Serious reportable events within the inpatient mental health care: Impact on physicians and nurses / Episodios graves notificables en atención hospitalaria de salud mental: repercusiones en médicos y enfermeras

Objectives. To investigate the prevalence of physicians and nurses involved in an adverse event within mental health. Materials and methods. A quantitative, cross-sectional study was performed. Six Flemish psychiatric hospitals (Belgium) participated in this exploratory cross-sectional study. All psychiatrists and nurses working in these hospitals were invited to complete an online questionnaire in March 2013. Results. 28 psychiatrists and 252 nurses completed the survey. 205 (73%) of the 280 respondents were personally involved at least once in an adverse event within their entire career. Respondents reported that the adverse event with the greatest impact was related to suicide in almost 64% of the cases. About one in eight respondents considered quitting their job because of it. Almost 18% declared that due to the impact of the event, they believed that the quality of the administered care was affected for longer than one month. Respondents stated that they received much support of colleagues (95%), the chief nurse (86%) and the partner (71%). Colleagues seemed to be most supportive in the recovery process. Conclusions. Physicians and nurses working in inpatient mental health care may be at high risk to being confronted with an adverse event at some point in their career. The influence on health professionals involved in an adverse event on their work is particularly important in the first 4-24h. Professionals at those moments had higher likelihood to be involved in another adverse event. Institutions should seriously consider giving support almost at that time (AU)

Objetivos. Investigar la prevalencia de médicos y enfermeras implicados en un episodio adverso en salud mental. Materiales y métodos. Se llevó a cabo un estudio cuantitativo y transversal. Seis hospitales psiquiátricos de Flandes (Bélgica) participaron en este estudio transversal de exploración. Se solicitó a todos los psiquiatras y enfermeras que trabajan en estos hospitales que completaran un cuestionario en línea en marzo de 2013. Resultados. Veintiocho psiquiatras y 252 enfermeras respondieron la encuesta. Doscientos cinco (73%) de los 280 encuestados participaron personalmente, al menos una vez, en un episodio adverso en toda su carrera. Los encuestados informaron de que el episodio adverso con mayores repercusiones estuvo relacionado con el suicidio en casi el 64% de los casos. Aproximadamente, uno de cada 8 encuestados consideró dejar el trabajo a causa de ello. Casi el 18% declaró que, debido a las repercusiones del episodio, creían que la calidad de la atención administrada se vio afectada durante más de un mes. Los encuestados declararon que recibieron mucho apoyo por parte de sus colegas (95%), la enfermera jefe (86%) y la pareja (71%). Al parecer, los compañeros fueron los más comprensivos en el proceso de recuperación. Conclusiones. Los médicos y enfermeras que trabajan en atención hospitalaria de salud mental pueden correr un gran riesgo de enfrentarse a un episodio adverso en algún momento de su carrera. La influencia de los profesionales sanitarios implicados en un episodio adverso en su trabajo es especialmente importante en las primeras 4-24h. Los profesionales en esos momentos tenían mayor probabilidad de verse implicados en otro episodio adverso. Las instituciones deberían considerar seriamente el hecho de prestar apoyo casi en el mismo momento (AU)

Personal, situational and organizational aspects that influence the impact of patient safety incidents: A qualitative study / Aspectos personales, situacionales y organizacionales que influyen en la repercusión de incidentes adversos durante una intervención sanitaria: un estudio cualitativo

Objectives. When a patient safety incident (PSI) occurs, not only the patient, but also the involved health professional can suffer. This study focused on this so-called ‘second victim’ of a patient safety incident and aimed to examine: (1) experienced symptoms in the aftermath of a patient safety incident; (2) applied coping strategies; (3) the received versus needed support and (4) the aspects that influenced whether one becomes a second victim. Materials and methods. Thirty-one in-depth interviews were performed with physicians, nurses and midwives who have been involved in a patient safety incident. Results. The symptoms were categorized under personal and professional impact. Both problem focused and emotion focused coping strategies were used in the aftermath of a PSI. Problem focused strategies such as performing a root cause analysis and the opportunity to learn from what happened were the most appreciated, but negative emotional responses such as repression and flight were common. Support from colleagues and supervisors who were involved in the same event, peer supporters or professional experts were the most needed. A few individuals described emotional support from the healthcare institution as unwanted. Rendered support was largely dependent on the organizational culture, a stigma remained among healthcare professionals to openly discuss patient safety incidents. Three aspects influenced the extent to which a healthcare professional became a second victim: personal, situational and organizational aspects. Conclusion. These findings indicated that a multifactorial approach including individual and emotional support to second victims is crucial (AU)

