Victoria Klemm

Zusammenfassung: Das Second-Victim-Phänomen beschreibt die psychische Belastung von Fachkräften im Gesundheitswesen nach unerwarteten, unerwünschten Ereignissen, unbeabsichtigten Fehlern oder Patient:innenschädigungen. Der Verlauf wird typischerweise in sechs Phasen beschrieben – von akuter emotionaler Reaktion über wiederkehrende Erinnerungen und die Suche nach Unterstützung bis hin zu möglichen Verarbeitungswegen (Verlassen, Überleben oder Wachsen). Häufige Symptome sind Schuld- und Schamgefühle, Angst, intrusive Erinnerungen und Selbstzweifel. Die Auswirkungen betreffen nicht nur die Betroffenen selbst, sondern auch Patient:innensicherheit und Organisationen: Erhöhtes Fehlerrisiko, defensive Medizin, Absentismus, Präsentismus sowie Fluktuation sind beschrieben. Im deutschsprachigen Raum zeigen elf SeViD-Studien (Second Victims im deutschsprachigen Raum) Prävalenzen von 53 bis 94 % bei gleichzeitig geringer Bekanntheit des Begriffs. Kollegiale Unterstützung stellt die wichtigste Ressource dar. Eine effektive Unterstützungsmaßnahme für Second Victims ist das Einführen von strukturierten Peer-Support-Programmen. Gesundheitsökonomische Modellierungen weisen zudem auf erhebliche Einsparpotenziale hin: Pro unterstützter Person können mehrere tausend Euro eingespart werden; hochgerechnet auf den stationären Sektor ergeben sich jährlich potenzielle Einsparungen in Milliardenhöhe. Unterstützungsangebote für Second Victims sind damit sowohl aus ethischer als auch aus gesundheitsökonomischer Perspektive von hoher Relevanz.

Background: Emergency Medical Dispatchers (EMDs) play a critical role in coordinating emergency responses while being remotely exposed to distressing incidents. The Second Victim Phenomenon (SVP) refers to emotional distress experienced by healthcare professionals following adverse events; however, its prevalence and impact among EMDs remain poorly understood. This study examines the prevalence, symptom burden, and support preferences related to SVP among EMDs in Germany. Methods: A cross-sectional survey was conducted using the validated SeViD-questionnaire, supplemented with demographic items. The survey assessed SVP prevalence, symptom severity, and preferred support measures. A web-based survey was distributed via professional networks. Descriptive statistics summarized sample characteristics and binary logistic regression was used to identify predictors of SVP and symptom burden. Results: Among 407 respondents, 315 completed the questionnaire (completion rate: 78%). More than half (62.2%) of participating EMDs identified as Second Victims, despite limited prior awareness of the phenomenon. Traumatic events such as patient deaths or suicides and aggressive behavior were central triggers. SVP was linked to symptoms including emotional strain and difficulties concentrating, with neuroticism associated with greater symptom load ( p = 0.02). Binary logistic regression suggested that higher scores of the personality trait openness and professional experience increase SVP risk ( p < 0.01). Although many affected EMDs refrained from seeking help, those who did often relied on their friends and family for support. Immediate time off, structured debriefing, and professional counseling emerged as the most valued support strategies. Conclusions: SVP is highly prevalent among EMDs, highlighting the need for targeted support strategies. Raising awareness, integrating SVP education into dispatcher training, and establishing accessible psychological support programs are essential to improve well-being and resilience in this professional group.

Zusammenfassung: Einleitung: Second Victims sind Beschäftigte im Gesundheitswesen, die von unerwünschten Ereignissen negativ betroffen sind und dazu neigen, dysfunktionale Bewältigungsstrategien zu entwickeln, die nicht nur ihre eigene, sondern auch die Sicherheit der Patient:innen gefährden. Ein wirksamer Weg, dieses Problem anzugehen, ist die Einführung von Peer-Support-Programmen. Dieser Beitrag berichtet über die Wirksamkeit eines Peer-Support-Programms an der österreichischen Klinik Hietzing (KHI). Methode: Nach den Peer-Support-Sitzungen wurden Telefoninterviews mit Hilfe eines Fragebogens durchgeführt. Es wurde eine deskriptive Analyse durchgeführt, die Häufigkeiten für nominale Variablen und Mittelwerte mit Standardabweichungen für ordinale und intervallskalierte Variablen ausweist. Ergebnisse: Bisher haben 70 Peer-Supporter Telefoninterviews nach einer Peer-Support-Sitzung ausgefüllt. Die Hauptgründe für die Sitzung waren schlechte Nachrichten aus dem privaten Umfeld und der Tod eines/einer Patienten:in. Die Peer-Supporter bewerteten die Nützlichkeit der Sitzungen für ihre Kollegen als sehr hoch, fühlten sich aber selbst danach nicht sehr belastet. Diskussion: Obwohl das Programm wirksam zu sein scheint, ist eine unzureichende Nutzung wahrscheinlich. Die hohe Bewertung der Nützlichkeit der durchgeführten Sitzungen durch die Peer-Supporter in Kombination mit der Tatsache, dass sie sich nicht sehr belastet fühlten, zeigt, dass das Programm für die Peer-Supporter sicher ist.

