1
|
Kappes M, Romero-Garcia M, Sanchez M, Delgado-Hito P. Coping trajectories of intensive care nurses as second victims: A grounded theory. Aust Crit Care 2024; 37:606-613. [PMID: 38360471 DOI: 10.1016/j.aucc.2024.01.001] [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: 11/21/2023] [Revised: 12/27/2023] [Accepted: 01/03/2024] [Indexed: 02/17/2024] Open
Abstract
A qualitative study that provides evidence of the institutional support required by intensive care unit (ICU) nurses as second victims of adverse events (AEs). BACKGROUND The phenomenon of second victims of AE in healthcare professionals can seriously impact professional confidence and contribute to the ongoing occurrence of AEs in hospitals. OBJECTIVES The objective of this study was to describe the coping trajectories of second victims among nurses working in ICUs in public hospitals in Chile. METHODS Conducting qualitative research through the grounded theory method, this study focused on high-complexity hospitals in Chile, using theoretical sampling. The participants consisted of 11 nurses working in ICUs. Techniques used included in-depth interviews conducted between March and May 2023, as well as a focus group interview. Analysis, following the grounded theory approach proposed by Strauss and Corbin, involved constant comparison of data. Open, axial, and selective coding were applied until theoretical data saturation was achieved. The study adhered to reliability and authenticity criteria, incorporating a reflexive process throughout the research. Ethical approval was obtained from the ethics committee, and the study adhered to the consolidated criteria for reporting qualitative research. RESULTS From the interviews, 29 codes were identified, forming six categories: perception of support when facing an AE, perception of helplessness when facing an AE, initiators of AE, responses when facing an AE, professional responsibility, and perception of AE. The perception of support when facing an AE emerged as the main category, determining whether the outcome was stagnation or overcoming of the phenomenon after the AE. CONCLUSIONS For the coping process of ICU nurses following an AE, the most crucial factor is the support from colleagues and supervisors.
Collapse
Affiliation(s)
- Maria Kappes
- Faculty of Health Care Sciences, Universidad San Sebastian, Puerto Montt, Chile.
| | - Marta Romero-Garcia
- Fundamental and Clinical Nursing Department, Faculty of Nursing, University of Barcelona, Barcelona, Spain; IDIBELL, Bellvitge Biomedical Research Institute, Avinguda de la Granvia, L'Hospitalet de Llobregat, Spain; International Research Project: HU-CI Project, Collado Villalba, Spain.
| | - Maria Sanchez
- Faculty of Health Care Sciences, Universidad San Sebastian, Puerto Montt, Chile.
| | - Pilar Delgado-Hito
- Fundamental and Clinical Nursing Department, Faculty of Nursing, University of Barcelona, Barcelona, Spain; IDIBELL, Bellvitge Biomedical Research Institute, Avinguda de la Granvia, L'Hospitalet de Llobregat, Spain; International Research Project: HU-CI Project, Collado Villalba, Spain.
| |
Collapse
|
2
|
Roesner H, Neusius T, Strametz R, Mira JJ. Economic Value of Peer Support Program in German Hospitals. Int J Public Health 2024; 69:1607218. [PMID: 38939515 PMCID: PMC11208334 DOI: 10.3389/ijph.2024.1607218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 06/04/2024] [Indexed: 06/29/2024] Open
Abstract
Objectives Acknowledging peer support as the cornerstone in mitigating the psychosocial burden arising from the second victim phenomenon, this study assesses the economic benefits of a Peer Support Program (PSP), compared to data of the Resilience In Stressful Events (RISE) program in the US, within the acute inpatient care sector in Germany. Methods Employing a Markov model, this economic evaluation analyzes the cost benefits, including sick day and dropout costs, over a 1-year period, comparing scenarios with and without the Peer Support Program from a hospital perspective. The costs were calculated as an example based on a hospital with 1,000 employees. The estimations are considered conservative. Results The anticipated outcomes demonstrate an average cost saving of €6,672 per healthcare worker participating in the Peer Support Program, leading to an annual budgetary impact of approximately €6,67 Mio. for the studied hospital. Conclusion The integration of a PSP proves economically advantageous for German hospitals, not only preserving financial resources but also reducing absenteeism, and mitigating turnover, thereby enhancing overall patient care.
