Maria Kappes

Purpose: This paper aims to evaluate changes in reporting rates and notification timeliness following implementation of an electronic patient safety reporting system in a high-complexity public hospital over eight years. Design/methodology/approach: A quasi-experimental before–after study without a control group analysed all eligible inpatient reports recorded from 2015 to 2022. The pre-implementation period was compared with the post-implementation period. Rates were calculated per 100 discharges and timeliness as notification days. A post hoc temporal sensitivity analysis compared pre-implementation, 2019 (pre-pandemic), 2020–2021 (early pandemic), and 2022 using Poisson rate ratios. Findings: Among 14,017 reports, the rate increased from 3.47 to 13.37 per 100 discharges (RR 3.86, 95% CI 3.70–4.02). It had already reached 7.58 in 2019 (rate ratio 2.19, 95% confidence interval 2.06–2.32 versus pre-implementation), rose to 15.30 during 2020–2021, and remained 15.86 in 2022. Median notification time decreased from 9 to 1 day. The change therefore began before Coronavirus Disease 2019 (COVID-19) and persisted in 2022. The electronic system may have contributed, particularly to notification timeliness, but the design does not support causal attribution. Originality/value: Separating temporal phases shows that the increase preceded COVID-19 and persisted in 2022. The findings are consistent with a possible contribution from electronic implementation, particularly to notification timeliness, while acknowledging that pandemic-related changes, increased safety awareness and previous underreporting may also have influenced reporting volume.

Objetivo: Describir el cumplimiento de los parámetros críticos del protocolo de antibioprofilaxis quirúrgica en un hospital de alta complejidad de Chile.Métodos: Estudio cuantitativo, observacional, descriptivo y transversal que sigue la guía STROBE. Se revisaron retrospectivamente fichas clínicas, hojas anestésicas y registros quirúrgicos de cirugías realizadas entre julio y septiembre de 2025. Se evaluó el cumplimiento de cuatro parámetros críticos: tipo de antibiótico, momento de administración, dosis ajustada según peso corporal y duración de la profilaxis. Cada procedimiento quirúrgico constituyó una unidad de análisis, definiéndose cumplimiento como la adherencia simultánea a todos los criterios establecidos.Resultados: Se analizaron 300 procedimientos quirúrgicos, correspondientes mayoritariamente a pacientes adultos y a especialidades quirúrgicas de alta frecuencia. El cumplimiento mostró comportamiento heterogéneo entre los parámetros evaluados. Se observó alta adherencia en duración adecuada de profilaxis y en administración oportuna del antibiótico. En contraste, se identificaron brechas en adecuación de la dosis según peso corporal y en el registro de la hora de administración. La redosificación intraoperatoria, evaluada solo en los casos en que estuvo indicada, presentó alto nivel de cumplimiento.Discusión: Aunque la adherencia al protocolo fue satisfactoria, las principales dificultades fueron el ajuste de dosis según peso corporal y el registro de su administración. Este hallazgo coincide con estudios que identifican la documentación del peso del paciente como punto crítico en implementación de antibioprofilaxis quirúrgica.Conclusiones: La antibioprofilaxis quirúrgica muestra alto cumplimiento en componentes estandarizados, mientras que los principales desafíos se concentran en parámetros que exigen mayor individualización clínica y calidad del registro.

Introduction: Fear of death is a relevant topic in nursing due to its impact on professional well-being and the quality of care. Objective: To analyze fear of death among nursing professionals in southern Chile according to their demographic and professional-occupational profiles and beliefs. Methodology: A quantitative, descriptive, and inferential study conducted on a random sample of 56 nursing professionals. The Collett-Lester Fear of Death Scale, adapted for the Chilean population, was administered; it assesses four dimensions, two of which are self-oriented and the other two other-oriented. Cut-off points were used to classify fear into low, moderate, and high levels. Results: 76.8 % of the participants exhibited moderate/high levels of fear of death. The highest scores were observed in the dimensions related to the death of others and the dying process of others, while fear of one’s own death showed the lowest scores. A significant association was identified between fear of death and religious belief (χ² = 6.46; p = 0.03; OR = 2.07). Discussion: The results show a heterogeneous expression of fear of death, with greater sensitivity observed in dimensions related to others. The association with religious beliefs should be interpreted with caution given the small sample size and the bivariate analysis. Conclusions: It is necessary to consider cultural and spiritual factors when designing emotional support interventions for nursing professionals and to explore this phenomenon further through future research.

