Experience and support of Chinese healthcare professionals as second victims of patient safety incidents: A cross-sectional study

Exploring the Experiences and Support of Nurses as Second Victims After Patient Safety Events in China: A Mixed-Method Approach

Aim

To investigate the current status of experience and support of nurses as second victims and explore its related factors in nurses.

Design

A sequential, explanatory, mixed-method study was applied.

Methods

A total of 406 nurses from seven tertiary hospitals in China were chosen as participants between September to October 2023. The Chinese version of the Second Victim Experience and Support Questionnaire (SVEST), Somatic Complaints of Sub-health Status Questionnaire (SCSSQ) and Generalized Anxiety Disorder (GAD-7) were applied to collect quantitative data. Eight nurses were selected for a qualitative study through in-depth interviews. Through interpretive phenomenological analysis, the interview data were analysed to explore the experience and support of nurses as second victims.

Results

Practice distress (15.74 ± 4.97) and psychological distress (15.48 ± 3.74) were the highest dimensions, indicating Chinese nurses experienced second victim-related practice and psychological distress. Nurses with different gender, age, education, marital status, income, working hours, professional titles, and unit types have different levels of second victim-related experience and support (p < 0.05). In addition, the score of SVEST was positively associated with SCSSQ (r = 0.444) and GAD-7 (r = 0.490) (p < 0.05). This qualitative study found that the experience and support of nurses as second victims included nurses' perceptions and needs for patient safety events; psychological, physical and practice distress of nurses; and nurses and hospitals coping style after patient safety events.

Discussion

Our findings suggest that nurses who are second victims of patient safety events experience severe practice and psychological distress, indicating that nursing managers should pay attention to psychological and practice distress of nurses after patient safety events and provide effective preventive measures.

Prevalence of the second victim phenomenon among intensive care unit nurses and the support provided by their organizations

BACKGROUND

Health professionals can be 'second victims' of adverse patient events. Second victimhood involves a series of physical and psychological signs and symptoms of varying severity and is most prevalent among nurses and women and in intensive care units (ICUs). Previous research has described personal and organizational coping strategies.

AIM

The objective of this research is to determine the prevalence of second victimhood, focusing on psychological distress, among Chilean adult intensive care nurses and its relationship with the support provided by their organizations.

STUDY DESIGN

A descriptive, correlational and cross-sectional study was conducted in seven intensive care units of Chilean hospitals.

RESULTS

Of a sample of 326 nurses, 90.18% reported having been involved in an adverse event and 67% reported psychological distress resulting from the adverse event. Embarrassment was the most prevalent psychological symptom (69%). Only 2.8% reported that their organization had an action plan for professionals in the event of a serious adverse event. Participants who had spent longer working in an ICU reported more support from their organization around adverse events.

CONCLUSION

Two-thirds of Chilean adult intensive care unit nurses report psychological stress following an adverse event. These results should be assessed internationally because second victims have major implications for the well-being of health professionals and, therefore, for retention and the quality of care.

RELEVANCE TO CLINICAL PRACTICE

Critical care leaders must actively promote a safe environment for learning from adverse events, and hospitals must establish a culture of quality that includes support programmes for second victims.

Response to patient safety incidents in healthcare settings in Ghana: the role of teamwork, communication openness, and handoffs

BACKGROUND

Patient safety incidents (PSIs) in healthcare settings are a critical concern globally, and Ghana is no exception. Addressing PSIs to improve health outcomes requires various initiatives to be implemented including improving patient safety culture, teamwork and communication between healthcare providers during handoffs. It is essential to acknowledge the significance of teamwork, communication openness, and effective handoffs in preventing and managing such incidents. These factors play a pivotal role in ensuring the well-being of patients and the overall quality of healthcare services.

AIM

This study assessed the occurrence and types of PSIs in health facilities in Ghana. It also examined the role of teamwork, handoffs and information exchange, and communication openness in response to PSIs by health professionals.

