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Norvell M, Connors CA, Wu AW. Confronting the inevitable: When a urologist feels like a second victim. Urol Oncol 2024; 42:315-318. [PMID: 38971673 DOI: 10.1016/j.urolonc.2024.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 06/03/2024] [Accepted: 06/09/2024] [Indexed: 07/08/2024]
Abstract
There are many opportunities for urologists to be emotionally impacted, and possibly injured, in the regular course of their work. In particular, urologists are vulnerable to become Second Victims as a result of errors, adverse events, and distressing clinical events. This article reviews best practices that individuals, training programs, hospitals, and healthcare systems can implement to intentionally and programmatically mitigate the short and long-term effects on healthcare professionals.
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Affiliation(s)
- Matt Norvell
- Department of Spiritual Care and Chaplaincy, Johns Hopkins Hospital, Baltimore, MD; Armstrong Institute for Patient Safety and Quality, Johns Hopkins University, Baltimore, MD
| | - Cheryl A Connors
- Armstrong Institute for Patient Safety and Quality, Johns Hopkins University, Baltimore, MD; Johns Hopkins Medicine, Baltimore, MD
| | - Albert W Wu
- Armstrong Institute for Patient Safety and Quality, Johns Hopkins University, Baltimore, MD; Johns Hopkins Bloomberg School of Public Health, Johns Hopkins Medicine, Baltimore, MD; Johns Hopkins University School of Medicine, Johns Hopkins Medicine, Baltimore, MD.
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Nzaumvila DK, Bongongo T, Govender I, Okeke SO. An evaluation of support to the second victims in Tshwane District Health Services, South Africa. S Afr Fam Pract (2004) 2024; 66:e1-e6. [PMID: 39354789 PMCID: PMC11447557 DOI: 10.4102/safp.v66i1.5980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 07/16/2024] [Accepted: 07/20/2024] [Indexed: 10/03/2024] Open
Abstract
BACKGROUND Initiatives to reduce patient safety incidents (PSI) and support healthcare professionals who may experience psychological trauma as a result are becoming increasingly common. However, little is known about the quality of the support provided by Tshwane District Health Services. Therefore, it is necessary to assess their assistance for the second victims in order to evaluate their effectiveness. METHODS A cross-sectional study was conducted, and 319 healthcare professionals from six primary health care institutions were invited to participate in the study. The sociodemographic information, work experience, emotional support, familiarity with the concept of the 'second victim' and involvement with PSIs were collected. RESULTS The mean age was 39.8 years, ranging from 22 years to 66 years. The majority of participants were females (n = 249; 78.1%), nurses (n = 153; 49.2%), and those with 5-9 years of experience (n = 82; 25.8%). Most participants (n = 168; 52.7%) were aware of the possibilities of emotional support, while less than half (n = 142; 44.5%) were familiar with the term 'second victim'. The cumulative incidence of adverse events in the institutions was 19.4%, and the majority of second victims (n = 39; 62.9%) emotionally felt the need to speak with someone about it, preferably outside of the workplace. Less than 5% of individuals received support that was initiated by existing structures at their workplace. CONCLUSION Frameworks exist to assist second victims, although they are only known to some healthcare professionals. However, their current use in Tshwane health facilities is ineffective. After experiencing PSIs, second victims often rely on psychological assistance outside of the workplace.Contribution: Authorities need to determine the causes behind some healthcare professionals' lack of awareness regarding the support framework for second victims, as well as their growing tendency to rely on psychologists outside of the workplace, and corrective measures should be implemented.
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Affiliation(s)
- Doudou K Nzaumvila
- Department of Family Medicine & Primary Health Care, Faculty of Medicine, Sefako Makgatho Health Sciences University, Pretoria.
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Johnson B, New L, Ballister M, Brown C, Scott S. Implementing a Peer Support Program for Second Victims. Am J Nurs 2024; 124:44-52. [PMID: 39185983 DOI: 10.1097/01.naj.0001050816.14247.78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Abstract
ABSTRACT The second victim phenomenon describes the distress frequently experienced by health care providers after an unintentional medical error or unexpected adverse event. However, few health care institutions have initiatives that proactively address this phenomenon. The pilot project discussed in this article aimed to create a peer support program for health care providers experiencing the second victim phenomenon. The project team validated the need for such a program among health care providers in the perioperative departments of two facilities within a large health care organization in the southeastern United States. To do this, they used a survey, the Second Victim Experience and Support Tool. Among survey respondents in the two departments, 80% and 87.6% indicated a strong desire to discuss their emotional challenges with a respected peer colleague after a traumatic event. The project team then developed and implemented a peer support program in three phases to 1) educate staff across the facility on second victimization, 2) recruit and train volunteer peer supporters, and 3) launch the pilot program by embedding these peer supporters in the two perioperative departments. A survey completed by participants in the pilot program showed that 80% of respondents found the peer support extremely beneficial, 20% found it very beneficial, and 100% would recommend peer support to a colleague. This successful pilot project could inform the establishment of peer support programs at other institutions to assist health care providers experiencing the second victim phenomenon.
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Affiliation(s)
- Bernadette Johnson
- Bernadette Johnson is assistant professor, assistant program director, and clinical director of the Medical University of South Carolina (MUSC) Nurse Anesthesia Program, Charleston, SC. Luci New is assistant professor and associate director of clinical education in the Department of Academic Nursing, Wake Forest University School of Medicine, Winston-Salem, NC. Michele Ballister is a staff certified registered nurse anesthetist (CRNA) at the MUSC, Charleston, SC. Courtney Brown is a staff CRNA III at Novant Health Forsyth Medical Center, Winston-Salem, NC. Susan Scott is adjunct associate professor at the University of Missouri-St Louis, Columbia, MO. Contact author: Bernadette Johnson, . The authors have disclosed no potential conflicts of interest, financial or otherwise
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Guerra-Paiva S, Mira JJ, Strametz R, Fernandes J, Klemm V, Madarasova Geckova A, Knezevic B, Potura E, Buttigieg S, Carrillo I, Sousa P. Application and Evaluation of a Multimodal Training on the Second Victim Phenomenon at the European Researchers' Network Working on Second Victims Training School: Mixed Methods Study. JMIR Form Res 2024; 8:e58727. [PMID: 39213524 PMCID: PMC11418314 DOI: 10.2196/58727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 05/14/2024] [Accepted: 06/24/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Health care workers (HCWs) are often impacted by distressing situations during patient care and can experience the second victim phenomenon (SVP). Addressing an adequate response, training, and increasing awareness of the SVP can increase HCWs' well-being and ultimately improve the quality of care and patient safety. OBJECTIVE This study aims to describe and evaluate a multimodal training organized by the European Researchers' Network Working on Second Victims to increase knowledge and overall awareness of SVP and second victim programs. METHODS We implemented a multimodal training program, following an iterative approach based on a continuous quality improvement process, to enhance the methodology and materials of the training program over the duration of 2 years. We conducted web-based surveys and group interviews to evaluate the scope and design of the training, self-directed learning materials, and face-to-face activities. RESULTS Out of 42 accepted candidates, 38 (90%) participants attended the 2 editions of the Training School program. In the second edition, the level of participants' satisfaction increased, particularly when adjusting the allocated time for the case studies' discussion (P<.001). After the multimodal training, participants stated that they had a better awareness and understanding of the SVP, support interventions, and its impact on health care. The main strengths of this Training School were the interdisciplinary approach as well as the contact with multiple cultures, the diversity of learning materials, and the commitment of the trainers and organizing team. CONCLUSIONS This multimodal training is suitable for different stakeholders of the health care community, including HCWs, clinical managers, patient safety and quality-of-care teams, academicians, researchers, and postgraduate students, regardless of their prior experience with SVP. Furthermore, this study represents a pioneering effort in elucidating the materials and methodology essential for extending this training approach to similar contexts.
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Affiliation(s)
- Sofia Guerra-Paiva
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, NOVA University Lisbon, Lisbon, Portugal
| | - José Joaquín Mira
- Alicante-Sant Joan Health District, Alicante, Spain
- Department of Health Psychology, Miguel Hernandez University, Elche, Spain
| | - Reinhard Strametz
- Wiesbaden Institute for Healthcare Economics and Patient Safety, RheinMain University of Applied Sciences, Wiesbaden, Germany
| | - Joana Fernandes
- NOVA National School of Public Health, NOVA University Lisbon, Lisbon, Portugal
| | - Victoria Klemm
- Wiesbaden Institute for Healthcare Economics and Patient Safety, RheinMain University of Applied Sciences, Wiesbaden, Germany
| | - Andrea Madarasova Geckova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, University of Pavol Jozef Šafárik, Košice, Slovakia
- Institute of Applied Psychology, Faculty of Social and Economic Sciences, Comenius University, Bratislava, Slovakia
| | - Bojana Knezevic
- Department for Quality Assurance and Improvement in Health Care, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Eva Potura
- Gesundheit Österreich GmbH, Bundesinstitut für Qualität im Gesundheitswesen, Vienna, Austria
| | - Sandra Buttigieg
- Department of Health Systems Management and Leadership, Faculty of Health Sciences,University of Malta, Malta, Malta
| | - Irene Carrillo
- Department of Health Psychology, Miguel Hernandez University, Elche, Spain
| | - Paulo Sousa
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, NOVA University Lisbon, Lisbon, Portugal
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Huang H, Liu T, Peng Y, Du X, Huang Q, Zhao Q, Xiao M, Luo Y, Zheng S. "Learn from Errors": Post-traumatic growth among second victims. BMC Public Health 2024; 24:2330. [PMID: 39198793 PMCID: PMC11350947 DOI: 10.1186/s12889-024-19738-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 08/08/2024] [Indexed: 09/01/2024] Open
Abstract
BACKGROUND Second victims, defined as healthcare providers enduring emotional and psychological distress after patient safety incidents (PSIs). The potential for positive transformation through these experiences is underexplored but is essential for fostering a culture of error learning and enhancing patient care. OBJECTIVE To explore the level and determinants of post-traumatic growth (PTG), applying the stress process model. METHODS The study was conducted at a tertiary general hospital in Chongqing, China. A descriptive, cross-sectional study design was used. A total of 474 s victims were included. An online survey was conducted in November 2021 to assess various factors related to the second victim experience. These factors included PSIs (considered as stressors), coping styles, perceived threats, and social support (acting as mediators), as well as the outcomes of second victim syndrome (SVS) and PTG. Statistical description, correlation analysis, and structural equation modeling were utilized for the data analysis. A p-value ≤ 0.05 was considered to indicate statistical significance. RESULTS The participants reported moderate distress (SVS = 2.84 ± 0.85) and PTG (2.72 ± 0.85). The total effects on SVS of perceived threat, negative coping, social support, positive coping, and PSIs were 0.387, 0.359, -0.355, -0.220, and 0.115, respectively, accounting for 47% of the variation in SVS. The total effects of social support, positive coping, and PSIs on PTG were 0.355, 0.203, and - 0.053, respectively, accounting for 19% of the variation in PTG. CONCLUSIONS The study provides novel insights into the complex interplay between perceived threats, coping styles, and social support in facilitating PTG among second victims. By bolstering social support and promoting adaptive coping strategies, the adverse effects of PSIs can be mitigated, transforming them into opportunities for resilience and growth, and offering a fresh perspective on managing PSIs in healthcare settings.
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Affiliation(s)
- Huanhuan Huang
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Tong Liu
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Ying Peng
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Xingyao Du
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Qi Huang
- School of Public Health, Chongqing Medical University, Chongqing, 400016, China
| | - Qinghua Zhao
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Mingzhao Xiao
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Yetao Luo
- Department of Nosocomial Infection Control, Second Affiliated Hospital, Army Medical University, Chongqing, 400037, China.
| | - Shuangjiang Zheng
- Department of Medical Affairs, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
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Huang RR, Xie YS, Chen GR, Shu LZ, Ding XM, Pan SH. Development and evaluation of a second victim training course for nursing managers. NURSE EDUCATION TODAY 2024; 142:106357. [PMID: 39154593 DOI: 10.1016/j.nedt.2024.106357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 07/30/2024] [Accepted: 08/13/2024] [Indexed: 08/20/2024]
Abstract
BACKGROUND Most nursing managers are not fully aware of second victims and may not be able to provide support. Moreover, there are relatively few training courses for nursing managers about second victims. AIM To describe the construction and evaluation of a second victim course for nursing managers. DESIGN A single-group pretest-posttest study design was used. SETTING A large comprehensive tertiary hospital with over 3000 beds in China. PARTICIPANTS Forty-nine nursing managers who met the inclusion and exclusion criteria participated in this training. Sixteen clinical frontline nurses who experienced adverse events within three months following the training were also invited. METHODS The course "Second Victim & Empathy Communication" was developed through a literature review and expert consultation and consisted of 4 unit modules: (1) adverse events & second victims, (2) the recovery trajectory of second victims, (3) second victim supportive resources, and (4) key strategies of empathy communication. A course evaluation questionnaire, an empathy communication questionnaire for nursing managers, a second victim evaluation questionnaire, and an open-ended question were used to measure the feasibility, acceptability and effectiveness of the course. RESULTS >97.96 % of the nursing managers were satisfied with the course, >97.96 % had learned new knowledge, and >95.92 % had changed their behavior and attitudes toward second victims. Their levels of empathetic communication differed significantly before and after training (t = -2.170, P = 0.035). Among these nursing managers, twenty-six participants provided positive and meaningful feedback and suggestions to the course by answering an open-ended question. A total of 66.6 % to 100 % of second victims were satisfied with the empathetic communication behavior exhibited by nursing managers. CONCLUSION The second victim training course is feasible and can be used for clinical training to enhance nursing managers' understanding of second victims and enhance their empathetic communication.
