Systematic Debriefing for Critical Events Facilitates Team Dynamics, Education, and Process Improvement

Abstract

Background: Debriefing is used in clinical settings to support interprofessional staff, improve processes, and identify educational needs. Nurses who lead debriefing sessions are empowered to improve processes. Problem: Nurse leaders identified the need for debriefing outside the critical care areas due to the rising acuity levels. Approach: Two nurse leaders developed a debriefing initiative in one urban teaching hospital following rapid responses, codes, and stressful situations. Nurses developed a Debriefing Facilitation Guide to collect qualitative aspects of clinical emergencies to improve processes, education, and team dynamics. Outcomes: Following each debriefing session, we deductively purposively coded the qualitative data into 3 a priori themes: the American Heart Association's team dynamics, process improvement, and educational opportunities. We identified opportunities for improvement for these themes during our first 54 debriefing sessions. Conclusions: Following each debriefing session, the debriefing nurse leader intervened on all educational and process improvement opportunities identified and facilitated positive team dynamics.

What and when to debrief: a scoping review examining interprofessional clinical debriefing

“…Most papers did not indicate whether facilitators had training (n=26) and those that did provided limited details. For example, one paper simply stated ‘extensive’ training was provided,70 whereas others outlined the duration of facilitator training (from 40 min47 to 4 hours43). Nine briefly described the style or content of training sessions.…”

“…All included papers described CD practices that had been formally established; however, eight studies also reported relatively informal CD 13 17 18 20 47 51 69 70. Due to their informal nature, characteristics were not clearly defined and therefore not analysed.…”

“…We propose shifting away from terminologies which are currently used such as ‘hot’ and ‘cold’ which are problematic because of unintentional connotations of psychological impact. For example, some authors position ‘hot’ debriefing as an opportunity for participants to quickly share emotional responses22 40 70 which inadvertently associates the debrief with heated emotions reflective of a stressful situation and potential psychological risk 84 85. Whereas others indicate ‘hot’ simply reflects a ‘short, team-based discussion immediately following an incident’38 that occurs ‘then and there’ 86.…”

First-Hand Recommendations for Nursing Management to Support Nurses Involved in the Process of Hastened Death: A Systematic Review of the Qualitative Evidence

“…Educational needs can be identifed. Tis improves the process and can protect professionals from burnout [44,45]. Time is essential to build relationships with the person who wishes to die and the family, and not having enough time can be perceived as a moral failure [6].…”