Clinical Nurse Specialist Practice Interventions for Second Victims of Adverse Patient Events

Abstract

Background: Second-victim impact describes emotional suffering that occurs secondary to an adverse patient event and occurs in approximately half of all healthcare providers. Immediate intervention is needed to reduce consequences including nursing turnover, job absenteeism, repeat adverse events, professional burnout, and posttraumatic stress. Purpose: To provide clinical nurse specialists a summary of second-victim impact secondary to adverse patient events, a review of associated negative outcomes, and clinical nurse specialist practice recommendations. Recommendations: Clinical nurse specialist nursing interventions include implementation of validated screening tools, identification of healthcare providers at high risk of second-victim impact, recognition of signs of second-victim impact, facilitating supportive clinical debriefings, providing supporting dialogue, and mentorship through stages of recovery and the institutional response. Clinical nurse specialist organization/system interventions to reduce the consequences of second-victim impact include supporting a culture of safety, leading organizational improvement, as well as advocating for education and support for second victims on the national level. Conclusions: Clinical nurse specialists have the potential to mitigate the effects of second-victim impact associated with adverse patient events and secondary complications through use of evidence-based practice interventions.

Coping strategies in health care providers as second victims: A systematic review

“…In order, the first personal coping mechanism relates to the first stage, that is, error identification. This is usually immediate and, right from that moment, the professional may be unable to continue with direct patient care (Bleazard, 2019). Subsequently, in the second stage, professional self‐reflection occurs, in which repeatedly reviewing the facts and attempting to understand what happened leads to self‐learning.…”

“…Such support programs are valued by health professionals when they are equipped to provide a rapid response (Tamburri, 2017), such as the program documented by the University of Missouri with a team capable of responding 24 h a day and 7 days a week. They also include peer support, which is valued by SVs (Cabilan et al., 2018; Bleazard, 2019; Pratt et al., 2012; Quillivan et al., 2016; Seys et al., 2013) as well as systems for helping professionals to communicate the error to the patient and family, providing support throughout this process (Bleazard 2019; Brandom et al., 2011; Joesten et al., 2015; Lewis et al., 2013; Seys et al., 2013).…”

“…In response to the research question that started this study, of the various coping strategies, peer support is widely preferred by SVs (Cabilan et al., 2018; Bleazard, 2019; Pratt et al., 2012; Quillivan et al., 2016; Seys et al., 2013). Some studies report that the fact that support is provided by strangers is a barrier to the use of support programs (Chan et al., 2017).…”

“…Thus, the implementation of peer “coaches” to support SVs has been well‐appreciated. These coaches must be trained and have the ability to anticipate the steps that the organization follows when investigating adverse events, which reduces the SV's anxiety (Bleazard, 2019; Vanyo et al., 2017).…”

“…The prevalence of the SV phenomenon has been documented in various ways. Some studies report that it occurs in approximately half of health professionals who have to deal with an adverse event in their professional life (Bleazard, 2019). A systematic review found that the prevalence of the SV phenomenon varies from 10.4% to 43.3% and that women are more afraid of losing their professional confidence or reputation than men (Seys et al., 2013).…”