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Affiliation(s)
- Rong-Rong Huang
- Department of Burn and Plastic Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Yu-Sheng Xie
- School of Nursing, Guizhou Medical University, Guiyang, China
| | - Gui-Ru Chen
- Department of Infectious Diseases, The People's Hospital of Aba Tibetan and Qiang Autonomous Prefecture, Aba Tibetan and Qiang Autonomous Prefecture, China.
| | - Ling-Zhi Shu
- Department of Nursing, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Xiao-Min Ding
- Department of Comprehensive Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Shi-Hua Pan
- Department of Neuropsychology, Zhongnan Hospital of Wuhan University, Wuhan, China
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Catalán L, Alvarado-Peña J, Torres-Soto G, Lorca-Sepúlveda B, Besoain-Cornejo AM, Kappes M. Second victim phenomenon among healthcare students: A scoping review. Nurse Educ Pract 2024; 79:104094. [PMID: 39146810 DOI: 10.1016/j.nepr.2024.104094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 07/16/2024] [Accepted: 07/31/2024] [Indexed: 08/17/2024]
Abstract
AIM This study aims to explore the "second victim" phenomenon in healthcare professions students following an adverse event. BACKGROUND In healthcare settings, adverse events affect not only patients but also the involved healthcare personnel, who experience a wide range of physical and psychological responses, a situation known as the second victim phenomenon. This phenomenon also extends to students in health-related professions during their clinical training, yet there needs to be more research specifically addressing this group. DESIGN A scoping review METHODS: This scoping review was guided by Arksey and O'Malley's methodological framework. In December 2023, we conducted a comprehensive database search in PubMed, the Cumulative Index of Nursing and Allied Health Literature (CINAHL) Complete, Web of Science (WoS), Scopus and the Virtual Health Library (VHL). The review included original research studies of any design that focused on the second victim phenomenon among students, published in English, Spanish, German or Portuguese, with no restrictions on the publication date. The review was reported according to PRISMA-ScR guidelines. RESULTS Seven studies were selected, primarily involving nursing and medical students. Common triggers of the second victim phenomenon in students were medication errors, patient falls and procedural errors. Described symptoms ranged from emotional distress, such as stress and hypervigilance, to physical symptoms, like sleep disturbances. Among the factors that influenced how this "second victim" phenomenon manifested in students were the reactions of their peers and the lack of support from supervisors. Contrary to the three possible outcomes described for professionals as second victims (surviving, thriving, or leaving), students are only described with two: giving up or moving on. CONCLUSION The studies highlighted the crucial role of peer and supervisor support in managing such difficult situations. The results suggest that additional research is necessary in other healthcare disciplines. Educational and healthcare institutions should improve their preventive and management strategies to address the phenomenon's impact on students.
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Affiliation(s)
- Lucía Catalán
- Faculty of Healthcare Sciences, Nursing School, Universidad San Sebastián, Santiago, Chile; Faculty of Nursing, Universidad Andres Bello, Santiago, Chile.
| | | | | | | | - Ana-María Besoain-Cornejo
- Faculty of Medicine & Science, Chemistry and Pharmacy School, Universidad San Sebastián, Chile; Health Technology Assessment in Primary Care and Mental Health (PRISMA) Research Group, Institut de Recerca Sant Joan de Deu, Esplugues de Llobregat, Spain.
| | - María Kappes
- Faculty of Healthcare Sciences, Nursing School, Universidad San Sebastián, Puerto Montt, Chile.
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Crawford C, Williams JR. Support Needs of Labor and Delivery Nurses After Traumatic Experiences. J Obstet Gynecol Neonatal Nurs 2024; 53:383-396. [PMID: 38369297 DOI: 10.1016/j.jogn.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/13/2024] [Accepted: 01/23/2024] [Indexed: 02/20/2024] Open
Abstract
OBJECTIVE To examine the effect of psychological distress, overall distress, and institutional support following a traumatic workplace event on absenteeism, turnover intention, and resilience among labor and delivery nurses. DESIGN A quantitative cross-sectional survey. SETTING Online distribution from January 13, 2021, to February 2, 2021. PARTICIPANTS A nationwide convenience sample of labor and delivery nurses recruited from the Association of Women's Health, Obstetric and Neonatal Nurses (N = 171). METHODS Participants completed a survey that included the Second Victim Experience and Support Tool-Revised and the Second Victim Support Desirability survey. We compared available versus desired support options using descriptive analyses. We examined levels of psychological distress and lack of institutional support in relation to turnover intention, absenteeism, and resilience using multiple regression analyses. RESULTS Participants identified and described various traumatic experiences in the workplace, including neonatal and maternal death, complicated births, and workplace violence. Participants indicated that the available support services did not meet their needs. Psychological distress, overall distress, and lack of institutional support were associated with absenteeism and turnover, whereas only institutional support was associated with resilience. CONCLUSION Labor and delivery nurses encounter various traumatic events in the workplace, and the support services provided after an event do not meet their needs. Additional research is needed to understand the scope of the problem and investigate best practices to assist labor and delivery nurses following traumatic events.
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Mahat S, Rafferty AM, Vehviläinen-Julkunen K, Härkänen M. Registered nurses' emotional responses to medication errors and perceived need for support: A qualitative descriptive analysis. J Adv Nurs 2024. [PMID: 38896107 DOI: 10.1111/jan.16280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 11/28/2023] [Accepted: 06/04/2024] [Indexed: 06/21/2024]
Abstract
AIMS To identify the contributing factors behind the second victim phenomenon, describe the emotional responses of nurses after medication errors, assess the support received by them after errors and recognize the need for a suitable support program for second victims. DESIGN Qualitative descriptive design. METHODS Eleven in-depth semi-structured interviews were conducted among registered nurses studying advanced degrees at a University in Finland during November 2021-April 2022. Data were analysed using thematic analysis. RESULTS The study results revealed four themes with various sub-themes which included: contributing factors behind the second victim phenomenon; emotional responses of nurses after error; support received by nurses; and the desired need for a support program for second victims. The severity of the error and the negative work environment acted as catalysts for the second victim phenomenon among nurses. A "bitter aftermath" of emotions and a sense of insufficient support added further risk to already stressed and anxious nurses. CONCLUSIONS This study identifies the early exploratory and enduring impact of memories associated with medication errors, some of them haunting nurses for long periods of time. Further, the need for support at different levels is highlighted to reduce the impact of negative emotions generated among nurses after medication errors. IMPLICATIONS FOR THE PROFESSION Through the lens of this study, it has been possible to identify contributing factors behind the second-victim phenomenon and enduring symptoms that make nurses vulnerable to becoming second victims of medication incidents. IMPACT This study addresses the aftermath effect of medication errors from the perspective of nurses involved with such incidents. It provides valuable insights for healthcare managers and nurse leaders to establish a just and blame-free culture in healthcare organizations and help emotionally traumatized nurses cope effectively after error. REPORTING METHOD The research adheres to Consolidated criteria for reporting qualitative research (COREQ) guidelines. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Sanu Mahat
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Anne Marie Rafferty
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | | | - Marja Härkänen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
- Research Centre for Nursing Science and Social and Health Management, Kuopio University Hospital, Wellbeing Services County of North Savo, Kuopio, Finland
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Mahat S, Lehmusto H, Rafferty AM, Vehviläinen-Julkunen K, Mikkonen S, Härkänen M. Impact of second victim distress on healthcare professionals' intent to leave, absenteeism and resilience: A mediation model of organizational support. J Adv Nurs 2024. [PMID: 38896051 DOI: 10.1111/jan.16291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 05/21/2024] [Accepted: 06/06/2024] [Indexed: 06/21/2024]
Abstract
AIMS To examine the relationship between the second victim distress and outcome variables, specifically: 'turnover intentions, absenteeism and resilience'. Furthermore, this study also assessed how organizational support mediates the relationship between second victim distress and outcome variables. DESIGN Cross-sectional survey. METHODS A cross-sectional survey study using regression and mediation analysis with bootstrapping was conducted among (n = 149) healthcare professionals in two university hospitals in Finland from September 2022 to April 2023 during different time periods. The Finnish version of the revised Second Victim Experience and Support Tool (FI-SVEST-R) was used to assess second victim distress, level of organizational support and related outcomes. RESULTS Psychological distress was the most frequently experienced form of reported second victim distress, and institutional support was the lowest perceived form of support by healthcare professionals. The study found second victim distress to have a significant association with work-related outcomes: turnover intention and absenteeism. However, no significant relationship was found with resilience. Mediation models with organizational support revealed a partially mediated relationship between second victim distress and work-related outcomes. CONCLUSIONS The findings from this study indicate that second victim experiences if not adequately addressed can lead to negative work-related outcomes such as increased job turnover and absenteeism. Such outcomes not only affect healthcare professionals but can also have a cascading effect on the quality of care. However, the mediating effect of organizational support suggests that if comprehensive support is provided, it is possible to mitigate the negative impact of the second victim phenomenon. IMPACT Raising awareness regarding the second victim phenomenon, promoting a culture of safety and shifting the paradigm from a blame to just culture helps in identifying the system flaws thus improving both patient and provider safety. REPORTING METHOD The study adheres to the STROBE reporting guidelines. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Sanu Mahat
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Helena Lehmusto
- Jorvi Hospital, Helsinki University Hospital Pharmacy, Espoo, Finland
| | - Anne Marie Rafferty
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | | | - Santtu Mikkonen
- Department of Environmental and Biological Sciences, Faculty of Science, Forestry and Technology, University of Eastern Finland, Kuopio, Finland
| | - Marja Härkänen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
- Wellbeing Services County of North Savo, Research Centre for Nursing Science and Social and Health Management, Kuopio University Hospital, Kuopio, Finland
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Wozniak H, Douflé G, Hamilton M, Santangelo E, Urner M, Parotto M, Herridge M, Dragoi L. Behind the Mask of ICU Healthcare Workers. Am J Respir Crit Care Med 2024; 209:1429-1430. [PMID: 38484214 PMCID: PMC11208967 DOI: 10.1164/rccm.202402-0350vp] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 03/13/2024] [Indexed: 06/15/2024] Open
Affiliation(s)
- Hannah Wozniak
- Interdepartmental Division of Critical Care Medicine and
- Department of Anesthesiology, Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Ghislaine Douflé
- Interdepartmental Division of Critical Care Medicine and
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada; and
| | - Mika Hamilton
- Interdepartmental Division of Critical Care Medicine and
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada; and
| | | | - Martin Urner
- Interdepartmental Division of Critical Care Medicine and
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada; and
| | - Matteo Parotto
- Interdepartmental Division of Critical Care Medicine and
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada; and
| | | | - Laura Dragoi
- Interdepartmental Division of Critical Care Medicine and
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Brunelli MV, Seisdedos MG, Maluenda Martinez M. Second Victim Experience: A Dynamic Process Conditioned by the Environment. A Qualitative Research. Int J Public Health 2024; 69:1607399. [PMID: 38939516 PMCID: PMC11208313 DOI: 10.3389/ijph.2024.1607399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 05/30/2024] [Indexed: 06/29/2024] Open
Abstract
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.
