The second victim phenomenon in health care: A literature review

Abstract

Aim: This study aimed to explore the knowledge on the second victim phenomenon (SVP) in health care, more specifically within the speciality of obstetrics. Methods: An extensive electronic search of multiple databases, with additional hand searching of the reference lists of pertinent articles regarding the SVP, was performed from May 2017 to December 2018. Results: A review of the literature suggests consistent evidence of the substantial impact of adverse medical events on health-care professionals across a range of specialities. The effects of an adverse medical event for the health-care professional are ominous, with many experiencing feelings of sadness, guilt and anxiety, as well as some displaying symptoms consistent with post-traumatic stress disorder. Negative effects may be exacerbated for health-care professionals in the case of an adverse maternal event due to its highly sensitive and dramatic nature, involving both maternal and neonatal lives. The provision of timely and effective support at the individual and more specifically the organisational level has been positively correlated with a second victim’s recovery. Yet, limited organisations have formal support interventions designed specifically for the needs of the second victim. Conclusions: It is evident that the consequences of adverse medical events on health-care professionals can be intense and numerous. The unique nature and high sensitivities surrounding obstetric care have the potential to exacerbate the negative consequences for the health-care professional following an adverse event. Still, there remains a dearth of information of the extent of adverse medical events and the SVP in the speciality of obstetrics.

Strategies to support health professionals in the condition of second victim: scoping review

“…In view of the results involving informal support strategies (6)(7)(13)(14)16,30,32,34,42,44,47,49,(59)(60)(61)(66)(67)(68)(69)(70)(71)(72)(73)(74)(75)(76)(77) , interpersonal relationships were reported in the studies more often, involving colleagues, spouses and friends, either by understanding the dynamics of work or the ease of expressing their feelings. Additionally, support from the multidisciplinary team of the department or unit, leaders/supervisors, risk managers and the governing body of the hospital was mentio ned (6,9,15,29,33,(43)(44)55,59,61,(65)(66)68,70,(75)(76) , In addition, it was mentioned that the disclosure of the AE to the patient/family served as a source of support (29,33,42,(58)…”

“…• Support from managers at all levels, counselors or therapist, department/unit or institution and psychological support (6,9,15,29,33,(43)(44)55,59,61,(65)(66)68,70,(75)(76) • Website Mitigating Impact in Second Victims (MISE) (39,(42)(43)(50)(51) • Second Victim Support Unit (USVIC) (62) • Coping strategies (13,16,(23)(24)(25)30,35,44,46,61,(63)(64) • Support from co-workers, spouse, family members, friends and multidisciplinary team ( 6,13,16,30,42,44,58,61,66,77) • Training and learning from error (24,42,(67)(68)71,…”

“…The fact of revealing the error with an apology to the patient/family (29,33,42,(58)(59)61) and talking to another person about the event (44,69,71,73) was also shown as support source.…”

“…Another aspect of this category was the conception that some studies addressed interventions and actions based on strategies with an emphasis on the problem and on emotion/cognition (35,(42)(43)61,63) and coping strategies, among them reflective writing (7,25) , temporary leave from work (33,55) , selfpunishment, self-defense or fact denial (27,35,55,63,66,71) and depersonalization (55) . Learning with error (42,(67)(68)71,(75)(76) , positive feedback (24,42) , proactive education (74) and the participation of the second victim in the AE root cause analysis process, in the construction of action plans and in the validation of the decision-making process to avoid future incidents (71,76) were also mentioned as a source of support for training.…”

What Ibero-American hospitals do when things go wrong? A cross-sectional international study

“…These results draw a scenario in which while promoting incident reporting and in-deep analysis to avoid future occurrences, patients are not encouraged to be informed so that they have the opportunity to receive fair compensation after suffering a severe AE. Additionally, if we consider the results of other studies that have shown that, at some point in their professional careers, most professionals will have made a medical error [17][18][19][20]. It means that, in most of these hospitals, this reality is ignored and no action is planned to alleviate the consequences that failures and errors have on the quality of care, despite having proposals on how to deal with this phenomenon for some time [21][22][23].…”