JHUSON Leadership Week 3: Authentic Nursing Leadership and Interprofessional Teamwork module content Newton, S. M. (2016)

1. Disruptive Behavior
Scott M. Newton, DNP, RN, MHA

2. Introduction
• Recognition
• Intervention
• Resolution

3. Recognition
• Johns Hopkins Continuum of
Concerning Behaviors (inappropriate,
disrespect, bullying, stalking, threats,
violence, physical harm, death)

4. Intervention: DESC Script
• Describe – situation or behavior
• Express – feelings or concerns
• Suggest – alternatives, seek agreement
• Consequences – if behavior continues

5. Intervention: Two-challenge Rule
• Assertively voice concern twice
• Person being challenged must
acknowledge concern
• If issue is unresolved, then escalate up
using chain of command

6. Acceptable Resolution
• Establishes boundaries
• Agrees on behaviors
• Maintains communication

7. Summary
• Conflict management starts with
recognition of behavior
• Structured interventions provide
pathways for action
• Unresolved conflict leads to
communication decay & increased
patient care risk

8. References
• Johns Hopkins (2014). Johns Hopkins continuum of disruptive behaviors at work.
Retrieved from
http://www.safeathopkins.org/z_archive_2015/recognize/continuum_disruptive_behavio
r/ on April 12, 2016.
• AHRQ (2014). Pocket guide: TeamSTEPPS 2.0 Retrieved from
http://www.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-
tools/teamstepps/instructor/essentials/pocketguide.pdf on April 12, 2016.