Nursing and health management's role in establishing organizational support structures is necessary to meet second victims' needs. This existing knowledge is significant to guide policy makers in developing a holistic and effective second victim support programme.
Nurses, like other healthcare professionals, such as physicians, pharmacists, and therapists, are susceptible to unanticipated patient harm, in which they suffer as second victims due to the immense personal and professional impact from the adverse event. The aim of the present study was to explore the psychological responses, coping strategies, and support needs of Singapore nurses as second victims of adverse events. A descriptive qualitative study was adopted. Eight participants (6 women and 2 men) who had been involved in an adverse event were interviewed and audio-recorded. Thematic analysis was performed to analyze the data. Seven themes emerged from the thematic analysis: responding psychologically after the event, feeling others' prejudice, having intrusive thoughts, drawing valuable lessons from the event, coping to recover after the event, taking responsibility for the mistakes made, and finding self-identity. The harmful effects of adverse events on nurses are long lasting. Second-victim nurses adopted various coping strategies to recover. The findings from the present study will guide the development of effective second-victim support programs.
The clinical decision support system is utilized to translate knowledge into evidence-based practice in clinical settings. Many studies have been conducted to understand users' adoption of the clinical decision support system. A critical review was conducted to understand the theoretical or conceptual frameworks used to inform the studies on the adoption of the clinical decision support system. The review identified 15 theoretical and conceptual frameworks using multiple hybrids of theories and concepts. The Technology Acceptance Model was the most frequently used baseline framework combined with frameworks such as the diffusion of innovation, social theory, longitudinal theory, and so on. The results from these articles yielded multiple concepts influencing the adoption of the clinical decision support system. These concepts can be recategorized into nine major concepts, namely, the information system, person (user or patient), social, organization, perceived benefits, emotions, trustability, relevance (fitness), and professionalism. None of the studies found all the nine concepts. That said, most of them have identified the information system, organization, and person concepts as three of its concepts affecting the use of the clinical decision support system. Within each of the concepts, its subconcepts were noted to be very varied. Yet each of these subconcepts has significantly contributed toward the different facets of the concepts. A pluralistic framework was built using the concepts and subconcepts to provide an overall framework construct for future study on the adoption of the clinical decision support system.
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