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Background: Healthcare adverse events (AEs) significantly impact professionals, often leading to emotional distress and lasting effects. This study investigates the impact of AEs on healthcare professionals in Romania, focusing on nurses to examine their experiences within the patient safety culture and the psychological consequences of AEs. With a limited body of research on patient safety, adverse events, and second victims (SVs) in Romania, this study addresses a crucial gap, highlighting the need for enhanced safety culture and support mechanisms for SVs. Methods: A cross-sectional study in Romania targeted healthcare professionals, focusing on nurses. Utilizing online and onsite surveys facilitated by the Order of Nurses, Midwives, and Medical Assistants in Romania, data were collected between April and June 2022, exploring AEs and related experiences. Statistical analysis included chi-square tests, Student's t-tests, one-way ANOVA, and logistic regression, using SPSS version 29.0. Results: This study surveyed 995 nurses in Romania, primarily aged 31–50 (67.8%). Over half (57.9%) reported near-miss incidents, and 30.8% were aware of serious adverse events. Nurses over 50 scored higher on safety culture (20.98 vs. 20.45, p =.024) than younger nurses. Higher safety culture scores were associated with reduced negative emotional responses (e.g., guilt, anxiety, insomnia, tiredness) following AEs. Higher safety culture scores were associated with reduced negative emotional responses. Additionally, 88.9% of nurses showed interest in training for coping with adverse events, highlighting the need for supportive interventions in healthcare settings. Discussion: This study underscores the significant emotional and professional impact of AEs on nurses in Romania, highlighting ongoing challenges in healthcare environments. The positive perception of safety culture among nurses suggests a basis for improvement, while training needs underscore areas for intervention. Tackling the second victim phenomenon is crucial for maintaining patient safety. [ABSTRACT FROM AUTHOR]

Patient safety in psychiatric inpatient facilities remains under-researched despite its crucial importance. This study aims to address this gap by using expert opinion to estimate the frequency of diverse patient safety incidents (PSIs) in psychiatric settings and to compare it with the existing literature. Utilizing a seven-step approach, a questionnaire based on the World Health Organization's International Classification for Patient Safety was developed and deployed. A total of 33 expert opinions were collected. Results showed a higher estimated incidence of PSIs in psychiatric settings compared to general healthcare, highlighting categories such as patient behavior, medication, and infrastructure as significant contributors. Experts emphasized the prevalence of incidents related to behavioral issues and inadequate infrastructure, areas often overlooked in the existing literature. Unlike general settings, psychiatric facilities appear more vulnerable to specific PSIs, such as those related to medication and building safety, underscoring the need for targeted safety measures. Our study suggests the existence of significant discrepancies between expert opinion and available research, with several underexplored domains in psychiatric patient safety. [ABSTRACT FROM AUTHOR]

The article discusses the potential of digital healthcare innovations to address the challenges facing European healthcare systems. Topics include the growing demand for healthcare due to ageing populations and chronic illnesses, the promises of digital healthcare solutions such as telemedicine and AI, and the barriers to achieving tangible results, particularly in the context of healthcare professionals' working conditions and the need for careful consideration of stakeholders' needs.

The second victim phenomenon (SVP) refers to workers negatively impacted by involvement in unanticipated adverse events or errors. While this phenomenon has been extensively studied in healthcare since its acknowledgment over 20 years ago, its presence and management in other high-risk industries have remained unclear. We conducted a scoping review aiming to map the SVP in non-healthcare industries, as well as to explore the available interventions or support programs addressed to help second victims (SVs). A total of 5818 unique records were identified and, after the screening process, 18 studies from eight sectors were included. All industries acknowledged the existence of the SVP, though many did not use a specific term for defining the SV. Similarities in psychological and emotional consequences were found across sectors. Support strategies varied, with the aviation sector implementing the most comprehensive programs. Self-care and peer support were the most reported interventions, while structured clinical support was not mentioned in any industry. Our review highlighted a lack of standardized terminology and industry-specific, evidence-based support interventions for the SVP outside of healthcare. Healthcare appears to be at the forefront of formally recognizing and addressing the SVP, despite traditionally learning from other high-reliability industries in safety practices. This presents opportunities for reciprocal learning and knowledge transfer between healthcare and other high-risk sectors. [ABSTRACT FROM AUTHOR]

Introduction: Central nervous system excitability depends on the task performed, muscle group solicited, and contraction type. However, little is known on corticospinal and motoneuronal excitability measured during locomotor exercise. This study aimed at determining the reliability of motor-evoked potentials (MEP) and thoracic motor-evoked potentials (TMEP) in dynamic mode during unfatiguing and fatiguing cycling exercise. Methods: Twenty-two participants completed four visits. Visit 1 comprised familiarization and an incremental cycling test to determine maximal power output (Wmax). The remaining visits encompassed unfatiguing evaluations, which included a total of eight brief bouts of moderate- (50% Wmax) and high-intensity cycling (80% Wmax), four at each intensity. In each bout, a set of two TMEPs, five MEPs, and one M-max were obtained. Subsequently, a fatiguing exercise to exhaustion at 80%Wmax was performed, with four sets of measurements 3 min through the exercise and four additional sets at exhaustion, both measured at 50% Wmax. Results: Intraclass correlation coefficients (ICCs) for 5, 10, 15, and 20 MEP⋅Mmax-1 revealed excellent reliability at both intensities and during cycling to exhaustion (ICC ≥0.92). TMEP⋅Mmax-1 showed ICCs ≥0.82 for moderate and high intensity, and it was not affected by fatigability. Overall standard error of measurement was 0.090 (0.083, 0.097) for MEP⋅Mmax-1 and 0.114 (0.105, 0.125) for TMEP⋅Mmax-1. A systematic bias associated with the number of stimulations, especially at high intensity, suggested that the evaluation itself may be influenced by fatigability. A mean reduction of 8% was detected in TMEP⋅Mmax-1 at exhaustion. Conclusions: Motoneuronal and corticospinal excitability measured in dynamic mode presented good to excellent reliability in unfatiguing and fatiguing exercise. Further studies inducing greater fatigability must be conducted to assess the sensitivity of central nervous system excitability during cycling. [ABSTRACT FROM AUTHOR]