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Affiliation(s)
- Maria Victoria Brunelli
- Escuela de Enfermería, Facultad de Ciencias Biomedicas, Universidad Austral, Buenos Aires, Argentina
| | - Mariana Graciela Seisdedos
- Departamento de Calidad y Seguridad del Paciente, Hospital Universitario Austral, Buenos Aires, Argentina
| | - Maria Maluenda Martinez
- Escuela de Enfermería, Facultad de Ciencias Biomedicas, Universidad Austral, Buenos Aires, Argentina
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Järvisalo P, Haatainen K, Von Bonsdorff M, Turunen H, Härkänen M. Interventions to support nurses as second victims of patient safety incidents: A qualitative study of nurse managers' perceptions. J Adv Nurs 2024; 80:2552-2565. [PMID: 38071607 DOI: 10.1111/jan.16013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 11/20/2023] [Accepted: 11/26/2023] [Indexed: 05/12/2024]
Abstract
AIMS To describe nurse managers' perceptions of interventions to support nurses as second victims of patient safety incidents and to describe the management of interventions and ways to improve them. DESIGN A qualitative study using interviews. METHODS A purposive sample of nurse managers (n = 16) recruited from three hospital districts in Finland was interviewed in 2021. The data were analysed using elements of inductive and deductive content analysis. RESULTS The study identified three main categories: (1) Management of second victim support, which contained three sub-categories related to the nurse manager's role, support received by the nurse manager and challenges of support management; (2) interventions to support second victims included existing interventions and operating models; and (3) improving second victim support, based on the sub-categories developing practices and developing an open and non-blaming patient safety culture. CONCLUSION Nurse managers play a crucial role in supporting nurses as second victims of patient safety incidents and coordinating additional support. Operating models for managing interventions could facilitate nurse managers' work and ensure adequate support for second victims. The support could be improved by increasing the awareness of the second victim phenomenon. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE Mitigating the harmful effects of patient safety incidents can improve nurses' well-being, reduce burden and attrition risks and positively impact patient safety. IMPACT Increasing awareness of the second victim phenomenon and coherent operation models would provide equal support for the nurses and facilitate nurse managers' work. REPORTING METHOD COREQ checklist was used. What does this paper contribute to the wider global clinical community? Nurse managers' role is significant in supporting the second victims and coordinating additional support. Awareness of the second victim phenomenon and coherent operating models can secure adequate support for the nurses and facilitate nurse managers' work.
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Affiliation(s)
- Paula Järvisalo
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Kaisa Haatainen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Monika Von Bonsdorff
- Jyväskylä University School of Business and Economics, University of Jyväskylä, Jyväskylä, Finland
| | - Hannele Turunen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
- Kuopio University Hospital, Kuopio, Finland
| | - Marja Härkänen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
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Bredenkamp K, Raschka MJ, Holmes A. A Review of Medication Errors and the Second Victim in Pediatric Pharmacy. J Pediatr Pharmacol Ther 2024; 29:100-106. [PMID: 38596421 PMCID: PMC11001212 DOI: 10.5863/1551-6776-29.2.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 06/06/2023] [Indexed: 04/11/2024]
Abstract
The concept of the second victim, described as the sense of victimization of health care professionals following the exposure to a traumatic, unanticipated medical error, was first introduced in 2000 by Albert W. Wu. Since then, the concept has gained immense traction and inspired the generation of assistance programs for second victims. With most second victim occurrences resulting from medication errors, pediatric pharmacists are at a high risk of experiencing second victim phenomenon. Second victims may experience both psychological and physical symptoms of distress often akin to post-traumatic stress disorder. Typical trajectories for second victims, as well as typical support needs, have been previously described, with several organizations responding by creating formal programs designed to support their staff in the events of traumatic workplace experiences. Most support programs involve peer-to-peer support, group sessions, and programs designed to increase coping skills. Additional resources are available for health care workers who do not have formalized support programs at their institution, although these are limited. Despite these resources, institutions across the country have room for additional growth in their support of employees who become second victims to tragedy.
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Affiliation(s)
| | | | - Amy Holmes
- Department of Pharmacy (AH), Atrium Health Wake Forest Baptist, Winston-Salem, NC
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Thumm EB, Schaeffer A, Michel A, McFarland AK, Long MH, Giano Z. The Relationship Between Restrictive Regulation of Midwives, Practice Environment, and Professional Burnout: A 7-State Mixed-Methods Comparison of Autonomous and Restrictive State Regulation. J Perinat Neonatal Nurs 2024; 38:137-146. [PMID: 38758270 DOI: 10.1097/jpn.0000000000000810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
PURPOSE The purpose of the study was to investigate the relationship between state regulation of the midwifery workforce, practice environment, and burnout. BACKGROUND Burnout threatens the US midwifery workforce, with over 40% of certified nurse-midwives meeting criteria. Burnout can lead to poorer physical and mental health and withdrawal from the workforce. Burnout in midwives has been associated with lack of control and autonomy. In the United States, midwives' autonomy is restricted through state-level regulation that limits scope of practice and professional independence. METHODS A mixed-methods study was conducted using an explanatory sequential approach. Quantitative and qualitative data were collected by online surveys and analyzed in a 2-stage process, followed by data integration. RESULTS State regulation was not found to be independently associated with burnout (n = 248; P = .250); however, mediation analysis showed a significant association between state regulation, practice environment, and burnout. Qualitative analysis mirrored the importance of practice environment and expanded on its features. CONCLUSION For midwives, unrestrictive practice regulation may not translate to burnout prevention without supportive practice environments. IMPLICATIONS FOR PRACTICE AND RESEARCH Interventions should focus on promoting job flexibility, realistic demands, and professional values. While midwives' commitment to patients and the profession can help bolster the workforce, it can also amplify negative experiences of the practice environment.
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Affiliation(s)
- E Brie Thumm
- Author Affiliations: University of Colorado College of Nursing, Aurora (Dr Thumm); Frontier Nursing University, Versailles, Kentucky (Dr Schaeffer); Rosalind Franklin University College of Nursing, North Chicago, Illinois (Dr Michel); Oregon Health & Science University School of Nursing, Ashland, Oregon (Dr McFarland); Charlottesville, Virginia (Dr Long); and Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado, Aurora (Dr Giano)
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16
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New L, Lambeth T. Second-Victim Phenomenon. Nurs Clin North Am 2024; 59:141-152. [PMID: 38272580 DOI: 10.1016/j.cnur.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
All in health care are at risk of involvement in adverse events. Oftentimes, the health care worker manifests physical, psychological, and professional effects and this is referred to as the second-victim phenomenon. Unmitigated recovery of a second victim can contribute to absenteeism, turnover intentions, burnout, and loss of joy and meaning in work. The preferred method of support among health care workers is a respected peer to provide emotional support. Health care organizations can contribute to a second victim's recovery by providing a culture of safety and diverse resources based on the needs of the individual.
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Affiliation(s)
- Luci New
- Department of Academic Nursing, Wake Forest University, School of Medicine, 525 Vine Street, Suite 230, Winston-Salem, NC 27101, USA.
| | - Tinisha Lambeth
- Department of Academic Nursing, Wake Forest University, School of Medicine, 525 Vine Street, Suite 230, Winston-Salem, NC 27101, USA
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Kang J, Kwon SS, Lee Y. Clinical nurses' work-life balance prediction due to patient safety incidents using classification and regression tree analysis: a secondary data analysis. BMC Nurs 2024; 23:70. [PMID: 38267902 PMCID: PMC10809596 DOI: 10.1186/s12912-024-01719-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/07/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Patient safety incidents lead to performance difficulties for nurses when providing nursing practice. This affects work-life balance and causes second and third-victimization. This study predicts factors affecting clinical nurses' work-life balance due to patient safety incidents using classification and regression tree analysis techniques. METHODS This study was a secondary analysis of data from a cohort research project, which used a descriptive survey for data collection. Participants comprised 372 nurses. Data were collected using SurveyMonkey, a mobile-based survey software solution, from January to September 2021. Data included the general characteristics of clinical nurses, second damage, second damage support, third damage, and work-life balance. The specific variables included in the analysis chosen through rigorous Lasso analysis form the foundation for predicting work-life balance. Variables with low explanatory power were excluded, thereafter, the variables selected by Lasso were analyzed with a classification and regression tree model to predict work-life balance. RESULTS A regression tree was applied to predict work-life balance using seven variables-education level, marital status, position, physical distress, second-victim support, turnover intentions, and absenteeism (selected through Lasso analysis). After pruning, at tree size four, when turnover intentions were < 4.250, physical distress < 2.875, and second-victim support < 2.345, the predicted work-life balance was 3.972. However, when turnover intentions were < 4.250, physical distress < 2.875, and second-victim support ≥ 2.345, then the predicted work-life balance was 2.760. CONCLUSIONS This study's insights offer crucial groundwork for crafting targeted workforce risk management strategies and fostering a conducive organizational culture to mitigate nursing occupational stress, potentially curbing the recurrence of patient safety incidents and improving nursing practice while enhancing patient outcomes. Future research should explore second and third victim experiences across various healthcare settings globally to understand their impact on WLB and patient safety outcomes.
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Affiliation(s)
- Jiwon Kang
- Department of Family, Health and Wellbeing, University of Minnesota Extension, 1420 Eckles Ave, St Paul, MN, 55108, US
- College of Nursing, Ajou University, 164 World Cup-Ro, Yeongtong-Gu, Suwon, 16499, South Korea
| | - Soon-Sun Kwon
- Departments of Mathematics and Department of Artificial Intelligence, College of Natural Sciences, Ajou University, 164 World Cup-Ro, Yeongtong-Gu, Suwon, 16499, South Korea
| | - Youngjin Lee
- College of Nursing, Ajou University, 164 World Cup-Ro, Yeongtong-Gu, Suwon, 16499, South Korea.
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Scarpis E, Beorchia Y, Moretti V, Favero B, Farneti F, Cocconi R, Quattrin R, Castriotta L. Second Victim Symptoms and Desired Support Strategies Among Italian Health Care Workers in Friuli-Venezia Giulia: Cross-Sectional Survey and Latent Profile Analysis. J Patient Saf 2024; 20:66-75. [PMID: 38099853 DOI: 10.1097/pts.0000000000001182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
BACKGROUND AND OBJECTIVE The second victim (SV) phenomenon concerns health care workers (HCWs) whose involvement in a medical error, as well as non-error patient safety events, has affected their well-being. Its prevalence ranges from 10% to 75% and can predispose HCWs to burnout, increasing the probability of committing errors. The primary aim of our study was to determine the prevalence of HCWs involved in an adverse patient safety event in Friuli Venezia Giulia Region (Italy). The secondary aims were to use latent profile analysis to identify profiles of SVs and factors influencing profile membership, and to evaluate the relationship between the severity of symptoms and desired support options. METHODS A cross-sectional survey through the Italian version of the Second Victim Experience and Support Tool tool was conducted in 5 local health authorities. Descriptive statistics were conducted for all variables. Associations and correlations were assessed with statistical tests, as appropriate. Latent profile analysis was based on the scores of dimensions measuring SVs' symptoms. Factors affecting profile membership were assessed through multinomial logistic regression. RESULTS A total of 733 HCWs participated. Of them, 305 (41.6%) experienced at least 1 adverse event. Among dimensions measuring SVs' symptoms, psychological distress had the highest percentage of agreement (30.2%). Three latent profiles were identified: mild (58.7%), moderate (24.3%), and severe (17.0%) symptoms. Severe symptoms profile was positively associated with the agreement for extraoccupational support and negatively associated with the agreement for organizational support. A respected colleague with whom to discuss the details of the incident (78.7%) and free counseling outside of work (71.2%) were the support options most desired by HCWs. The severity of symptoms was directly associated with the desire for support strategies. CONCLUSIONS The prevalence of HCWs involved in adverse events is consistent with the literature. Three latent profiles have been identified according to SV symptoms, and the higher the severity of symptoms, the greater the reliance on extraoccupational support.
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Affiliation(s)
- Enrico Scarpis
- From the Dipartimento di Area Medica, Università degli Studi di Udine
| | | | - Valentina Moretti
- From the Dipartimento di Area Medica, Università degli Studi di Udine
| | - Beatrice Favero
- From the Dipartimento di Area Medica, Università degli Studi di Udine
| | - Federico Farneti
- SOC Rischio Clinico, Qualità e Accreditamento, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Roberto Cocconi
- SOC Rischio Clinico, Qualità e Accreditamento, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Rosanna Quattrin
- SOC Rischio Clinico, Qualità e Accreditamento, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
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Tomooka M, Matsumoto C, Maeda H. Effectiveness of a preceptors' social support program to aid novice nurses' error experience on preceptors' skill and novice nurses' perception of social support: A quasi-experimental study. Jpn J Nurs Sci 2024; 21:e12563. [PMID: 37749995 DOI: 10.1111/jjns.12563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 08/22/2023] [Accepted: 08/30/2023] [Indexed: 09/27/2023]
Abstract
AIM To evaluate the effectiveness of the preceptors' social support program (PSSP) on preceptors' social support skill-supportive relationships and post-error support-and novice nurses' perception of received social support. METHODS This study employed a quasi-experimental pretest-posttest design with a control group of a non-random assigned sample of 47 preceptors and novice nurses and an intervention group of 48 each. Intervention group preceptors received training in building supportive relationships skill and post-error support skills three times in the PSSP over 7 months. Preceptors' social support skill and novice nurses' perception of received social support were measured as primary outcomes. Data were collected at baseline (T0), 1 month after the second session (T1), and 1 month after the last session (T2) and analyzed. RESULTS No significant differences in demographics or scores were shown at baseline (T0). Preceptors in the intervention group showed significantly better supportive relationships (T2, 101.6 ± 9 vs. 96.9 ± 7.6, 95% CI [0.95, 8.42], p = .015) and better performance of post-error support (T2, 67.6 ± 5 vs. 62 ± 6.5, 95% CI [2.78, 8.32], p < .001). Intervention group preceptors' social support skill increased or remained stable, while it decreased over time in the control group. Novice nurses in the intervention group received significantly better supportive relationships and post-error support from preceptors (T2, median 112 vs. 101, p = .007; 70.5 vs. 65, p = .028, respectively). CONCLUSIONS The PSSP improved preceptors' supportive relationship skills and post-error support performance, leading to novice nurses' perceptions of better supportive relationships and receiving greater post-error support.
