An exploration of Neonatal Intensive Care Unit (NICU) staff experiences of attending pre-brief and debrief groups surrounding a patient's death or redirection of care

Woolgar, Francesca; Archibald, Sarah-Jane

doi:10.1016/j.jnn.2021.03.007

Cited by 4 publications

(6 citation statements)

References 16 publications

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“…• Physicians mentioned, n = 18 [ 25 , 61 , 63 , 64 , 73 , 81 – 83 , 85 , 87 , 89 , 92 , 94 , 100 , 105 , 107 , 109 , 110 , 113 ]…”

Section: Resultsmentioning

confidence: 99%

“…• Nursing, n = 18 [ 56 – 59 , 69 , 71 , 72 , 74 , 77 – 79 , 81 , 82 , 87 , 89 , 94 , 96 , 98 , 102 , 107 – 110 ]…”

Section: Resultsmentioning

confidence: 99%

“…• Acknowledgement of vulnerabilities in an open, safe environment [ 18 , 61 ] • Questioning of personal beliefs and actions [ 109 ] Enhanced self-assessment Identification of strengths and weaknesses • Greater ease with receiving critical feedback from others [ 61 , 136 ] • Critical reflection of oneself, encouraging both cognitive and emotional self-awareness of beliefs, values and attitudes [ 25 , 119 ]. Personal impact Participants felt appreciated [ 28 , 110 ]. Provide emotional support and helping to process responses • Decreases stress and preventing burnout [ 18 , 24 , 81 , 89 , 137 ].…”

Section: Resultsmentioning

confidence: 99%

“…• Decreased anxiety [ 24 , 119 , 136 ] Increased compassion and retention of empathy [ 18 , 119 , 130 , 132 , 137 ]. Participants felt more motivated [ 84 , 106 , 130 ] Participants felt safe [ 18 , 28 , 110 , 136 , 152 ]. Promotes hope [ 136 ] …”

Section: Resultsmentioning

confidence: 99%

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A systematic scoping review of group reflection in medical education

Phua,

Owyong,

Leong

et al. 2024

BMC Med Educ

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Background Reviewing experiences and recognizing the impact of personal and professional views and emotions upon conduct shapes a physician’s professional and personal development, molding their professional identity formation (PIF). Poor appreciation on the role of reflection, shortages in trained tutors and inadequate ‘protected time’ for reflections in packed medical curricula has hindered its integration into medical education. Group reflection could be a viable alternative to individual reflections; however, this nascent practice requires further study. Methods A Systematic Evidence Based Approach guided Systematic Scoping Review (SSR in SEBA) was adopted to guide and structure a review of group reflections in medical education. Independent searches of articles published between 1st January 2000 and 30th June 2022 in bibliographic and grey literature databases were carried out. Included articles were analysed separately using thematic and content analysis, and combined into categories and themes. The themes/categories created were compared with the tabulated summaries of included articles to create domains that framed the synthesis of the discussion. Results 1141 abstracts were reviewed, 193 full-text articles were appraised and 66 articles were included and the domains identified were theories; indications; types; structure; and benefits and challenges of group reflections. Conclusions Scaffolded by current approaches to individual reflections and theories and inculcated with nuanced adaptations from other medical practices, this SSR in SEBA suggests that structured group reflections may fill current gaps in training. However, design and assessment of the evidence-based structuring of group reflections proposed here must be the focus of future study.

