 26% 37% 23% 5% 14% 22% 60%
h. Physical abuse 0% 1% 4% 95% 0% 1% 3% 96%

(2) If you answered "Sometimes" or "Often" to any item in question #1, how many different individuals committed the potentially intimidating behaviors? Please select NA if the question does not apply. 1-2 3-5 More than 5 NA
  27% 40% 24% 9%

(3) Please tell us how frequently in the past year you've experienced the following potential effects of intimidation.
Key: Often = more than 10 times this year; Sometimes = 3-10 times this year; Rarely = 1-2 times this year; Never = no occurrences.

Potential Effects of Intimidation

Often Sometimes Rarely Never

a. Despite concern (even if vague), I've assumed that a medication order is correct and safe rather than interact with a particular prescriber.

4% 14% 30% 52%

b. Despite concern (even if vague), I've assumed that a medication order is correct and safe because of the stellar reputation of the prescriber.

4% 12% 26% 58%

c. I've asked colleagues to help me interpret an order or validate its safety so that I do not have to interact with a particular prescriber.

19% 29% 28% 24%

d. I've refrained from contacting a prescriber and attempted to clarify the safety of an order by researching the topic myself.

20% 26% 26% 28%

e. I've asked another professional to talk to the prescriber (or other professional) about the safety of an order if it involves a particularly intimidating person.

3% 10% 22% 65%

f. I've asked/suggested/allowed a physician to give a medication himself despite concerns (even if vague) about its safety.

1% 6% 25% 68%

g. I've felt pressured to accept an order, dispense a product, or administer a medication despite concerns (even if vague) about its safety.

5% 14% 34% 46%

(4) Please respond "Yes" or "No" to the following statements related to intimidation in the workplace.
Statements
Yes
No
a. Past experiences with intimidation have altered the way I handle order clarification or questions about medication orders. 49% 51%
b. My organization has clearly defined an effective process for handling disagreements with the safety of an order. 57% 43%
c. The process for handling clinical disagreements allows me to bypass the prescriber or my supervisor if necessary. 35% 65%
d. My organization deals effectively with intimidating behavior. 40% 60%
e. My organization/manager would support me if I reported intimidating behavior by another professional. 70% 30%
f. I've been involved in a medication error in the past year where intimidation played a role. 9% 91%



Total for Pharmacist: 354
(1) Please tell us how frequently in the past year you've encountered potentially intimidating behaviors.
Key: Often = more than 10 times this year; Sometimes = 3-10 times this year; Rarely = 1-2 times this year; Never = no occurrences.
Potentially Intimidating Behaviors
By Physicians/Prescribers
By Others
(e.g., pharmacist, nurse, supervisor)
Often Sometimes Rarely Never Often Sometimes Rarely Never
a. Reluctance or refusal to answer your questions, return phone calls or pages 19% 44% 28% 9% 12% 26% 44% 17%
b. Condescending language or voice intonation 21% 40% 31% 9% 22% 35% 31% 12%
c. Impatience with questions 21% 39% 31% 9% 19% 36% 32% 13%
d. Strong verbal abuse 3% 15% 36% 46% 5% 14% 31% 50%
e. Negative or threatening body language 2% 10% 23% 64% 4% 10% 26% 60%
f. Reporting you to your manager (actual or threat) 3% 7% 31% 60% 4% 16% 24% 56%
g. "Just give what I/the attending ordered." 19% 32% 33% 17% 6% 21% 28% 45%
h. Physical abuse 0% 0% 3% 97% 0% 0% 3% 97%

(2) If you answered "Sometimes" or "Often" to any item in question #1, how many different individuals committed the potentially intimidating behaviors? Please select NA if the question does not apply. 1-2 3-5 More than 5 NA
  25% 38% 30% 7%

(3) Please tell us how frequently in the past year you've experienced the following potential effects of intimidation.
Key: Often = more than 10 times this year; Sometimes = 3-10 times this year; Rarely = 1-2 times this year; Never = no occurrences.

Potential Effects of Intimidation

Often Sometimes Rarely Never

a. Despite concern (even if vague), I've assumed that a medication order is correct and safe rather than interact with a particular prescriber.

5% 20% 38% 36%

b. Despite concern (even if vague), I've assumed that a medication order is correct and safe because of the stellar reputation of the prescriber.

2% 19% 35% 44%

c. I've asked colleagues to help me interpret an order or validate its safety so that I do not have to interact with a particular prescriber.

22% 35% 25% 17%

d. I've refrained from contacting a prescriber and attempted to clarify the safety of an order by researching the topic myself.

