Elaine Cristine da Conceição Vianna

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.

Healthcare workers experienced substantial psychosocial challenges during the coronavirus disease 2019 (COVID-19) pandemic, yet longitudinal evidence on changes in work-related pleasure, suffering, and harm remains limited. This study investigated longitudinal changes in psychosocial risk indicators among Brazilian healthcare professionals during two phases of the pandemic. A prospective observational study was conducted with 113 healthcare professionals who completed two online assessments in April–June 2020 (T1) and November 2020–January 2021 (T2). Work-related pleasure and suffering were assessed using the Scale of Indicators of Pleasure and Suffering at Work (EIPST), and work-related harm was evaluated using the Work-Related Harm Assessment Scale (EADRT). Paired comparisons were performed using paired t-tests with bootstrap confidence intervals; effect sizes were estimated using Cohen’s d and probability of superiority. After adjustment for multiple comparisons, statistically significant reductions remained for professional burnout (p = 0.001; d = 0.31) and psychological harm (p = 0.006; d = 0.26). Although overall work-related suffering showed a nominally significant reduction (p = 0.034; d = 0.21), this finding did not remain statistically significant after adjustment for multiple comparisons. The corresponding effect sizes were small, and most psychosocial risk indicators remained within critical risk classifications at both assessments. Professional fulfillment changed from a critical to a satisfactory classification, although its longitudinal difference was not statistically significant. These findings suggest modest reductions in psychosocial distress over time while highlighting the persistence of critical psychosocial risks. Organizational strategies aimed at preventing psychosocial hazards and promoting healthy working conditions remain essential to protect healthcare workers during routine practice and future public health emergencies.

Introduction: Patient safety is a relevant, timely and globally significant topic. In hospital settings, despite ongoing discussions and advances in patient safety, adverse events continue to occur, impacting not only patients but also healthcare professionals. Health professionals involved in adverse events are considered second victims. This justifies the growing and pertinent interest in the phenomenon of second victim, as this experience affects the competencies and skills of health professionals while influencing their personal livesand general health. Objective: To map and characterize the repercussions experienced by health professionals who have experienced the phenomenon of second victims due to incidents or adverse events related to patient safety in health services. Method: We will conduct a scoping review following the Joanna Briggs Institute’s methodology for scoping reviews, in alignment with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) extension. The databases to be searched include PUBMED, SCOPUS, CINAHL, Web of Science (WOS) and LILACS, while the gray literature will be retrieved from the Brazilian Digital Library of Theses and Dissertations (BDTD) and PROQUEST. The identified studies will be compiled and uploaded to EndNote (version X9.3.3), where duplicates will be removed. Two independent reviewers will import the studies into the Rayyan QCR® for organization and selection, with disagreements resolved by a third party. The selection of studies will be based on the population, the concept investigated and the context. The data will be extracted through a pre-established form. Results: The findings will be analyzed in a descriptive and narrative way, aligning the data with the objective of the study and the research question. The data will are presented in tables, diagrams, and graphs containing information from the extraction tool.

Introduction In the context of global population ageing, there is a continuous and significant increase in the average age of nursing professionals. However, evidence indicates that age bias may hinder older workers’ access to the necessary support to remain active in the workforce. Method and analysis This scoping review aims to map and characterise the scientific literature on age bias directed at older nursing professionals in the workplace, conducted using the Joanna Briggs Institute methodology for scoping reviews and aligned with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Databases include MEDLINE (PubMed), CINAHL (EBSCOhost), LILACS, Scopus, APA PsycInfo and grey literature in Google Scholar. Two independent reviewers will screen titles and abstracts, followed by a full-text review of potentially relevant articles. Another reviewer will reconcile discrepancies. Two independent reviewers will extract data from the included articles using a data extraction tool developed for this review. The results will be tabulated and presented in a diagram and/or tables and summarised to explicitly address the review’s objective. Ethics and dissemination Findings will be disseminated through professional networks, conference presentations and publication in a scientific journal. Registration details https://doi.org/10.17605/OSF.IO/TR5ZK.

Healthcare workers in both the public and private systems were on the front line of the fight against the COVID-19 pandemic. As a consequence, they faced uncertainty, heavy demand, excessive working hours, and the fear of contracting the virus. To investigate the occurrence of psychological distress among public and private healthcare workers at the start of the COVID-19 pandemic. An observational, quantitative study was conducted from April to June of 2020, enrolling workers who had cared for suspected and confirmed cases of covid-19 in Brazil. Psychological distress was assessed using the Self-Reporting Questionnaire-20. Associations between the outcome and independent variables were analyzed using the chi-square test. Majorities of the 400 healthcare workers studied were nursing professionals (69.8%), worked in the Southeast region of Brazil (69.5%), were affiliated to a public healthcare institution (71.8%), and had a mean working week of 45.81 hours. The rate of psychological distress in the sample was 56.8%. There was no statistically significant association between the outcome and the type of organization (public/private). There were associations between psychological distress and professional category and between psychological distress and prior comorbidities. There was evidence of impact on mental wellbeing irrespective of care level or setting. Psychological distress was one of the greatest challenges faced by the healthcare workers during the pandemic, irrespective of the type of institution, and was a phenomenon of relevance to occupational health in general during the pandemic.

