In search of an international multidimensional action plan for second victim support: a narrative review.

BACKGROUND: Insights around second victims (SV) and patient safety has been growing over time. An overview of the available evidence is lacking. This review aims to describe (i) the impact a patient safety incident can have and (ii) how healthcare professionals can be supported in the aftermath of a patient safety incident. METHODS: A literature search in Medline, EMBASE and CINAHL was performed between 1 and 2010 and 26 November 2020 with studies on SV as inclusion criteria. To be included in this review the studies must include healthcare professionals involved in the aftermath of a patient safety incident. RESULTS: In total 104 studies were included. SVs can suffer from both psychosocial (negative and positive), professional and physical reactions. Support can be provided at five levels. The first level is prevention (on individual and organizational level) referring to measures taken before a patient safety incident happens. The other four levels focus on providing support in the aftermath of a patient safety incident, such as self-care of individuals and/or team, support by peers and triage, structured support by an expert in the field (professional support) and structured clinical support. CONCLUSION: The impact of a patient safety incident on healthcare professionals is broad and diverse. Support programs should be organized at five levels, starting with preventive actions followed by self-care, support by peers, structured professional support and clinical support. This multilevel approach can now be translated in different countries, networks and organizations based on their own culture, support history, structure and legal context. Next to this, they should also include the stage of recovery in which the healthcare professional is located in.

Self-Assessment of Patient Safety Reporting and Learning System in Private Hospitals in Indonesia.

Introduction: Hospitals are required to implement patients safety incident (PSI) reporting, analysis, and problem-solving. Self-assessment is important for exploring gaps and strengthening PSI reporting and learning system. Objectives: This study examined PSI reporting and learning systems through self-assessment based on WHO guidance, analysis of section scores by hospital class, and analysis of section relationships. Method: This cross-sectional study was conducted on 193 health workers from 47 Indonesian non-profit private hospitals selected using non-probability sampling. Samples in each hospital consisted of seven hospital staff, including quality and patients' safety committee, infectious diseases control committee, manager/head of nursing, as well as functional staff comprising doctors, nurses, pharmacists, and nutritionists. Six aspects based on WHO guidance were measured in this study namely 1) environment for reporting, 2) reporting rules and content, 3) analysis and investigation, 4) governance, 5) action and learning, as well as 6) patients' and family engagement. The data obtained were analyzed using univariate and bivariate analysis. Results: The results showed that the total average score was 64.7 ± 3.3, and the average score on all components of PSI reporting and learning system was minimum 59.3 and maximum 69.6 of a total score of 100. The lowest average score was found in patients' and family engagement component at 59.3 ± 8.4. Class B hospitals had higher average scores on each component than class C and D hospitals, except on the action and learning and patients' and family engagement section. There was a significant positive linear correlation between each section of PSI reporting and learning system (p-value < 0.01). Conclusion: The PSI reporting and learning system in hospitals is in need of improvement across all aspects. One specific area that requires attention is the implementation of mechanisms for patient and family engagement, which can play an important role in promoting safety programs.