Personal, situational and organizational aspects that influence the impact of patient safety incidents: A qualitative study.
OBJECTIVE
When a patient safety incident (PSI) occurs, not only the patient, but also the involved health professional can suffer. This study focused on this so-called "second victim" of a patient safety incident and aimed to examine: (1) experienced symptoms in the aftermath of a patient safety incident; (2) applied coping strategies; (3) the received versus needed support and (4) the aspects that influenced whether one becomes a second victim.


METHODS
Thirty-one in-depth interviews were performed with physicians, nurses and midwives who have been involved in a patient safety incident.


RESULTS
The symptoms were categorized under personal and professional impact. Both problem focused and emotion focused coping strategies were used in the aftermath of a PSI. Problem focused strategies such as performing a root cause analysis and the opportunity to learn from what happened were the most appreciated, but negative emotional responses such as repression and flight were common. Support from colleagues and supervisors who were involved in the same event, peer supporters or professional experts were the most needed. A few individuals described emotional support from the healthcare institution as unwanted. Rendered support was largely dependent on the organizational culture, a stigma remained among healthcare professionals to openly discuss patient safety incidents. Three aspects influenced the extent to which a healthcare professional became a second victim: personal, situational and organizational aspects.


CONCLUSIONS
These findings indicated that a multifactorial approach including individual and emotional support to second victims is crucial.
Leuven Institute for Healthcare Policy, KU Leuven, Leuven, Belgium.
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Van Gerven
Leuven Institute for Healthcare Policy, KU Leuven, Leuven, Belgium.
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Deweer
Patient Safety and Risk Management, University of Missouri Health Care, Columbia, MO, USA.
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Scott
Amadeo Avogadro University of Eastern Piedmont, Faculty of Medicine, Novara, Italy.
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Panella
Occupational & Organizational Psychology and Professional Learning, KU Leuven, Leuven, Belgium.
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Euwema
Leuven Institute for Healthcare Policy, KU Leuven, Leuven, Belgium.
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Sermeus
Leuven Institute for Healthcare Policy, KU Leuven, Leuven, Belgium; University Hospitals Leuven & Flemish Hospital Network - KU Leuven, Leuven, Belgium. Electronic address: kris.vanhaecht@med.kuleuven.be.
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Vanhaecht
D000059:Accidents / Q000523:psychology*; D000223:Adaptation, Psychological; D000328:Adult; D004644:Emotions; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D019300:Medical Errors / Q000523:psychology*; D009721:Nurse Midwives / Q000523:psychology; D009726:Nurses / Q000523:psychology; D015279:Organizational Culture; D061214:Patient Safety; D010820:Physicians / Q000523:psychology; D036301:Qualitative Research; D057545:Social Stigma; D012944:Social Support; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology*
Comadronas; Enfermeras; Errores médicos; Medical errors; Médicos; Nurse midwives; Nurses; Patient safety; Physicians; Second victim; Segunda víctima; Seguridad del paciente