الفهرس 
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Abstract
The American Association of Critical Care Nurses (AACN), (2005) has noted that collaboration among healthcare providers, which is paramount to establishing and sustaining a healthy work environment, is lost in the presence of disruptive behaviors. A sentinel event alert was issued by the Joint Commission (TJC), (2008) to warn organizations of the safety risks posed by disruptive behaviors and to increase awareness of this risk for both individual workers and healthcare organizations. Nurses perceive could explain how much they are motivated to learn safety knowledge, and do safe work behaviors, which then contributes to individual- and organization-level safety record if their organization followed the proper policies to control bullying (Neal, et al., 2004). Disruptive behavior “can have a significant impact on care delivery, which can adversely affect patient safety and quality outcomes of care” Rosenstein and O’Daniel, (2008). This study was conducted in order to assess the relationship between medication errors occurrence and bullying among nurses through the following objectives: 1- Determine the relationship between nurses’ disruptive behavior and the occurrence of medication administration errors. 2- Determine the progression of errors over a nurse’s work shift based on observations during the working periods A purposive sample of nurses who work in primary health care units and centers All the staff nurses who accepted to participate in this study. They been selected according to the following criteria: • Nurses having diploma school nurse, Technical institute of nursing and bachelor or nursing with at least one year of experience of nursing practice. • In the study settings, all of the nurses are married. • Nurses who have past history of any disruptive behaviors in workplace. - At the beginning of the study, all nurses from the aforementioned centers and units were included to constitute from the population who fulfill the sampling criteria were present on the day of data collection. They agreed to be interviewed and were included as subjects for the study, until the sample size reached 100 nurses. Twenty nurses working in the kebly medical health care center, Shebin Elkoom. Twenty nurses working in the medical health care center, Quesna. Ten nurses working in the medical health care unit, El- Shohada. Fifteen nurses working in the medical health care center, Menouf. Fifteen nurses working in the medical health care center, Berkit El-Saba. Five nurses working in the clinic of Kafer Rabee, Tala Five nurses working in the clinic of Shama, Ashmoun. Five nurses working in the clinic of Abuawaly, El-Bagour. Five nurses working in the clinic of Akhmas, El-Sadat. The tools for data collection included the following: I: An interview questionnaire: Negative Acts Questionnaire-Revised NAQ-R developed by Einarsen et al., (2009). Part 1: covered bullying and categorized it as the following: a- work related bullying b- person related bullying c- physically intimidating bullying Part 2: contains 15 questions such as (obtaining information on formal and informal educational preparation, the workplace effort to deal with bullying, etc). Part 3: Demographic information of the studied nurses (age, sex, highest educational degree, obtained number of years as a RN, etc). II: an observational checklist: It was adapted from (Medication Error types as categorized by Center for Advancement in Patient Safety MEDMARX, 2004) tool. Three categories of medication errors were defined: • Core 1 errors. Deviation from the following safe medication administration practices: (maintaining package integrity to the time of dose administration, etc). Core 2 errors. Preparation and administration errors: (including incorrect administration time, incorrect preparation of doses, etc) • Core 3 errors. Deviations from prescribed therapy (i.e., if the drug, dose, dosage form, route of administration, etc). The main findings of the study reveled the following: • Nursing nurse mangers, peers or fellow nurses, physicians, managers and the patient’s families were the main sources of bullying. • Both currently bullied and witnessed bullying nurses do suffer from many internal and external behaviors that affect them badly as a result of bullying. • Seventy-one percent of the studied nurses thought that, bullying should be covered in their nursing education. • Seventy percent of the studied nurses been bullied at work over last six months. • The majority of the nurses reported that, Workplace bullying wasn’t included in any courses in their formal nursing education. • Seventy-one percent of the studied nurses claimed that, Information about workplace bullying should be included in nursing curriculum. • The majority of nurses had reported that, bullying was not addressed in staff education in workplace. There is a negative relation between socio-demographic (age, years of experience and, education and grade in jobs) and bullying types. • The percent of observed frequency of medication errors during administration process by the researcher for the studied nurses was very high in all types of medication errors and almost all with high statistical significance. • Regarding to the socio-demographic variables as (age, years of experience, education and grade in jobs) and negative acts total there is a negative relationship between both of them. • There is a positive relationship between socio- demographic data as (age, education and grade in jobs) and medication administration error total score. • There is a statistical significant difference between sociodemographic factors as (age & years of experience, education level), bullying and medication error occurrence. • The nurses who were being bullied in the workplace sixty six percent and who were witnessed the others in the workplace while the others were bullied thirty-four percent.