The second victim phenomenon in health care: A literature review

2019 ◽  
Vol 48 (6) ◽  
pp. 629-637 ◽  
Author(s):  
Puvashnee Nydoo ◽  
Basil J. Pillay ◽  
Thajasvarie Naicker ◽  
Jagidesa Moodley
Keyword(s):  
Health Care ◽  
Health Care Professional ◽  
Health Care Professionals ◽  
Obstetric Care ◽  
Negative Consequences ◽  
Post Traumatic Stress ◽  
Negative Effects ◽  
Substantial Impact ◽  
Second Victim ◽  
Adverse Medical Events

Aim: This study aimed to explore the knowledge on the second victim phenomenon (SVP) in health care, more specifically within the speciality of obstetrics. Methods: An extensive electronic search of multiple databases, with additional hand searching of the reference lists of pertinent articles regarding the SVP, was performed from May 2017 to December 2018. Results: A review of the literature suggests consistent evidence of the substantial impact of adverse medical events on health-care professionals across a range of specialities. The effects of an adverse medical event for the health-care professional are ominous, with many experiencing feelings of sadness, guilt and anxiety, as well as some displaying symptoms consistent with post-traumatic stress disorder. Negative effects may be exacerbated for health-care professionals in the case of an adverse maternal event due to its highly sensitive and dramatic nature, involving both maternal and neonatal lives. The provision of timely and effective support at the individual and more specifically the organisational level has been positively correlated with a second victim’s recovery. Yet, limited organisations have formal support interventions designed specifically for the needs of the second victim. Conclusions: It is evident that the consequences of adverse medical events on health-care professionals can be intense and numerous. The unique nature and high sensitivities surrounding obstetric care have the potential to exacerbate the negative consequences for the health-care professional following an adverse event. Still, there remains a dearth of information of the extent of adverse medical events and the SVP in the speciality of obstetrics.

Digital Diabetes Care System Observations from a market acceptance evaluation study in Vietnam (Preprint)

2019 ◽  
Author(s):  
Tran Quang Khanh ◽  
Pham Nhu Hao ◽  
Eytan Roitman ◽  
Baruch Marganitt ◽  
Avivit Cahn
Keyword(s):  
Health Care ◽  
Blood Glucose ◽  
Health Care Professional ◽  
Diabetes Care ◽  
Health Care Professionals ◽  
Mobile App ◽  
Physician Satisfaction ◽  
Diabetes Clinic ◽  
Blood Glucose Monitor ◽  
Hba1c Levels

BACKGROUND Digital technologies are gaining an important role in the management of patients with diabetes. The GlucoMe solution integrates multiple aspects of diabetes care: 1) Wireless blood glucose monitor - communicates glucose data automatically to any smartphone; 2) Mobile-app - securely transmits real-time blood glucose monitor data for cloud based analyses, and enables 2-way communication between patients and health care professionals; 3) Digital diabetes clinic – analyzes and presents data to the health care professional; and 4) Control tower software provides population management reports and sends individualized alerts. OBJECTIVE Assess clinical outcomes and user satisfaction of incorporating the GlucoMe digital solution in diabetes clinics of a developing country. METHODS Five hospital endocrinology clinics in Vietnam participated in a market acceptance evaluation pilot of the GlucoMe system. The clinics sequentially recruited all patients willing to join, so long as they had a smartphone and access to internet connectivity. Patients were provided with the GlucoMe app and blood glucose monitor and instructed in their use in individual or groups sessions. The digital diabetes clinic and control tower software were installed in the clinic computers. Face-to-face visits were conducted at baseline and at 12 weeks, with monthly digital visits scheduled in the interim and additional digital visits performed as needed. HbA1c levels were measured at baseline and at 12 weeks (±20 days). Treatment modification was at the discretion of the treating physician. Outcome measures included adherence to glucose monitoring, change in glycemic parameters and patient and physician satisfaction as assessed by questionnaires. Only patients completing the pilot were included in data analyses. RESULTS The study recruited 300 patients of whom 279 patients completed the evaluation. Dropout was due to change in internet access availability (18) or death (3). Adherence to glucose measurements gradually declined, yet, at study end 81% of the patients were measuring glucose at least once a week. Digital contact from the health care professional to the patient or vice-versa (excluding automated alerts) occurred in average every 6.2 days. Average glucose levels declined from 170.4±64.6 mg/dl in the first two weeks to 150.8±53.2 mg/dl in the last two weeks (P<0.001) (n=221). HbA1c levels at baseline and 12 weeks were available for only 126 of the patients and declined from 8.3±1.9% to 7.6±1.3 (P<0.001). Over 95% of the physicians and patients stated they would strongly support the broad usage of the GlucoMe platform in diabetes clinics across the country. CONCLUSIONS The GlucoMe digital solution was broadly accepted by both patients and health care professionals and improved glycemic outcomes. The digital platform yielded increased number of patient-health care professional interactions, yet of short duration, enabling judicious allocation of limited time resources. The durability, scalability and cost-effectiveness of this approach merit further study.

