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AnteayerJournal of Clinical Nursing

Negative Emotions Experienced on the Occurrence of Medication Errors by Nurses: A Mixed‐Method Systematic Review

ABSTRACT

Aim

This study aims to explore the negative emotions experienced by nurses following medication errors.

Design

Mixed-method systematic review.

Methods

A systematic search was conducted in PubMed, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature, PsycINFO and Google Scholar for studies published in English between January 2013 and October 2024. The Joanna Briggs Institute critical appraisal tool was used to assess article quality and data were analysed through qualitative content analysis.

Results

From 1619 screened studies, 19 were selected: 14 qualitative, 3 quantitative and 2 mixed-method. The negative emotions experienced by nurses, as second victims of medication errors, can be categorised into 8 groups: Fear, anger, disturbance, sadness, shame, guilt, low self-esteem and depression. Additionally, the following 11 types of fear were identified: Fear of judgement, disrespect, losing one's job, getting scolded and contempt, retaliation and punishment, reaction, consequences, disciplinary actions and lawsuits, patient's well-being, reporting a medication error and losing patient's/their families' trust. Furthermore, two types of shame were identified: Internal and external shame.

Conclusions

The negative emotions that nurses experience as second victims can persist long after the error occurs. It underscores the need for structured psychological support systems to foster a culture of ‘responsibility without blame’.

Implications for the Profession and Patient Care

Addressing nurses' emotional challenges as second victims enhances their well-being and improves global healthcare safety and quality.

Impact

These findings highlight the need for healthcare leaders and policymakers to implement interventions that foster a supportive, non-punitive workplace with the aim of improving the emotional well-being of nurses following medication errors.

Reporting Method

The study adhered to PRISMA guidelines.

Patient or Public Contribution

None.

Trail Registration

Prospero code: CRD42023439304.

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