The impact of errors on healthcare professionals in the critical care setting

J Crit Care. 2019 Aug:52:16-21. doi: 10.1016/j.jcrc.2019.03.001. Epub 2019 Mar 14.

Abstract

Purpose: Medical errors occur at high rates in intensive care units (ICUs) and have great consequences. The impact of errors on healthcare professionals is rarely discussed. We hypothesized that issues regarding blame and guilt following errors in the ICU exist and may be dependent on type of practitioner, level of experience, and error type.

Materials and methods: An online survey was conducted of members of a large critical care medical society addressing three clinical scenarios of procedural, diagnostic and treatment errors.

Results: Nine hundred one practitioners responded. In all scenarios, negative feeling after medical errors occurred in all practitioners regardless of experience or field. Surgeons and anesthesiologists showed higher negative responses after procedural errors while internal medicine and emergency medicine practitioners had higher negative responses after diagnostic errors. Survey respondents identified multiple ways to address these adverse feelings, including debriefing with the medical team (68%), talking with colleagues (68%) and discussing with patients and families (36%).

Conclusions: In critical care, blame and guilt after medical errors are common and affect all providers. Critical care practitioners have identified methods which may help mitigate adverse feeling after medical errors, including debriefing and talking with colleagues. Hospitals may benefit from developing these types of strategies after medical errors.

Keywords: Adverse events; Blame culture; Medical error; Patient safety; Second victim.

MeSH terms

  • Anxiety
  • Critical Care / methods*
  • Critical Care / psychology
  • Emergency Medicine
  • Guilt*
  • Hospitals
  • Humans
  • Intensive Care Units
  • Internet
  • Internship and Residency
  • Malpractice
  • Medical Errors / psychology*
  • Nurse Practitioners / psychology*
  • Physician Assistants / psychology*
  • Physicians / psychology*
  • Surveys and Questionnaires