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Affiliation(s)
- Misa Tomooka
- Doctoral Program in Nursing, Graduate School of Health Science, Kumamoto University, Kumamoto, Japan
| | - Chiharu Matsumoto
- Department of Nursing, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Hitomi Maeda
- Department of Nursing, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
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Prothero MM, Huefner K, Sorhus M. Nurse Leader Attitudes and Beliefs Regarding Medical Errors. J Nurs Adm 2024; 54:10-15. [PMID: 38051909 DOI: 10.1097/nna.0000000000001371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
OBJECTIVE This study aimed to explore nurse leader attitudes and beliefs about medical errors. BACKGROUND The perfectibility model suggests errors are avoidable if nurses are trained and follow safety guidelines. This impacts how nurse leaders approach medical errors. Nurse leaders (NLs) may be the first person to whom a nurse reports an error. Leaders support nurses through the investigation process and subsequent recovery. METHODS A cross-sectional quantitative study was conducted to determine NL attitudes toward medical errors using the Medical Error Attitude Scale (MEAS). RESULTS MEAS scores were high in all categories. Medical error perception was significant for NLs with institutional support programs and when compared with job titles. Medical error approach and perception were significant for NLs with direct reports who had committed a medical error. CONCLUSION This study provides insight into NLs' views on medical errors, awareness of NLs who have had nurses involved in medical errors, and formal caregiver support programs.
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Affiliation(s)
- Marie M Prothero
- Author Affiliations: Assistant Professor (Dr Prothero) and Registered Nurses (Huefner and Sorhus), College of Nursing, Brigham Young University, Provo, Utah
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Guerra-Paiva S, Lobão MJ, Simões DG, Fernandes J, Donato H, Carrillo I, Mira JJ, Sousa P. Key factors for effective implementation of healthcare workers support interventions after patient safety incidents in health organisations: a scoping review. BMJ Open 2023; 13:e078118. [PMID: 38151271 PMCID: PMC10753749 DOI: 10.1136/bmjopen-2023-078118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 11/30/2023] [Indexed: 12/29/2023] Open
Abstract
OBJECTIVES This study aims to map and frame the main factors present in support interventions successfully implemented in health organisations in order to provide timely and adequate response to healthcare workers (HCWs) after patient safety incidents (PSIs). DESIGN Scoping review guided by the six-stage approach proposed by Arksey and O'Malley and by PRISMA-ScR. DATA SOURCES CINAHL, Cochrane Library, Embase, Epistemonikos, PsycINFO, PubMed, SciELO Citation Index, Scopus, Web of Science Core Collection, reference lists of the eligible articles, websites and a consultation group. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Empirical studies (original articles) were prioritised. We used the Mixed Methods Appraisal Tool Version 2018 to conduct a quality assessment of the eligible studies. DATA EXTRACTION AND SYNTHESIS A total of 9766 records were retrieved (last update in November 2022). We assessed 156 articles for eligibility in the full-text screening. Of these, 29 earticles met the eligibility criteria. The articles were independently screened by two authors. In the case of disagreement, a third author was involved. The collected data were organised according to the Organisational factors, People, Environment, Recommendations from other Audies, Attributes of the support interventions. We used EndNote to import articles from the databases and Rayyan to support the screening of titles and abstracts. RESULTS The existence of an organisational culture based on principles of trust and non-judgement, multidisciplinary action, leadership engagement and strong dissemination of the support programmes' were crucial factors for their effective implementation. Training should be provided for peer supporters and leaders to facilitate the response to HCWs' needs. Regular communication among the implementation team, allocation of protected time, funding and continuous monitoring are useful elements to the sustainability of the programmes. CONCLUSION HCWs' well-being depends on an adequate implementation of a complex group of interrelated factors to support them after PSIs.
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Affiliation(s)
- Sofia Guerra-Paiva
- Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA National School of Public Health, NOVA University Lisbon, Lisboa, Portugal
| | - Maria João Lobão
- Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA National School of Public Health, NOVA University Lisbon, Lisboa, Portugal
- Internal Medicine Department, Hospital de Cascais Dr Jose de Almeida, Alcabideche, Portugal
| | - Diogo Godinho Simões
- Public Health Unit of ACES Almada-Seixal, Almada, Portugal
- NOVA National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
| | - Joana Fernandes
- NOVA National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
| | - Helena Donato
- Documentation and Scientific Information Service, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Irene Carrillo
- Health Psychology, Miguel Hernandez University, Elche, Spain
- Health Psychology, FISABIO, Miguel Hernandez University, Elche, Spain
| | - José Joaquín Mira
- Health Psychology, Miguel Hernandez University, Elche, Spain
- Salud Alicante-Sant Joan Health District, Elche, Spain
| | - Paulo Sousa
- Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA National School of Public Health, NOVA University Lisbon, Lisboa, Portugal
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Jang H, Scantling D, Allee L, Brahmbhatt TS. Secondary Traumatic Stress Disorder in the Surgical Profession. J Surg Res 2023; 292:176-181. [PMID: 37625207 DOI: 10.1016/j.jss.2023.06.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 06/05/2023] [Accepted: 06/25/2023] [Indexed: 08/27/2023]
Abstract
INTRODUCTION The psychological impact of treating individuals who have undergone severely traumatic experiences is known as secondary traumatic stress (STS). It has been well characterized by mental health therapists and social workers. Analysis of STS in surgeons and medical students is limited to merely a handful of studies, with only 1 paper describing STS in trauma surgeons and two describing STS in medical students. This review aims to provide a comprehensive account of existing work on STS, identify gaps in knowledge of STS in surgeons and medical students, and distinguish STS from other similar phenomena that have been commonly misidentified by recent works. MATERIALS AND METHODS A review of the literature in English was conducted through PubMed. MeSH terms included "STS, compassion fatigue, vicarious traumatization, and secondary trauma." All papers referenced in the identified works were screened and assessed for relevance. RESULTS Only two studies that directly assess STS in surgeons were identified. STS levels reported varied widely between the two. Similar studies were identified that focused on burnout, compassion fatigue, or post-traumatic stress disorder, which are similar but not identical. Only 1 study evaluated STS in trauma surgeons and found that 65% of those in the study had at least 1 symptom of STS. Only two studies were identified that studied STS in medical students, but with conflicting results on prevalence. It was identified that there are various measuring tools to assess for STS symptoms but no established standard of assessment that allows for cross-comparisons. CONCLUSION Knowledge of STS is extremely limited in surgeons and medical students, not only due to a general lack of awareness of STS but also due to confusion and misuse of other related terms. This review calls for more efforts to identify and address STS in surgeons and medical students while also standardizing methodologies that screen for STS symptoms.
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Affiliation(s)
- Hyerim Jang
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - Dane Scantling
- Department of Surgery, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - Lisa Allee
- Department of Surgery, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - Tejal S Brahmbhatt
- Division of Trauma and Acute Care Surgery & Surgical Critical Care, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts.
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Mousa O, Sadeq Alghazal M, Abdullah AlBather A, Nasser Alhassan A, Hussain Alamer M, Taher Alghadeer Z, Fayea Alasiri S. A Study on Patient Safety Incidents and the Second Victim Phenomenon Among Healthcare Providers in Al-Ahsa, Saudi Arabia. Cureus 2023; 15:e49324. [PMID: 38143649 PMCID: PMC10748826 DOI: 10.7759/cureus.49324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2023] [Indexed: 12/26/2023] Open
Abstract
BACKGROUND A second victim (SV) is a healthcare worker who is traumatized by an unexpected adverse patient case, therapeutic mistake, or patient-associated injury that has not been anticipated. Often, the second victim experiences direct guilt for the harm caused to the patients. Healthcare organizations are often unaware of the emotional toll that adverse events can have on healthcare providers (HCPs) who can be harmed by the same incidents that harm their patients. Second victims (SVs) were present in 10.4% up to 43.3% of cases following an adverse event. AIM This study aims to examine the second victim phenomenon among healthcare providers at Al-Ahsa hospitals, its prevalence, symptoms, associated factors, and support strategies. METHODS Four major public hospitals participated in this cross-sectional study. The study used the German standardized questionnaire "SeViD-I survey." The directors of the four hospitals sent invitations with links to participate to healthcare providers who had worked in their hospitals for over six months after completing their internship program. RESULTS More than one-quarter of the respondents (90 (28%)) have been victims of a second victim incident before; of those, 63 (70%) have had it once, 12 (13.3%) twice, and 15 (16.7) repeatedly. In our study, the risk factors for a second victim only appeared in the male gender and were statistically significant. Strong reactivation of situations outside of the workplace was reported in 36 (40%) participants. Thirty-five (38.9%) participants reported reactivating the situation on the job site. Twenty-eight (31%) participants reported aggressive psychosomatic reactions (headaches and back pain). In 28 (31.1%) participants, sleep problems or excessive sleep needs were pronounced. The median of feeling symptoms was 7.2. As for supporting strategies, 64 (71.1%) respondents considered emotional support and crisis management to be very helpful. Sixty-six (73.3%) respondents found a safe chance to be very helpful. CONCLUSION The findings of this study indicate that healthcare providers in Al-Ahsa, Saudi Arabia, suffer from second victim traumatization at high rates. Several symptoms appear in the second victim, and most do not receive enough support.
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Affiliation(s)
- Ola Mousa
- Department of Obstetrics and Gynecology Nursing, Faculty of Nursing, Minia University, Minya, EGY
| | | | | | - Amna Nasser Alhassan
- Department of Medical-Surgical Nursing, King Faisal General Hospital, Al-Ahsa, SAU
| | | | | | - Salha Fayea Alasiri
- College of Applied Medical Sciences, King Faisal University, Al-Ahsa, SAU
- Department of Health Informatics, King's College London, London, GBR
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Naya K, Aikawa G, Ouchi A, Ikeda M, Fukushima A, Yamada S, Kamogawa M, Yoshihara S, Sakuramoto H. Second victim syndrome in intensive care unit healthcare workers: A systematic review and meta-analysis on types, prevalence, risk factors, and recovery time. PLoS One 2023; 18:e0292108. [PMID: 37788270 PMCID: PMC10547210 DOI: 10.1371/journal.pone.0292108] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 09/13/2023] [Indexed: 10/05/2023] Open
Abstract
INTRODUCTION Patient safety incidents, including medical errors and adverse events, frequently occur in intensive care units, leading to a significant psychological burden on healthcare workers. This burden results in second victim syndrome, which impacts the psychological and psychosomatic well-being of these workers. However, a systematic review focusing specifically on this condition among intensive care unit healthcare workers is lacking. Therefore, we aimed to conduct a systematic review and meta-analysis to examine the occurrence of second victim syndrome among intensive care unit healthcare workers, including the types, prevalence, risk factors, and recovery time associated with this condition. METHODS We conducted a comprehensive search of the MEDLINE, CINAHL, PsycINFO, and Igaku Chuo Zasshi databases. The eligibility criteria encompassed retrospective, prospective, and cross-sectional studies and controlled trials, with no language restrictions. Data on the type, prevalence, risk factors, and recovery time of second victim syndrome were extracted and pooled. Prevalence estimates from the included studies were combined using a random-effects meta-analytic model. RESULTS Of the 2,245 records retrieved, 16 potentially relevant studies were identified. Following full-text evaluation, five studies met the inclusion criteria and were included in the review. The findings revealed that 58% of intensive care unit healthcare workers experienced second victim syndrome. Frequent symptoms included guilt (12-68%), anxiety (38-63%), anger at self (25-58%), and lower self-confidence (7-58%). However, specific risk factors exclusive to intensive care unit healthcare workers were not identified in the review. Furthermore, approximately 20% of individuals took more than a year to recover or did not recover at all from the second victim syndrome. CONCLUSIONS Thus, this condition is prevalent among intensive care unit healthcare workers and may persist for extended periods, potentially exceeding a year. The risk factors for second victim syndrome in the intensive care unit setting are unclear and require further investigation.