Collapse
Affiliation(s)
- Hannah Roesner
- Hochschule RheinMain, Wiesbaden, Germany
- Miguel Hernández University of Elche, Elche, Spain
| | | | | | - José Joaquín Mira
- Department of Health Psychology, Miguel Hernández University, Elche, Spain
| |
Collapse
|
3
|
Sugimura N, Ogasawara K. Events related to medication errors and related factors involving nurses’ behavior to reduce medication errors in Japan: a Bayesian network modeling-based factor analysis and scenario analysis. JOURNAL OF EDUCATIONAL EVALUATION FOR HEALTH PROFESSIONS 2024; 21:12. [PMID: 38858820 PMCID: PMC11223988 DOI: 10.3352/jeehp.2024.21.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 06/05/2024] [Indexed: 06/12/2024]
Abstract
PURPOSE This study aimed to identify the relationships between medication errors and the factors affecting nurses’ knowledge and behavior in Japan using Bayesian network modeling. It also aimed to identify important factors through scenario analysis with consideration of nursing students’ and nurses’ education regarding patient safety and medications. METHODS We used mixed methods. First, error events related to medications and related factors were qualitatively extracted from 119 actual incident reports in 2022 from the database of the Japan Council for Quality Health Care. These events and factors were then quantitatively evaluated in a flow model using Bayesian network, and a scenario analysis was conducted to estimate the posterior probabilities of events when the prior probabilities of some factors were 0%. RESULTS There were 10 types of events related to medication errors. A 5-layer flow model was created using Bayesian network analysis. The scenario analysis revealed that “failure to confirm the 5 rights,” “unfamiliarity with operations of medications,” “insufficient knowledge of medications,” and “assumptions and forgetfulness” were factors that were significantly associated with the occurrence of medical errors. Conclusion This study provided an estimate of the effects of mitigating nurses’ behavioral factors that trigger medication errors. The flow model itself can also be used as an educational tool to reflect on behavior when incidents occur. It is expected that patient safety education will be recognized as a major element of nursing education worldwide and that an integrated curriculum will be developed.
Collapse
Affiliation(s)
- Naotaka Sugimura
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Katsuhiko Ogasawara
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
- Graduate School of Engineering, Muroran Institute of Technology, Muroran, Japan
| |
Collapse
|
4
|
Frietsch T, Rondinelli MB, Levy JH. Congratulation, Appraisal, and Comment on the 25 Years Anniversary of Serious Hazards of Blood Transfusion. Transfus Med Hemother 2024; 51:193-197. [PMID: 38867812 PMCID: PMC11166404 DOI: 10.1159/000532049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 07/17/2023] [Indexed: 06/14/2024] Open
Affiliation(s)
- Thomas Frietsch
- German Task Force for Clinical Hemotherapy IAKH and the German National Error Registry for Hemotherapy, Marburg, Germany
| | - Maria B. Rondinelli
- UOC Medicina Trasfusionale e Cellule staminali, IAO San Camillo-Forlanini, Rome, Italy
| | - Jerrold H. Levy
- Department of Anesthesiology, Critical Care and Surgery (Cardiothoracic), Duke University School of Medicine, Durham, NC, USA
| |
Collapse
|
5
|
Catalán L, Kappes M, Morgado G, Oliveira D. Ethical issues in research with second victims: A scoping review. Nurs Ethics 2024:9697330241238345. [PMID: 38476037 DOI: 10.1177/09697330241238345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
BACKGROUND Second victim is the name given to the healthcare personnel-most often a nursing professional-involved with the error that led to the adverse event to a patient and who, as a result, have experienced negative psychological effects. Research with second victims has increased over the years, however concerns exist with regards to the ethical risks imposed upon these individuals. AIM To explore the extent to which research with second victims of adverse events in healthcare settings adhere to ethical requirements. METHODS A scoping review was conducted following Arksey and O'Malley's methodological framework and using the following databases: PUBMED, Web of Science, and SCOPUS. Original research of any study design focused on second victims and published in English, Spanish, or Portuguese in 2014-2023 