Ethical issues in research with second victims: A scoping review.

BACKGROUND: Second victim is the name given to the healthcare personnel-most often a nursing professional-involved with the error that led to the adverse event to a patient and who, as a result, have experienced negative psychological effects. Research with second victims has increased over the years, however concerns exist with regards to the ethical risks imposed upon these individuals. AIM: To explore the extent to which research with second victims of adverse events in healthcare settings adhere to ethical requirements. METHODS: A scoping review was conducted following Arksey and O'Malley's methodological framework and using the following databases: PUBMED, Web of Science, and SCOPUS. Original research of any study design focused on second victims and published in English, Spanish, or Portuguese in 2014-2023 were included. A critical narrative approach was used to discuss the findings. ETHICAL CONSIDERATIONS: The review followed ethical guidelines emphasizing accurate authorship attribution and truthful data reporting. RESULTS: Fifteen studies using qualitative (n = 2), quantitative (n = 10), and mixed-method (n = 3) designs were included. Over half were not assessed by a research ethics committee, with questionable reasons given by the authors. One-third did not refer to having used an informed consent. In two studies, participants were recruited by their workplace superiors, which could potentially right to autonomy and voluntary participation. CONCLUSION: Over half of the included studies with second victims did not comply with fundamental ethical aspects, with risk to inflict respect for individual autonomy, confidentiality, and of not causing any harm to participants. IMPLICATIONS FOR NURSING RESEARCH: Healthcare personnel involved in adverse events are most often nursing professionals; therefore, any breach of ethics in research with this population is likely to directly affect their rights as research participants. We provide recommendations to promote better research practices with second victims towards safeguarding their rights as research participants.

Impacto del terremoto más potente de la humanidad en el desarrollo profesional de la enfermería en el sur de Chile / Impacto do terremoto mais poderoso da humanidade no desenvolvimento profissional da enfermagem no sul do Chile / The Impact of humankind’s most powerful earthquake on the professional development of nursing in the South of Chile

Introduction: Natural catastrophes influence the progress of nursing. The largest recorded earthquake in the world occurred in the South of Chile and is documented as driving the development of nursing in the city of Valdivia, but not in similarly-affected places. Objective: To describe the impact of the mega-earthquake of 1960 in the development of professional nursing in Los Lagos. Methodology: qualitative-historical study. Snowball sampling. Data collection through semi-structured interviews and secondary sources. Inclusion criteria: belonging to the health team of the place and period studied. Informants with cognitive deterioration were excluded. Thematic analysis was carried out. Atlas Ti version 8.3.0 was used. Study approved by ethics committee. Results: in 1960 there were no nurses in Los Lagos and the only hospital in the area was incapacitated. A field hospital was installed, and a new hospital was built with national and international help, which led toarrival of the earliest nurses. Conclusion: the mega-earthquake drove the improvement of health infrastructure and the subsequent arrival of the earliest nurses, which contributed to more complex local health services and raised the quality of care. (AU)

Introducción: Las catástrofes naturales influyen en el progreso de la enfermería. En el surde Chile ocurrió el mayor terremoto registrado en el mundo y está documentado cómo impulsó el desarrollo de la enfermería en la ciudad de Valdivia, pero no en otras localidades igual de afectadas. Objetivo: Develar el impacto del mega terremoto de 1960 en el desarrollo de la enfermería profesional en Los Lagos. Metodología: Estudio cualitativo histórico. Muestreo bola de nieve. Recolección de datos mediante entrevistas semiestructuradas y fuentes secundarias. Criterio de inclusión: pertenecer al equipo de salud del lugar en el periodo estudiado. Se excluyó informantes con deterioro cognitivo. Se realizó análisis temático. Se utilizó software Atlas Ti versión 8.3.0. Estudio aprobado por comité de ética. Resultados: En 1960 no existían enfermeras en Los Lagos y el único hospital del lugar quedó inhabilitado. Se instaló un hospital de campaña y, gracias a ayuda nacional e internacional, se construyó un nuevo hospital lo que desencadenó la llegada de las primeras enfermeras. Conclusión: El mega terremoto impulsó la mejora de la infraestructura sanitaria y la consecuente llegada de las primeras enfermeras, lo que contribuyó a complejizar las prestaciones de salud local y elevó la calidad de los cuidados. (AU)

