Second victims and mindfulness: A systematic review

Abstract

Second victims are healthcare professionals who have been involved in an unanticipated clinical event or medical error and are negatively impacted on professional and/or personal levels. One of the most prevalent symptoms second victims endure is stress, which correlates with burnout and powerlessness. These symptoms may deeply impact second victims on professional and personal levels, but can also influence healthcare organizations. Distracted and stressed clinicians can possibly create a medical error and are at an increased risk to leave their chosen profession or institution. The purpose of this systematic review is to evaluate the literature pertaining to the second victim phenomenon and the effect of mindfulness-based interventions on perceived symptoms. PubMed, CINAHL, Scopus, and Google Scholar were used to conduct this literature search. There were 23,294 articles for consideration, after the original search. The review identified n ¼ 15 publications as meeting inclusion requirements. These studies indicated that mindfulnessbased interventions positively impact stress, burnout, and self-compassion. Future research is needed to establish mindfulness-based interventions effectiveness on second victims.

Strategies to support health professionals in the condition of second victim: scoping review

“…• Support from managers at all levels, counselors or therapist, department/unit or institution and psychological support (6,9,15,29,33,(43)(44)55,59,61,(65)(66)68,70,(75)(76) • Website Mitigating Impact in Second Victims (MISE) (39,(42)(43)(50)(51) • Second Victim Support Unit (USVIC) (62) • Coping strategies (13,16,(23)(24)(25)30,35,44,46,61,(63)(64) • Support from co-workers, spouse, family members, friends and multidisciplinary team ( 6,13,16,30,42,44,58,61,66,77) • Training and learning from error (24,42,(67)(68)71,…”

“…Another aspect of this category was the conception that some studies addressed interventions and actions based on strategies with an emphasis on the problem and on emotion/cognition (35,(42)(43)61,63) and coping strategies, among them reflective writing (7,25) , temporary leave from work (33,55) , selfpunishment, self-defense or fact denial (27,35,55,63,66,71) and depersonalization (55) . Learning with error (42,(67)(68)71,(75)(76) , positive feedback (24,42) , proactive education (74) and the participation of the second victim in the AE root cause analysis process, in the construction of action plans and in the validation of the decision-making process to avoid future incidents (71,76) were also mentioned as a source of support for training.…”

“…Studies have also mentioned physical, religious and spiritual activities (67)(68)70) , self-forgiveness, the review of perfectionist behavior (44) and self-compassion (68) as a source of support for the second victim.…”

Time to take a breath: Rebalancing the human and technical aspects of patient safety

“…12,13 Miller et al review the literature on the effectiveness of mindfulness-based interventions -a distinctly nontechnical solution -to reduce stress, burnout, and increase self-compassion in healthcare workers who have become second victims. 14 Adams et al analyzed a large database to investigate how healthcare systems handled patient safety events related to Health Information Technology. 15 They found that nearly two-thirds of events had not been resolved at the time of reporting.…”

“…review the literature on the effectiveness of mindfulness-based interventions – a distinctly non-technical solution – to reduce stress, burnout, and increase self-compassion in healthcare workers who have become second victims. 14…”