Objectives: Patient safety incidents (PSIs) are common in healthcare. Open communication facilitated by psychological safety in healthcare could contribute to the prevention of PSIs and enhance patient safety. The aim of the study was to explore medical professionals\' responses to a PSI in relation to psychological safety in Slovak healthcare. Methods: Sixteen individual semi-structured interviews with Slovak medical professionals were performed. Obtained qualitative data were transcribed verbatim and analysed using the conventional content analysis method and the consensual qualitative research method. Results: We identified eight responses to a PSI from medical professionals themselves as well as their colleagues, many of which were active and with regard to ensuring patient safety (e.g., notification), but some of them were passive and ultimately threatening patients\' safety (e.g., silence). Five superiors\' responses to the PSI were identified, both positive (e.g., supportive) and negative (e.g., exaggerated, sharp). Conclusion: Medical professionals\' responses to a PSI are diverse, indicating a potential for enhancing psychological safety in healthcare.

UNASSIGNED: When adverse events (AE) occur, there are different consequences for healthcare professionals. The environment in which professionals work can influence the experience. This study aims to explore the experiences of second victims (SV) among health professionals in Argentina.
UNASSIGNED: A phenomenological study was used with in-depth interviews with healthcare professionals. Audio recordings and verbatim transcriptions were analyzed independently for themes, subthemes, and codes.
UNASSIGNED: Three main themes emerged from the analysis: navigating the experience, the environment, and the turning point. Subthemes were identified for navigating the experience to describe the process: receiving the impact, transition, and taking action.
UNASSIGNED: SVs undergo a process after an AE. The environment is part of this experience. It is a turning point in SVs\' professional and personal lives. Improving the psychological safety (PS) environment is essential for ensuring the safety of SVs.

BACKGROUND: Knowledge about patient safety in orthodontics is scarce. Lack of standardisation and a common terminology hinders research and limits our understanding of the discipline. This study aims to 1) summarise current knowledge about patient safety incidents (PSI) in orthodontic care by conducting a systematic literature search, 2) propose a new standardisation of PSI terminology and 3) propose a future research agenda on patient safety in the field of orthodontics.
METHODS: A systematic literature search was performed in the main online sources of PubMed, Web of Science, Scopus and OpenGrey from their inception to 1 July 2023. Inclusion criteria were based on the World Health Organization´s (WHO) research cycle on patient safety. Studies providing information about the cycle\'s steps related to orthodontics were included. Study selection and data extraction were performed by two of the authors.
RESULTS: A total of 3,923 articles were retrieved. After review of titles and abstracts, 41 articles were selected for full-text review and 25 articles were eligible for inclusion. Seven provided information on the WHO\'s research cycle step 1 (\"measuring harm\"), twenty-one on \"understanding causes\" (step 2) and twelve on \"identifying solutions\" (step 3). No study provided information on Steps 4 and 5 (\"evaluating impact\" or \"translating evidence into safer care\").
CONCLUSIONS: Current evidence on patient safety in orthodontics is scarce due to a lack of standardised reporting and probably also under-reporting of PSIs. Current literature on orthodontic patient safety deals primarily with \"measuring harms\" and \"understanding causes of patient safety\", whereas less attention has been devoted to initiatives \"identifying solutions\", \"evaluating impact\" and \"translating evidence into safer care\". The present project holds a proposal for a new categorisation, terminology and future research agenda that may serve as a framework to support future research and clinical initiatives to improve patient safety in orthodontic care.
BACKGROUND: PROSPERO (CRD42022371982).

OBJECTIVE: To determine the factors related with the perception of feeling safe during pre-hospital emergency care.
METHODS: A multi-centred, cross-sectional study. Data collection from April 2021 to March 2022, in the Centro de Emergencias Sanitarias 061 (Andalusia, Spain).
METHODS: witnesses of health care by emergency medical services.
METHODS: minors, or communication barriers.
METHODS: Witness Perceived Safety Scale ESPT10. The variables studied were related with sociodemographic data, the request for health care, the patient, the hospital transfer and patient safety incidents. A multivariate linear regression model was constructed for the dependent variable. The study followed STROBE statement.
RESULTS: Responses were obtained from 1400 witnesses. The linear regression model showed that the score on the scale increased as the witnesses felt more satisfied (B = 1.302; p < 0.001). On the contrary, the score was lower when the witness reported a patient safety incident (B = -2.856; p < 0.001 and B = -3.166; p < 0.001), or when the assistance took place in a public space (B = -0.722; p = 0.017).
CONCLUSIONS: The level of satisfaction, the occurrence of a patient safety incident, and the place of health care are related factors with the perception of the witnesses. The Witness Perceived Safety Scale ESPT10 could be considered a valid and useful patient safety indicator.