scholarly journals The physician’s Achilles heel—surviving an adverse event

2019 ◽  
Vol 26 (6) ◽  
Author(s):  
I. Stukalin ◽  
B. C. Lethebe ◽  
W. Temple
Keyword(s):  
Health Care ◽  
Adverse Event ◽  
Traumatic Stress ◽  
Health Care Professionals ◽  
Institutional Support ◽  
Post Traumatic Stress ◽  
Event Scale ◽  
Self Blame ◽  
Brief Cope ◽  
Post Traumatic

Background Of hospitalized patients in Canada, 7.5% experience an adverse event (ae). Physicians whose patients experience aes often become second victims of the incident. The present study is the first to evaluate how physicians in Canada cope with aes occurring in their patients.Methods Survey participants included oncologists, surgeons, and trainees at the Foothills Medical Centre, Calgary, AB. The surveys were administered through REDCap (Research Electronic Data Capture, version 9.0: REDCap Consortium, Vanderbilt University, Nashville, TN, U.S.A.). The Brief cope (Coping Orientation to Problems Experienced) Inventory, the ies-r (Impact of Event Scale–Revised), the Causal Dimension Scale, and the Institutional Punitive Response scale were used to evaluate coping strategies, prevalence of post-traumatic stress, and institutional culture with respect to aes.Results Of 51 responses used for the analysis, 30 (58.8%) came from surgeons and 21 (41.2%) came from medical specialists. On the ies-r, 54.9% of respondents scored 24 or higher, which has been correlated with clinically concerning post-traumatic stress. Individuals with a score of 24 or higher were more likely to report self-blame (p = 0.00026) and venting (p = 0.042). Physicians who perceive institutional support to be poor reported significant post-traumatic stress (p = 0.023). On multivariable logistic regression modelling, self-blame was associated with an ies-r score of 24 or higher (p = 0.0031). No significant differences in ies-r scores of 24 or higher were observed between surgeons and non-surgeons (p = 0.15). The implications of aes for physicians, patients, and the health care system are enormous. More than 50% of our respondents showed emotional pathology related to an ae. Higher levels of self-blame, venting, and perception of inadequate institutional support were factors predicting increased post-traumatic stress after a patient ae.Conclusions Our study identifies a desperate need to establish effective institutional supports to help health care professionals recognize and deal with the emotional toll resulting from aes.

Involuntary automaticity: a work-system induced risk to safe health care

2005 ◽  
Vol 18 (4) ◽  
pp. 211-216 ◽  
Author(s):  
Brian Toft ◽  
Hugo Mascie-Taylor
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Health Care Professionals ◽  
Health Care Organizations ◽  
Negative Effects ◽  
Care Community ◽  
Work System ◽  
Skilled Action ◽  
Conscious Attention

Automaticity is the term given by psychologists to the skilled action that people develop through repeatedly practising the same activity, for example driving a car. Usually, automaticity is discussed in terms of the benefits it brings to people, such as the reduction in the degree of conscious attention a person needs to pay to such skilled activities. However, there is evidence to suggest that substantial costs may also be associated with such learned behaviour. Managing patient safety is a difficult task and one of the ways in which health-care professionals seek to accomplish it is through the use of verbal challenge-response protocols. However, it is argued in this paper that it is possible for the negative effects of automaticity to involuntarily capture those using such verbal checklist techniques and cause them to erroneously believe that the treatment that they are about to administer to a patient is safe when it is not. This phenomenon does not, however, seem to have been recognized by the health-care community nationally or internationally. We conclude that patient safety could be significantly improved worldwide if the organizational arrangements which appear to induce involuntary automaticity were to be robustly addressed by the management of all health-care organizations.

scholarly journals Canadian health care professionals' knowledge, attitudes and perceptions of nutritional genomics

2010 ◽  
Vol 104 (8) ◽  
pp. 1112-1119 ◽  
Author(s):  
Mark Weir ◽  
Karine Morin ◽  
Nola Ries ◽  
David Castle
Keyword(s):  
Health Care ◽  
Health Care Professional ◽  
Health Care Professionals ◽  
Social Issues ◽  
Genome Project ◽  
Regulatory Oversight ◽  
Canadian Health ◽  
Open Debate ◽  
Canadian Health Care ◽  
Nutritional Genomics

