Effects of Horizontal Violence among Nurses on Patient Safety: Mediation of Organizational Communication Satisfaction and Moderated Mediation of Organizational Silence.

AIMS This study aimed to investigate the effect of nurses' horizontal violence on patient safety as mediated by organizational communication satisfaction and to examine the moderated mediation effect of organizational silence. BACKGROUND Patient safety is a worldwide concern in healthcare, but patients still experience adverse events. Among factors affecting patient safety, organizational silence must be examined in relation to organizational communication satisfaction and horizontal violence. METHOD A total of 301 nurses working at four general hospitals with over 500 beds in Gyeonggi-do were recruited from October to November 2018. Data were collected through questionnaires and analyzed using SPSS 25.0 and SPSS PROCESS macro. RESULTS Horizontal violence directly affected patient safety and indirectly affected patient safety via mediation by organizational communication satisfaction. Organizational communication satisfaction had a partial mediation effect, and organizational silence had a significant moderated mediation effect in the path from horizontal violence to organizational communication. CONCLUSION To enhance patient safety, educational programs and strategies that improve organizational silence and organizational communication satisfaction should be developed at an organizational level. IMPLICATIONS FOR NURSING MANAGEMENT Hospital administrators should be aware of the pivotal impact of organizational silence among nurses on patient safety.