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Affiliation(s)
- Kazuaki Naya
- Department of Adult Health Nursing, Tokyo Healthcare University Wakayama Faculty of Nursing, Wakayama City, Wakayama, Japan
| | - Gen Aikawa
- Department of Adult Health Nursing, College of Nursing, Ibaraki Christian University, Hitachi, Ibaraki, Japan
| | - Akira Ouchi
- Department of Adult Health Nursing, College of Nursing, Ibaraki Christian University, Hitachi, Ibaraki, Japan
| | - Mitsuki Ikeda
- Department of Emergency and Critical Care Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba City, Ibaraki, Japan
| | - Ayako Fukushima
- Department of Critical Care and Disaster Nursing, Japanese Red Cross Kyushu International College of Nursing, Munakata, Fukuoka, Japan
| | - Shuhei Yamada
- Department of Adult Health Nursing, Tokyo Healthcare University Wakayama Faculty of Nursing, Wakayama City, Wakayama, Japan
| | - Megumi Kamogawa
- Department of Critical Care and Disaster Nursing, Japanese Red Cross Kyushu International College of Nursing, Munakata, Fukuoka, Japan
| | - Shun Yoshihara
- Department of Critical Care and Disaster Nursing, Japanese Red Cross Kyushu International College of Nursing, Munakata, Fukuoka, Japan
| | - Hideaki Sakuramoto
- Department of Critical Care and Disaster Nursing, Japanese Red Cross Kyushu International College of Nursing, Munakata, Fukuoka, Japan
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Dato Md Yusof YJ, Ng QX, Teoh SE, Loh CYL, Xin X, Thumboo J. Validation and use of the Second Victim Experience and Support Tool questionnaire: a scoping review. Public Health 2023; 223:183-192. [PMID: 37672831 DOI: 10.1016/j.puhe.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/23/2023] [Accepted: 08/01/2023] [Indexed: 09/08/2023]
Abstract
OBJECTIVES Patient safety incidents can impact not only patients and families but also healthcare providers, who may experience negative emotions and symptoms, such as anxiety, guilt, stress, and loss of confidence. To identify and support these "second victims," a screening tool called the Second Victim Experience and Support Tool (SVEST) has been developed. This scoping review aims to map our current knowledge of the SVEST in terms of its scope of use, validation and limitations. STUDY DESIGN Scoping review. METHODS In accordance with the framework outlined by Arksey and O'Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews, we conducted a literature search in MEDLINE, CINAHL, Cochrane Library, SCOPUS, Embase and PsycINFO databases from database inception up till 1 March 2023. RESULTS A total of 31 studies were reviewed. The SVEST has been cross-culturally adapted from English into other languages. The SVEST has been successfully used in different contexts and with various healthcare professionals, including doctors, nurses, allied health professionals, midwives and pharmacists. The tool has been used to assess the impact of second victim experiences and the effectiveness of support interventions in addressing the phenomenon. Validity assessment of translated versions of SVEST in the reviewed studies revealed good content validity in most cases, although some studies did not report clear values for scale-level Content Validity Index. On the whole, SVEST is generally a reliable and valid tool, although further refinements and modifications may improve its validity and reliability. CONCLUSIONS The review highlights the significance of SVEST as a crucial resource for healthcare providers and organisations that prioritise well-being and safety in health care. It also underscores the importance of recognising the needs of second victims and offering them appropriate interventions to manage the aftermath of adverse events.
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Affiliation(s)
- Y J Dato Md Yusof
- Health Services Research Unit, Singapore General Hospital, Singapore
| | - Q X Ng
- Health Services Research Unit, Singapore General Hospital, Singapore.
| | - S E Teoh
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - C Y L Loh
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - X Xin
- Health Services Research Unit, Singapore General Hospital, Singapore
| | - J Thumboo
- Health Services Research Unit, Singapore General Hospital, Singapore; SingHealth Duke-NUS Medicine Academic Clinical Programme, Duke-NUS Medical School, Singapore
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Li X, Che CC, Li Y, Wang L, Chong MC. The mediating role of coping styles in the relationship between second victim experience and professional quality of life among nurses: a cross-sectional study. BMC Nurs 2023; 22:312. [PMID: 37700282 PMCID: PMC10496327 DOI: 10.1186/s12912-023-01473-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 08/30/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Studies have shown that second-victim experiences could increase risks of the compassion fatigue while support from individuals and organisations is most often protection. However, the risk for poor compassion satisfaction and increased compassion fatigue in nurses aroused by adverse events remains an underestimated problem, meanwhile, litter known about the role of positive and negative coping styles among nurses suffering from adverse events. This study aims to investigate the effect of second-victim experiences on the professional quality of life among nurses and to determine the mediating role of coping styles in the relationship between second-victim experiences and professional quality of life. METHODS Multistage sampling was used to recruit registered nurses from Hunan province in China. Registered nurses who identified themselves as experiencing adverse events from nine tertiary hospitals were included in this study. Participants were recruited to complete a survey on the second victim experience and support tool, the simplified coping style questionnaire, and the professional quality of life scale. The stress coping theory was used to develop the framework in this study. The structural equation modelling approach was used for conducting the mediating effects analysis via IBM SPSS Statistics 26.0 and Mplus 8.3. RESULTS In total, 67% (n = 899) of nurses reported a second victim experience during their careers. In a bivariate analysis, both second-victims experiences and coping styles were significantly associated with their professional quality of life. The results showed that the effects of second victim experiences on their professional quality of life were fully mediated by coping styles. A total of 10 significantly indirect pathways were estimated, ranging from -0.243 to 0.173. CONCLUSIONS Second-victim experiences are common among nurses in this study. Since the mediating effects of coping styles were clarified in this study, it is imperative to promote the perception of negative coping styles and encourage nurses to adopt more positive coping styles with adequate support systems.
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Affiliation(s)
- Xizhao Li
- Department of Nursing Science, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Chong Chin Che
- Department of Nursing Science, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Yamin Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Ling Wang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Mei Chan Chong
- Department of Nursing Science, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
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Potura E, Klemm V, Roesner H, Sitter B, Huscsava H, Trifunovic-Koenig M, Voitl P, Strametz R. Second Victims among Austrian Pediatricians (SeViD-A1 Study). Healthcare (Basel) 2023; 11:2501. [PMID: 37761698 PMCID: PMC10531173 DOI: 10.3390/healthcare11182501] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/04/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Background: The second victim phenomenon (SVP) plays a critical role in workplace and patient safety. So far, there are limited epidemiological data on the SVP in German-speaking countries. Some studies have been carried out in Germany, but so far, no quantitative studies have been carried out in Austria examining the prevalence, symptom load and preferred support measures for second victims (SVs). This study therefore examines the SVP among Austrian pediatricians. (2) Methods: A nationwide, cross-sectional and anonymous online study was conducted using the SeViD questionnaire (Second Victims in Deutschland) including the Big Five Inventory-10 (BFI-10). Statistical analysis included binary-logistic and multiple linear regression with the bootstrapping, bias-corrected and accelerated (BCa) method based on 1000 bootstrap samples. (3) Results: Of 414 Austrian pediatricians, 89% self-identified as SVs. The main cause of becoming an SV was the unexpected death or suicide of a patient. High neuroticism and extraversion values as well as working in outpatient care positively correlated with having experienced the SVP. A preferred support strategy was access to legal counseling. (4) Conclusions: Austrian pediatricians have the highest SVP prevalence measured with the SeViD questionnaire. Further research should focus on prevention strategies and intervention programs.
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Affiliation(s)
- Eva Potura
- The Second Victim Association Austria, 11900 Vienna, Austria; (E.P.)
| | - Victoria Klemm
- Wiesbaden Institute for Healthcare Economics and Patient Safety (WiHelP), Wiesbaden Business School, RheinMain University of Applied Sciences, 65183 Wiesbaden, Germany
| | - Hannah Roesner
- Wiesbaden Institute for Healthcare Economics and Patient Safety (WiHelP), Wiesbaden Business School, RheinMain University of Applied Sciences, 65183 Wiesbaden, Germany
| | - Barbara Sitter
- The Second Victim Association Austria, 11900 Vienna, Austria; (E.P.)
| | - Herbert Huscsava
- The Second Victim Association Austria, 11900 Vienna, Austria; (E.P.)
| | | | - Peter Voitl
- First Vienna Pediatric Medical Center, Sigmund Freud University Vienna, 1220 Vienna, Austria
| | - Reinhard Strametz
- Wiesbaden Institute for Healthcare Economics and Patient Safety (WiHelP), Wiesbaden Business School, RheinMain University of Applied Sciences, 65183 Wiesbaden, Germany
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Cohen R, Sela Y, Nissanholtz-Gannot R. Addressing the second victim phenomenon in Israeli health care institutions. Isr J Health Policy Res 2023; 12:30. [PMID: 37667398 PMCID: PMC10476320 DOI: 10.1186/s13584-023-00578-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 08/31/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND The 'second victim' phenomenon (SVP) refers to practitioners who experience a negative physical or emotional response, as well as a professional decline, after participating or witnessing an adverse event. Despite the Israeli Ministry of Health's implementation of specific protocols regarding the overall management of adverse events in health organizations over the past decade, there is limited knowledge regarding healthcare managers' perceptions of the 'second victim' occurrence. METHODS A phenomenological qualitative approach was used to identify an accurate view of policy. Fifteen senior risk manager/and policy makers were interviewed about their knowledge and perceptions of the 'second victim'. Topics addressed included reporting mechanisms of an adverse event, the degree of organizational awareness of 'second victim', and identifying components of possible intervention programs and challenges to implementing those programs. RESULTS Examining current procedures reveals that there is limited knowledge about uniform guidance for health care organizations on how to identify, treat, or prevent SVP among providers. The employee support programs that were offered were sporadic in nature and depended on the initiative of a direct manager or the risk manager. CONCLUSIONS Currently, there is little information or organizational discussion about the possible negative effects of AE on healthcare practitioners. To provide overall medical care that is safe and effective for patients, the health system must also provide a suitable response to the needs of the medical provider. This could be achieved by establishing a national policy for all healthcare organizations to follow, raising awareness of the possible occurrence of SVP, and creating a standard for the subsequent identification, treatment and future prevention for providers who may be suffering.
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Affiliation(s)
- Rinat Cohen
- Department of Health System Management, School of Health Science, Ariel University, Ariel, Israel
- Nursing Department, Ramat Gan Academic College, Ramat Gan, Israel
- Rishon Le Zion, Israel
| | - Yael Sela
- Nursing Department, Ruppin Academic College, Emek-Hefer, Israel
| | - Rachel Nissanholtz-Gannot
- Department of Health System Management, School of Health Science, Ariel University, Ariel, Israel
- Smokler Center for Health Policy Research, Meyers JDC-Brookdale Institute, Jerusalem, Israel
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Seys D, Panella M, Russotto S, Strametz R, Joaquín Mira J, Van Wilder A, Godderis L, Vanhaecht K. In search of an international multidimensional action plan for second victim support: a narrative review. BMC Health Serv Res 2023; 23:816. [PMID: 37525127 PMCID: PMC10391912 DOI: 10.1186/s12913-023-09637-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/03/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Insights around second victims (SV) and patient safety has been growing over time. An overview of the available evidence is lacking. This review aims to describe (i) the impact a patient safety incident can have and (ii) how healthcare professionals can be supported in the aftermath of a patient safety incident. METHODS A literature search in Medline, EMBASE and CINAHL was performed between 1 and 2010 and 26 November 2020 with studies on SV as inclusion criteria. To be included in this review the studies must include healthcare professionals involved in the aftermath of a patient safety incident. RESULTS In total 104 studies were included. SVs can suffer from both psychosocial (negative and positive), professional and physical reactions. Support can be provided at five levels. The first level is prevention (on individual and organizational level) referring to measures taken before a patient safety incident happens. The other four levels focus on providing support in the aftermath of a patient safety incident, such as self-care of individuals and/or team, support by peers and triage, structured support by an expert in the field (professional support) and structured clinical support. CONCLUSION The impact of a patient safety incident on healthcare professionals is broad and diverse. Support programs should be organized at five levels, starting with preventive actions followed by self-care, support by peers, structured professional support and clinical support. This multilevel approach can now be translated in different countries, networks and organizations based on their own culture, support history, structure and legal context. Next to this, they should also include the stage of recovery in which the healthcare professional is located in.
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Affiliation(s)
- Deborah Seys
- Department Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35, Leuven, Belgium.