Introduction: Midwives frequently encounter adverse events, potentially leading to the Second Victim Phenomenon (SVP), a condition marked by emotional distress, selfdoubt, and psychological symptoms. This study investigates the prevalence, key triggers, symptom severity, and support needs of...

[This corrects the article DOI: 10.2196/64125.].

UNSTRUCTURED In the field of research, psychological safety has been widely recognized as a contributing factor to improving the quality of care and patient safety. However, its consideration in the curricula and traineeship pathways of residents and health care students is scarce. This study aims to determine the extent to which health care trainees acquire psychological safety competencies during their internships in clinical settings and identify what measures can be taken to promote their learning. A mixed methods observational study based on a consensus conference and an open-ended survey among a sample of health care trainee mentors from health care institutions in a pan-European context was conducted. First, we administered an ad hoc questionnaire to assess the perceived degree of acquisition or implementation and significance of competencies (knowledge, attitudes, and skills) and institutional interventions in psychological safety. Second, we asked mentors to propose measures to foster among trainees those competencies that, in the first phase of the study, obtained an average acquisition score of <3.4 (scale of 1-5). A content analysis of the information collected was carried out, and the spontaneity of each category and theme was determined. In total, 173 mentors from 11 pan-European countries completed the first questionnaire (response rate: 173/256, 67.6%), of which 63 (36.4%) participated in the second consultation. The competencies with the lowest acquisition level were related to warning a professional that their behavior posed a risk to the patient, managing their possible bad reaction, and offering support to a colleague who becomes a second victim. The mentors’ proposals for improvement of this competency gap referred to training in communication skills and patient safety, safety culture, work climate, individual attitudes, a reference person for trainees, formal incorporation into the curricula of health care degrees and specialization pathways, specific systems and mechanisms to give trainees a voice, institutional risk management, regulations, guidelines and standards, supervision, and resources to support trainees. In terms of teaching methodology, the mentors recommended innovative strategies, many of them based on technological tools or solutions, including videos, seminars, lectures, workshops, simulation learning or role-playing with or without professional actors, case studies, videos with practical demonstrations or model situations, panel discussions, clinical sessions for joint analysis of patient safety incidents, and debriefings to set and discuss lessons learned. This study sought to promote psychological safety competencies as a formal part of the training of future health care professionals, facilitating the translation of international guidelines into practice and clinical settings in the pan-European context.

Background: Healthcare workers negatively affected by adverse events are known as Second Victims (SV). The Second Victim Phenomenon (SVP) is widespread globally and can result in various consequences, such as anxiety, loss of confidence, and defensive medicine. To address this, the KoHi-project offers organizational peer support for SVs at the Clinic Hietzing (KHI) in Vienna, Austria. Methods: A five-hour training program prepared 122 volunteers as peer supporters (KoHis) at KHI. Initial assessment (KoHi-I) in 2019 using the SeViD-questionnaire was followed by a repeat (KoHi-V) in 2022. Additionally, peer supporters underwent quantitative evaluations after training (KoHi-II), each session (KoHi-III), and after three sessions (KoHi-IV). KoHi-I-III were descriptively analyzed, while KoHi-IV and -V await evaluation. Results: Initial study showed a 43% SVP prevalence at KHI. Most KoHis joined for ethical reasons and skill improvement, displaying high motivation. Post-training, they reported increased competency in supporting SVs. KoHi-III showed 53.3% of sessions initiated by KoHis, often triggered by personal distress. KoHis rated their support as highly helpful (M = 8.57 on a ten-point Likert-scale) and felt minimal burden (M = 3.42 on a ten-point Likert-scale) afterward. No significant correlations were found. Conclusions: SVP is widespread at KHI. The five-hour training adequately prepared KoHis. Underreporting or underutilization of the program is suspected, possibly due to self-stigmatization of SVs. Being a peer supporter appears safe for KoHis. Psychological safety of voluntary supporters should be prioritized in hospital peer support programs. European hospitals lack organizational support for SVs, highlighting the importance of interventions like KoHi. Key messages: • The SVP is common among healthcare workers at KHI. • The implemented organizational peer support seems to not negatively impact the voluntary peer supporters’ wellbeing.

