Journal List > Perspect Nurs Sci > v.13(1) > 1060414

Jang and Lee: Healthcare Professionals Involved in Medical Errors and Support Systems for Them: A Literature Review



The purpose of this study was to identify the current state of research on healthcare professionals who make medical errors, who are known as “second victims”, and support systems for them. Methods: An extensive search was conducted in electronic databases, Google, and websites related to patient safety using search terms such as “second victims”, “medical errors”, “adverse events”, and “sentinel events”. Results: Research to date in Korea has rarely focused on healthcare professionals’ experiences after making medical errors. Abroad, there are comprehensive and systematic reviews of the impact of medical errors on healthcare professionals, their coping responses, and support systems for these second victims. Additionally, several institutes related to patient safety provide official guidelines and accessible support systems to support second victims in the aftermath of medical errors, especially serious adverse events. Conclusion: The impact of medical errors on healthcare professionals is profound and complex. Although systematic support systems for second victims are imperative, this has been overlooked in Korea. Thus, more research about the experiences of healthcare professionals after medical errors needs to be conducted prior to developing support systems or programs. Additionally, further efforts are required to raise awareness of the necessity of supporting healthcare professionals in healthcare systems.


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Table 1.
Summary of Included Systematic Review
Categories Sirriyeh el al. (2010) Seys el al. (2013) Seys el al. (2013) Lewis et al. (2013) Total n (%)
Goal Identify impact of being involved in a medical error on the health professional, copping strategies in the short and longer term, and factors that influence the immediate response to error and/or the way in which individuals cope Identify supportive interventional strategies for second victims Review definitions of second victims, and prevalence of second victims, impact of the medical error/adverse event on the second victim, and individual coping strategies used by second victims Review the effect of medical errors on nurse
Searching strategy 1. Database searching 1. Database searching 1. Database searching 1. Database searching
- PsychInfo - CINAHL - CINAHL - CochraneLibrary
- ScienceDirect, 2. Manual search of reference lists 2. Manual review of reference lists from relevant articles 2. Manual search of reference lists
- The CochraneLibrary
- Embase 3. External review by three experts
2. Manual search of reference lists 3. Review by three experts
3. Assessment of study quality
Major search terms Coping with/respond to/attitude towards/ commit/perception of committing/making/ recover from making Psychology/emotions/ feelings/burnout/ depression/empathy /attitude of health personnel/burnout, professional [MeSH]/ depressive disorder [MeSH]/empathy [MeSH] Psychology/emotions/ feelings/burnout/ depression/empathy / attitude of health personnel/burnout, professional [MeSH]/ depressive disorder [MeSH]/empathy [MeSH] Nurse/nurses/ nursing
Coping/response/ attitude/commit/ perception/making/ recover
- Medical error
- Medical mistake
- Medical mishap - Medical error
- Medical blunder - Mistake
- Medical adverse event - Second victim - Second victim - Mishap
- Medical incident - Medical error - Medical error - Blunder
- Medical error - Medical error - Adverse event
[MeSH] [MeSH] - Incident
- Adverse event - Adverse event
Inclusion criteria Published between 1980 and 2009 English language
peer-reviewed journals
Published until september 2010 Englishlanguage Published through September 2010 English language Published between 1980 and December 2011 English language
Peer-reviewed journals
Studies that Studies that
- Used the error fit the Reason's definition - Provided a definition of second victim in health care settings.
- Focused on health professionals and trainees - Assessed prevalence of medical errors/adverse events on health care providers.
- Focused on the psychological or emotional outcomes of medical errors for health professionals - Reproduced the impact of a medical error/adverse event on the health care provider.
Exclusion criteria Not suggested Conference reports newspaper stories personal stories of health care professionals in a scientific journal Not published in English, conference reports, newspaper stories, and personal stories of health care professionals in a scientific journal Not suggested
Number of articles reviewed by target population 24 31 41 21 117
   Doctors 19 14 20   53 (43.1)
   Medical students 3 2 4   9 (7.3)
   Medical educator 1 2 1   4 (3.3)
   Nurse 6 8 10 21 45 (36.6)
   National experts   1 1   2 (1.6)
   Other health professionals 2 1 2   5 (4.1)
   Patients 1 1 1   3 (2.4)
   Not specified     2   2 (1.6)
Type of study/Design          
  Research article          
   Quantative 10 8 12 1 31 (26.5)
   Qualitative 11 1 12 1 15 1 13 1 51 (43.6) 4 (3.4)
   Mixed method 1 1 1 1 4 4 (3.4) 4 (3.4)
   Correlational       4 1 4 (3.4) 1 (0.9)
   Descriptive       1 1 (0.9)
   Comparison 2   1 1   1 (0.9) 3 (2.6)
   Prospective cohort 2   1 2   3 (2.6) 2 (1.7)
   3~year longitudinal     2   2 (1.7)
   Prospective 3~year longitudinal          
  Non research article   10 9   19 (16.2)
Setting Primary, secondary, tertiary and community care settings

Multiple count among systematic review research

Nonresearch articles include opinions, case study, reports, reviews, editorial, commentary etc.

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