Objectives: To describe healthcare providers' symptoms evoked by patient safety incidents (PSIs), the duration of these symptoms and the association with the degree of patient harm caused by the incident.
Design: Cross-sectional survey.
Setting: 32 Dutch hospitals that participate in the 'Peer Support Collaborative'.
Participants: 4369 healthcare providers (1619 doctors and 2750 nurses) involved in a PSI at any time during their career.
Interventions: All doctors and nurses working in direct patient care in the 32 participating hospitals were invited via email to participate in an online survey.
Primary and secondary outcome measures: Prevalence of symptoms, symptom duration and its relationship with the degree of patient harm.
Results: In total 4369 respondents were involved in a PSI and completely filled in the questionnaire. Of these, 462 reported having been involved in a PSI with permanent harm or death during the last 6 months. This had a personal, professional impact as well as impact on effective teamwork requirements. The impact of a PSI increased when the degree of patient harm was more severe. The most common symptom was hypervigilance (53.0%). The three most common symptoms related to teamwork were having doubts about knowledge and skill (27.0%), feeling unable to provide quality care (15.6%) and feeling uncomfortable within the team (15.5%). PSI with permanent harm or death was related to eightfold higher likelihood of provider-related symptoms lasting for more than 1 month and ninefold lasting longer than 6 months compared with symptoms reported when the PSI caused no harm.
Conclusion: The impact of PSI remains an underestimated problem. The higher the degree of harm, the longer the symptoms last. Future studies should evaluate how these data can be integrated in evidence-based support systems.
Keywords: health personnel/psychology; hospitals; patient safety; peer support; stress, psychological.
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Conflict of interest statement
Competing interests: None declared.
Evidence Brief: The Quality of Care Provided by Advanced Practice Nurses.2014 Sep. In: VA Evidence Synthesis Program Evidence Briefs [Internet]. Washington (DC): Department of Veterans Affairs (US); 2011–. VA Evidence Synthesis Program Evidence Briefs. 2011–. PMID: 27606392 Free Books & Documents. Review.
Medical Error Prevention.2020 Feb 5. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan–. StatPearls. 2020 Jan–. PMID: 29763131 Free Books & Documents. Review.
Personal, situational and organizational aspects that influence the impact of patient safety incidents: A qualitative study.Rev Calid Asist. 2016 Jul;31 Suppl 2:34-46. doi: 10.1016/j.cali.2016.02.003. Epub 2016 Apr 20. Rev Calid Asist. 2016. PMID: 27106771
Increased Risk of Burnout for Physicians and Nurses Involved in a Patient Safety Incident.Med Care. 2016 Oct;54(10):937-43. doi: 10.1097/MLR.0000000000000582. Med Care. 2016. PMID: 27213542
Physicians' Difficulties Due to Patient Safety Incidents in Korea: a Cross-Sectional Study.J Korean Med Sci. 2020 May 4;35(17):e118. doi: 10.3346/jkms.2020.35.e118. J Korean Med Sci. 2020. PMID: 32356419 Free PMC article.
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Responding to adverse patient safety events in Viet Nam.BMC Health Serv Res. 2019 Sep 18;19(1):677. doi: 10.1186/s12913-019-4518-y. BMC Health Serv Res. 2019. PMID: 31533699 Free PMC article.
- Conway J, Federico F, Stewart K, et al. Respectful management of serious clinical adverse events. IHI Innovation Series white paper. Cambridge, Massachusetts: Institute for Healthcare Improvement, 2011. Available on http://www.ihi.org/