OBJECTIVE: To describe nurse managers\' perceptions of interventions to support nurses as second victims of patient safety incidents and to describe the management of interventions and ways to improve them.
METHODS: A qualitative study using interviews.
METHODS: A purposive sample of nurse managers (n = 16) recruited from three hospital districts in Finland was interviewed in 2021. The data were analysed using elements of inductive and deductive content analysis.
RESULTS: The study identified three main categories: (1) Management of second victim support, which contained three sub-categories related to the nurse manager\'s role, support received by the nurse manager and challenges of support management; (2) interventions to support second victims included existing interventions and operating models; and (3) improving second victim support, based on the sub-categories developing practices and developing an open and non-blaming patient safety culture.
CONCLUSIONS: Nurse managers play a crucial role in supporting nurses as second victims of patient safety incidents and coordinating additional support. Operating models for managing interventions could facilitate nurse managers\' work and ensure adequate support for second victims. The support could be improved by increasing the awareness of the second victim phenomenon.
UNASSIGNED: Mitigating the harmful effects of patient safety incidents can improve nurses\' well-being, reduce burden and attrition risks and positively impact patient safety.
CONCLUSIONS: Increasing awareness of the second victim phenomenon and coherent operation models would provide equal support for the nurses and facilitate nurse managers\' work.
UNASSIGNED: COREQ checklist was used. What does this paper contribute to the wider global clinical community? Nurse managers\' role is significant in supporting the second victims and coordinating additional support. Awareness of the second victim phenomenon and coherent operating models can secure adequate support for the nurses and facilitate nurse managers\' work.

BACKGROUND: Patient safety incidents (PSIs) in healthcare settings are a critical concern globally, and Ghana is no exception. Addressing PSIs to improve health outcomes requires various initiatives to be implemented including improving patient safety culture, teamwork and communication between healthcare providers during handoffs. It is essential to acknowledge the significance of teamwork, communication openness, and effective handoffs in preventing and managing such incidents. These factors play a pivotal role in ensuring the well-being of patients and the overall quality of healthcare services.
OBJECTIVE: This study assessed the occurrence and types of PSIs in health facilities in Ghana. It also examined the role of teamwork, handoffs and information exchange, and communication openness in response to PSIs by health professionals.
METHODS: A cross-sectional study was conducted among 1651 health workers in three regions of Ghana. Using a multi-staged sampling technique, the Survey on Patient Safety Culture Hospital Survey questionnaire and the nurse-reported scale were used to collect the data and it was analysed by descriptive statistics, Pearson correlation, and linear multiple regression model at a significance of 0.05.
RESULTS: There was a reported prevalence of PSIs including medication errors (30.4%), wound infections (23.3%), infusion reactions (24.7%), pressure sores (21.3%), and falls (18.7%) at least once a month. There was a satisfactory mean score for responses to adverse events (3.40), teamwork (4.18), handoffs and information exchange (3.88), and communication openness (3.84) among healthcare professionals. Teamwork, handoffs and information exchange and communication openness were significant predictors of response to PSIs, accounting for 28.3% of the variance.
CONCLUSIONS: Effective teamwork, handoffs and information exchange, and communication openness in the healthcare environment are critical strategies to enhance PSI response. Creating a culture that encourages error response through teamwork, communication and handoffs provides healthcare professionals with opportunities for learning and improving patient outcomes. Training programs should therefore target health professionals to improve patient safety and competency. Through the implementation of evidence-based practices and learning from past incidents, the healthcare system will be able to deliver safe and high-quality care to patients nationwide. Patient safety must be recognized as an ongoing process. Therefore, a meaningful improvement in patient outcomes requires all stakeholders\' commitment.

