Second victim phenomenon in a surgical area: online survey

Second Victim Experience: A Dynamic Process Conditioned by the Environment. A Qualitative Research

Objectives

When adverse events (AE) occur, there are different consequences for healthcare professionals. The environment in which professionals work can influence the experience. This study aims to explore the experiences of second victims (SV) among health professionals in Argentina.

Methods

A phenomenological study was used with in-depth interviews with healthcare professionals. Audio recordings and verbatim transcriptions were analyzed independently for themes, subthemes, and codes.

Results

Three main themes emerged from the analysis: navigating the experience, the environment, and the turning point. Subthemes were identified for navigating the experience to describe the process: receiving the impact, transition, and taking action.

Conclusion

SVs undergo a process after an AE. The environment is part of this experience. It is a turning point in SVs' professional and personal lives. Improving the psychological safety (PS) environment is essential for ensuring the safety of SVs.

Second Victim Experiences of Health Care Learners and the Influence of the Training Environment on Postevent Adaptation

Objective

To investigate the experience of medical and graduate learners with second victim experience (SVE) after medical errors or adverse patient outcomes, including impact on training and identification of factors that shape their postevent recovery.

Patients and Methods

The validated Second Victim Experience and Support Tool-Revised (SVEST-R), Physician Well-Being Index, and supplemental open-ended questions were administered to multidisciplinary health care learners between April 8, 2022, and May 30, 2022, across a large academic health institution. Open-ended responses were qualitatively analyzed for iterative themes related to impact of SVE on the training experience.

Results

Of the 206 survey respondents, 144 answered at least 1 open-ended question, with 62.1% (n=91) reporting at least 1 SVE. Participants discussed a wide range of SVEs and indicated that their postevent response was influenced by their training environment. Lack of support from supervisors and staff exacerbated high stress situations. Some trainees felt blamed and unsupported after a traumatic experience. Others emphasized that positive training experiences and supportive supervisors helped them grow and regain confidence. Learners described postevent processing strategies helpful to their recovery. Some, however, felt disincentivized from seeking support.

Conclusion

This multidisciplinary study of learners found that the training environment was influential in postevent recovery. Our findings support the need for the inclusion of education on SVEs and adaptive coping mechanisms as part of health care professional educational curriculums. Educators and health care staff may benefit from enhanced education on best practices to support trainees after stressful or traumatic patient events.

Elimination of punitive outcomes and criminalization of medical errors

PURPOSE OF REVIEW

The penalization of error in the health field continues to be one of the main barriers in the notification, analysis and proposals for measures to improve adverse events. Strategies should be established in order to develop a nonpunitive culture with the sole purpose of learning from mistakes and improving patient safety.

RECENT FINDINGS

Strategies are established for the development of a nonpunitive culture, such as promoting confidentiality and data protection in the notification and analysis of adverse events.

SUMMARY

Despite education, improvements in quality and safety in healthcare, mistakes will undoubtedly occur. The creation of a protected, blame-free environment that promotes systematic reporting of adverse events will provide valuable information for preventive work and the desired improvement in patient and health team safety.