During the COVID-19 pandemic, longstanding issues involving nursing work, which has always involved significant risks of illness and infection, were intensified. It is necessary to acknowledge the risks and nurses’ perceptions about the risks qualitatively during the period of the health crisis. The aim of this study was to examine the health repercussions perceived by nursing workers in emergency services during the outbreak of the COVID-19 pandemic in Brazil. This was a qualitative, descriptive, cross-sectional study. The settings of the study were emergency services with a national scope; the participants were nursing workers. Data were collected via face-to-face virtual calling interviews and analyzed via a content analysis technique, which was supported by IRAMUTEQ software. The formation of textual classes pointed in three thematic directions, from which three categories emerged: nursing workers’ exposure, due to a lack of protective equipment, to the risk of being contaminated with, falling ill from, and transmitting the COVID-19 virus; changes in work environments, processes, and relations in response to the pandemic; and physical, mental, and psychosocial alterations perceived by emergency service nursing workers. The exposure to the virus, risk of contamination, and changes in the work environment and relations all resulted in health repercussions, which were perceived as physical, mental, and psychosocial alterations that were described as dietary disturbances, physical fatigue, burnout, increased smoking, anxiety, sleep alterations, fear, exhaustion, stress, social isolation, loneliness, distancing from relatives, and social stigma.

Objective: To describe actions taken by the organizational management of an emergency service due to the COVID-19 pandemic, determined according to the prevalence of cases of infection by the coronavirus, severe acute respiratory syndrome, and flu-like illnesses. Methods: Experience report based on a retrospective analysis of the attention for respiratory syndromes in the first semester of 2019 and 2020, in addition to an analysis of documents from the institutional protocols of a federal emergency service. Development: An increase in the number of attendances was observed, representing 7.25% and 19.4% of cases in 2019 and 2020, respectively. This was due to the creation of the Crisis Office, including a multidisciplinary team created to elaborate the plan of action, changes in the physical structure and in the work processes, and training sessions. Final considerations: It became clear that the planning, coordination of actions based on the decisions of the Crisis Office, and the dissemination of reliable information, taking into consideration a focal point, were essential for the organization, management of the emergency service, and protection to the workers.

Objetivo: Identificar medidas de prevenção de infecção do trato urinário associada ao uso de cateter vesical de demora, através de educação em saúde. Método: Pesquisa descritiva, quantitativa, com 95 profissionais de enfermagem de um hospital público, no município do Rio de Janeiro. A produção dos dados ocorreu de julho a setembro de 2019, a partir do instrumento “Rastreamento de risco para infecção do trato urinário associado ao uso de cateter vesical de demora”, contendo perguntas fechadas e um jogo dos erros, ancorado na gamificação. Procedeu-se análise através de valores absolutos, relativos e frequência acumulada, à luz do referencial teórico. Resultados: A frequência diária da higiene do meato uretral foi apontada erroneamente por 44,21% dos participantes. A conduta a ser tomada em caso de desconexão do sistema de drenagem fechado com o cateter vesical de demora obteve assertiva por 87,37% dos participantes. Evidenciaram-se 144 prevalências de erros não identificados pelos participantes, 76,55% concentraram-se nos itens ausência do dispositivo de clampeamento da bolsa coletora e volume de urina na bolsa coletora superior ao recomendado; e 23,45% à fixação do cateter vesical de demora em região inapropriada, acondicionamento incorreto da bolsa coletora no chão e ausência de equipamento de proteção individual. Conclusão: Comprovou-se desconhecimento da equipe de saúde sobre frequência da higiene diária do meato uretral, volume de urina superior ao recomendado na bolsa coletora e inobservância da ausência de dispositivo de clampeamento no sistema de drenagem fechado. Lacunas norteadoras ao planejamento e execução do serviço de Educação Permanente em Saúde.