- Department Public Health and Primary Care, KU Leuven, Leuven, Belgium.
| | - Massimiliano Panella
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Sophia Russotto
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | | | - José Joaquín Mira
- The Foundation for the Promotion of Health and Biomedical Research of Valencia Region, Alicante, Spain
- Health Psychology Department, Miguel Hernandez University, Elche, Spain
| | - Astrid Van Wilder
- Department Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Lode Godderis
- Department Public Health and Primary Care, KU Leuven, Leuven, Belgium
- External Service for Prevention and Protection at Work, IDEWE, Heverlee, Belgium
| | - Kris Vanhaecht
- Department Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Department of Quality, University Hospitals Leuven, 3000, Leuven, Belgium
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Sahay A, McKenna L. Nurses and nursing students as second victims: A scoping review. Nurs Outlook 2023; 71:101992. [PMID: 37302259 DOI: 10.1016/j.outlook.2023.101992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 05/12/2023] [Accepted: 05/12/2023] [Indexed: 06/13/2023]
Abstract
BACKGROUND Second victim describes the impact on health care professionals after an error causing preventable patient harm. However, to date, the impact of making errors in practice by nurses and/or nursing students is unclear. PURPOSE To describe and understand what is known about nurses and nursing students as second victims. METHODS A scoping review was completed using three databases: CINAHL, Medline, and Proquest for the period between 2010 and 2022. A total of 23 papers underwent thematic analysis. DISCUSSION Three themes were identified: (a) Psychological distress and symptomatology, (b) Coping-response/reactions to errors, and (c) Seeking support and understanding. CONCLUSION Nurses and nursing students' well-being and productivity levels can be negatively affected by inadequate team and organisational support. To improve team functioning, appropriate support mechanisms must be implemented to assist nurses who experience significant distress after making errors. Nursing leadership should prioritise improving support programs, assessing workload allocation, and increasing awareness amongst leaders of the potential benefits of providing support to second victims.
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Affiliation(s)
- Ashlyn Sahay
- School of Nursing and Midwifery, Central Queensland University, Mackay, QLD, Australia.
| | - Lisa McKenna
- School of Nursing and Midwifery, La Trobe University, Bundoora, VIC, Australia.
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Allender EA, Bottema SM, Bosley CL, Holst SJ, Clark WJ, Weaver AL, Rivera-Chiauzzi EY, Finney RE. Use of the Revised Second Victim Experience and Support Tool to Examine Second Victim Experiences of Respiratory Therapists. Respir Care 2023; 68:749-759. [PMID: 37041030 PMCID: PMC10208995 DOI: 10.4187/respcare.10719] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
BACKGROUND Respiratory therapists (RTs) work alongside allied health staff, nurses, and physicians during stressful and traumatic events that can be associated with emotional and physiological implications known as second victim (SV) experiences (SVEs). This study aimed to evaluate SVEs of RTs, including both positive and negative implications. METHODS RTs within a large academic health care organization across Minnesota, Wisconsin, Florida, and Arizona were asked to participate in an anonymous survey that included the validated Second Victim Experience and Support Tool-Revised to assess SVEs as well as desired support services. RESULTS Of the RTs invited to participate, 30.8% (171/555) completed the survey. Of the 171 survey respondents, 91.2% (156) reported that they had been part of a stressful or traumatic work-related event as an RT, student, or department support staff member. Emotional or physiologic implications experienced by respondents as SVs included anxiety 39.1% (61/156), reliving of the event 36.5% (57/156), sleeplessness 32.1% (50/156), and guilt 28.2% (44/156). Following a stressful clinical event, 14.8% (22/149) experienced psychological distress, 14.2% (21/148) experienced physical distress, 17.7% (26/147) indicated lack of institutional support, and 15.6% (23/147) indicated turnover intentions. Enhanced resilience and growth were reported by 9.5% (14/147). Clinical and non-clinical events were reported as possible triggers for SVEs. Nearly half of respondents 49.4% (77/156) indicated feeling like an SV due to events related to COVID-19. Peer support was the highest ranked form of desired support following an SVE by 57.7% (90/156). CONCLUSIONS RTs are involved in stressful or traumatic clinical events, resulting in psychological/physical distress and turnover intentions. The COVID-19 pandemic has had a significant impact on RTs' SVEs, highlighting the importance of addressing the SV phenomenon among this population.
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Affiliation(s)
- Erica A Allender
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota
| | - Sophia M Bottema
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota
| | - Christopher L Bosley
- Department of Anesthesiology and Perioperative Medicine-Respiratory Care, Mayo Clinic, Rochester, Minnesota
| | - Stephanie J Holst
- Department of Anesthesiology and Perioperative Medicine-Respiratory Care, Mayo Clinic, Rochester, Minnesota
| | - William J Clark
- Department of Anesthesiology and Perioperative Medicine-Respiratory Care, Mayo Clinic, Rochester, Minnesota
| | - Amy L Weaver
- Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota
| | | | - Robyn E Finney
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota.
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Fischer C. Valuable Support After My First Adverse Event. Nurs Womens Health 2023:S1751-4851(23)00087-9. [PMID: 37271180 DOI: 10.1016/j.nwh.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 04/21/2023] [Indexed: 06/06/2023]
Abstract
A good charge nurse can see the effect an unanticipated emergency has on the staff and knows the support of colleagues is critical.
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Kim SA, Lee T. Impact of patient-safety incidents on Korean nurses' quality of work-related life: A descriptive correlational study. Nurs Open 2023; 10:3862-3871. [PMID: 36812029 PMCID: PMC10170948 DOI: 10.1002/nop2.1644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 12/02/2022] [Accepted: 02/04/2023] [Indexed: 02/24/2023] Open
Abstract
AIM We investigated the impact of patient safety incidents on the quality of nurses' work-related lives, based on the Culture-Work-Health model. DESIGN Descriptive correlational study. METHODS An online survey was administered between March 10 and 18, 2020 to 622 nurses in South Korea who had experienced patient safety incidents within the past year. Descriptive analysis was performed along with inferential statistics, including one-way ANOVA, correlation, and multiple linear regression (p < 0.05). RESULTS A multiple linear regression analysis was used to identify factors affecting participants' quality of work-related life. Significantly influential factors were resonant leadership, just culture, organizational support, organizational health, and overall work experience. CONCLUSIONS Resonant leadership and culture positively affects nurses' quality of work-related life. Therefore, it is critical to evaluate nurses' perceptions of these factors and use these factors in creating administrative interventions to assist nurses in improving their work experiences.
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Affiliation(s)
- Sun Aee Kim
- Management Planning Team, CHA Bundang Medical Center, Seongnam, South Korea
| | - Taewha Lee
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, South Korea
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Krommer E, Ablöscher M, Klemm V, Gatterer C, Rösner H, Strametz R, Huf W, Ettl B. Second Victim Phenomenon in an Austrian Hospital before the Implementation of the Systematic Collegial Help Program KoHi: A Descriptive Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1913. [PMID: 36767279 PMCID: PMC9915153 DOI: 10.3390/ijerph20031913] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: The Second Victim Phenomenon (SVP) is widespread throughout health care institutions worldwide. Second Victims not only suffer emotional stress themselves; the SVP can also have a great financial and reputational impact on health care institutions. Therefore, we conducted a study (Kollegiale Hilfe I/KoHi I) in the Hietzing Clinic (KHI), located in Vienna, Austria, to find out how widespread the SVP was there. (2) Methods: The SeViD (Second Victims in Deutschland) questionnaire was used and given to 2800 employees of KHI, of which 966 filled it in anonymously. (3) Results: The SVP is prevalent at KHI (43% of the participants stated they at least once suffered from SVP), although less prevalent and pronounced than expected when compared to other studies conducted in German-speaking countries. There is still a need for action, however, to ensure a psychologically safer workspace and to further prevent health care workers at KHI from becoming psychologically traumatized.
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Affiliation(s)
- Elisabeth Krommer
- Karl Landsteiner Institute for Clinical Risk Management, Wolkersbergenstraße 1, 1130 Vienna, Austria
| | - Miriam Ablöscher
- Karl Landsteiner Institute for Clinical Risk Management, Wolkersbergenstraße 1, 1130 Vienna, Austria
| | - Victoria Klemm
- Wiesbaden Institute for Healthcare Economics and Patient Safety (WiHelP), Wiesbaden Business School, RheinMain UAS, Bleichstr. 44, 65183 Wiesbaden, Germany
| | - Christian Gatterer
- Karl Landsteiner Institute for Clinical Risk Management, Wolkersbergenstraße 1, 1130 Vienna, Austria
| | - Hannah Rösner
- Wiesbaden Institute for Healthcare Economics and Patient Safety (WiHelP), Wiesbaden Business School, RheinMain UAS, Bleichstr. 44, 65183 Wiesbaden, Germany
| | - Reinhard Strametz
- Wiesbaden Institute for Healthcare Economics and Patient Safety (WiHelP), Wiesbaden Business School, RheinMain UAS, Bleichstr. 44, 65183 Wiesbaden, Germany
| | - Wolfgang Huf
- Karl Landsteiner Institute for Clinical Risk Management, Wolkersbergenstraße 1, 1130 Vienna, Austria
| | - Brigitte Ettl
- Karl Landsteiner Institute for Clinical Risk Management, Wolkersbergenstraße 1, 1130 Vienna, Austria
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Li J, Yan X, Chen G, Sun H. Mindfulness meditation intervention improves the mindfulness awareness level of nurses' second victims to enhance their psychological support. SAGE Open Nurs 2023; 9:23779608231178136. [PMID: 37273551 PMCID: PMC10233569 DOI: 10.1177/23779608231178136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 05/06/2023] [Accepted: 05/09/2023] [Indexed: 06/06/2023] Open
Abstract
Introduction The medical staff involved in adverse events, referred to as second victims, usually suffer second victim syndrome endangering their health. Still, there are few organizational support projects in this area in China. Objective To explore the effect of mindfulness meditation on the level and needs of organizational support, and mindfulness awareness among nurses as second victims. Methods Forty-six nurses from a comprehensive tertiary hospital in Wuhan, China were selected to participate in the study. This study was conducted using a convenience sampling method for eight weeks of mindfulness meditation intervention. The Second Victim Experience and Support Tool and Mindfulness Attention Awareness Scale were used to assessing the need for support and mindfulness awareness of nurses prior to intervention, during the fourth and eighth weeks of intervention, and at the conclusion of the intervention course. Results The difference between the scores measured before the intervention, in the fourth week, and in the eighth week of intervention showed that the need for the second victim support from work-related organizations was significant (F = 34.513, p = .000); there was no significant difference in the scores related to the need for nonwork-related support of the second victim in the participating nurses (F = 1.373, p = .257); the scores of the level of mindfulness awareness were (64.85 ± 11.41), (68.63 ± 11.33), and (71.20 ± 8.41), a significant difference (F = 18.848; p = .000) was found in terms of before and after the intervention; nurses' second victim support needs gradually shifted from evasion to confronting problems appropriately. Conclusion Mindfulness meditation intervention is applicable to the second victim population of nurses. It is an effective way to support second victim nurses and can effectively improve their level of mindfulness and awareness.
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Affiliation(s)
- Jieli Li
- Department of Neurosurgery, Zhongnan Hospital of Wuhan
University, Wuhan, China
| | - Xixi Yan
- Department of Allergy, Zhongnan Hospital of Wuhan
University, Wuhan, China
| | - Guiru Chen
- Department of Nursing, People's
Hospital of Aba Tibetan and Qiang Autonomous Prefecture, Aba Prefecture, China
| | - Huimin Sun
- Department of Nursing, Zhongnan Hospital of Wuhan
University, Wuhan, China
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Asif M, Li M, Hussain A, Jameel A, Hu W. Impact of perceived supervisor support and leader-member exchange on employees' intention to leave in public sector museums: A parallel mediation approach. Front Psychol 2023; 14:1131896. [PMID: 36935955 PMCID: PMC10020624 DOI: 10.3389/fpsyg.2023.1131896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 02/13/2023] [Indexed: 03/06/2023] Open
Abstract
High staff turnover in certain public sector organizations in Pakistan is a challenging problem, and organizations strive to reduce this issue using different mechanisms. Therefore, this research investigates the parallel mediation impact of perceived organizational support (POS) and organizational citizenship behavior (OCB) on the relationships among perceived supervisor support (PSS), leader-member exchange (LMX), and employee's intention to leave (IL). Data were collected from 482 employees working in public sector museums in Pakistan in three waves. Structural equation modeling (SEM) with a two-step approach was used to evaluate the data. The research found that both POS and OCB mediate the negative relationship between PSS and IL and between LMX and IL in a parallel mediation mechanism. Public sector museums should focus on providing visible supervisory support and develop a healthy work environment where the exchange relationship between supervisors and subordinates strengthens to reduce the possibility of the employee's leave intentions.
