An Evidence and Consensus-Based Definition of Second Victim: A Strategic Topic in Healthcare Quality, Patient Safety, Person-Centeredness and Human Resource Management

Abstract

The concept of second victims (SV) was introduced 20 years ago to draw attention to healthcare professionals involved in patient safety incidents. The objective of this paper is to advance the theoretical conceptualization and to develop a common definition. A literature search was performed in Medline, EMBASE and CINAHL (October 2010 to November 2020). The description of SV was extracted regarding three concepts: (1) involved persons, (2) content of action and (3) impact. Based on these concepts, a definition was proposed and discussed within the ERNST-COST consortium in 2021 and 2022. An international group of experts finalized the definition. In total, 83 publications were reviewed. Based on expert consensus, a second victim was defined as: “Any health care worker, directly or indirectly involved in an unanticipated adverse patient event, unintentional healthcare error, or patient injury and who becomes victimized in the sense that they are also negatively impacted”. The proposed definition can be used to help to reduce the impact of incidents on both healthcare professionals and organizations, thereby indirectly improve healthcare quality, patient safety, person-centeredness and human resource management.

How deep is a problem of second victims for medical staff? A pilot study in Croatia

“…The decisive factor will be how we handle them’, the second victim phenomenon was described by Scott et al 14 in the first empirical study with 31 s victims who were ‘healthcare providers who are involved in an unanticipated adverse patient event, in a medical error and/or a patient related injury and become victimized in the sense that the provider is traumatized by the event’. Recently, this definition has been updated by the ERNST project in accordance to current data, as ‘any health care worker, directly or indirectly involved in an unanticipated adverse patient event, unintentional healthcare error, or patient injury, and becomes victimized in the sense that also the worker is negatively impacted’ [ 15 , p. 6].…”

Second-Victim-Traumatisierungen – Auswirkungen auf Behandelnde und Patienten

“…So werden beispielsweise auch bei Großschadensereignissen vielfach Gesundheitsfachpersonen nachhaltig traumatisiert [3]. Im Jahr 2022 etablierten internationale Expertinnen und Experten des European Researchers' Network Working on Second Victims (ERNST) eine neue internationale evidenz-und konsensbasierte Definition des Begriffs "Second Victim": "Any health care worker, directly or indirectly involved in an unanticipated adverse patient event, unintentional healthcare error, or patient injury and who becomes victimized in the sense that they are also negatively impacted" [4].…”

Support and Recovery Strategies for Second Victims

“…1 An SV is defined as an HCW who is directly or indirectly involved in an unanticipated adverse patient event or injury or unintentional health care error and who becomes victimized in the sense that they are also negatively affected. 2 Evidence suggests that the prevalence of SVs after an error or adverse event can be up to 43.3%. 1,3…”

“…Such errors and adverse events can result in patient harm or death; this makes patients the “first victim.” In addition to the patient, three other groups also can be considered victims of an error or adverse event: health care workers (HCWs), who are considered second victims (SVs); the reputation of the facility (ie, third victim); and patients who can be subsequently harmed (ie, fourth victim) 1 . An SV is defined as an HCW who is directly or indirectly involved in an unanticipated adverse patient event or injury or unintentional health care error and who becomes victimized in the sense that they are also negatively affected 2 . Evidence suggests that the prevalence of SVs after an error or adverse event can be up to 43.3% 1,3 …”