Experiences of Nurses as Second Victims in Hospital Acute Care: Thematic Synthesis of Qualitative Studies

BackgroundAdverse events on acute hospital wards contribute to second victim experiences among nurses, which may adversely affect their personal and professional functioning.Review QuestionWhat are the experiences of nurses as second victims of adverse events in hospital acute care?Type of ReviewA qualitative research synthesis using the three-stage thematic synthesis approach by Thomas and Harden.MethodsThe literature review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and reported with reference to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement for qualitative evidence synthesis. A systematic search was carried out in Scopus, ProQuest, PubMed, Web of Science, and ScienceDirect. The included qualitative studies were critically appraised using the Critical Appraisal Skills Programme (CASP) checklist, and textual data extracted from seven studies involving a total of 96 participants were synthesized using Thomas and Harden's thematic synthesis approach.ConclusionsThree analytical themes representing nurses' experiences as a second victim were synthesized: dealing with harm; between support and loneliness; and understanding and learning from adverse events as a strategy for prevention.ImplicationsIt is necessary for the management of health-care facilities to adopt the principles of a just and blame-free culture that supports second victims to provide learning from their errors and constructive debriefing after adverse events, together with accessible peer support and psychological services.