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Affiliation(s)
- Muhammad Asif
- School of Management, Jiangsu University, Zhenjiang, China
| | - Mingxing Li
- School of Management, Jiangsu University, Zhenjiang, China
- *Correspondence: Mingxing Li,
| | - Abid Hussain
- School of Management, Jiangsu University, Zhenjiang, China
| | - Arif Jameel
- School of Management, Jiangsu University, Zhenjiang, China
| | - Weijun Hu
- School of Archaeology, Jilin University, Changchun, China
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Miehl N, Warkentin P, Docherty A, Najjar R. Introducing a Legal Simulation in Undergraduate Nursing. J Nurs Educ 2023; 62:62. [PMID: 36279547 DOI: 10.3928/01484834-20220912-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Golz C, Oulevey Bachmann A, Defilippis TS, Kobleder A, Peter KA, Schaffert R, Schwarzenbach X, Kampel T, Hahn S. Preparing students to deal with the consequences of the workforce shortage among health professionals: a qualitative approach. BMC MEDICAL EDUCATION 2022; 22:756. [PMID: 36333793 PMCID: PMC9636659 DOI: 10.1186/s12909-022-03819-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 09/26/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Healthcare is facing a shortage of qualified healthcare professionals. The pandemic has brought to light the fragile balance that affects all healthcare systems. Governments have realized that these systems and the professionals working in them need support at different levels to strengthen the retention of the workforce. Health professionals' education can play an important role in ensuring that new generations of workers have sound personal and professional competencies to successfully face the challenges of professional practice. These challenges are described in the literature, but the extent to which they are considered in health professionals' education is less clear. METHODS This qualitative study compares the professional challenges and educational needs described in the literature with the current curricula for health professionals offered in Switzerland. Data were collected nationally through focus group interviews with 65% of Switzerland's directors of bachelor's and master's programs of health professions (nursing, physiotherapy, occupational therapy, midwifery, nutrition and dietetics, osteopathy, radiologic medical imaging technology, health promotion and prevention, and health sciences). The data attained were analyzed using knowledge mapping. RESULTS The results reveal a gap among education programs with regard to occupational health promotion and cultural diversity. Both topics are taught with a sole focus on patients, and students are expected to adopt similar strategies for their health promotion and stress management. Physicians are insufficiently involved in interprofessional education. The programs fail to enhance health professionals' political, economic and digital competencies. CONCLUSION The results of this study offer clear guidance about what topics need to be integrated into curricula to improve health professionals' well-being at work and their preparedness to face daily professional challenges.
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Affiliation(s)
- Christoph Golz
- Department of Health Professions, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland.
| | - Annie Oulevey Bachmann
- La Source School of Nursing, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Tiziana Sala Defilippis
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Locarno, Switzerland
| | - Andrea Kobleder
- Department of Health, Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland
| | - Karin Anne Peter
- Department of Health Professions, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland
| | - René Schaffert
- School of Health Professions, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Xenia Schwarzenbach
- Department of Health Professions, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland
| | - Thomas Kampel
- La Source School of Nursing, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Sabine Hahn
- Department of Health Professions, Bern University of Applied Sciences, Murtenstrasse 10, 3008, Bern, Switzerland
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O'Meara S, D'Arcy F, Dowling C, Walsh K. The psychological impact of adverse events on urology trainees. Ir J Med Sci 2022:10.1007/s11845-022-03202-8. [PMID: 36329289 PMCID: PMC9633123 DOI: 10.1007/s11845-022-03202-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022]
Abstract
Introduction Adverse events (AE) are an inevitable reality in healthcare, with an incidence of 7.5–14.1% worldwide. AEs are recognised to cause psychological and emotional distress in healthcare workers, with surgeons being particularly susceptible. We report the first data on the emotional impact in relation to adverse events in surgeons in the Republic of Ireland (ROI). Methods We distributed a web-based survey to all urology trainees in the ROI. The questionnaire focused on trainees’ personal account of AEs, their emotional response, perceived contributing factors and perceived benefit of support systems. The primary care PTSD screen (PC-PTSD-V) assessed for PTSD. Results A total of 16 responses were received from 12 (75%) registrars and 4 (25%) SHOs. Of the AEs reported, 12 (75%) were ≥ Clavien-Dindo 3b. Contributing factors identified included lapse of judgement (n = 6, 37.5%), risk of procedure (n = 7, 43%), lack of experience (n = 4, 25%). Anxiety (n = 8, 50%), guilt (n = 7, 44%) and sleep problems (n = 4, 25%) were the most reported emotional responses. Physical symptoms were reported in 2 (12%) trainees. A PC-PTSD-V score ≥ 3 was reported in 2 (12%) trainees. Most trainees (n = 13, 81%) reported talking to someone following the event with most (n = 12, 93%) talking to a consultant or NCHD colleague. Most respondents (n = 14, 87%) agreed that their training could better prepare them for the personal impact of AEs. Conclusion Surgical trainees report negative psychological and emotional responses that are consistent with second victim symptoms. Those surveyed felt that their training could better prepare them for the personal impact of such events. Supplementary Information The online version contains supplementary material available at 10.1007/s11845-022-03202-8.
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Affiliation(s)
- Sorcha O'Meara
- Department of Urology, University College Hospital Galway, Galway, Ireland.
| | - Frank D'Arcy
- Department of Urology, University College Hospital Galway, Galway, Ireland
| | - Catherine Dowling
- Department of Urology, University College Hospital Galway, Galway, Ireland
| | - Kilian Walsh
- Department of Urology, University College Hospital Galway, Galway, Ireland
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Quadros DVD, Magalhães AMMD, Boufleuer E, Tavares JP, Kuchenbecker RDS, Dal Pai D. Falls Suffered by Hospitalized Adult Patients: Support to the Nursing Team as the Second Victim. AQUICHAN 2022. [DOI: 10.5294/aqui.2022.22.4.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective: To describe the support received by the second victim in falls suffered by hospitalized adult patients from the nursing team’s perspective. Materials and Methods: This is an exploratory and descriptive study with a qualitative approach, conducted in a large general hospital in the southern region of Brazil. Data collection was carried out through semi-structured interviews with 21 nursing professionals (seven nurses and fourteen nursing technicians) selected by random sampling, who worked in the inpatient units where falls occurred with a level of harm ranging from moderate to severe during March and May of 2020. The data were submitted to content analysis from July to August of the same year. Results: On the one hand, from the nursing team’s perspective, support for the second victim was considered incipient by the hospital institution. On the other, participants highlighted the support received by their families and peers in the work environment. The study followed the guidelines of the Consolidated Criteria for Reporting Qualitative Research (COREQ). Conclusions: An institutional flow of support for the second victim needs to be formalized to mitigate the repercussions on staff.
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Santana-Domínguez I, González-de la Torre H, Verdú-Soriano J, Nolasco A, Martín-Martínez A. Validation and Psychometric Properties of the Spanish Version of the Second Victim Experience and Support Tool Questionnaire. J Patient Saf 2022; 18:692-701. [PMID: 35175235 DOI: 10.1097/pts.0000000000000989] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aimed to assess the validity and psychometric properties of the Spanish version of the Second Victim Experience and Support Tool (SVEST-E) questionnaire. METHODS This was a cross-sectional study aimed at midwives and obstetricians in Spain. An online survey was conducted consisting of 2 parts: the first part collected different variables, and the second part collected the SVEST-E. The temporal stability of the instrument was evaluated using the test-retest method. For the construct validity and reliability, an exploratory factor analysis and a confirmatory factor analysis were performed using FACTOR program v.10 with a polychoric correlation matrix. RESULTS A total of 689 professionals participated in the study (323 obstetrician physicians/366 midwives). The mean (SD) score on the SVEST-E for the total sample was 3.09 (0.50). The parallel analysis of the exploratory factor analysis suggested a 5-factor solution, with a total explained variability of 61.8%. The goodness-of-fit indices of the model were the following: root mean square error of approximation = 0.038 (95% confidence interval [CI], 0.031-0.042) and comparative fit index = 0.989 (95% CI, 0.988-0.992). The factor model obtained was confirmed by confirmatory factor analysis, obtaining the values of root mean square error of approximation = 0.038 (95% CI, 0.026-0.053) and comparative fit index = 0.989 (95% CI, 0.969-1.000). The intraclass correlation coefficient was 0.97 (95% CI, 0.94-0.99). CONCLUSIONS The SVEST-E instrument maintains the same items as the original questionnaire but introduces changes in the organization of its dimensions. The Spanish version maintains adequate construct validity, reliability, and temporal stability, so it is a valid tool to evaluate the second victim experience in Spanish health professionals.
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Affiliation(s)
| | | | - José Verdú-Soriano
- Department of Community Nursing, Preventive Medicine, Public Health and History of Science, Faculty of Health Sciences
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Quadros DVD, Magalhães AMMD, Wachs P, Severo IM, Tavares JP, Dal Pai D. Modeling of adult patient falls and the repercussions to Nursing as a second victim. Rev Lat Am Enfermagem 2022; 30:e3617. [PMID: 35920541 DOI: 10.1590/1518-8345.5830.3617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 03/27/2022] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE analyze the falls of adult hospitalized patients and their repercussions on the Nursing worker as the second victim. METHOD an exploratory, descriptive and qualitative study conducted in two stages - identification of falls with moderate to severe damage and the modeling of falls using the software Functional Resonance Analysis Method; and analysis of the repercussions on the worker as the second victim by means of semi-structured interviews submitted to Content Analysis, with 21 Nursing workers. RESULTS a total of 447 falls of adult patients were identified, 12 of which with moderate to severe damage, occurred in the absence of the companion, while using sleep inducing, hypotensive or muscle strength altering medications. The modeling identified 22 functions related to the Standard Operating Procedure, to the fall prevention protocol and to the post-event actions. Of these, eight presented variability in their execution. In the second step, the categories "The complexity of care to prevent falls" and "Feelings of the second victim" emerged. CONCLUSION falls are complex phenomena and prevention requires involvement of the patient, family and multi-professional team. The professionals involved are second victims and experience feelings of guilt, fear, anguish and helplessness. This study can contribute to the multi-professional spirit and to the early approach to second victims.
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Affiliation(s)
| | | | - Priscila Wachs
- Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | | | - Juliana Petri Tavares
- Universidade Federal do Rio Grande do Sul, Escola de Enfermagem, Porto Alegre, RS, Brasil
| | - Daiane Dal Pai
- Universidade Federal do Rio Grande do Sul, Escola de Enfermagem, Porto Alegre, RS, Brasil
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Sordi LPD, Lourenção DCDA, Gallasch CH, Baptista PCP. The second victim experience: cross-cultural adaptation of an instrument for the Brazilian context. Rev Gaucha Enferm 2022; 43:e20210010. [PMID: 35920520 DOI: 10.1590/1983-1447.2022.20210010.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 10/08/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To cross-culturally adapt and analyze the evidence of content validity of the Second Victim Experience and Support Tool for the Portuguese language spoken in Brazil. METHOD Psychometric study of cross-cultural adaptation following the steps of the Patient-Reported Outcome Measurement Information System. Semantic, idiomatic, experimental, and conceptual equivalences were evaluated. The content validity was verified using the Content Validity Ratio. 31 health professionals from the city of São Paulo participated in the pre-test. RESULTS The equivalence analysis showed an agreement rate was 88.7%. The content validity presented 86% of the items with Content Validity Ratio values above the stipulated. In the pre-test, the participants reported that they understood the items of the instrument and only 10% of the participants reported difficulty in understanding any item. CONCLUSION The Brazilian version of the Second Victim Experience and Support Tool presented a good translation quality and good evidence of content validity.
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Affiliation(s)
- Luisa Petelincar De Sordi
- Universidade de São Paulo (USP) , Escola de Enfermagem, Programa de Pós-Graduação em Gerenciamento em Enfermagem. São Paulo, São Paulo, Brasil
| | | | - Cristiane Helena Gallasch
- Universidade do Estado do Rio de Janeiro (UERJ) , Faculdade de Enfermagem. Rio de Janeiro, Rio de Janeiro, Brasil
| | - Patrícia Campos Pavan Baptista
- Universidade de São Paulo (USP) , Escola de Enfermagem, Departamento de Orientação Profissional. São Paulo, São Paulo, Brasil
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Yılmaz Y, Üngüren E, Tekin ÖA, Kaçmaz YY. Living with Infection Risk and Job Insecurity during COVID-19: The Relationship of Organizational Support, Organizational Commitment, and Turnover Intention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:8516. [PMID: 35886371 PMCID: PMC9316448 DOI: 10.3390/ijerph19148516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 07/05/2022] [Accepted: 07/10/2022] [Indexed: 12/13/2022]
Abstract
The COVID-19 outbreak caused a stressful process for hospitality employees in terms of both being infected and experiencing the risk of losing their jobs. Stressful working conditions increase employees' turnover intentions (TI). This study aims to analyze the relationship among perceived organizational support (POS), organizational commitment (OC), and turnover intention (TI) within the context of employees' infection status and perceived job insecurity (JI). In this context, the study tests a moderated mediation research model. Having adopted a quantitative research method, data were acquired from 490 respondents who work at five-star accommodation companies in Alanya, Turkey. Findings show that the impact of POS on OC and IT differ according to employees' infection status during the COVID-19 outbreak and their perceived JI. The findings of the study reveal empirical results in understanding employee attitudes toward companies alongside perceived job insecurity for those who are infected as well as for those who are not. Moreover, the study presents theoretical and practical contributions to reduce the negative impact of job insecurity and risk of infection on turnover intentions, which have been considered to be main sources of stress throughout the pandemic.