were included. A critical narrative approach was used to discuss the findings. ETHICAL CONSIDERATIONS The review followed ethical guidelines emphasizing accurate authorship attribution and truthful data reporting. RESULTS Fifteen studies using qualitative (n = 2), quantitative (n = 10), and mixed-method (n = 3) designs were included. Over half were not assessed by a research ethics committee, with questionable reasons given by the authors. One-third did not refer to having used an informed consent. In two studies, participants were recruited by their workplace superiors, which could potentially right to autonomy and voluntary participation. CONCLUSION Over half of the included studies with second victims did not comply with fundamental ethical aspects, with risk to inflict respect for individual autonomy, confidentiality, and of not causing any harm to participants. IMPLICATIONS FOR NURSING RESEARCH Healthcare personnel involved in adverse events are most often nursing professionals; therefore, any breach of ethics in research with this population is likely to directly affect their rights as research participants. We provide recommendations to promote better research practices with second victims towards safeguarding their rights as research participants.
Collapse
Affiliation(s)
| | | | | | - Déborah Oliveira
- Universidad Andres Bello
- Millennium Institute for Care Research (MICARE)
| |
Collapse
|
6
|
Tang W, Xie Y, Yan Q, Teng Y, Yu L, Wei L, Li J, Chen Y, Huang X, Yang S, Jia K. Exploring the Experiences and Support of Nurses as Second Victims After Patient Safety Events in China: A Mixed-Method Approach. Risk Manag Healthc Policy 2024; 17:573-586. [PMID: 38501130 PMCID: PMC10944798 DOI: 10.2147/rmhp.s451766] [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: 11/25/2023] [Accepted: 02/29/2024] [Indexed: 03/20/2024] Open
Abstract
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.
Collapse
Affiliation(s)
- Wenzhen Tang
- The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People’s Republic of China
| | - Yuanxi Xie
- The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People’s Republic of China
| | - Qingfeng Yan
- The Sanming Second Hospital, Sanming, Fujian Province, 366099, People’s Republic of China
| | - Yanjuan Teng
- The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People’s Republic of China
| | - Li Yu
- The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People’s Republic of China
| | - Liuying Wei
- Nanning Fourth People’s Hospital, Nanning, Guangxi Zhuang Autonomous Region, 530021, People’s Republic of China
| | - Jinmei Li
- Wanxiu District Chengnan Community Health Service Center, Wuzhou, Guangxi Zhuang Autonomous Region, 543000, People’s Republic of China
| | - Yuhui Chen
- The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People’s Republic of China
| | - Xiaolin Huang
- The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People’s Republic of China
| | - Shaoli Yang
- The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People’s Republic of China
| | - Kui Jia
- The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People’s Republic of China
| |
Collapse
|
7
|
Kappes M, Delgado-Hito P, Contreras VR, Romero-García M. Prevalence of the second victim phenomenon among intensive care unit nurses and the support provided by their organizations. Nurs Crit Care 2023; 28:1022-1030. [PMID: 37614030 DOI: 10.1111/nicc.12967] [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: 04/01/2023] [Revised: 07/24/2023] [Accepted: 08/04/2023] [Indexed: 08/25/2023]
Abstract
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.
Collapse
Affiliation(s)
- Maria Kappes
- Faculty of Health Care Sciences, Universidad San Sebastian, Puerto Montt, Chile
| | - Pilar Delgado-Hito
- Fundamental and Clinical Nursing Department, Faculty of Nursing, University of Barcelona, Barcelona, Spain
- IDIBELL, Bellvitge Biomedical Research Institute, Avinguda de la Granvia, L'Hospitalet de Llobregat, Spain
- International Research Project: Proyecto HU-CI, Collado Villalba, Spain
| | | | - Marta Romero-García
- Fundamental and Clinical Nursing Department, Faculty of Nursing, University of Barcelona, Barcelona, Spain
- IDIBELL, Bellvitge Biomedical Research Institute, Avinguda de la Granvia, L'Hospitalet de Llobregat, Spain
- International Research Project: Proyecto HU-CI, Collado Villalba, Spain
| |
Collapse
|
8
|
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.