Nutritional genomics has reached the public through applications of the Human Genome Project offered direct to consumers (DTC). The ability to pursue nutrigenetic testing without the involvement of a health care professional has received considerable attention from academic and policy commentators. To better understand the knowledge and attitudes of Canadian health care professionals regarding nutritional genomics and nutrigenetic testing, qualitative research in the form of focus group discussions was undertaken. Four key themes emerged: (1) concerns over DTC testing; (2) lack of health care professional competency; (3) genetic scepticism and inevitability; (4) expectation of regulation. Together, they indicate that health care professionals have little knowledge about nutritional genomics and hold contradictory attitudes towards genomics in general, and to nutritional genomics in particular. Respondents argue in favour of a delivery model where health care professionals act as intermediaries. They are also aware of their lack of competency to provide such services. To ensure greater public protection, respondents cite the importance of more stringent regulatory oversight of DTC genetic testing. Whether such an approach is necessary to address the various ethical and social issues raised by nutrigenetic testing remains an open debate.

scholarly journals Self-Medication Practices Among Health Care Professional Students in a Tertiary Care Hospital, Pune

2017 ◽  
Vol 10 (1) ◽  
pp. 63-68 ◽  
Author(s):  
Manjusha Sajith ◽  
Sruthi M. Suresh ◽  
Naveen T. Roy ◽  
Dr. Atmaram Pawar
Keyword(s):  
Health Care ◽  
Health Care Professional ◽  
Health Care Professionals ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Self Medication ◽  
Medication Practice ◽  
Professional Students ◽  
Professional Exposure

Background: Self-medication practice is common among health care professionals due to their professional exposure to drugs and knowledge of treatment of their disease. Objective: The aim was to assess self-medication practice among medical, pharmacy, and nursing students in a tertiary care hospital, Pune. Method: A cross-sectional survey was carried out over a period of three months. A self-administered questionnaire was used for data collection. Results: A total of 318 students participated in the survey; among them106 were medical, 106 were nurses and 106 were Pharmacy students. Out of the total participants, 52.5% were females. Among them, 280 (87.5%) were practicing self- medication. Most drugs for self-medication were obtained from the pharmacy or drug shops, and the most commonly used drugs were non-steroidal anti- inflammatory drugs(81.2%) and antipyretics (67.6%) and antibiotics (35.0%). However, 112 (35.0%) of health care professional students had received antibiotics without medical prescription in the past few months. Common reported illnesses were fever and chills (62.5%) followed by headache (40.0%) and common cold(35.0%).The main reasons for self- medication was that their knowledge about drugs and diseases helped them (67%) and their health problem was not serious(65%). 40 (12.0%) were against self -medication practice and their reasons were fear of misdiagnosis of illness and adverse effect of drugs. Conclusion: Our study concluded that self-medication was practiced with a range of drugs among health care professional students. Educating the students and creating awareness among them may decrease the chance of self-medication practice.

scholarly journals Continuous Monitoring of Vital Signs in the General Ward Using Wearable Devices: Randomized Controlled Trial

10.2196/15471 ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. e15471
Author(s):  
Mariska Weenk ◽  
Sebastian J Bredie ◽  
Mats Koeneman ◽  
Gijs Hesselink ◽  
Harry van Goor ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Continuous Monitoring ◽  
Controlled Trial ◽  
Vital Signs ◽  
Physician Assistants ◽  
Wearable Devices ◽  
General Ward ◽  
Negative Effects ◽  
Randomized Controlled

Background Wearable devices can be used for continuous patient monitoring in the general ward, increasing patient safety. Little is known about the experiences and expectations of patients and health care professionals regarding continuous monitoring with these devices. Objective This study aimed to identify positive and negative effects as well as barriers and facilitators for the use of two wearable devices: ViSi Mobile (VM) and HealthPatch (HP). Methods In this randomized controlled trial, 90 patients admitted to the internal medicine and surgical wards of a university hospital in the Netherlands were randomly assigned to continuous vital sign monitoring using VM or HP and a control group. Users’ experiences and expectations were addressed using semistructured interviews. Nurses, physician assistants, and medical doctors were also interviewed. Interviews were analyzed using thematic content analysis. Psychological distress was assessed using the State Trait Anxiety Inventory and the Pain Catastrophizing Scale. The System Usability Scale was used to assess the usability of both devices. Results A total of 60 patients, 20 nurses, 3 physician assistants, and 6 medical doctors were interviewed. We identified 47 positive and 30 negative effects and 19 facilitators and 36 barriers for the use of VM and HP. Frequently mentioned topics included earlier identification of clinical deterioration, increased feelings of safety, and VM lines and electrodes. No differences related to psychological distress and usability were found between randomization groups or devices. Conclusions Both devices were well received by most patients and health care professionals, and the majority of them encouraged the idea of monitoring vital signs continuously in the general ward. This comprehensive overview of barriers and facilitators of using wireless devices may serve as a guide for future researchers, developers, and health care institutions that consider implementing continuous monitoring in the ward. Trial Registration Clinicaltrials.gov NCT02933307; http://clinicaltrials.gov/ct2/show/NCT02933307.

