Abstract:
Objective To examine individual, situational and organisational aspects that influence psychological impact and recovery of a patient safety incident on physicians, nurses and midwives.
Design
Cross-sectional, retrospective surveys of physicians, midwives and nurses.
Setting
33 Belgian hospitals.
Participants
913 clinicians (186 physicians, 682 nurses, 45 midwives) involved in a patient safety incident.
Main outcome measures
The Impact of Event Scale was used to retrospectively measure psychological impact of the safety incident at the time of the event and compare it with psychological impact at the time of the survey.
Results
Individual, situational as well as organisational aspects influenced psychological impact and recovery of a patient safety incident. Psychological impact is higher when the degree of harm for the patient is more severe, when healthcare professionals feel responsible for the incident and among female healthcare professionals. Impact of degree of harm differed across clinicians. Psychological impact is lower among more optimistic professionals. Overall, impact decreased significantly over time. This effect was more pronounced for women and for those who feel responsible for the incident. The longer ago the incident took place, the stronger impact had decreased. Also, higher psychological impact is related with the use of a more active coping and planning coping strategy, and is unrelated to support seeking coping strategies. Rendered support and a support culture reduce psychological impact, whereas a blame culture increases psychological impact. No associations were found with job experience and resilience of the health professional, the presence of a second victim support team or guideline and working in a learning culture.
Conclusions
Healthcare organisations should anticipate on providing their staff appropriate and timely support structures that are tailored to the healthcare professional involved in the incident and to the specific situation of the incident.
Citation: Eva Van Gerven, Luk Bruyneel, Massimiliano Panella, Martin Euwema, Walter Sermeus, Kris Vanhaecht
Psychological Impact And Recovery After Involvement In A Patient Safety Incident: A Repeated Measures Analysis BMJ Open 2016;6:e011403 doi:10.1136/bmjopen-2016-011403
Received: 4 February 2016, Revised: 26 May 2016, Accepted: 3 August 2016, Published: 31 August 2016
Copyright: This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Contributors
EVG and LB contributed equally to this paper. The manuscript has been read and approved by all authors. All persons listed as authors have contributed to preparing the manuscript and the International Committee of Medical Journal Editors (ICMJE) criteria for authorship have been met (see table below)
Funding
This work was supported by the taskforce second victim of the Flemish Hospital Network-KULeuven & Federal Public Service Health, Food Chain Safety and Environment of Belgium.
Competing interests
None declared.
Provenance and peer review
Not commissioned; externally peer reviewed.
Data sharing statement
The authors make materials, data and associated protocols promptly available to others without preconditions by emailing luk.bruyneel@med.kuleuven.be.