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Affiliation(s)
- Yusuf Yılmaz
- Department of Recreation Management, Faculty of Tourism, Akdeniz University, Antalya 07070, Turkey
| | - Engin Üngüren
- Department of Business Management, Faculty of Economics, Administrative and Social Sciences, Alanya Alaaddin Keykubat University, Antalya 07450, Turkey;
| | - Ömer Akgün Tekin
- Department of Gastronomy and Culinary Arts, Manavgat Faculty of Tourism, Akdeniz University, Antalya 07600, Turkey;
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Second Victim Experience and Perception Discordance of the Colonoscopic Perforation. Dig Dis Sci 2022; 67:2857-2865. [PMID: 34283361 DOI: 10.1007/s10620-021-07107-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 06/09/2021] [Indexed: 12/09/2022]
Abstract
BACKGROUND Perforation is the most serious adverse event of colonoscopy, but rarely considered from the view of colonoscopists' second victim experience and perception discordance between colonoscopists and patients. AIMS We aimed to evaluate colonoscopists' second victim experience and the perception discordance between colonoscopists and patients for the colonoscopic perforation. METHODS A survey for colonoscopic perforation was performed for the colonoscopists and outpatients who visited the university hospital between February 1, 2020, and April 30, 2020. The questionnaire included questions regarding colonoscopists' satisfaction for the intervention strategies offered to patients and patient-colonoscopist perception on colonoscopic perforation. A modified Korean version of the "Second Victim Experience and Support Tool (K-SVEST)" was used to assess the second victim experiences and supportive resources for the colonoscopists. RESULTS Survey results from 160 colonoscopists and 165 patients were analyzed. The colonoscopists' satisfaction scores were higher for strategies related to sufficient explanation, empathy, courteous listening, and monetary compensation. The scores of the K-SVEST for the second victim experience were highest in psychological distress, followed by loss of professional self-efficacy, colleague support, physical distress, non-work-related support, institutional support, and turnover intentions/absenteeism. Significant patient-colonoscopist discordance was noted for the same colonoscopic perforation scenario on the judgment of medical error, health professionals' apology, monetary compensation, and criminal penalties for the colonoscopists. CONCLUSIONS Colonoscopists can suffer emotionally and physically from the second victim experience after colonoscopic perforation. In addition, the significant patient-colonoscopist discordance should be considered to make a better communication for the colonoscopic perforation.
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Abstract
BACKGROUND Unanticipated adverse events could harm not only patients and families but also health care professionals. These people are defined as second victims. Second victim distress (SVD) refers to physical, emotional, and professional problems of health care professionals. While positive patient safety cultures (PSCs) are associated with reducing severity of SVD, there is a dearth of research on the association between PSCs and SVD and the mediation effects in those associations. OBJECTIVES The purpose of this study was to explore the associations between PSCs and SVD and verify the multiple mediation effects of colleague, supervisor, and institutional supports. METHODS A cross-sectional study using a self-report questionnaire was conducted among 296 nurses in South Korea. The participants were selected by quota sampling in 41 departments including general wards, intensive care units, etc. Descriptive statistics, Pearson's correlation, multiple linear regression, and multiple mediation analysis were conducted using SPSS 25.0 and the PROCESS macros. RESULTS Nonpunitive response to errors, communication openness, and colleague, supervisor, and institutional supports had negative correlations with SVD (Ps < .05). In the multiple mediation model, a nonpunitive response to error showed a significant direct effect on SVD (direct effect β = -.26, P < .001). Colleague, supervisor, and institutional supports showed a significant indirect effect between nonpunitive response to error and SVD; colleague (indirect effect β [Boot LLCI-Boot ULCI] = -.03 [-0.06 to -0.00]), supervisor (.03[0.00 to 0.07]), and institutional support (-.04 [-0.07 to -0.01]). CONCLUSION The study suggests that establishing nonpunitive organizational cultures is an effective strategy to reduce SVD. The findings highlight the importance of promoting programs that strengthen PSCs in hospitals and prioritizing support resources to reduce SVD among nurses.
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Affiliation(s)
- Sun-Aee Kim
- Management and Planning Team, CHA Bundang Medical Center, Seongnam, Gyeonggi-do, Republic of Korea (Dr S.-A. Kim); College of Nursing, Research Institute of Nursing Science, Pusan National University, Yangsan-si, Gyeongsangnam-do, Republic of Korea (Dr E.-M. Kim); and Department of Nursing, Koje University, Koje, Republic of Korea (Dr Lee)
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Yan J, Li L, Li J, Wang S, Wu X, Xiao P, Zhong Z, Ding S, Xie J, Cheng ASK. Stepwise Interactive Situated Training Program for Young Nurses’ Safety Behavior and Interrupted Coping Behavior. Healthcare (Basel) 2022; 10:healthcare10071157. [PMID: 35885683 PMCID: PMC9320381 DOI: 10.3390/healthcare10071157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/15/2022] [Accepted: 06/18/2022] [Indexed: 11/16/2022] Open
Abstract
Young nurses’ safety behavior and interrupted coping behavior affect patient safety. A stepped, interactive and situated training program should be evaluated to assist young nurses in improving themselves. This study aimed to evaluate the effect of the stepwise interactive situated training program on safety behavior and practice ability with respect to nursing interruptions for young nurses and its influencing factors. This was a quasi-experimental, one-group, self-control and pretest–post-test design study. Six hundred young nurses in two provinces were included. The participants underwent a stepwise interactive situated training program from March to August 2019. The program was delivered by designated head nurses and consisted of five themes: mobilization, theoretical training, operational training, specialized training and self-improvement. Five hundred and sixty-two young nurses completed this study. The safety behavior and the practice of nursing interruption were significantly higher after intervention than before. Professional titles, age and occupational time were the influence factors. The stepwise interactive situated training program was effective at improving young nurses’ safety behavior and interrupted coping behavior. Nurses with higher professional titles performed better with regard to the safety behavior and the practice of nursing interruption.
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Affiliation(s)
- Jin Yan
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha 410000, China; (J.Y.); (S.W.); (Z.Z.); (S.D.)
| | - Lijun Li
- Xiangya Nursing School, Central South University, Changsha 410000, China; (L.L.); (J.L.); (X.W.); (P.X.)
| | - Jie Li
- Xiangya Nursing School, Central South University, Changsha 410000, China; (L.L.); (J.L.); (X.W.); (P.X.)
| | - Sha Wang
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha 410000, China; (J.Y.); (S.W.); (Z.Z.); (S.D.)
| | - Xiaoqi Wu
- Xiangya Nursing School, Central South University, Changsha 410000, China; (L.L.); (J.L.); (X.W.); (P.X.)
| | - Panpan Xiao
- Xiangya Nursing School, Central South University, Changsha 410000, China; (L.L.); (J.L.); (X.W.); (P.X.)
| | - Zhuqing Zhong
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha 410000, China; (J.Y.); (S.W.); (Z.Z.); (S.D.)
| | - Siqing Ding
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha 410000, China; (J.Y.); (S.W.); (Z.Z.); (S.D.)
| | - Jianfei Xie
- Nursing Department, The Third Xiangya Hospital of Central South University, Changsha 410000, China; (J.Y.); (S.W.); (Z.Z.); (S.D.)
- Correspondence:
| | - Andy S. K. Cheng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong 999077, China;
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Santana-Domínguez I, González-De La Torre H, Verdú-Soriano J, Berenguer-Pérez M, Suárez-Sánchez JJ, Martín-Martínez A. Feelings of being a second victim among Spanish midwives and obstetricians. Nurs Open 2022; 9:2356-2369. [PMID: 35633515 PMCID: PMC9374404 DOI: 10.1002/nop2.1249] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 04/05/2022] [Accepted: 05/08/2022] [Indexed: 11/11/2022] Open
Abstract
Aim The aim of this study was to determine the prevalence of feelings of being a second victim among midwives and obstetricians in Spain and to explore possible differences between the two professions. Design Cross‐sectional descriptive‐analytical observational study. Methods An online survey collecting several variables was administered throughout the Spanish territory. Spanish version of the Second Victim Experience and Support Tool (SVEST) was used. The data collection period was from May to December 2020. Results A total sample of 719 obstetricians and midwives were studied. There were significant differences between the two groups with respect to seven dimensions of SVEST: greater feelings of being a second victim among obstetricians in the dimensions physical distress/p ≤ .001, non‐work‐related support/p ≤ .001 and absenteeism/p ≤ .001 and greater feelings of being a second victim among midwives in the dimensions psychological distress/p ≤ .001, supervisor support/p = .011, professional self‐efficacy/p ≤ .001 and intention to change jobs/p ≤ .001.
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Affiliation(s)
- Irene Santana-Domínguez
- University of Las Palmas de Gran Canaria (ULPGC), Las Palmas de Gran Canaria-Canary Islands, Spain.,Canary Health Service. Obstetrics and Gynaecology Department, Gran Canaria Maternal and Infant University Hospital Complex, Canary Islands, Spain
| | - Héctor González-De La Torre
- Research Unit of Insular Maternal and Child University Hospital Complex of Gran Canaria, Canary Health Service, Las Palmas de Gran Canaria-Canary Islands, Spain.,University of La Laguna (ULL)-Nursing Unit La Palma, Tenerife-Canary Islands, Spain
| | - José Verdú-Soriano
- Department of Community Nursing, Preventive Medicine, Public Health and History of Science, Faculty of Health Sciences, University of Alicante (UA), Alicante, Spain
| | - Miriam Berenguer-Pérez
- Department of Community Nursing, Preventive Medicine, Public Health and History of Science, Faculty of Health Sciences, University of Alicante (UA), Alicante, Spain
| | - Juan José Suárez-Sánchez
- University of Las Palmas de Gran Canaria (ULPGC), Las Palmas de Gran Canaria-Canary Islands, Spain.,Canary Health Service, Direction of Primary Care Gran Canaria, Canary Islands, Spain
| | - Alicia Martín-Martínez
- University of Las Palmas de Gran Canaria (ULPGC), Las Palmas de Gran Canaria-Canary Islands, Spain.,Canary Health Service. Obstetrics and Gynaecology Department, Gran Canaria Maternal and Infant University Hospital Complex, Canary Islands, Spain
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Mohd Kamaruzaman AZ, Ibrahim MI, Mokhtar AM, Mohd Zain M, Satiman SN, Yaacob NM. The Effect of Second-Victim-Related Distress and Support on Work-Related Outcomes in Tertiary Care Hospitals in Kelantan, Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6454. [PMID: 35682042 PMCID: PMC9180130 DOI: 10.3390/ijerph19116454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/12/2022] [Accepted: 05/24/2022] [Indexed: 02/01/2023]
Abstract
After a patient safety incident, the involved healthcare providers may experience sustained second-victim distress and reduced professional efficacy, with subsequent negative work-related outcomes and the cultivation of resilience. This study aims to investigate the factors affecting negative work-related outcomes and resilience with a hypothetical triad of support as the mediators: colleague, supervisor, and institutional support. This cross-sectional study recruited 733 healthcare providers from three tertiary care hospitals in Kelantan, Malaysia. Three steps of hierarchical linear regression were developed for both outcomes (negative work-related outcomes and resilience). Four multiple mediator models of the support triad were analyzed. Second-victim distress, professional efficacy, and the support triad contributed significantly in all the regression models. Colleague support partially mediated the relationship defining the effects of professional efficacy on negative work-related outcomes and resilience, whereas colleague and supervisor support partially mediated the effects of second-victim distress on negative work-related outcomes. Similar results were found regarding resilience, with all support triads producing similar results. As mediators, the support triads ameliorated the effect of second-victim distress on negative work-related outcomes and resilience, suggesting an important role of having good support, especially after encountering patient safety incidents.
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Affiliation(s)
- Ahmad Zulfahmi Mohd Kamaruzaman
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia;
| | - Mohd Ismail Ibrahim
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia;
| | - Ariffin Marzuki Mokhtar
- Department of Anesthesiology and Intensive Care, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia;
| | - Maizun Mohd Zain
- Public Health Unit, Hospital Raja Perempuan Zainab II, Kota Bharu 16150, Kelantan, Malaysia;
| | - Saiful Nazri Satiman
- Medical Division, Kelantan State Health Department, Kota Bharu 16150, Kelantan, Malaysia;
| | - Najib Majdi Yaacob
- Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia;
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