Repercussions of the second victim phenomenon on health care workers: Scoping review

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Abstract
Patient safety is a key pillar of healthcare services and the quality of care provided. Despite ongoing efforts, safety incidents still occur, resulting in victims beyond the patient. The healthcare professionals involved are considered second victims, warranting studies in the field of worker safety. Objective: To map the repercussions experienced by healthcare professionals who have experienced the “second victim” phenomenon resulting from patient safety incidents in healthcare services. Method: A scoping review guided by the JBI and PRISMA-ScR methodologies. A preliminary search was conducted, finding no evidence of existing records or publications with the same objective. The protocol was registered on the Open Science Foundation platform. The search strategy followed the three recommended steps. The databases consulted were MEDLINE, SCOPUS, CINAHL, WOS, LILACS, and, for gray literature, the Brazilian Digital Library of Theses and Dissertations and ProQuest. There were no restrictions on language, year, or methodology; the PCC mnemonic was used as an eligibility criterion: population—healthcare professionals; concept—second victim phenomenon related to patient safety incidents; context—healthcare services. Studies that did not meet the objective and PCC criteria were excluded. The selection and data extraction were performed by independent researchers and conducted anonymously. Results: Of the 2,129 records retrieved, 37 publications comprised the final sample. The publications were collected between 2009 and 2024 and were identified in 22 countries across five continents. There was a predominance of publications from Europe (n = 12), with qualitative studies being the most common (n = 14); the hospital setting was the most frequently cited (n = 25), and nursing was the most studied population (n = 27). The most frequently cited health descriptors were “second victims” (n = 17) and “adverse events” (n = 14). Of the selected studies, 13 used measurement instruments to identify the phenomenon. Thirty-nine repercussions were mapped, categorized from the perspective of worker health in physical, mental, professional and social dimensions based on the study’s assumptions. The professional dimension presented the highest number of repercussions. The mental dimension identified suicidal thoughts or behavio as a risk to physical integrity. Conclusion: The repercussions indicate a strong relationship between the second victim phenomenon and worker health and safety, impacting the professional and personal lives of the professionals involved.

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