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The Second Victim Phenomenon: Implications and Solutions to Support Health Worker Safety

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences & Services".

Deadline for manuscript submissions: closed (22 March 2023) | Viewed by 12209

Special Issue Editors


E-Mail Website1 Website2
Guest Editor
1. German Coalition for Patient Safety (Aktionsbuendnis Patientensicherheit e.V.), Alte Jakob Str. 81, 10179 Berlin, Germany
2. Wiesbaden Business School, Rhein Main University of Applied Science, 65183 Wiesbaden, Germany
Interests: patient safety; clinical risk management; quality of care; resilience and psychosocial support for health care workers; second victim phenomenon

E-Mail Website
Guest Editor
Faculty of Social Services and Health Care, LAB University of Applied Sciences, 53850 Lappeenranta, Finland
Interests: learning about patient safety; action after adverse events; second victim phenomenon; psychological safety and support

Special Issue Information

Dear Colleagues,

Healthcare is associated with a relevant risk that may lead to avoidable harm of patients and their next of kin, the so-called first victims who should be supported best to cope with this situation. However, healthcare providers may also be harmed due to this event, needing support to move on. Albert Wu coined the term “second victim” (Wu, 2000) for those “health care provider[s] involved in an unanticipated adverse patient event, medical error and/or a patient related-injury who become victimized in the sense that the provider is traumatized by the event” (Scott, 2010).

Being a second victim may lead to dysfunctional coping strategies, reducing both health worker wellbeing and safety of care for further patients of affected healthcare workers. Although research indicates that second victim traumatization is a common phenomenon among all healthcare workers, this topic is still regarded as taboo in many healthcare organizations. leading to stigmatization and discrimination of those suffering from being traumatized as second victims.

Second victim traumatization is clearly a common work-related trauma for healthcare workers, urging occupational medicine to foster knowledge about this phenomenon and development and implementation of evidence-based support programs to be available for all healthcare workers if needed. While somatic health worker safety has led to enormous improvement for health worker safety, it is now time to build up and distribute psychological PPE.

Papers adding relevant knowledge to all aspects of the second victim phenomenon are invited to this Special Issue.

Prof. Dr. Reinhard Strametz
Dr. Susanna Tella
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • second victim
  • health worker safety
  • patient safety
  • psychological support
  • resilience in health care

Published Papers (5 papers)