METHODS

A cross-sectional study was conducted among 1651 health workers in three regions of Ghana. Using a multi-staged sampling technique, the Survey on Patient Safety Culture Hospital Survey questionnaire and the nurse-reported scale were used to collect the data and it was analysed by descriptive statistics, Pearson correlation, and linear multiple regression model at a significance of 0.05.

RESULTS

There was a reported prevalence of PSIs including medication errors (30.4%), wound infections (23.3%), infusion reactions (24.7%), pressure sores (21.3%), and falls (18.7%) at least once a month. There was a satisfactory mean score for responses to adverse events (3.40), teamwork (4.18), handoffs and information exchange (3.88), and communication openness (3.84) among healthcare professionals. Teamwork, handoffs and information exchange and communication openness were significant predictors of response to PSIs, accounting for 28.3% of the variance.

CONCLUSIONS

Effective teamwork, handoffs and information exchange, and communication openness in the healthcare environment are critical strategies to enhance PSI response. Creating a culture that encourages error response through teamwork, communication and handoffs provides healthcare professionals with opportunities for learning and improving patient outcomes. Training programs should therefore target health professionals to improve patient safety and competency. Through the implementation of evidence-based practices and learning from past incidents, the healthcare system will be able to deliver safe and high-quality care to patients nationwide. Patient safety must be recognized as an ongoing process. Therefore, a meaningful improvement in patient outcomes requires all stakeholders' commitment.

Validation and use of the Second Victim Experience and Support Tool questionnaire: a scoping review

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.

Second-victim Experience and Support Desire Among Nurses Working at Regional Levels in China

AIM

To describe and analyse the degree of second victim syndrome and the desire for supports among nurses working in regional hospitals in China.

BACKGROUND

The evidence on the prevalence of second victim among healthcare workers remains inconsistent and have rarely focused on the regional level.

METHODS

A quantitative, descriptive, survey-based, online, cross-sectional study was conducted among 1,194 nurses in three regional hospitals.

RESULTS

A total of 918 (76.88%) nurses, who reported have had experienced patient safety incidents, were selected for the final analysis. The mean score for the Chinese version of the Second Victim Experience and Support Tool (C-SVEST) was (65.58±10.05). Psychological distress (15.91±2.99) and practice distress (15.26±4.32) had the highest score. The mean score for the desired form of support was (4.29±0.614). The option 'the opportunity to get guidance and suggestions for future work' was rated the most desired.

CONCLUSION

Nurses working at the regional level reported a similar degree of second victim experience and support desire, while the prevalence was much higher.

IMPLICATIONS FOR NURSING MANAGEMENT

The second victim phenomenon has become increasingly complex and challenging, and deserve more attention. Not only Safety-I, abut also Safety-II approaches are suggested to integrated to patient safety.

Second-victim experience and support among nurses in mainland China

AIMS

To investigate the experience and support of nurses as second victims in adverse events and explore factors.

BACKGROUND

Adverse events have significant negative influences on healthcare professionals. However, there is still a lack of research on the impacts of individual and event factors.

METHODS

A cross-sectional survey via a self-report electronic questionnaire was sent to approximately 6400 nurses from six tertiary comprehensive hospitals in mainland China. The socio-demographic, adverse event-related information and second-victim experience and support questionnaires were used.

RESULTS

Approximately 2897 (45.26%) of nurses were involved in at least one adverse event that mainly caused psychological distress. Male nurses, Grade I adverse events, public reports and discussions of adverse events were related to the second-victim reaction. Discussing with a respected colleague was the most strongly desired form of support.

CONCLUSIONS

Chinese nurses have reported a high prevalence of psychological reactions. Follow-up studies must consider other potential factors.

IMPLICATIONS FOR NURSING MANAGEMENT

Nursing managers should consider the factors that affect second victims and provide support based on the expectations of nurses. Psychological first-aid and immediate and mid- to long-term support strategies should be provided to help the second victim alleviate distress.