Horizontal Violence or Workplace Bullying Among Intensive Care Unit Nurses: A Mixed Systematic Review

Aims To synthesise literature about horizontal violence or workplace bullying among Intensive Care Unit nurses, exploring its awareness, factors, impacts, and strategies. Design Following PRISMA standards, a mixed systematic review using a narrative synthesis approach and thematic analysis design of the Joanna Briggs Institute. Data Sources Four electronic databases from 2013 to 2023 studies published were searched. Results Eight studies were included: three qualitative and five quantitative. Four key themes emerged: (i) awareness and understanding of horizontal violence or workplace bullying, (ii) factors affecting horizontal violence or workplace bullying, (iii) impacts of horizontal violence or workplace bullying, and (iv) strategies to address horizontal violence or workplace bullying. Conclusion Addressing horizontal violence or workplace bullying requires hospitals should adopt conflict resolution policies, stress management programs, and supportive supervision to improve nurse retention. Nurse management should establish confidential reporting mechanisms, provide training on interpersonal respect, and implement supportive structures to promote psychological safety. Intensive care unit nurses are encouraged to take proactive steps to address workplace bullying, ensuring improved staff well-being and care quality. Impact This paper addresses a significant gap in the literature regarding horizontal violence or workplace bullying among Intensive Care Unit nurses. The findings will impact on healthcare administrators, policymakers, and educators. By understanding horizontal violence or workplace bullying, strategies can be implemented to improve workplace environment, support nurses' well-being, increase nurse retention, and improve the quality of patient care. Reporting Method This systematic review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The review methodology, including data selection, extraction, and synthesis, follows PRISMA standards to ensure clarity, transparency, and reproducibility. Patient or Public Contribution This study did not include patient or public involvement in its design, conduct, or reporting. Trial Registration There is a protocol that does not require registration, it made accessible at: https:// doi. org/ 10. 17605/ OSF.IO/ CFNEJ.