Coping with medical error: a systematic review of papers to assess the effects of involvement in medical errors on healthcare professionals' psychological well-being

Correspondence to Reema Sirriyeh, Institute of Psychological Sciences, University of Leeds, Leeds LS2 9JT, UK; [email protected]

Introduction

Involvement in errors has been found to elicit a significant emotional response from health professionals.¹ While the impact of error on patients is well documented, there are only two reviews that discuss the impact of medical error on professionals.^{2 3} Both fail to provide an adequate discussion of findings relating to coping or outcomes beyond the immediate error event. There remains a need to identify factors that moderate the emotional effects of an error on the individual, and to understand how individuals cope with being involved in an error in the short- and longer term. It may then be possible to develop effective support mechanisms that serve the needs of different people and reduce the emotional burden associated with making an error. Therefore, the research questions posed for this review were:

• What is the impact of being involved in a medical error on the health professional?

• How do health professionals cope in the short- and longer term when they have been involved in a medical error?

• Are there any factors (referred to below as moderating factors) that influence the immediate response to error and/or the way in which individuals cope?

Methods

Search identification and selection

Electronic databases (Web of Science, Medline 1950–2009, PsychInfo 1967–2009, Science Direct, The Cochrane Library, Embase 1980–2009) were searched using terms that covered both attitudes towards making errors, as well as the responses following such errors. Seven distinct searches were conducted to retrieve all of the relevant information as displayed in table 1. An information scientist checked the search strategy to ensure the capture of all relevant articles. All searches were limited to studies on humans, written in the English language and published between 1980 and 2009. The reference lists of all relevant articles identified were hand-searched.

Table 1

Search terms

Search no	Search history
1	coping with medical (error or mistake or mishap or blunder or adverse event or incident)
2	respond to medical (error or mistake or mishap or blunder or adverse event or incident)
3	attitude towards medical (error or mistake or mishap or blunder or adverse event or incident)
4	commit medical (error or mistake or mishap or...