Objetivo: mapear as evidências existentes sobre o fenômeno da segunda vítima em países latino-americanos. Método: realizou-se uma revisão de escopo segundo as diretrizes do Joanna Briggs Institute, incluindo estudos sobre a segunda vítima entre profissionais e estudantes da área da saúde na América Latina. A busca foi conduzida nas bases Scopus, PubMed, EBSCO, ProQuest, Journal Storage, Biblioteca Virtual em Saúde e Google Scholar. Foram considerados estudos quantitativos, qualitativos, mistos, editoriais e relatos de caso, publicados entre 2014 e 2025, em inglês, espanhol e português. Resultados: incluíram-se 25 estudos, a maioria conduzida no Brasil (52%). Os estudos concentraram-se em diversos profissionais de saúde e estudantes. As principais consequências psicológicas foram culpa, pensamentos recorrentes e distúrbios do sono. Observou-se a ausência de estudos sobre programas de apoio estruturados na América Latina. Conclusão: o fenômeno da segunda vítima é frequente na América Latina, com predomínio do impacto psicológico entre profissionais da saúde. Ressalta-se a falta de intervenções regionais e a necessidade de programas de apoio específicos. Enfatiza-se a importância das estratégias de enfrentamento e do apoio institucional para fortalecer o bem-estar, a retenção e a cultura de segurança do paciente.

Objetivo: mapear la evidencia existente sobre el fenómeno de segunda víctima en países latinoamericanos. Método: se llevó a cabo una revisión exploratoria según lineamientos de Joanna Briggs Institute que incluyó estudios sobre la segunda víctima en personal sanitario y estudiantes de salud en Latinoamérica. La búsqueda se efectuó en las bases Scopus, PubMed, Ebsco, ProQuest, Journal Storage, Biblioteca Virtual de Salud y Google Scholar. Se consideraron estudios cuantitativos, cualitativos, mixtos, editoriales y reportes de casos, publicados entre 2014 y 2025 en inglés, español y portugués. Resultados: se incluyeron 25 estudios, la mayoría conducidos en Brasil (52,0%). Los estudios se centraron en diversos profesionales sanitarios y estudiantes. Las principales consecuencias psicológicas fueron la culpa, pensamientos recurrentes y alteraciones del sueño. Destacó la falta de estudios de programas de apoyo estructurados en Latinoamérica. Conclusión: el fenómeno de segunda víctima es frecuente en Latinoamérica, con predominio del impacto psicológico en el personal sanitario. Resalta la falta de intervenciones regional y la necesidad de programas de apoyo específicos. Se subraya la importancia de estrategias de afrontamiento y apoyo institucional para fortalecer el bienestar, la retención y la cultura de seguridad del paciente.

Objective: to map the existing evidence on the phenomenon of second victims in Latin American countries. Method: an exploratory review was carried out according to guidelines from the Joanna Briggs Institute, including studies on the second victim phenomenon among health personnel and health students in Latin America. The search was performed on the Scopus, PubMed, Ebsco, ProQuest, Journal Storage, Virtual Health Library and Google Scholar databases. Quantitative, qualitative, mixed, editorial, and case reports published between 2014 and 2025 in English, Spanish, and Portuguese, were considered. Results: 25 studies were included, most of them conducted in Brazil (52.0%), which focused on a range of healthcare professionals and students. The main psychological consequences included guilt, recurrent thoughts and sleep disturbances. The lack of studies on structured support programs in Latin America is a highlight. Conclusion: the second victim phenomenon is frequent in Latin America, predominantly impacting psychological aspects on health personnel. Lack of regional interventions underscore the need for specific support programs, highligthing the importance of coping strategies and institutional support to strengthen patient well-being, retention, and safety culture.

Background: Adverse events are common in intensive care units (ICUs), and nurses involved may experience the second victim phenomenon (SVP), which includes a range of physical and psychological symptoms. This study aimed to understand the SVP among ICU nurses in Chilean public hospitals by describing its prevalence and characteristics and by exploring nurses’ personal experiences. Methods: A sequential explanatory mixed‐methods design was used. The quantitative phase involved a cross‐sectional, multicenter study with ICU nurses selected through cluster probabilistic sampling. The Second Victim Experience and Support Tool (SVEST) and a safety culture checklist were applied. Analyses were conducted using SPSS. The qualitative phase was designed to deepen understanding of the quantitative findings and included in‐depth interviews and a focus group with nurses meeting predefined criteria for second victim distress; qualitative data were analyzed following an interpretive descriptive approach, supported by ATLAS.ti. Results: Among 326 ICU nurses, 81.9% reported involvement in at least one adverse event. Psychological distress emerged as the most affected domain, with guilt reported as the predominant emotion. Peer support was the most valued, while institutional support was considered limited. Quantitative findings also indicated high intention to absenteeism, reduced professional self‐efficacy, and significant regional differences. Qualitative findings from 11 participants revealed intense emotional responses, including fear, guilt, and helplessness. A lack of institutional support and the presence of a punitive culture were frequently reported. Peer and family support were essential for coping and encouraged individual and collective learning. The absence of formal support mechanisms intensified the psychological burden. Conclusions: SVP is highly prevalent among ICU nurses in Chile and significantly impacts their emotional well‐being. While peer support plays a crucial role in recovery, the lack of institutional support reinforces a punitive environment. These findings underscore the need to develop structured support strategies that foster a culture of safety and promote the well‐being of healthcare worker.