23% 34% 25% 18%

e. I've asked another professional to talk to the prescriber (or other professional) about the safety of an order if it involves a particularly intimidating person.

4% 14% 31% 51%

f. I've asked/suggested/allowed a physician to give a medication himself despite concerns (even if vague) about its safety.

0% 6% 26% 68%

g. I've felt pressured to accept an order, dispense a product, or administer a medication despite concerns (even if vague) about its safety.

6% 22% 40% 32%

(4) Please respond "Yes" or "No" to the following statements related to intimidation in the workplace.
Statements
Yes
No
a. Past experiences with intimidation have altered the way I handle order clarification or questions about medication orders. 57% 43%
b. My organization has clearly defined an effective process for handling disagreements with the safety of an order. 50% 50%
c. The process for handling clinical disagreements allows me to bypass the prescriber or my supervisor if necessary. 32% 68%
d. My organization deals effectively with intimidating behavior. 39% 61%
e. My organization/manager would support me if I reported intimidating behavior by another professional. 72% 28%
f. I've been involved in a medication error in the past year where intimidation played a role. 10% 90%



Total for Nurse: 1565
(1) Please tell us how frequently in the past year you've encountered potentially intimidating behaviors.
Key: Often = more than 10 times this year; Sometimes = 3-10 times this year; Rarely = 1-2 times this year; Never = no occurrences.
Potentially Intimidating Behaviors
By Physicians/Prescribers
By Others
(e.g., pharmacist, nurse, supervisor)
Often Sometimes Rarely Never Often Sometimes Rarely Never
a. Reluctance or refusal to answer your questions, return phone calls or pages 21% 39% 27% 12% 7% 21% 41% 31%
b. Condescending language or voice intonation 30% 40% 24% 7% 13% 31% 37% 19%
c. Impatience with questions 27% 42% 25% 7% 10% 31% 40% 19%
d. Strong verbal abuse 6% 17% 35% 42% 3% 9% 26% 62%
e. Negative or threatening body language 6% 16% 31% 47% 4% 11% 22% 63%
f. Reporting you to your manager (actual or threat) 4% 11% 27% 58% 3% 9% 23% 65%
g. "Just give what I/the attending ordered." 10% 24% 33% 32% 3% 7% 21% 69%
h. Physical abuse 0% 1% 4% 95% 0% 1% 2% 97%

(2) If you answered "Sometimes" or "Often" to any item in question #1, how many different individuals committed the potentially intimidating behaviors? Please select NA if the question does not apply. 1-2 3-5 More than 5 NA
  36% 39% 17% 9%

(3) Please tell us how frequently in the past year you've experienced the following potential effects of intimidation.
Key: Often = more than 10 times this year; Sometimes = 3-10 times this year; Rarely = 1-2 times this year; Never = no occurrences.

Potential Effects of Intimidation

Often Sometimes Rarely Never

a. Despite concern (even if vague), I've assumed that a medication order is correct and safe rather than interact with a particular prescriber.

1% 9% 24% 66%

b. Despite concern (even if vague), I've assumed that a medication order is correct and safe because of the stellar reputation of the prescriber.

1% 9% 19% 71%

c. I've asked colleagues to help me interpret an order or validate its safety so that I do not have to interact with a particular prescriber.

15% 31% 28% 26%

d. I've refrained from contacting a prescriber and attempted to clarify the safety of an order by researching the topic myself.

11% 27% 27% 35%

e. I've asked another professional to talk to the prescriber (or other professional) about the safety of an order if it involves a particularly intimidating person.

3% 11% 23% 62%

f. I've asked/suggested/allowed a physician to give a medication himself despite concerns (even if vague) about its safety.

1% 5% 25% 69%

g. I've felt pressured to accept an order, dispense a product, or administer a medication despite concerns (even if vague) about its safety.

3% 13% 31% 54%

(4) Please respond "Yes" or "No" to the following statements related to intimidation in the workplace.
Statements
Yes
No
a. Past experiences with intimidation have altered the way I handle order clarification or questions about medication orders. 49% 51%
b. My organization has clearly defined an effective process for handling disagreements with the safety of an order. 62% 38%
c. The process for handling clinical disagreements allows me to bypass the prescriber or my supervisor if necessary. 33% 67%
d. My organization deals effectively with intimidating behavior. 39% 61%
e. My organization/manager would support me if I reported intimidating behavior by another professional. 70% 30%
f. I've been involved in a medication error in the past year where intimidation played a role. 7% 93%

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