Background: The Second Victim Phenomenon (SVP) significantly impacts the well-being of healthcare professionals and patient safety. While the SVP has been explored in various healthcare settings, there are limited data on its prevalence and associated factors among nurses in Austria. This study investigates the prevalence, symptomatology, and preferred support measures for SVP among Austrian nurses. Methods: A nationwide, cross-sectional, anonymous online survey was conducted September to December 2023 using the SeViD questionnaire (Second Victims in German-speaking Countries), which includes the Big Five Inventory-10 (BFI-10). Statistical analyses included binary logistic regression and multiple linear regression using the bias-corrected and accelerated (BCa) bootstrapping method based on 5000 bootstrap samples. Results: A total of 928 participants responded to the questionnaire with a response rate of 15.47%. The participants were on average 42.42 years old and were mainly women (79.63%). Among the respondents, 81.58% (744/912) identified as Second Victims (SVs). The primary cause of becoming an SV was aggressive behavior from patients or relatives. Females reported a higher symptom load than males, and higher agreeableness was linked to increased symptom severity. Notably, 92.47% of SVs who sought help preferred support from colleagues, and the most pronounced desire among participants was to process the event for better understanding. Conclusions: The prevalence of SVP among Austrian nurses is alarmingly high, with aggressive behavior identified as a significant trigger. The findings emphasize the necessity for tailored support strategies, including peer support and systematic organizational interventions to mitigate the impact of SVP on nurses and to improve overall patient care. Further research should focus on developing and implementing effective prevention and intervention programs for healthcare professionals in similar settings.

Background: In the field of research, psychological safety has been widely recognized as a contributing factor to improving the quality of care and patient safety. However, its consideration in the curricula and traineeship pathways of residents and health care students is scarce. Objective: This study aims to determine the extent to which health care trainees acquire psychological safety competencies during their internships in clinical settings and identify what measures can be taken to promote their learning. Methods: A mixed methods observational study based on a consensus conference and an open-ended survey among a sample of health care trainee mentors from health care institutions in a pan-European context was conducted. First, we administered an ad hoc questionnaire to assess the perceived degree of acquisition or implementation and significance of competencies (knowledge, attitudes, and skills) and institutional interventions in psychological safety. Second, we asked mentors to propose measures to foster among trainees those competencies that, in the first phase of the study, obtained an average acquisition score of <3.4 (scale of 1-5). A content analysis of the information collected was carried out, and the spontaneity of each category and theme was determined. Results: In total, 173 mentors from 11 pan-European countries completed the first questionnaire (response rate: 173/256, 67.6%), of which 63 (36.4%) participated in the second consultation. The competencies with the lowest acquisition level were related to warning a professional that their behavior posed a risk to the patient, managing their possible bad reaction, and offering support to a colleague who becomes a second victim. The mentors’ proposals for improvement of this competency gap referred to training in communication skills and patient safety, safety culture, work climate, individual attitudes, a reference person for trainees, formal incorporation into the curricula of health care degrees and specialization pathways, specific systems and mechanisms to give trainees a voice, institutional risk management, regulations, guidelines and standards, supervision, and resources to support trainees. In terms of teaching methodology, the mentors recommended innovative strategies, many of them based on technological tools or solutions, including videos, seminars, lectures, workshops, simulation learning or role-playing with or without professional actors, case studies, videos with practical demonstrations or model situations, panel discussions, clinical sessions for joint analysis of patient safety incidents, and debriefings to set and discuss lessons learned. Conclusions: This study sought to promote psychological safety competencies as a formal part of the training of future health care professionals, facilitating the translation of international guidelines into practice and clinical settings in the pan-European context.

Background: Health care workers (HCWs) are often impacted by distressing situations during patient care and can experience the second victim phenomenon (SVP). Addressing an adequate response, training, and increasing awareness of the SVP can increase HCWs’ well-being and ultimately improve the quality of care and patient safety. Objective: This study aims to describe and evaluate a multimodal training organized by the European Researchers’ Network Working on Second Victims to increase knowledge and overall awareness of SVP and second victim programs. Methods: We implemented a multimodal training program, following an iterative approach based on a continuous quality improvement process, to enhance the methodology and materials of the training program over the duration of 2 years. We conducted web-based surveys and group interviews to evaluate the scope and design of the training, self-directed learning materials, and face-to-face activities. Results: Out of 42 accepted candidates, 38 (90%) participants attended the 2 editions of the Training School program. In the second edition, the level of participants’ satisfaction increased, particularly when adjusting the allocated time for the case studies’ discussion (P<.001). After the multimodal training, participants stated that they had a better awareness and understanding of the SVP, support interventions, and its impact on health care. The main strengths of this Training School were the interdisciplinary approach as well as the contact with multiple cultures, the diversity of learning materials, and the commitment of the trainers and organizing team. Conclusions: This multimodal training is suitable for different stakeholders of the health care community, including HCWs, clinical managers, patient safety and quality-of-care teams, academicians, researchers, and postgraduate students, regardless of their prior experience with SVP. Furthermore, this study represents a pioneering effort in elucidating the materials and methodology essential for extending this training approach to similar contexts.