Date of Conferral



Doctor of Nursing Practice (DNP)




Joanne M. Minnick


Workplace nurse-on-nurse bullying is a well-known phenomenon in health care organizations at both national and global levels. Healthcare organizations struggle to find effective solutions to help nurses to mitigate bullying and incivility and create safer work environments. The purpose of this systematic literature review doctoral project was to critically appraise the literature to find the best research evidence to show that higher levels of structural empowerment lead to lower levels of incivility and increase nurses’ ability to create safer and more positive work environments. Kanter’s theory of structural empowerment served as the theoretical framework for this review. The evidence-based question is focused on a systematic review of horizontal violence, bullying, incivility, and nurses’ perceptions of structural empowerment show that nurses who feel structurally empowered are more likely to create a positive work environment. A systematic review was completed using multiple databases. The literature search was limited to articles published from 2012 to 2019 and yielded 365 articles with 12 articles meeting the inclusion and exclusion criteria. The Melnyk, Fineout-Overholt Levels of Evidence Pyramid Hierarchy was used for grading the evidence. The conclusion was that empowered nurses are less likely to experience horizontal violence, especially if they have access to information and opportunity in the workplace. Also, nurses who feel structurally empowered are more likely to mitigate bullying behaviors in the workplace and improve the work environment. The findings can lead to positive social change by empowering nurses to create safer work environments.