Background: Mental health problems are increasingly common among children and adolescents, making schools a key setting for health promotion. Nurses can play a central role in prevention and support, but in Chile, the role of the school nurse has not yet been formally established. Understanding nursing students’ experiences in school-based mental health promotion can inform curriculum development and strengthen professional identity. Methods: A qualitative study with a phenomenological approach was conducted with third-year nursing students enrolled in a mental health course (N = 64). Data was collected through six individual interviews and one focus group, transcribed verbatim and analyzed using ATLAS.ti 25.0.1^®. To ensure rigor, the study was guided by the Consolidated Criteria for Reporting Qualitative Research (COREQ), and trustworthiness was ensured following Lincoln and Guba’s criteria. Results: Five main categories emerged: nursing’s role in mental health promotion; perceptions of health promotion as prevention; use of the educational process, with difficulties in formulating objectives; perceived self-efficacy, marked by initial uncertainty in working with children; and experiences in implementing projects, including reflections on the professional role, mixed feelings, facilitators, barriers, and coping strategies. Facilitators included faculty support, teacher collaboration, and group cohesion, while barriers were related to limited experience, challenges in managing children, and external conditions such as noise and unsuitable classroom conditions. Conclusions: School-based practicums in mental health promotion are valuable opportunities to integrate theory and practice, strengthen professional identity, and develop communication. Strengthening undergraduate curricula with systematic training in these areas is essential for preparing nurses for their role in school and community health. Integrating these experiences into clinical and assistive practice can enhance early detection, interprofessional collaboration, and the promotion of healthier school environments.

Introduction: School violence is a global and complex problem. Objective: Identify the types of school violence and their associated factors in Peruvian adolescents. Materials and Methods: An analytical cross-sectional study was conducted. Two self-administered instruments were administered to 253 adolescents selected through stratified random sampling from the first to fifth grade of secondary school at a Peruvian public institution in 2024. Bivariate and multivariate regression analyses were used to identify factors associated with school violence. Results: Verbal violence (63.24%) and psychological violence (54.94%) were the most prevalent, while physical violence (37.55%) and sexual violence (3.95%) were less frequent. The most influential factors were individual (75.49%), social (62.87%), and family (56.13%) factors, whereas community (35.56%), cultural (35.97%), and school (43.10%) factors had less influence. Bivariate analysis revealed significant associations between school violence and sex (p = 0.03), family type (p = 0.02), socioeconomic status (p = 0.01), and area of residence (p = 0.03). Multivariate analysis found an association between individual, family, and social factors and school violence, specifically with verbal and psychological violence. Discussion: These findings confirm the central role of personal, social, and family dynamics in shaping experiences of school violence. Addressing only school-related factors may be insufficient; interventions should also target adolescents' interpersonal environments to achieve long-term impact. Conclusions: School violence is a complex and multifactorial phenomenon. Comprehensive intervention strategies are recommended, not only to reduce violence but also to promote positive school climates that support learning and emotional well-being.

La simulación clínica de alta fidelidad se ha consolidado como una estrategia educativa efectiva para la formación de profesionales de la salud. Este artículo describe una experiencia formativa interprofesional entre la carrera de Enfermería de una universidad chilena y la Academia Nacional de Bomberos, orientada a preparar a estudiantes para la atención en escenarios de emergencias y desastres. El OBJETIVO de esta intervención fue desarrollar una estrategia educativa basada en simulación de alta fidelidad para fortalecer competencias clínicas, decisionales y de trabajo en equipo en contextos de alta complejidad, aportando al campo de la formación interprofesional en situaciones de emergencia y desastre. CUERPO DE LA ESTRATEGIA DE INTERVENCIÓN. Participaron 165 estudiantes de Enfermería (de primero y cuarto año), 13 académicos y 54 bomberos voluntarios. La actividad se estructuró en etapas de coordinación, asignación de roles, desarrollo del simulacro y retroalimentación. Se trabajó en un entorno seguro y controlado que simuló una catástrofe de gran escala, favoreciendo el aprendizaje experiencial, el trabajo en equipo, el liderazgo y la toma de decisiones clínicas en tiempo real. CONCLUSIONES. El simulacro permitió una experiencia inmersiva y significativa, fortaleciendo competencias clínicas e interprofesionales. Se recomienda integrar este tipo de estrategias de simulación de alta fidelidad en el currículo de Enfermería y extender su aplicación a otras disciplinas del ámbito de la salud.