Second victim experiences and impact among acute care nurses: An exploratory study.

AIM: To explore the experience of second victim symptoms and adverse outcomes among nurses working in public healthcare institutions; understand the preferred components of a structured support programme; and explore the barriers to accessing existing support strategies. BACKGROUND: The second victim phenomenon is experienced by nurses during patient-related adverse events, requiring further exploration. METHODS: A mixed-methods design. Second Victim Experience and Support Tool and semi-structured individual interviews were used among nurses involved in adverse events that occurred from January 2022 to April 2023. Descriptive statistics was used to describe sociodemographic characteristics and survey responses. Thematic analysis was used to analyse qualitative data. RESULTS: Nurses (n = 12) experienced second victim-related physical, psychological and professional distress (58.3% to 83.3%) within one month after the event. Nurses continued to experience second victim-related distress (58.3%) three months after and turnover intentions (58.4%). Having a respected peer to discuss what happened was the most desired component of a support programme (75.0%). Five qualitative themes: (i) whirlwind of immediate emotions, (ii) lasting impact of adverse events, (iii) organisational barriers, (iv) coping resources at organisational level and (v) positive individual coping strategies. DISCUSSION: Nurses experienced immediate and profound distress, highlighting the pervasive and distressing nature of the second victim phenomenon. CONCLUSION: It is critical to recognise the second victim phenomenon and improve organisational climate to provide adequate support to affected nurses. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Organisations can establish a structured second victim support system, allowing nurses to seek emotional aid during the occurrence of adverse events. Establishing national policies as guidelines for organisations to refer to, raise awareness of the second victim phenomenon, and provide a standardised approach for identification and intervention for affected nurses.

Knot the Best Scenario: A Case of a Knotted Nasogastric Tube.

ABSTRACT: Nasogastric tubes are widely used in clinical practice for enteral nutrition, medication administration, and gastric decompression. Common complications of their use-such as tube blockage, displacement, and accidental removal-are well described in the literature. However, knotting-a complication that occurs when a knot forms in the nasogastric tube in situ-is rare. This report presents the case of a nasogastric tube that became knotted, causing difficulty in its removal. Key takeaways from this case are discussed, among them that more emphasis should be placed on safe nasogastric tube removal in practitioner training to better prevent such complications in the future.

Evaluation of infrared technology to detect category I and suspected deep tissue injury in hospitalised patients.

OBJECTIVE: To evaluate the use of an infrared thermography device in assessing skin temperature among category I pressure ulcer (PU) and/or suspected deep tissue injuries (SDTI) with intact skin. METHODS: An observational cross-sectional study design was used. Adult inpatients (cases) who had a category I PU or suspected deep tissue injury (skin intact) on the sacral or heel during the study period (March to April 2018) were recruited. Patients without a PU were also recruited to act as control. Thermal images of the patient's PU site and non-PU site were taken within 24 hours of PU occurrence. Thermal images of the control patients (no PU) were also taken. Each PU case was matched to three control patients in terms of age, gender, race and anatomical sites. All thermal images were taken using a portable CAT S60 Thermal Imaging Rugged Smartphone (Caterpillar Inc., US) that provided readings of the skin temperature in degrees Celsius. RESULTS: A total of 17 cases and 51 controls were recruited. Among the cases, the mean difference in skin temperature between the PU site (mean: 31.14°C; standard deviation [SD]: 1.54) and control site within the cases (mean: 28.93°C; SD: 3.47) was significant (difference: 2.21±3.66°C; p=0·024). When comparing between all cases and controls, the mean temperature difference was non-significant. When comparing between the category I PU and suspected deep pressure injury cases, the mean difference was also non-significant. CONCLUSION: Using infrared thermography technology at the bedside to measure skin temperature will support the clinical diagnosis of patients with skin types I to III. However, there is a need for a more accurate and objective measurement to identify and diagnose early category I PU or suspected deep tissue injury in adult patients with darker skin types 4 and above, enabling early initiation of preventive measures in the hospital acute care setting.

Patients' Experience After a Fall and Their Perceptions of Fall Prevention: A Qualitative Study.

An exploratory descriptive study was conducted to explore the perspectives of patients who had fallen in the hospital; 100 patients were interviewed. An inductive content analysis approach was adopted. Six themes emerged: Apathetic toward falls, self-blame behavior, reluctance to impose on busy nurses, negative feelings toward nurses, overestimating own ability, and poor retention of information. Patients often downplayed the risks of falls and were reluctant to call for help.