The emotional impact of errors or adverse events on healthcare providers in the NICU: The protective role of coworker support

J Adv Nurs. 2018 Jan;74(1):172-180. doi: 10.1111/jan.13403. Epub 2017 Aug 31.


Aims: To examine the impact of errors or adverse events on emotional distress and professional quality of life in healthcare providers in the neonatal intensive care unit, and the moderating role of coworker support.

Background: Errors or adverse events can result in negative outcomes for healthcare providers. However, the role of coworker support in improving emotional and professional outcomes has not been examined.

Design: A cross-sectional online survey from a quality improvement initiative to train peer supporters in a neonatal intensive care unit.

Methods: During 2015, 463 healthcare providers in a neonatal intensive care unit completed a survey assessing their experiences with an error or adverse event, anxiety, depression, professional quality of life and coworker support.

Results: Compared with those who did not experience an error or adverse event (58%), healthcare providers who observed (23%) or were involved (19%) in an incident reported higher levels of anxiety and secondary traumatic stress. Those who were involved in an event reported higher levels of depression and burnout. Differences between the three groups (no event, observation and involvement) for compassion satisfaction were non-significant. Perceived coworker support moderated the association between experiencing an event and both anxiety and depression. Specifically, experiencing an event was associated with higher levels of anxiety and depression when coworkers were perceived as low in supportiveness, but not when they were viewed as highly supportive.

Conclusion: Findings suggest that errors or adverse events can have a harmful impact on healthcare providers and that coworker support may reduce emotional distress.

Keywords: coworker support; emotional distress; errors; healthcare providers; nursing; quality of life.

MeSH terms

  • Adult
  • Anxiety / etiology
  • Cross-Sectional Studies
  • Depression / etiology
  • Emotions*
  • Empathy
  • Female
  • Humans
  • Intensive Care Units, Neonatal*
  • Interprofessional Relations*
  • Male
  • Medical Errors / psychology*
  • Middle Aged
  • Peer Group
  • Personnel, Hospital / psychology*
  • Professional Role*
  • Quality Improvement
  • Quality of Life
  • Reproducibility of Results
  • Surveys and Questionnaires