Collapse
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
| |
Collapse
|
9
|
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: 0] [Impact Index Per Article: 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.
Collapse
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
| |
Collapse
|
10
|
Cohen R, Sela Y, Halevi Hochwald I, Nissanholz-Gannot R. Nurses' Silence: Understanding the Impacts of Second Victim Phenomenon among Israeli Nurses. Healthcare (Basel) 2023; 11:1961. [PMID: 37444795 DOI: 10.3390/healthcare11131961] [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: 06/09/2023] [Revised: 07/05/2023] [Accepted: 07/05/2023] [Indexed: 07/15/2023] Open
Abstract
INTRODUCTION The 'second victim' phenomenon, (SVP) refers to a health professional who was involved in an adverse event (AE) and continues to suffer from the event to the detriment of personal and professional functioning. The second victims' natural history of recovery model predicts stages of the phenomenon from AE occurrence until the 'moving on' stage and serves as a suitable structure for many organizational support programs worldwide. PURPOSE Using the second victims' natural history of recovery model to examine the impact of the SVP on Israeli nurses, with a specific focus on the organizational support they felt they required compared with the support they felt that they had received from their organizations. METHODS Fifteen in-depth interviews were conducted, using a semi-structured questionnaire, among nurses who had experienced the SVP. The interviews were recorded subject to the interviewees' consent, transcribed, and analyzed using thematic content analysis. FINDINGS Throughout all six stages of recovery, all interviewees reported physical and emotional manifestations following exposure to an AE, regardless of the type of event or severity. They also reported difficulty in emotion regulation, as well as damage to functioning and overall quality of life. Most of the nurse interviewees reported a need to share the events with someone, but, despite this desire to receive appropriate support, almost none of them proactively requested help from a professional source, nor did their organizational management initiate proactive support. This lack of referral for further assistance is possibly explained through limited awareness of the SVP as a valid response to an AE, a perceived lack of legitimacy to receive organizational support, and personal barriers that accompany the phenomenon. CONCLUSIONS Appropriate organizational support, offered proximal to an AE as well as over time, is essential for the nurse, the patient, and the organization. Personal barriers, together with limited awareness, may challenge the identification and provision of appropriate assistance. Hence, it is important to address the phenomenon as part of the general organizational policy to improve the quality of care and patient safety.
Collapse
Affiliation(s)
- Rinat Cohen
- Department of Health Systems Management, Ariel University, Ariel 4076405, Israel
- Nursing Department, Ramat Gan Academic College, Ramat Gan 5211401, Israel
| | - Yael Sela
- Nursing Department, Faculty of Social and Community Sciences, Ruppin Academic Center, Emeq-Hefer 4025000, Israel
| | - Inbal Halevi Hochwald
- School of Nursing, Max Stern Yezreel Valley College, The Yezreel Valley, Emeq Yezreel 1930600, Israel
| | - Rachel Nissanholz-Gannot
- Department of Health Systems Management, Ariel University, Ariel 4076405, Israel
- Smokler Center for Health Policy Research, Meyers-JDC-Brookdale Institute, Jerusalem 9103702, Israel
| |
Collapse
|
11
|
Jung SJ, Song JE, Bae SH, Lee Y, Gwon SH, Park JH. Simulation-based training program on patient safety management: A quasi-experimental study among new intensive care unit nurses. NURSE EDUCATION TODAY 2023; 126:105823. [PMID: 37080013 DOI: 10.1016/j.nedt.2023.105823] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 04/10/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Patient safety is an essential responsibility of nurses. However, newly graduated nurses experience patient safety incidents due to a lack of patient safety competency. In particular, intensive care unit nurses provide care to critical patients, making it difficult for new nurses to maintain patient safety. Therefore, it is necessary to improve the patient safety competency of newly graduated nurses working in the intensive care