Introdução: A carga de doença atribuível a infecção pelo COVID-19 entre os profissionais de saúde na linha de frente do combate à doença, até então desconhecida, deve orientar as políticas para o enfrentamento da pandemia, considerando as particularidades de cada categoria profissional e as regionalidades. Objetivos: Estimar a carga da doença atribuível a infecção pelo COVID-19 entre os profissionais de enfermagem, estimar os Anos de Vida Perdidos devido a mortalidade prematura (YLL), estimar os Anos Perdidos por Incapacidade (YLD) e estimar os Anos de Vida Ajustados por Incapacidade (DALY) no período de vinte de março a 5 de maio de 2020. Método: Estudo ecológico. Foram utilizados dados de mortalidade, morbidade e expectativa por faixa-etária dos profissionais de enfermagem registrados no Observatório da Enfermagem do Conselho Federal de Enfermagem (COFEN) no Instituto Brasileiro de Geografia e Estatística (IBGE). O peso da doença foi extraído do Estudo de Carga de Doença Global (GBD) de 2017, considerando a infecção respiratória de vias inferiores moderada. A análise considerou a distribuição segundo categoria profissional, sexo e faixa-etária. Resultados: Foram analisados 81 óbitos e 6427 profissionais diagnosticados com COVID-19. A enfermagem Brasileira perdeu 562,51 DALY (IC95% 495,24 – 629,79). Destes, 88,35% foram por morte prematura. A taxa de DALY perdidos por 1000 profissionais padronizada por idade foi de 87,52. O DALY foi maior entre os profissionais de 31 – 40 anos de idade (926,12). Conclusão: Mais de 500 DALY foram perdidos no Brasil devido a infecção pelo COVID-19 entre os profissionais de enfermagem, essencialmente por mortalidade prematura.

Introdução: Em todo mundo, a epidemia do COVID-19 afeta milhares de pessoas com reflexos devastadores no setor saúde e impactos negativos na força de trabalho assistencial. A carga de doença atribuível a infecção pelo COVID-19 entre os profissionais de saúde na linha de frente do combate à doença, até então desconhecida, deve orientar as políticas para o enfrentamento da pandemia, considerando as particularidades de cada categoria profissional e as regionalidades. A questão de pesquisa é: Qual a carga da infecção pelo COVID-19 entre os profissionais de enfermagem no Brasil? Objetivos: Estimar a carga da doença atribuível a infecção pelo COVID-19 entre os profissionais de enfermagem, estimar os anos de vida perdidos devido a mortalidade prematura (YLLs), estimar os anos perdidos por incapacidade (YLD) e estimar os anos de vida ajustados por incapacidade (DALY). Método: Trata-se de um estudo ecológico, onde o conjunto de indivíduos é a unidade de análise. Foram utilizados dados de mortalidade, morbidade e expectativa por faixa-etária dos profissionais de enfermagem registrados no Observatório da Enfermagem do Conselho Federal de Enfermagem (COFEn) até o dia 05 de maio de 2020 e no Instituto Brasileiro de Geografia e Estatística (IBGE) relativo ao ano de 2018, respectivamente. Foram estimados a prevalência da doença, os Anos de Vida Perdidos (YLL) e os Anos Vividos com Incapacidade (YLD). A soma destes dois últimos, possibilitou estimar os Anos de Vida Ajustados por Incapacidade (DALY). O peso da doenças foi extraída do Estudo de Carga de Doença Global (GBD) de 2017, considerando a infecção respiratória de vias inferiores moderada. A análise considerou a distribuição segundo categoria profissional, sexo e faixa-etária. Resultados: Foram analisados 91 óbitos e 10.748 profissionais diagnosticados com COVID-19. A prevalência da doença foi de 0,046% com taxa de letalidade de 0,85%. Entre 20 de março e 5 de maio, a enfermagem Brasileira perdeu 498,13 DALY (IC95% 438,62 – 557,64). Destes, 81,04% foram por morte prematura. A taxa de DALY perdidos por 1000 profissionais padronizada por idade foi de 216,02. O DALY foi maior entre os profissionais de 31 – 40 anos de idade (901,36 DALYs). O YLD foi maior entre as mulheres (453,70 YLDs e taxa de 1.37/mil) e entre os Técnicos de Enfermagem (217,01 YLDs e taxa de 164.37/mil). O sexo feminino representou 82,76% do total de DALYs. Nesse grupo, a taxa de YLD foi 27,5 vezes maior do que na população masculina. Conclusão: Quase 500 DALY foram perdidos no Brasil devido a infecção pelo COVID-19 entre os profissionais de enfermagem, essencialmente por mortalidade prematura. Este estudo permite comparar a carga da doença com outros profissionais, entre regiões e outros países, salientando-se, no entanto, a necessidade de estudos de base populacional para cada profissional de saúde que forneçam informação específica de morbilidade, para orientar e informar decisões acerca da implementação de medidas para a redução da carga da doença e melhoria dos desfechos relacionados ao COVID-19.