Obstetrics is a well-known area for malpractice and medical-legal claims, specifically as they relate to injuries the baby suffers during the intrapartum period. There is a direct implication for nurses\' work in labor and delivery because the law recognizes that monitoring fetal well-being during labor is a nursing responsibility. Using institutional ethnography, we uncovered how two powerful ruling discourses, namely biomedical and medical-legal risk discourses, socially organize nurses\' fetal surveillance work in labor and delivery through the use of an intertextual hierarchy and an ideological circle.

After a patient safety incident, the involved healthcare providers may experience sustained second-victim distress and reduced professional efficacy, with subsequent negative work-related outcomes and the cultivation of resilience. This study aims to investigate the factors affecting negative work-related outcomes and resilience with a hypothetical triad of support as the mediators: colleague, supervisor, and institutional support. This cross-sectional study recruited 733 healthcare providers from three tertiary care hospitals in Kelantan, Malaysia. Three steps of hierarchical linear regression were developed for both outcomes (negative work-related outcomes and resilience). Four multiple mediator models of the support triad were analyzed. Second-victim distress, professional efficacy, and the support triad contributed significantly in all the regression models. Colleague support partially mediated the relationship defining the effects of professional efficacy on negative work-related outcomes and resilience, whereas colleague and supervisor support partially mediated the effects of second-victim distress on negative work-related outcomes. Similar results were found regarding resilience, with all support triads producing similar results. As mediators, the support triads ameliorated the effect of second-victim distress on negative work-related outcomes and resilience, suggesting an important role of having good support, especially after encountering patient safety incidents.

BACKGROUND: In situations of home care, patients and their family members must address problems and emergencies themselves. For this reason, home-visiting nurses (HVNs) must practice risk management to ensure that patients can continue receiving care in the comfort of their homes. The purpose of this study was to examine HVNs\' attitudes toward risk management.
METHODS: This study adopted a qualitative description approach. Semi-structured interviews were conducted to collect information on HVNs\' risk management behavior and their attitudes toward it. Participants comprised 11 HVNs working at home-visiting nursing agencies in a prefecture of Japan. Transcribed interviews were analyzed using content analysis.
RESULTS: Nurses\' attitudes toward risk management comprised the following themes: (i) predicting and avoiding risks, (ii) ensuring medical safety in home settings, (iii) coping with incidents, and (iv) playing the role of administrators in medical safety, which was answered only by administrators.
CONCLUSIONS: When practicing risk management, home-visiting nurses should first assess the level of understanding of the patient and family, followed by developing safety measures tailored to their everyday needs. These results further suggest that administrators should take actions to foster a working environment conducive to risk management. These actions include coordinating duties to mitigate risk and improve the process of reporting risks. This study provides a baseline for future researchers to assist patients and families requiring medical care services of this nature.

\"Second victims\" are defined as healthcare professionals who are traumatized physically, psychologically, or emotionally as a result of encountering any patient safety incidents. The Revised Second Victim Experience and Support Tool (SVEST-R) is a crucial instrument acknowledged worldwide for the assessment of the second victim phenomenon in healthcare facilities. Hence, the aim of this study was to evaluate the psychometric properties of the Malay version of the SVEST-R. This was a cross-sectional study that recruited 350 healthcare professionals from a teaching hospital in Kelantan, Malaysia. After obtaining permission from the original author, the instrument underwent 10 steps of established translation process guidelines. Pretesting of 30 respondents was performed before embarking on the confirmatory factor analysis (CFA) to evaluate internal consistency and construct validity. The analysis was conducted using the R software environment. The final model agreed for 7 factors and 32 items per the CFA\'s guidelines for good model fit. The internal consistency was determined using Raykov\'s rho and showed good results, ranging from 0.77 to 0.93, with a total rho of 0.83. The M-SVEST-R demonstrated excellent psychometric properties and adequate validity and reliability. This instrument can be used by Malaysian healthcare organizations to assess second victim experiences among healthcare professionals and later accommodate their needs with the desired support programs.