unit. OBJECTIVES To analyze the effects of a simulation-based training program on patient safety management on the patient safety competency, patient safety management activity, communication self-efficacy, and teamwork of newly graduated nurses working in an intensive care unit. DESIGN A quasi-experimental study. SETTINGS The study was conducted at a university in Korea. PARTICIPANTS A total of 44 newly graduated nurses working in the intensive care unit of a university hospital. METHODS A simulation-based training program on patient safety management was applied to the experimental group (n = 22), while only the usual hospital training program was used for the control group (n = 22). A structured questionnaire survey comprising Patient Safety Competency Self-Evaluation, Patient Safety Management Activities, the Korean version of the self-efficacy questionnaire, and K-self assessment of teamwork was conducted at baseline test (T1), post test (T2), and follow-up test (T3). Data were analyzed using a repeated measures ANOVA. RESULTS The experimental group showed significantly higher patient safety competency, patient safety knowledge, and patient safety skills, along with higher communication self-efficacy scores than the control group (p < .05) after the intervention and at four weeks after the intervention. CONCLUSIONS The simulation-based training program on patient safety management effectively improved the patient safety competency, patient safety knowledge, and patient safety skills as well as communication self-efficacy of newly graduated nurses working in an intensive care unit.
Collapse
Affiliation(s)
- Su Jin Jung
- College of Nursing Research Institute of Nursing Science, Ajou University, Suwon, Republic of Korea
| | - Ju-Eun Song
- College of Nursing Research Institute of Nursing Science, Ajou University, Suwon, Republic of Korea
| | - Sun Hyoung Bae
- College of Nursing Research Institute of Nursing Science, Ajou University, Suwon, Republic of Korea
| | - Youngjin Lee
- College of Nursing Research Institute of Nursing Science, Ajou University, Suwon, Republic of Korea
| | - Seok Hyun Gwon
- College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Jin-Hee Park
- College of Nursing Research Institute of Nursing Science, Ajou University, Suwon, Republic of Korea.
| |
Collapse
|
12
|
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.
Collapse
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
| |
Collapse
|
13
|
Sugimura N, Sato M, Sumi N, Yano R. Validity and reliability of the Japanese version of the Nursing Performance Instrument. Jpn J Nurs Sci 2022; 20:e12518. [PMID: 36344443 DOI: 10.1111/jjns.12518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/07/2022] [Accepted: 10/05/2022] [Indexed: 11/09/2022]
Abstract
AIM Work performance of nurses is a critical aspect that concerns the safety of both nurses and patients, but also secondarily influences nurses' turnover due to serious fatigue and burnout. Monitoring nursing performance as well as fatigue is important for appropriate safety management of patients and nurses, and the development of a monitoring tool is essential. The Nursing Performance Instrument (NPI) can provide comprehensive and brief monitoring of nursing performance. This study aimed to verify the validity and reliability of a Japanese version of the NPI (NPI-J). METHODS A cross-sectional study was conducted on nurses who work in inpatient care across five Japanese hospitals. We considered appropriate factor numbers with parallel analysis and the Velicer's minimum average partial test. The construct validity was evaluated using exploratory factor analysis, confirmatory factor analysis (CFA), and Pearson's correlation analysis. Cronbach's alpha was calculated for the internal consistency. RESULTS A three-factor model eventually showed acceptable fit indices in the CFA. Moreover, the correlation results among the three factors indicated discriminant validity comparable to the original NPI. The correlation results with acute fatigue, chronic fatigue, and burnout verified convergent validity. Internal consistency was insufficient. CONCLUSION The NPI-J demonstrated acceptable construct validity. This instrument can assess nurses' perceptions of their performance by measuring each item. Future work on the reliability of the sub-concepts will require additional items or reliability testing based on generalizability theory and item response theory.
