Filipino Nurses as Second Victims of Medication Error: A Sequential Mixed-Methods Study

Vollständiger Abstract

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Introduction: The second victim phenomenon—the psychological and emotional distress experienced by healthcare professionals following an adverse clinical event—remains underexplored in the Philippines, particularly after high-alert medication (HAM) errors. Objective: This study described second-victim-related experiences and their emotional and professional impacts and explored nurses’ lived experiences to inform support interventions. Methods: A sequential explanatory mixed-methods design was used. In Phase 1, 200 registered nurses at a tertiary hospital in Metro Manila completed an initial screening survey; 21 who self-reported involvement in an intravenous HAM error within the previous three years completed the Second Victim Experience and Support Tool–Revised (SVEST-R). Descriptive statistics were used. In Phase 2, six nurses with moderate-to-high second-victim-related distress participated in phenomenological interviews analyzed using Colaizzi’s method. Results: Among the 200 screened nurses, 21 (10.5%) reported involvement in an intravenous HAM error, most commonly a wrong-dose error during routine medication administration. Reported contributing factors included high workload, distractions, poor communication, and fatigue. SVEST-R findings indicated psychological, physical, and professional impacts and limited perceived organizational support. Six qualitative themes described emotional distress, threats to professional identity, heightened vigilance, support and stigma, coping and resilience, and calls for system-level change. Conclusion: The findings highlight the need for structured support, confidential debriefing, just-culture leadership, and integration of emotional support into patient-safety policies.