The doctoral dissertation in the field of Nursing Science will be examined at the Faculty of Health Sciences at Kuopio campus.
What is the topic of your doctoral research? Why is it important to study the topic?
The topic of the doctoral research was “Healthcare professionals as second victims of medication errors and their perceptions of support”.
Medication errors have long been recognised as a significant concern in healthcare globally. A report from the US National Academy of Medicine and a subsequent report from the World Health Organization have established medication errors as the third leading cause of death among hospitalised patients, resulting in an annual cost of approximately 42 billion US dollars. While the immediate and most visible impact of medication errors is on patients, its effect extends far beyond, profoundly impacting the healthcare professionals involved in these incidents known as “second victims”.
The topic “second victim” has been extensively studied and the term has been widely used in other countries to describe the psychological, physical, and social repercussions faced by healthcare professionals after committing a medical error. However, this concept remains underexplored in Finland, leaving a gap in understanding how Finnish healthcare professionals experience and cope with such events. Given this context, it was crucial to investigate and describe the impact of the second victim phenomenon among Finnish healthcare professionals, while also exploring the availability and effectiveness of existing support strategies targeted at them. The research not only highlighted the experience of Finnish HCPs but also provided insights into how healthcare organisations could better address the second victim phenomenon.
What are the key findings or observations of your doctoral research?
This study provides valuable insights into the well-known yet rarely recognised concept of “healthcare professionals as second victims” within the Finnish healthcare community. Specifically, the research focused on the emotional responses of second victims following medication errors and explored Finnish healthcare professionals' perceptions of their support needs and the strategies required to address them. The foundation of this research was based on the negative emotions expressed by healthcare professionals in England and Wales in reported medication error incidents. The study explored the emotional responses and perspectives of Finnish registered nurses regarding the support they received and their desired support. The data collected from Finnish registered nurses revealed similar negative emotional experiences to those reported in the English data. Furthermore, the findings demonstrated that organisational support mediates the relationship between the distress experienced by second victims and adverse work-related outcomes, such as turnover intentions and work absenteeism. However, the percentage of work absenteeism was found to be relatively low among Finnish healthcare professionals. Contrary to expectations, the resilience of Finnish healthcare professionals was not significantly associated with either second victim distress or the level of organisational support.
This research is unique in its application of various research designs and analytical techniques. Additionally, it introduces a validated tool, the Second Victim Experience and Support Tool-Revised (SVEST-R), which was translated and psychometrically validated for the first time in Finland (FI-SVEST-R). This tool can now be used to measure second victim distress and the support needs of healthcare professionals in the Finnish context.
For the scientific community, this study highlights a critical gap in addressing the well-being of healthcare professionals following adverse events. It is also the first study of its kind to be conducted in Finland, providing a foundation for further research in this area. For the public, the findings contribute to improved healthcare safety by ensuring that those providing care are better supported, resilient, and mentally healthy—ultimately leading to improved patient outcomes.
How can the results of your doctoral research be utilised in practice?
The results of my doctoral research on the second victim phenomenon among healthcare professionals can be applied in practice in several significant ways. First, Finnish healthcare institutions can develop and implement structured support programmes tailored to the specific needs and preferences of second victims, as expressed in this study. These programmes would provide targeted emotional and professional support, ensuring a more effective recovery process for healthcare providers following adverse events.
Second, the findings of this research can inform policy changes aimed at transitioning from a punitive, blame-oriented culture to a non-punitive, open, and just culture. Such a shift would emphasise learning from errors rather than punishing individuals, fostering a safer and more supportive working environment for healthcare professionals. Finally, this research can be used to improve existing second-victim curricula and support programmes by aligning them more closely with the unique needs of Finnish healthcare professionals. Enhancing these educational programmes will ensure that healthcare providers are better equipped to navigate the emotional and psychological challenges associated with patient safety incidents, ultimately promoting resilience and improving the quality of care.
What are the key research methods and materials used in your doctoral research?
This doctoral research was conducted in four parts and was a multi-method study. The first part of this study followed a retrospective qualitative descriptive design, where n=72,390 medication error incident reports from England and Wales reported in 2016 were analysed. In the second phase of this study, a semi-structured interview was conducted among registered nurses working in Finnish healthcare institutions. This study's third phase comprised translation and psychometric validation of an instrument named Second Victim Experience and Support Tool (Revised) into Finnish. This translated and validated instrument was then used to conduct a cross-sectional survey among Finnish healthcare professionals to study the feelings and experiences of healthcare professionals after making medication errors, and their perception of support available at their workplace. Additionally, three open-ended questions concerning the significant challenges healthcare professionals faced after getting involved in medication errors, the support they received from their workplace and the support they desired in the aftermath of the errors.
The doctoral dissertation of Sanu Mahat, MPH, RN, entitled Healthcare Professionals as Second Victims of Medication Errors and their Perceptions of Support will be examined at the Faculty of Health Sciences. The Opponent in the public examination will be Professor Maritta Välimäki of the University of Helsinki, and the Custos will be Associate Professor Marja Härkänen of the University of Eastern Finland. The public examination will be in English.
For further information, please contact:
Sanu Mahat, MPH, sanu.mahat@uef.fi, +358406755623, https://uefconnect.uef.fi/en/sanu.mahat/