Introduction: Chronic fatigue is the most common and debilitating symptomin people with multiple sclerosis (PwMS). Recently, exercise has been proven to alleviate chronic fatigue and improve physical functions. Tailoring the training intervention to the potential fatigue causes could optimize the beneficial effects of training on fatigue. The objective of this study was to compare the effectiveness of an individualized (IND) versus a traditional (TRAD) exercise intervention in reducing chronic fatigue. Methods: Twenty-nine PwMS with high chronic fatigue were randomly assigned to 12 wk of either a TRAD or IND exercise intervention. TRAD comprised aerobic and resistance exercises according to the guidelines for PwMS. IND specifically addressed identified individual weaknesses. Participants visited the laboratory before and after training for the following assessments: patient-reported outcomes (fatigue, quality of life, depression questionnaires), incremental cycling test (peak oxygen uptake (...)), and cycling fatigue test (maximal voluntary contraction, rating of perceived exertion). Results: Similar improvements in fatigue, depression, and quality of life were observed between groups (P > 0.05). Compared with TRAD, IND induced a significant greater increase in ... (+21.0% ± 13.9% vs 6.8%± 11.5%, P < 0.05) and a greater reduction in rating of perceived exertion at a given submaximal intensity (-30.3% ± 18.9% vs -12.1% ± 20.4%, P < 0.001), whereas maximal voluntary contraction increased similarly in both groups (P > 0.05). Conclusions: Although tailored exercise improved similarly fatigue and other subjective parameters (depression, quality of life, sleep quality) compared with than traditional exercise intervention, prescribing an individualized intervention led to greater improvement in ... (but not maximal strength) and perception of effort. This may have positive functional consequences for patients. [ABSTRACT FROM AUTHOR]

The editorial discusses the importance of psychological safety in healthcare settings to improve patient outcomes and quality of care. It highlights the impact of preventable adverse events on healthcare workers and emphasizes the need for workforce resilience to provide optimal care. The article calls for organizational support, training, and a culture of safety to address the second victim phenomenon and promote a fair and accountable environment in healthcare organizations. By implementing strategies to support professionals and prioritize patient safety, healthcare systems can create a more effective and compassionate environment for both patients and healthcare workers. [Extracted from the article]

Objectives: This study aimed to evaluate gender-based disparities in preventable adverse events due to low-value practices (LVPs) in primary care. Methods: A retrospective cohort study in Alicante, Spain. Results: A total of 1,516 patient records were examined, finding that older individuals and women experienced more LVP-related events. Female patients faced a higher volume of such events than males with the same health issue. Interaction analysis revealed patients treated by male physicians had more severe events, while those attended by females experienced milder ones. Adverse events were more frequent in LVPs associated with gender-based reasons. Conclusion: These results highlight the need for tailored healthcare professional awareness programs on overuse's impact on safety. Addressing outcome differences between male and female patients should inform awareness campaigns. [ABSTRACT FROM AUTHOR]

Objectives: To explore speaking up behaviours, barriers to openly expressing patient safety concerns, and perceived psychological safety climate in the clinical setting in which healthcare trainees from Ibero-America were receiving their practical training. Methods: Cross-sectional survey of healthcare trainees from Colombia, Mexico, and Spain (N = 1,152). Before the field study, the Speaking Up About Patient Safety Questionnaire (SUPS-Q) was translated into Spanish and assessed for face validity. A confirmatory factor analysis was conducted to establish the construct validity of the instrument, and the reliability was assessed. The SUPS-Q was used to evaluate voice behaviours and the perceived psychological safety climate among Ibero-American trainees. Descriptive and frequency analyses, tests for contrasting means and proportions, and logistic regression analyses were performed. Results: Seven hundred and seventy-one trainees had experience in clinical settings. In the previous month, 88.3% had experienced patient safety concerns, and 68.9% had prevented a colleague from making an error. More than a third had remained silent in a risky situation. Perceiving concerns, being male or nursing student, and higher scores on the encouraging environment scale were associated with speaking up. Conclusion: Patient safety concerns were frequent among Ibero-American healthcare trainees and often silenced by personal and cultural barriers. Training in speaking up and fostering safe interprofessional spaces is crucial. [ABSTRACT FROM AUTHOR]

Objectives: Acknowledging peer support as the cornerstone in mitigating the psychosocial burden arising from the second victim phenomenon, this study assesses the economic benefits of a Peer Support Program (PSP), compared to data of the Resilience In Stressful Events (RISE) program in the US, within the acute inpatient care sector in Germany. Methods: Employing a Markov model, this economic evaluation analyzes the cost benefits, including sick day and dropout costs, over a 1-year period, comparing scenarios with and without the Peer Support Program from a hospital perspective. The costs were calculated as an example based on a hospital with 1,000 employees. The estimations are considered conservative. Results: The anticipated outcomes demonstrate an average cost saving of €6,672 per healthcare worker participating in the Peer Support Program, leading to an annual budgetary impact of approximately €6,67 Mio. for the studied hospital. Conclusion: The integration of a PSP proves economically advantageous for German hospitals, not only preserving financial resources but also reducing absenteeism, and mitigating turnover, thereby enhancing overall patient care. [ABSTRACT FROM AUTHOR]