Objetivos. Cuando se produce un incidente adverso durante una intervención sanitaria, no solo puede sufrir el paciente, sino también el profesional sanitario implicado. Este estudio se centró en la conocida como ‘segunda víctima’ de un incidente adverso durante una intervención y su objetivo fue evaluar: 1) los síntomas experimentados a raíz de un incidente adverso durante una intervención sanitaria; 2) las estrategias de afrontamiento que se aplicaron; 3) el apoyo recibido frente al apoyo necesario, y 4) los aspectos que influyeron en que uno se convirtiera en una segunda víctima. Material y métodos. Se llevaron a cabo 31 entrevistas exhaustivas con médicos, enfermeras y comadronas que habían estado involucrados en un incidente adverso durante una intervención. Resultados. Los síntomas se clasificaron por repercusión personal y profesional. Se utilizaron estrategias de afrontamiento centradas en el problema y en la emoción después de un incidente adverso durante una intervención. Las estrategias centradas en el problema, como el análisis de la causa primordial y la oportunidad de aprender de lo sucedido, fueron las más apreciadas, pero las respuestas emocionales negativas, como represión y huida, eran frecuentes. Lo más necesitado era el apoyo de colegas y supervisores que participaron en la misma intervención, partidarios de los compañeros o expertos profesionales. Algunas personas describen el apoyo emocional de la institución sanitaria como no deseado. El apoyo prestado depende, en gran medida, de la cultura organizacional, aunque entre los profesionales sanitarios subsiste el estigma de hablar abiertamente de incidentes adversos durante una intervención. Tres aspectos influyeron en la medida en que un profesional sanitario se convirtió en una segunda víctima: aspectos personales, situacionales y organizacionales. Conclusión. Estos resultados indicaron que es fundamental un enfoque multifactorial que incluya apoyo individual y emocional a la segunda víctima (AU)

Serious reportable events within the inpatient mental health care: Impact on physicians and nurses.

OBJECTIVES: To investigate the prevalence of physicians and nurses involved in an adverse event within mental health. MATERIALS AND METHODS: A quantitative, cross-sectional study was performed. Six Flemish psychiatric hospitals (Belgium) participated in this exploratory cross-sectional study. All psychiatrists and nurses working in these hospitals were invited to complete an online questionnaire in March 2013. RESULTS: 28 psychiatrists and 252 nurses completed the survey. 205 (73%) of the 280 respondents were personally involved at least once in an adverse event within their entire career. Respondents reported that the adverse event with the greatest impact was related to suicide in almost 64% of the cases. About one in eight respondents considered quitting their job because of it. Almost 18% declared that due to the impact of the event, they believed that the quality of the administered care was affected for longer than one month. Respondents stated that they received much support of colleagues (95%), the chief nurse (86%) and the partner (71%). Colleagues seemed to be most supportive in the recovery process. CONCLUSIONS: Physicians and nurses working in inpatient mental health care may be at high risk to being confronted with an adverse event at some point in their career. The influence on health professionals involved in an adverse event on their work is particularly important in the first 4-24h. Professionals at those moments had higher likelihood to be involved in another adverse event. Institutions should seriously consider giving support almost at that time.

Personal, situational and organizational aspects that influence the impact of patient safety incidents: A qualitative study.

OBJECTIVES: When a patient safety incident (PSI) occurs, not only the patient, but also the involved health professional can suffer. This study focused on this so-called "second victim" of a patient safety incident and aimed to examine: (1) experienced symptoms in the aftermath of a patient safety incident; (2) applied coping strategies; (3) the received versus needed support and (4) the aspects that influenced whether one becomes a second victim. MATERIALS AND METHODS: Thirty-one in-depth interviews were performed with physicians, nurses and midwives who have been involved in a patient safety incident. RESULTS: The symptoms were categorized under personal and professional impact. Both problem focused and emotion focused coping strategies were used in the aftermath of a PSI. Problem focused strategies such as performing a root cause analysis and the opportunity to learn from what happened were the most appreciated, but negative emotional responses such as repression and flight were common. Support from colleagues and supervisors who were involved in the same event, peer supporters or professional experts were the most needed. A few individuals described emotional support from the healthcare institution as unwanted. Rendered support was largely dependent on the organizational culture, a stigma remained among healthcare professionals to openly discuss patient safety incidents. Three aspects influenced the extent to which a healthcare professional became a second victim: personal, situational and organizational aspects. CONCLUSION: These findings indicated that a multifactorial approach including individual and emotional support to second victims is crucial.

Team spirit makes the difference: the interactive effects of team work engagement and organizational constraints during a military operation on psychological outcomes afterwards.

This article prospectively explores the effects of collective team work engagement and organizational constraints during military deployment on individual-level psychological outcomes afterwards. Participants were 971 Dutch peacekeepers within 93 teams who were deployed between the end of 2008 and beginning of 2010, for an average of 4 months, in the International Security Assistance Force. Surveys were administered 2 months into deployment and 6 months afterwards. Multi-level regression analyses demonstrated that team work engagement during deployment moderated the relation between organizational constraints and post-deployment fatigue symptoms. Team members reported less fatigue symptoms after deployment if they were part of highly engaged teams during deployment, particularly when concerns about organizational constraints during deployment were high. In contrast, low team work engagement was related to more fatigue symptoms, particularly when concerns about organizational constraints were high. Contrary to expectations, no effects for team work engagement or organizational constraints were found for post-traumatic growth. The present study highlights that investing in team work engagement is important for those working in highly demanding jobs.

Agreeableness and activeness as components of conflict behaviors.

Handling social conflict is usually described in terms of 2 dimensions that either cause the behavior (concern for one's own and others' goals) or that result from it (integration and distribution). In contrast, agreeableness and activeness are common factors of modes and taxonomies of conflict behavior that do not confound independent and dependent variables. This article specifies the extent to which avoiding, accommodating, compromising, problem solving, indirect fighting, and 2 forms of direct fighting--issue fighting and outcome fighting--each positively or negatively relate to agreeableness and activeness. Systematic observations of videotaped simulations by 82 male police sargeants handling a standardized conflict with either a subordinate or a superior supported and refined this metataxonomy.