scholarly journals Identity Matters- Perceptions of Inter-Professional Feedback in the Context of Workplace-based Assessment in Diabetology Training: A Qualitative Study

2020 ◽  
Author(s):  
Katrin Feller ◽  
Christoph Berendonk
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Professional ◽  
Health Care Professionals ◽  
Allied Health ◽  
University Hospital ◽  
Professional Collaboration ◽  
Professional Groups ◽  
Allied Health Care ◽  
Workplace Based Assessment

Abstract Background: Inter-professional collaboration is acknowledged as essential for quality patient-care. However, little is known about receptiveness to inter-professional feedback in the postgraduate training. This study explores, in light of social identity theory, the perceptions of residents, supervising physicians and allied health care professionals regarding inter-professional feedback in the context of workplace-based assessment. Methods: For six months, residents in diabetology at the University Hospital of Bern performed formative workplace-based assessments under direct observation of a supervising physician and an allied health care professional. Feedback from both observers was given to the resident after every assessment. Subsequently, focus group discussions were conducted to collect the participants’ perceptions of inter- and intra-professional feedback. Transcripts were analyzed qualitatively using a thematic analysis approach. Results: We identified four main themes: (1) Identity and hierarchy; (2) Interdependence of feedback source and feedback content; (3) Impact on collaboration and patient-care; (4) Logistical and organizational requirements. While different social identities are the source of inter-professional hierarchies, they did not impede the receptiveness to feedback. Perceived trustworthiness of the feedback was attributed with more importance than professional affiliations, whereas intra-professional hierarchies between physicians led to the perception of a more summative nature of the feedback and rather impeded receptiveness. According to the participants, inter-professional feedback raised awareness of the working reality of other team members and had a positive impact on communication between the different professional groups. Moreover, participants reported positive response from patients regarding the inter-professional collaboration they experienced. Considerable organizational effort is required to enable the parallel observation of a resident’s consultation by a supervising physician and an allied health care professional. Conclusions: Feedback from allied health care professionals can be a valuable learning resource for residents, given its role outside the sometimes conflicting area of intra-professional hierarchies. Inter-professional feedback in the context of workplace-based assessment carries the potential to strengthen collaboration between the different professional groups.

scholarly journals Dietary Supplement Use in a Pediatric Inpatient Population

2004 ◽  
Vol 9 (2) ◽  
pp. 110-116
Author(s):  
Roberta M. Tankanow ◽  
Kelly A. Dwyer ◽  
Darcie-Ann Streetman
Keyword(s):  
Health Care ◽  
Dietary Supplements ◽  
Medical Record ◽  
Dietary Supplement ◽  
Health Care Professional ◽  
Health Care Professionals ◽  
Herbal Supplement ◽  
Supplement Use ◽  
Pediatric Inpatient ◽  
Dietary Supplement Use

OBJECTIVES Patients are assuming responsibility for their own health by self-medicating with dietary supplements, often without physician knowledge or oversight. The objectives of this study were to determine: 1) pediatric dietary supplement use by surveying parents of children who were hospitalized in a university institution; 2) if any health care professional inquired about supplement use at the time the child was hospitalized; 3) whether the use of a supplement was documented in the patient's medical record; and 4) parents' attitudes about dietary supplements. STUDY DESIGN Parents of 100 hospitalized pediatric patients (&lt;18 years of age) were randomly selected to complete a survey about their child's use of dietary supplements prior to and during hospitalization. They were also asked if they intended to use these products after hospitalization. The purpose of the study was explained, informed consent was obtained, and parents were given ample time to complete the survey. RESULTS Fifty percent of parents reported giving their child a dietary supplement prior to hospitalization; 17% reported use of an herbal supplement. Only 24% of parents reported being asked about supplement use by a health care professional upon admission or during the hospital stay. The response to only five of these queries was documented in the child's medical record. CONCLUSIONS Increasing dietary supplement use mandates that all health care professionals elicit this information as part of the routine History and Physical Examination at the time a child is hospitalized. This information should also be documented in the patient's medical record. Likewise, parents should be encouraged to discuss the use of these products with their physician and pharmacist.

