Other Titles
Rapid Presentation Round
Abstract
Background/Significance: SVEs describe the physiological, psychological, and professional impact experienced by providers involved in near misses, adverse events, and unanticipated patient outcomes.1-3 Studies estimate that more than half of providers have SVEs and their sequelae at least once in their lifetime, further exacerbated by a lack of institutional support, potentially contributing to burnout, compassion fatigue, and attrition.1-4 Existing literature addresses SVE in physicians and nurses; even so, the literature is sparse when it comes to APPs, providers positioned between nursing and medical models, often navigating clinical spaces without structured support systems.
Purpose: To develop an evidence-supported, system-level framework addressing SVEs among APPs in acute care settings. This initiative aims to promote psychological safety, connection, and resilience, which are important pillars of a HWE.
Methods: This framework will integrate the Scott three-tiered model of second victim recovery, just culture principles, and the AACN’s HWE framework.5 First, a needs assessment will be performed by surveying APPs to determine prevalence, barriers, and facilitators to disclosure, and existing coping mechanisms using the Second Victim Experience and Support Tool-Revised (SVEST-R).3,6 Thereafter, a tiered response system will be designed based on Scott’s model, starting with informal to formal peer and organizational leadership support to confidential referral pathways.1 Lastly, a pilot will be implemented, collecting feedback using mixed data across service lines employing APPs. Tools like the Plan-Do-Study-Act (PDSA) and the Consolidated Framework for Implementation Research (CFIR) will be used to identify barriers, build on strengths, and support scalable, data-driven implementation and continuous improvement.7-8
Projected Outcomes: Anticipated immediate outcomes include greater emotional self-awareness, stronger connection, increased help-seeking, and improved perceptions of just culture and support. Anticipated long-term outcomes include higher resilience and reduced intent to leave.
Future Implications: This conceptual initiative aligns with Sigma’s mission to create HWE by addressing APP well-being at both individual and organizational levels. By developing a structured, APP-specific support infrastructure, healthcare systems can foster psychological safety, decrease intent to leave, while sustaining a high-performing and compassionate workforce.
Notes
References:
1. Scott SD, Richardson, M, Davidson, JE. Shifting Culture Through Structured Organizational Second Victim Support. In: Richardson M, Davidson JE, eds. Workplace Wellness: From Resiliency to Suicide Prevention and Grief Management. Springer International Publishing AG; 2023:263-274. doi:10.1007/978-3-031-16983-0_18
2. Werthman JA, Brown A, Cole I, et al. Second Victim Phenomenon and Nursing Support: An Integrative Review. Journal of radiology nursing. 2021;40(2):139-145. doi:10.1016/j.jradnu.2020.12.014
3. Winning AM, Merandi J, Rausch JR, et al. Validation of the Second Victim Experience and Support Tool-Revised in the Neonatal Intensive Care Unit. Journal of patient safety. 2021;17(8):531-540. doi:10.1097/PTS.0000000000000659
4. White RM, Delacroix R. Second victim phenomenon: Is ‘just culture’ a reality? An integrative review. Applied nursing research. 2020;56. doi:10.1016/j.apnr.2020.151319
5. Parker P, Pena H, Stokes J, et al. Longitudinal Evaluation of Implementation of AACN's Healthy Work Environment Framework in an Intensive Care Unit. Am J Crit Care. 2025;34(3):183-192. doi:10.4037/ajcc2025172
6. Burlison JD, Scott SD, Browne EK, Thompson SG, Hoffman JM. The Second Victim Experience and Support Tool: Validation of an Organizational Resource for Assessing Second Victim Effects and the Quality of Support Resources. J Patient Saf. 2017;13(2):93-102. doi:10.1097/PTS.0000000000000129
7. Taylor MJ, McNicholas C, Nicolay C, Darzi A, Bell D, Reed JE. Systematic review of the application of the plan–do–study–act method to improve quality in healthcare. BMJ quality & safety. 2014;23(4):290-298. doi:10.1136/bmjqs-2013-001862
8. Breimaier HE, Heckemann B, Halfens RJ, Lohrmann C. The Consolidated Framework for Implementation Research (CFIR): a useful theoretical framework for guiding and evaluating a guideline implementation process in a hospital-based nursing practice. BMC Nurs. 2015;14:43. Published 2015 Aug 12. doi:10.1186/s12912-015-0088-4
Sigma Membership
Alpha Tau
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Pilot/Exploratory Study
Keywords:
Acute Care, Interprofessional, Interdisciplinary, Stress/Coping, Psychological Stress, Stress Management, Coping, Nurse Practitioners, Physician Assistants, Second Victims, Victims--Psychosocial Factors
Recommended Citation
Aguilar, Al-Zada, "Supporting Advanced Practice Providers (APPs) Through Second Victim Experiences (SVEs)" (2026). Creating Healthy Work Environments (CHWE). 43.
https://www.sigmarepository.org/chwe/2026/presentations_2026/43
Conference Name
Creating Healthy Work Environments
Conference Host
Sigma Theta Tau International
Conference Location
Washington, DC, USA
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-04-28
Supporting Advanced Practice Providers (APPs) Through Second Victim Experiences (SVEs)
Washington, DC, USA
Background/Significance: SVEs describe the physiological, psychological, and professional impact experienced by providers involved in near misses, adverse events, and unanticipated patient outcomes.1-3 Studies estimate that more than half of providers have SVEs and their sequelae at least once in their lifetime, further exacerbated by a lack of institutional support, potentially contributing to burnout, compassion fatigue, and attrition.1-4 Existing literature addresses SVE in physicians and nurses; even so, the literature is sparse when it comes to APPs, providers positioned between nursing and medical models, often navigating clinical spaces without structured support systems.
Purpose: To develop an evidence-supported, system-level framework addressing SVEs among APPs in acute care settings. This initiative aims to promote psychological safety, connection, and resilience, which are important pillars of a HWE.
Methods: This framework will integrate the Scott three-tiered model of second victim recovery, just culture principles, and the AACN’s HWE framework.5 First, a needs assessment will be performed by surveying APPs to determine prevalence, barriers, and facilitators to disclosure, and existing coping mechanisms using the Second Victim Experience and Support Tool-Revised (SVEST-R).3,6 Thereafter, a tiered response system will be designed based on Scott’s model, starting with informal to formal peer and organizational leadership support to confidential referral pathways.1 Lastly, a pilot will be implemented, collecting feedback using mixed data across service lines employing APPs. Tools like the Plan-Do-Study-Act (PDSA) and the Consolidated Framework for Implementation Research (CFIR) will be used to identify barriers, build on strengths, and support scalable, data-driven implementation and continuous improvement.7-8
Projected Outcomes: Anticipated immediate outcomes include greater emotional self-awareness, stronger connection, increased help-seeking, and improved perceptions of just culture and support. Anticipated long-term outcomes include higher resilience and reduced intent to leave.
Future Implications: This conceptual initiative aligns with Sigma’s mission to create HWE by addressing APP well-being at both individual and organizational levels. By developing a structured, APP-specific support infrastructure, healthcare systems can foster psychological safety, decrease intent to leave, while sustaining a high-performing and compassionate workforce.
Description
Integrating just culture, the American Association of Critical-Care Nurses' (AACN's) Healthy Work Environment (HWE), and Scott’s model, along with quality improvement (QI) frameworks, this initiative will identify barriers, promote support, and enhance psychological safety among APPs who have SVEs. Anticipated outcomes include improved emotional awareness, connection, and resilience, fostering a healthier, more compassionate work environment.