Introdução: Os desastres naturais influenciam o progresso da enfermagem. O maior terremoto registrado no mundo ocorreu no sul do Chile e está documentado como promoveu o desenvolvimento da enfermagem na cidade de Valdivia, mas não em outros locais igualmente afetados. Objetivo: Revelar o impacto do mega terremoto de 1960 no desenvolvimento da enfermagem profissional em Los Lagos. Metodologia: Estudo qualitativo histórico. Amostragem de bola de neve. Coleta de dados por meio de entrevistas semiestruturadas e fontes secundárias. Critérios de inclusão: pertencer à equipe de saúde do local no período estudado. Foram excluídos informantes com comprometimento cognitivo. Foi realizada análise temática. Foi utilizado o software Atlas Ti versão 8.3.0. Estudo aprovado por comitê de ética. Resultados: Em 1960 não havia enfermeiros em Los Lagos e o único hospital da região estava desativado. Foi instalado um hospital de campanha e, graças a ajudas nacionais e internacionais, foi construído um novo hospital, o que desencadeou a chegada dos primeiros enfermeiros. Conclusão: O megaterremoto promoveu a melhoria da infraestrutura de saúde e a consequente chegada dos primeiros enfermeiros, o que contribuiu para tornar os serviços de saúde locais mais complexos e elevar a qualidade do atendimento. (AU)

Suspensiones quirúrgicas: un desafío para la gestión clínica post Covid 19

Objetivo: Determinar la frecuencia, las causas y los factores asociados de suspensión de cirugías programadas en un hospital de alta complejidad en un periodo de 5 años. Materiales y Método: Se realizó un estudio descriptivo transversal, en un hospital terciario del sur de Chile durante los años 2014 a 2018. Se describe la frecuencia de suspensión quirúrgica del establecimiento y por especialidad, especificando sus principales causas. Además, se identificaron aquellas suspensiones evitables y sus factores asociados mediante regresión logística. Resultados: La tasa de suspensión en los 5 años de estudio fue de 11,2%. Neurocirugía y Traumatología tuvieron la mayor tasa de suspensión (18,8% y 13,9%, respectivamente), mientras que Ginecología y Obstetricia la menor (4,1%). Las causas más frecuentes fueron la inasistencia del paciente (16,9%), la prolongación de la cirugía anterior (16,4%) y la paralización de actividades por motivos gremiales (7,9%). Un 80,1% de las causas fueron evitables. La especialidad quirúrgica y la edad del paciente fueron los factores asociados más relevantes. Discusión: Se evidenció una alta tasa de suspensiones quirúrgicas y la mayoría por causas evitables. Su disminución puede ser la intervención más costo efectiva para contribuir a reducir las extensas listas de espera quirúrgica posterior a la crisis sanitaria por COVID 19, ya que sólo requiere optimizar los recursos existentes. Conclusiones: La suspensión quirúrgica es un problema frecuente en el proceso quirúrgico. Nuestros resultados permiten identificar a los grupos de mayor riesgo de suspensión, asignar responsabilidades a los equipos quirúrgicos y desarrollar estrategias efectivas para su prevención.

Aim: To determine the frequency, the causes and the associated factors of the surgical cancellation of scheduled surgeries at the Hospital Base Valdivia between the years 2014 and 2018. Materials and Method: A descriptive cross-sectional study was carried out. Were described the frequency of suspension of scheduled surgeries of the establishment, by specialty and their main causes, identifying those that can be avoided. In addition, the factors associated with suspension were identified by logistic regression. Results: The suspension rate in the 5 years of study was 11.2%. Neurosurgery and Traumatology had the highest frequency of surgical cancellation (18.8% y 13.9%, respectively), Obstetrics, and Gynecology the lowest (4.1%). The most frequent causes of suspension were the absence of the patient (16.9%), the prolongation of the previous surgery (16.4%) and the suspension of activities due to Union reasons (7.9%). 80.1% of the causes were avoidable. The age and surgical specialty were the most relevant associated factorsm Discussion: A high rate of surgical suspensions and most for avoidable reasons were evident. Reducing surgical cancellations can be the most cost effective intervention to help reduce the extensive post-health crisis surgical waiting lists by COVID 19, as it only requires optimizing existing resources. Conclusions: Surgical suspension is a common problem in the surgical process. Our results allow to identify the groups most at risk of suspension, assign responsibilities to surgical teams and develop effective strategies for their prevention.