An Exploration of Safety Culture, Second Victim Phenomenon and Negative Work Outcomes in Health Care Settings

The aim of the study was to explore the impact of patient safety culture on nurses' negative work outcomes resulting from patient safety incidents, as well as the mediating roles of second victim support and distress.

A cross-sectional survey was conducted. The participants included 208 nurses, each with over a year of clinical experience, working in hospitals across South Korea.

Data were collected through self-reported questionnaires on general characteristics, patient safety culture, second victim support and distress, and negative work outcomes. The collected data were analyzed using descriptive statistics, the t-test, ANOVA, the Scheffé test, and Pearson correlation coefficients. Additionally, model 6 of Hayes' PROCESS macro and the Sobel test were employed to determine the mediating effect.

Mediation analysis revealed significant indirect effects of patient safety culture on the work outcomes experienced by nurses following patient safety incidents, mediated by second victim distress, after controlling for participants' marital status, position, and the severity of patient safety incidents.

This study demonstrates that in healthcare settings, patient safety culture that supports the second victim and alleviates second victim distress mitigates the negative work outcomes resulting from patient safety incidents. The findings highlight the significance of culturally sensitive support systems, particularly considering the diverse impacts on Korean nurses. Based on this study, healthcare leaders are recommended to develop strategies to support nurses and reduce their second victim distress, which can ultimately improve patient safety and the quality of nursing care.

The findings of this study can be used to develop strategies to support second victims in addressing their distress. Taking steps to alleviate the distress of second victims will help prevent negative work outcomes in nurses.