AuthorWiseman, Tamara L.
AdvisorWise, Barbara V.
MetadataShow full item record
Other TitlesLet's Talk Debriefing Projecy
AbstractProblem and Purpose: Structured debriefings inconsistently occur in a level IV Neonatal Intensive Care Unit (NICU). Lack of a structured debriefing process negatively impacts provider physical/emotional health and patient outcomes. Lack of debriefing conversations leads to unconstructive feedback and unidentified areas for team and patient outcome improvement. The purpose of this quality improvement (QI) project is to implement, the Team Strategies and Tools to Enhance Performance and Patient Safety Debriefing Tool (TeamSTEPPS) following high-risk deliveries in infants 22-32-week gestation and emergency/resuscitation codes in a 52 bed, level IV NICU in the mid-Atlantic region. The goal is to facilitate debriefings after 100% of the critical events and enhance positive team communication during debriefings. Methods: The project was implemented for 12 weeks. The population included a multidisciplinary NICU staff. The project involved training staff on the use of the standardized debriefing tool, documenting high-risk deliveries, frequency of debriefing guided by the TeamSTEPPS debriefing tool, and evaluating debriefing outcomes using the REFLECT Tool. The primary QI metrics included the number of staff trained and educated, patient gestational age, high-risk delivery and emergency codes, occurrence of debriefing, debriefings guided by TeamSTEPPS Debriefing Tool, and staff assessment of the debriefings using the REFLECT Tool. Data was analyzed using descriptive statistics to identify trends in the percentage of debriefings that occurred following 22-32 weeks gestation deliveries and emergency/resuscitation codes. Results: During implementation phase, twenty percent of the NICU staff were trained/educated in the debriefing process. A total of four debriefings occurred using the TeamSTEPPS Debriefing Tool. Post critical events debriefings increased from one percent to fifteen percent. Team communication, role delineation, and patient stabilization time improved during a subsequent critical event. Conclusions: This QI project demonstrated the feasibility of implementing a structured debriefing tool in a high acuity NICU, to improve team communications and patient outcomes following critical events. Increased nursing and provider staff engagement, and ongoing training would enhance debriefing facilitation. Future considerations include expanding debriefing after all emergent deliveries, including the labor and delivery team, and piloting in smaller NICUs.
DescriptionPDF designated as Part 2 is a poster of the project highlights.
critical incident debriefing
Intensive Care Units, Neonatal
Identifier to cite or link to this itemhttp://hdl.handle.net/10713/13720
Showing items related by title, author, creator and subject.
Impact of Traumatic Events and Organizational Response: A Study of Bank RobberiesMiller-Burke, Jude; Attridge, Mark (1998-08-01)This study explored how experiencing a traumatic event in the workplace affects employees’ physical health, mental health, personal functioning, and work performance. Post-event use of health care services and the effectiveness of critical incident stress debriefing (CISD) sessions and other coping interventions were also examined. A retrospective self-report methodology and mailed survey were used with 141 employees of 42 different banks that had been recently robbed. The results found that most employees had multiple negative consequences from experiencing a bank robbery. Psychological, physical, work, and personal areas all were affected by the robbery. CISD interventions delivered post-robbery were rated as helpful by 78% of employees who attended. Implications for employers, providers and organizational policy are discussed.
Impact of Terrorist Attacks on Use of Critical Incident Stress Management ServicesAttridge, Mark; Parker, Marcie; Bergmark, Edward (2002-06)Critical incident stress management (CISM) services can help employees cope with traumatic workplace events. National data from an employee assistance provider (Optum), shows a dramtic increase in use of CISMs after the 9/11/2001 terrorist attacks on America. Also, results of evaluation surveys collected nationwide and reflecting the workplace experiences following 135 CISM events found that managers highly valued these crisis response services. A five-item evaluation measure is presented for CISM services from EAPs.
Debriefing Practices in Nursing Education Programs in the United StatesFey, Mary K.; Jenkins, Louise Sherman (2014)Debriefing is essential to learning in simulation based education. However, little is known about current debriefing practices. While there is no single theory of debriefing, consistent themes about the characteristics of debriefing emerge from the simulation literature. The purpose of this study was to describe debriefing practices in prelicensure nursing programs. Logistic regression analysis identified the characteristics of the nursing program and the simulation administrator that are associated with the use of theory based debriefing. A descriptive cross-sectional design was used. Data was collected via the internet. The study questionnaire consisted of three parts: demographic questions about the nursing program, questions about the simulation administrator, and questions about debriefing practices. The study sample comprised prelicensure nursing programs from across the United States representing all entry level degree programs (n = 502). Descriptive analyses showed that most programs have integrated simulation into their curriculum. Most schools designate a faculty member to have responsibility for simulation activities. The majority of debriefing facilitators have no training in debriefing. Less than 20% of all debriefers have their competence assessed. Debriefing is not usually guided by a theory or model. The majority of respondents (82%) reported debriefing practices that incorporated the concepts of Kolb's experiential learning theory. Further data analysis explored the relationships that significantly affected the use of theory based debriefing practices. The presence of a designated simulation administrator was significantly associated with the use of theory based debriefing. Simulation administrators who had formal training in simulation and who were in the 46-55 year old age group were significantly more likely to practice theory based debriefing. Training and competency assessment, along with structuring debriefing discussions were significantly associated with the use of theory based debriefing. Findings suggest that nursing programs should allocated resources to several aspects of the simulation program. Programs should have a designated simulation administrator. This person should have training in simulation based education. All faculty who facilitate debriefings should have training and should have their competence assessed regularly. This study provides information about debriefing practices; the study should be repeated with other types of learners (e.g. medical students, licensed practitioners).