Collapse
Affiliation(s)
- Naotaka Sugimura
- Graduate School of Health Sciences Hokkaido University Sapporo Japan
| | - Miho Sato
- Faculty of Health Sciences Hokkaido University Sapporo Japan
| | - Naomi Sumi
- Faculty of Health Sciences Hokkaido University Sapporo Japan
| | - Rika Yano
- Faculty of Health Sciences Hokkaido University Sapporo Japan
| |
Collapse
|
14
|
Riegel M, Klemm V, Bushuven S, Strametz R. Self-Stigmatization of Healthcare Workers in Intensive Care, Acute, and Emergency Medicine. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14038. [PMID: 36360916 PMCID: PMC9655018 DOI: 10.3390/ijerph192114038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/21/2022] [Accepted: 10/23/2022] [Indexed: 06/16/2023]
Abstract
This quantitative study examines whether employees in the fields of intensive care or acute and emergency medicine experience psychological distress because of their daily work. In addition, it was examined if self-stigmatization tendencies can significantly influence the willingness to seek help, and therefore psychological problems are not being treated adequately. These problems lead to various difficulties in professional and private contexts and ultimately endanger patient safety. From May to June 2021, an online questionnaire survey was conducted. This questionnaire combined two validated measuring instruments (PHQ-D and SSDS). To ensure high participation, the departments of anesthesia and/or intensive care medicine in 68 German hospitals were contacted, of which 5 responded positively. A total of 244 people participated in the questionnaire survey. On average, depressive symptoms were of mild severity. At the same time, self-stigmatization regarding depressive symptoms was high. These results highlight the practical need to prepare staff who work in the field of intensive care or acute and emergency medicine at the early onset for potentially traumatic and emotionally demanding events during their university education or studies. Adequate, evaluated, and continuously available support services from the psychosocial field should become an integral part of every staff care structure.
Collapse
Affiliation(s)
- Maike Riegel
- Institut für Mensch, Arbeit und Psychologie (IMAP), Rennenbergstraße 3, 53639 Königswinter, Germany
| | - Victoria Klemm
- Wiesbaden Institute for Healthcare Economics and Patient Safety (WiHelP), Wiesbaden Business School, RheinMain UAS, Bleichstr. 44, 65183 Wiesbaden, Germany
| | - Stefan Bushuven
- Institute for Infection Control and Infection Prevention, Hegau-Jugendwerk Gailingen, Health Care Association District of Constance, 78224 Singen, Germany
- Institute of Medical Education, University Hospital, LMU Munich, 80336 Munich, Germany
- Department of Anesthesiology and Critical Care, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79085 Freiburg im Breisgau, Germany
| | - Reinhard Strametz
- Wiesbaden Institute for Healthcare Economics and Patient Safety (WiHelP), Wiesbaden Business School, RheinMain UAS, Bleichstr. 44, 65183 Wiesbaden, Germany
| |
Collapse
|
15
|
Understanding Moral Distress among Eldercare Workers: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159303. [PMID: 35954662 PMCID: PMC9368675 DOI: 10.3390/ijerph19159303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/18/2022] [Accepted: 07/21/2022] [Indexed: 02/04/2023]
Abstract
The aging of the population in Western countries will increase the use of social and health services in the future. Employees in eldercare are at risk for experiencing moral distress, which is associated with poor work ability. The causes and consequences of moral distress among eldercare workers remain undiscovered. This scoping review investigates the existing studies of causes and consequences of moral distress among eldercare workers. Additionally, it seeks evidence of interventions designed to mitigate moral distress in eldercare workers. Fourteen studies were included in the final review. Most of the included studies were qualitative, aiming to increase understanding of morally challenging situations in eldercare. We also found quantitative studies with cross-sectional designs and small sample sizes. Thus, no reliable evidence of causal effects between moral distress and worker wellbeing in eldercare was found. We found no interventions undertaken to resolve moral distress among eldercare workers, either. More research is needed on the causes and consequences of moral distress and on interventions to mitigate moral distress among eldercare workers. This is of utmost importance to increase the attractiveness of eldercare as a workplace and to improve eldercare workers’ ability to work and sustain long working careers.
Collapse
|