PS 1-44 THE CONSEQUENCES OF MEDICAL ERRORS ON HEALTHCARE PROVIDERS: THE CONCEPT OF SECOND VICTIM

Sunday, October 23, 2016
Bayshore Ballroom ABC, Lobby Level (Westin Bayshore Vancouver)
Poster Board # PS 1-44

Victoria Koné, MD, Public health unit: Risk Management and Quality of Care, Paris Centre University Hospital Group, AP-HP, Paris, France, Gwenaelle Vidal-Trecan, MD, PhD, Department of Public Health, Faculty of Medicine, Paris Descartes University, Sorbonne Paris Cité, Paris, France., Paris, France and Clément Duret, MD, Public health ward: Risk Management and Quality of Care, Paris Centre University Hospital Group, AP-HP, France, Paris, France
Purpose:

Patients are the first victims medical of errors; they can suffer very heavy damages. It has also been noticed that healthcare providers involved in these events can be impacted. They are considered as "second victims". To gather knowledge acquired about these second victims on individual and institutional consequences, we performed a literature review.

Method:

Articles, published between 1990 and July 2015, in English or French, were identified using key words in the most known medical databases.  After reading the titles and the abstracts of the relevant titles, the selected articles were read and the search was completed by a manual search of other articles referred to in these articles. The analysis of original articles was presented as results. Previous reviews of the literature and a search exploring main websites on quality and safety of care on guidelines or expert opinions were used for the discussion.

Result:

Among 110 articles, only 55 met our inclusion criteria. Emotional impact was found in every article, negative feelings (e.g., guilt, loss of self-confidence, doubt on professional practice, anxiety and fear) were identified in most studies. The highlight of mental suffering was the suicidal thoughts and even suicides attempted or committed. Emotional impact was tempered by various factors (e.g., human, staff, patient, organizational, work or environment, and complaint).

There were two opposite theories about the link between severity of medical errors and the emotional impact: some did not find a link and other found links including damage duration.

Thirteen studies reported coping strategies. Many studies presented how issues related to distress of healthcare providers were managed by institutions.

Eleven studies reported that after facing a care associated adverse event, healthcare professionals changed their practices.

In most cases, no support is offered for caregivers. Shame, blame and isolation are felt by second victims.

Conclusion:

The need of taking care of second victims must be known because it is a concern for both caregivers and patient safety and quality of care. This improvement goes through a deep cultural change and the implementation of active support in hospitals.

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