“Second victim” phenomenon among healthcare workers: a cross-sectional study in northeastern Italy

Background

The term “second victim” describes the distress experienced by healthcare workers after patient safety incidents (PSIs), which can lead to burnout, defensive medicine practices and absenteeism. This could be critical in healthcare setting, already facing staff shortages. The aims were to evaluate the prevalence of PSIs in a healthcare facility in Northeastern Italy, the impact of the phenomenon on these workers and their preferred support options.

Methods

A cross-sectional survey was conducted. Eligible participants completed the Italian version of the 35-item SVEST-R (“Revised Second Victim Experience and Support Tool”) questionnaire via the EUSurvey platform: it covers 7 dimensions (psychological/physical distress, colleague/supervisor/organizational support, professional self-efficacy) and 2 outcomes (turnover intentions, absenteeism) on a 5-point Likert scale. The proportion of responses with a mean score ≥4 in a domain indicates a high level of criticality in that area.

Results

Of the 740 professionals who responded to the questionnaire, 56.9% [CI95% 53.3-60.5] reported a PSI. The majority of PSIs were no harm events (44.7%[CI95% 40.0-49.0]) and occurred in medical areas (30.2%[CI95% 25.8-34.6]). High mean scores (≥4) were found in the physical distress area (51.3%[CI95% 46.5-56.1]), higher distress was also registered among women in the psychological domain (56.5% vs 34.65% in men, χ2 p < 0.001). A lack was felt in the organizational support area (mean scores ≥4 in 31.4%[CI95% 26.9-35.8] of responders), while peer support appeared to be good (1.9%[CI95% 0.6-3.2]). The possibility of discussing the event with a colleague was considered a good support option by 82.2% [CI95% 79.4-84.9] of responders.

Conclusions

This study suggests that more than half of the healthcare professionals can be considered as “second victims” of PSIs and highlights potential areas of intervention by healthcare organizations to guarantee the well-being of their staff members.

Key messages

• A significant proportion of healthcare workers can be “second victims” of patient safety incidents and frequently experience symptoms of distress after these events.

• Support systems targeted towards those at greater risk of distress could be especially important.