scholarly journals Examination of Coping Strategies among On-Site Paramedics

2021 ◽  
Vol 16 (2) ◽  
pp. 184-195
Author(s):  
Vladimír Moskola ◽  
Ágnes Dóra Sándor ◽  
Éva Susánszky ◽  
Andrea Székely ◽  
István Hornyák ◽  
...  
Keyword(s):  
Health Care ◽  
Coping Strategies ◽  
Health Care Professionals ◽  
Psychological Symptoms ◽  
Health Behaviours ◽  
Patient Treatment ◽  
Negative Effects ◽  
Ambulance Personnel ◽  
Level Of Education ◽  
Ways Of Coping Questionnaire

The occurrence of physical and psychological symptoms that negatively influence everyday activities, efficient job performance, and professional patient treatment are common among paramedic workers. Aim: We uncovered the characteristic coping strategies applied by on-site paramedics and searched for correlations between these strategies and demographic, socio-economic characteristics, as well as factors related to work, workplace, and health behaviours. Sample and methodology: The survey was conducted between March 1, 2018, and February 28, 2019, among employees of the DG National Ambulance Service and participants of the Chamber of Hungarian Health Care Professionals. We used an abbreviated version of the Ways of Coping Questionnaire that contains 22 items (WOC-22). Descriptive statistics, independent samples T-tests, correlation calculations, analysis of variance with the Games-Howell post-hoc test were also carried out. Results: Tension reduction was a more common coping strategy among female and/or single paramedics as well as also being characteristic of people who work as paramedic officers. Problem-oriented coping stood out as a characteristic of people who have a higher level of education and/or are more satisfied with their financial situation. Risk-seeking appears dominantly among those who are not religious and/or have a lower level of education. Conclusions: Although paramedics are basically characterized by problem-oriented coping strategies, they quite often apply non-adaptive strategies as well; consequently, the chance of developing anxiety remains higher for them. Our aim is to use effective intervention methods for curbing the development of anxiety conditions among the ambulance personnel that have long-lasting negative effects on health care. To achieve this goal, we recommend including a questionnaire about coping strategies into the admission process of would-be paramedics; also, completing such questionnaires among the whole emergency workforce.

scholarly journals Identity Matters - Perceptions of Inter- and Intra-Professional Feedback in the Context of Workplace-based Assessment in Diabetology Training: A Qualitative Study

2019 ◽  
Author(s):  
Katrin Feller ◽  
Christoph Berendonk
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Professional ◽  
Health Care Professionals ◽  
Allied Health ◽  
University Hospital ◽  
Professional Collaboration ◽  
Professional Groups ◽  
Allied Health Care ◽  
Workplace Based Assessment

Abstract Background: Inter-professional collaboration is acknowledged as essential for quality patient-care. However, little is known about receptiveness to inter-professional feedback in the postgraduate training. This study explores, in light of social identity theory, the perceptions of residents, supervising physicians and allied health care professionals regarding inter- and intra-professional feedback in the context of workplace-based assessment. Methods: For six months, residents in diabetology at the University Hospital of Bern performed formative workplace-based assessments under direct observation of a supervising physician and an allied health care professional. Feedback from both observers was given to the resident after every assessment. Subsequently, focus group discussions were conducted to collect the participants’ perceptions of inter- and intra-professional feedback. Transcripts were analyzed qualitatively using a thematic analysis approach. Results: We identified four main themes: (1) Identity and hierarchy; (2) Interdependence of feedback source and feedback content; (3) Impact on collaboration and patient-care; (4) Logistical and organizational requirements. While different social identities are the source of inter-professional hierarchies, they did not impede the receptiveness to feedback. Perceived trustworthiness of the feedback was attributed with more importance than professional affiliations, whereas intra-professional hierarchies between physicians led to the perception of a more summative nature of the feedback and rather impeded receptiveness. According to the participants, inter-professional feedback raised awareness of the working reality of other team members and had a positive impact on communication between the different professional groups. Moreover, participants reported positive response from patients regarding the inter-professional collaboration they experienced. Considerable organizational effort is required to enable the parallel observation of a resident’s consultation by a supervising physician and an allied health care professional. Conclusions: Feedback from allied health care professionals can be a powerful learning resource for residents, given its role outside the sometimes conflicting area of intra-professional hierarchies. Inter-professional feedback in the context of workplace based assessment carries the potential to strengthen collaboration between the different professional groups and to improve patient care.

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