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Research

15 pages, 2515 KiB  
Article
First Results of Peer Training for Medical Staff—Psychosocial Support through Peer Support in Health Care
by Dominik Hinzmann, Marion Koll-Krüsmann, Andrea Forster, Andreas Schießl, Andreas Igl and Susanne Katharina Heininger
Int. J. Environ. Res. Public Health 2022, 19(24), 16897; https://doi.org/10.3390/ijerph192416897 - 16 Dec 2022
Viewed by 1459
Abstract
Background: In view of the increasing strain on health workers, psychosocial support measures are becoming more important. The core of a sustainable concept is the establishment of peer support teams. Two aspects are central: first, target group-specific training content, and second, suitable staff [...] Read more.
Background: In view of the increasing strain on health workers, psychosocial support measures are becoming more important. The core of a sustainable concept is the establishment of peer support teams. Two aspects are central: first, target group-specific training content, and second, suitable staff members who are trained as peers. The goal of the study was to obtain a first look at what content can be taught in peer training for medical staff, how the training is evaluated by the target group, and which people are interested in training from peers. Methods: During the period 2017–2022, Peer Training for medical staff was developed by a non-profit institution in Germany with state funding and the support of a medical professional association and evaluated during the project. Participants (N = 190) in the Peer Training course were interviewed in advance about their experiences and stresses at work using an anonymous questionnaire. After completing the training modules, the participants filled out an evaluation form. Results: The participants of the Peer Training were predominantly female (70.5%) and middle-aged (between 31 and 50 years old). Most (80.3%) experienced stressful events themselves, mostly without any preparation (93.5%) or follow-up (86.8%) by the employer. The participants estimate their workload in the medium range. The proportion of stressed individuals among the participants was below that of various comparison groups as available reference values. The training module itself was evaluated very positively. Conclusions: The content and framework parameters of the training were rated very well. There is a high degree of fit with the requirements in the health sector. The participants in the Peer Training seem to represent a good cross-section of the target group medical staff, also regarding their own experiences, seem to have a good psychological constitution and are therefore very suitable to work as peers after the training. Full article
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9 pages, 659 KiB  
Article
Second Victim Support at the Core of Severe Adverse Event Investigation
by Angel Cobos-Vargas, Pastora Pérez-Pérez, María Núñez-Núñez, Eloísa Casado-Fernández and Aurora Bueno-Cavanillas
Int. J. Environ. Res. Public Health 2022, 19(24), 16850; https://doi.org/10.3390/ijerph192416850 - 15 Dec 2022
Cited by 7 | Viewed by 1794
Abstract
There is limited evidence and a lack of standard operating procedures to address the impact of serious adverse events (SAE) on healthcare workers. We aimed to share two years’ experience of a second victim support intervention integrated into the SAE management program conducted [...] Read more.
There is limited evidence and a lack of standard operating procedures to address the impact of serious adverse events (SAE) on healthcare workers. We aimed to share two years’ experience of a second victim support intervention integrated into the SAE management program conducted in a 500-bed University Hospital in Granada, Spain. The intervention strategy, based on the “forYOU” model, was structured into three levels of support according to the degree of affliction and the emotional needs of the professionals. A semi-structured survey of all workers involved in an SAE was used to identify potential second victims. Between 2020 and 2021, the SAE operating procedure was activated 23 times. All healthcare workers involved in an SAE (n = 135) received second-level support. The majority were physicians (51.2%), followed by nurses (26.7%). Only 58 (43.0%) received first-level emotional support and 47 (34.8%) met “second victim” criteria. Seven workers (14.9%) required third-level support. A progressive increase in the notification rates was observed. Acceptance of the procedure by professionals and managers was high. This novel approach improved the number of workers reached by the trained staff; promoted the visibility of actions taken during SAE management and helped foster patient safety culture in our setting. Full article
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11 pages, 593 KiB  
Article
Calling for Help—Peer-Based Psychosocial Support for Medical Staff by Telephone—A Best Practice Example from Germany
by Dominik Hinzmann, Andrea Forster, Marion Koll-Krüsmann, Andreas Schießl, Frederick Schneider, Tanja Sigl-Erkel, Andreas Igl and Susanne Katharina Heininger
Int. J. Environ. Res. Public Health 2022, 19(23), 15453; https://doi.org/10.3390/ijerph192315453 - 22 Nov 2022
Cited by 2 | Viewed by 1213
Abstract
Background: A telephone support hotline (PSU-HELPLINE) was established at the beginning of the pandemic due to the burden on health professionals and the lack of support at the workplace. The aim of this study was to evaluate the telephone support service for health [...] Read more.