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“…• Physicians mentioned, n = 18 [ 25 , 61 , 63 , 64 , 73 , 81 – 83 , 85 , 87 , 89 , 92 , 94 , 100 , 105 , 107 , 109 , 110 , 113 ]…”

Section: Resultsmentioning

confidence: 99%

“…• Nursing, n = 18 [ 56 – 59 , 69 , 71 , 72 , 74 , 77 – 79 , 81 , 82 , 87 , 89 , 94 , 96 , 98 , 102 , 107 – 110 ]…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

A systematic scoping review of group reflection in medical education

Phua,

Owyong,

Leong

et al. 2024

BMC Med Educ

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“…Palliative care courses strengthened staff’s competency and comfort with EOL care 18. Formal debriefing sessions allowed HCP to safely express their opinions, reconcile their grief and validate their actions through mutual support 40…”

Section: Resultsmentioning

confidence: 99%

Experiences of healthcare personnel with death in the neonatal intensive care unit: a systematic review of qualitative studies

Wong

Charles

Mok

et al. 2023

Arch Dis Child Fetal Neonatal Ed

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ObjectiveTo synthesise evidence from qualitative studies on the experiences of healthcare personnel (HCP) in the neonatal intensive care unit (NICU) caring for dying neonates.MethodsWe conducted a systematic search, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO: CRD42021250015), of four databases (PubMed, Embase, PsycINFO and CINAHL) from date of inception of the databases to 31 December 2021 using MeSH terms and related keywords. Data were analysed using three-step inductive thematic synthesis. Quality assessment of included studies was performed.ResultsThirty-two articles were included. There were 775 participants, majority (92.6%) of whom were nurses and doctors. Quality of studies was variable. The narratives of HCP coalesced into three themes: sources of distress, coping methods and the way forward. Sources of distress encompassed HCP’s discomfort with neonatal deaths; poor communication among HCP and with patient’s family; lack of support (from organisations, peers and HCP’s family) and emotional responses (guilt, helplessness and compassion fatigue). Methods of coping included setting emotional boundaries, support from colleagues, clear communication and compassionate care and well-designed end-of-life workflows. Steps taken by HCP to move forward and overcome the emotionally turbulent effects of NICU deaths included finding meaning in death, building deeper relationship with patients’ families and the NICU team and embracing purpose and pride in work.ConclusionHCP face several challenges when a death occurs in the NICU. HCP can provide better end-of-life care if their undesirable experiences with death are mitigated by better understanding and overcoming factors causing distress.

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Complex end‐of‐life decision‐making during neonatal retrieval: A retrospective cohort study

Cantelmi,

Jardine,

Griffin

et al. 2024

J Paediatrics Child Health

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AimThe aim of this study was to compare patients referred to our retrieval service who were palliated before transfer, versus those transferred who were palliated within 7 days of birth.MethodsWe conducted a retrospective chart review of infants referred to our neonatal retrieval service between 1 December 2015 and 31 March 2022 who died during retrieval or within 7 days of referral. Demographic and clinical data were collected from the service database and electronic medical records.ResultsData on 60 infants were analysed; 25 (42%) infants were not transported and were palliated at the referring hospital, 35 (58%) infants were transported and later palliated at the accepting hospital. The most common primary diagnoses were prematurity (42%) and hypoxemic ischemic encephalopathy (HIE) (42%). Infants palliated at the referring hospital were more likely than those transported and later palliated to require resuscitation including chest compressions (52% vs. 23%, P = 0.02), management for hypotension (72% vs. 20%, P < 0.001) and management for pneumothorax (28% vs. 0%, P = 0.001) and less likely to require management for seizures (8% vs. 43%, P = 0.003).ConclusionsPalliation at the referring hospital should be considered as an option when escalating care is predicted to not affect outcome. In this cohort the infants least likely to be transported required significant management during stabilisation. Determining the infants for whom transport is non‐beneficial remains difficult.

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An exploration of Neonatal Intensive Care Unit (NICU) staff experiences of attending pre-brief and debrief groups surrounding a patient's death or redirection of care

Cited by 4 publications

References 16 publications

A systematic scoping review of group reflection in medical education

A systematic scoping review of group reflection in medical education

Experiences of healthcare personnel with death in the neonatal intensive care unit: a systematic review of qualitative studies

Complex end‐of‐life decision‐making during neonatal retrieval: A retrospective cohort study

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