Background: A telephone support hotline (PSU-HELPLINE) was established at the beginning of the pandemic due to the burden on health professionals and the lack of support at the workplace. The aim of this study was to evaluate the telephone support service for health professionals in terms of its burden, benefits, and mechanisms of action. Methods: Data collection was conducted during and after calls by PSU-HELPLINE counsellors. In addition to the socio-demographic data evaluation, burdens of the callers and the benefits of the calls were collected. The content-analytical evaluation of the stresses as well as the effect factors were based on Mayring’s (2022). Results: Most of the callers were highly to very highly stressed. The usefulness of the conversation was rated as strong to very strong by both callers and counsellors. The PSU-HELPLINE was used primarily for processing serious events and in phases of overload. The support work was carried out through the following aspects of so-called effect factors, among others: psychoeducation, change of perspective, resource activation, problem actualization, connectedness, information, problem solving, self-efficacy, and preservation of resources. Conclusions: The expansion of local peer support structures and the possibility of a telephone helpline are recommended. Further research is needed. Full article
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19 pages, 419 KiB  
Article
Addressing Acute Stress among Professionals Caring for COVID-19 Patients: Lessons Learned during the First Outbreak in Spain (March–April 2020)
by José Joaquín Mira, Ángel Cobos-Vargas, Maria Pilar Astier-Peña, Pastora Pérez-Pérez, Irene Carrillo, Mercedes Guilabert, Virtudes Pérez-Jover, Cesar Fernández-Peris, María Asunción Vicente-Ripoll, Carmen Silvestre-Busto, Susana Lorenzo-Martínez, Jimmy Martin-Delgado, Carlos Aibar and Jesús Aranaz
Int. J. Environ. Res. Public Health 2021, 18(22), 12010; https://doi.org/10.3390/ijerph182212010 - 16 Nov 2021
Cited by 9 | Viewed by 2728
Abstract
Objectives: To describe lessons learned during the first COVID-19 outbreak in developing urgent interventions to strengthen healthcare workers’ capacity to cope with acute stress caused by health care pressure, concern about becoming infected, despair of witnessing patients’ suffering, and critical decision-making requirements [...] Read more.
Objectives: To describe lessons learned during the first COVID-19 outbreak in developing urgent interventions to strengthen healthcare workers’ capacity to cope with acute stress caused by health care pressure, concern about becoming infected, despair of witnessing patients’ suffering, and critical decision-making requirements of the SARS-CoV-2 pandemic during the first outbreak in Spain. Methods: A task force integrated by healthcare professionals and academics was activated following the first observations of acute stress reactions starting to compromise the professionals’ capacity for caring COVID-19 patients. Literature review and qualitative approach (consensus techniques) were applied. The target population included health professionals in primary care, hospitals, emergencies, and nursing homes. Interventions designed for addressing acute stress were agreed and disseminated. Findings: There are similarities in stressors to previous outbreaks, and the solutions devised then may work now. A set of issues, interventions to cope with, and their levels of evidence were defined. Issues and interventions were classified as: adequate communication initiative to strengthen work morale (avoiding information blackouts, uniformity of criteria, access to updated information, mentoring new professionals); resilience and recovery from physical and mental fatigue (briefings, protecting the family, regulated recovery time during the day, psychological first aid, humanizing care); reinforce leadership of intermediate commands (informative leadership, transparency, realism, and positive messages, the current state of emergency has not allowed for an empirical analysis of the effectiveness of proposed interventions. Sharing information to gauge expectations, listening to what professionals need, feeling protected from threats, organizational flexibility, encouraging teamwork, and leadership that promotes psychological safety have led to more positive responses. Attention to the needs of individuals must be combined with caring for the teams responsible for patient care. Conclusions: Although the COVID-19 pandemic has a more devastating effect than other recent outbreaks, there are common stressors and lessons learned in all of them that we must draw on to increase our capacity to respond to future healthcare crises. Full article
15 pages, 625 KiB  
Article
Prevalence of Second Victims, Risk Factors, and Support Strategies among German Nurses (SeViD-II Survey)
by Reinhard Strametz, Johannes C. Fendel, Peter Koch, Hannah Roesner, Max Zilezinski, Stefan Bushuven and Matthias Raspe
Int. J. Environ. Res. Public Health 2021, 18(20), 10594; https://doi.org/10.3390/ijerph182010594 - 10 Oct 2021
Cited by 23 | Viewed by 2799
Abstract
Background: Second victim phenomena (SVP) are critical to workplace and patient safety, and epidemiological data are limited to investigate the causes and impact on German health care. We investigated SVP in German nurses regarding prevalence, causes, and predisposition compared to a preceding study [...] Read more.
Background: Second victim phenomena (SVP) are critical to workplace and patient safety, and epidemiological data are limited to investigate the causes and impact on German health care. We investigated SVP in German nurses regarding prevalence, causes, and predisposition compared to a preceding study on German physicians (Second Victims in Deutschland/SeViD-I). Methods: We conducted a nationwide anonymous cross-sectional online study in 2020 using a modified SeViD questionnaire including the BFI-10 (personality traits). Statistical analysis was conducted using chi² tests and binary logistic regression models. Results: Of 332 nurses, 60% reported to experience SVP at least once a working lifetime, with a 12-month prevalence among SVP of 49%. Of the nurses, 24% reported recovery times of more than 1 year. In contrast to physicians from SeViD-I, a main cause for becoming a second victim was aggressive behavior by patients. High neuroticism values, higher age, and medium work life experience, but neither gender nor workplace position, were predisposing for SVP. Like SeViD-I, nurses reported demand for an institutional response in cases of SVP. Conclusions: SVP is common among German nurses and comprises other causes and a different course than in physicians. Further research should concentrate on specific prevention strategies, e.g., profession- and workplace-based educational programs. Full article
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