Debriefing: A Brief Overview
Critical Event Debriefing
Ugwu et al. (2020) discuss positive aspects of using debriefing to help identify medical errors, improve communication and team performance, and help healthcare workers manage high emotions following a critical event. Ugwu et al. (2020) found that although the evidence and research show the significant importance of using debriefing in a healthcare setting, most hospitals still fail to utilize debriefing tools regularly. After studying over one hundred participants, fifty percent reported that their hospital had little or no debriefing following a crisis event such as patient death, code, or emotional experience. The authors state that throughout their study that, they found for debriefing to be effective, hospitals must cultivate a workplace culture that encourages debriefing sessions; to do this, healthcare workers need a generalized template for debriefing and would benefit from education on the importance of making debriefing an integral part of their workplace experiences.
No job has a zero-stress level. However, the job of bedside nurses, especially those working in a neonatal intensive care unit, is high stress in nature. Within these high-stress environments, nurses make critical decisions that can significantly impact patients' lives. This article stresses the importance of NICU nurses taking the extra time to avoid psychological exhaustion and burnout. Implementing tools such as an easy-to-follow debriefing plan and committing to using the tool regularly can deter nurse burnout.
Comparison of Debriefing Models
Gnatt et al. (2018) evaluated current best practices for healthcare-based debriefing models. Gnatt et al. (2018) studied over 90 nursing students and split them into groups, each group with a different debriefing model. During their research, Gnatt et al. (2018) found that facilitated debriefings, which involve having individuals gather for a complete discussion of the events that occurred, promoted a more in-depth evaluation of the situation and expression of feelings associated with the events that took place. Other forms of debriefing studied by Gnatt et al. (2018) include self-debriefing and feedback with no discussion.
Research has shown that most learning experiences following clinical situations, codes, or traumatic event occurs in the debriefing process and not during the situation itself. With that knowledge, it is crucial to have an adequate debriefing model to help facilitate learning and digestion of the events. There is no current best practice regarding the format and steps of debriefing, which is often left up to the person who initiated the debriefing or the hospitals' standards. Having a standardized facilitated debriefing model can help nurses express anxieties and fears, ask questions, and receive feedback from others regarding hospital situations. It also ensures that each debriefing can invoke essential and meaningful conversations about situations, no matter who is leading the debriefing.
Effects of Peer-led Debriefing on Cognitive Load
This article was written by Na and Roh (2021), two nurse practitioners based in the Republic of Korea. The article discusses a study completed by Na and Roh (2021) to determine the impact of implementing peer-led debriefing. The study challenges the status quo of hospital debriefing by arguing that peer-led debriefing sessions are just as, if not more, effective than debriefing sessions led by designated debriefing staff. This article discusses how registered nurses tend to be more willing to participate in peer-to-peer communication during debriefing sessions than opening up to an experienced debriefer, often allowing nurses to reflect deeper and learn from the debriefing session. Na and Roh (2021) proved that peer-led debriefing sessions could positively impact nurses’ cognitive load, performance, and emotions.
Through studying 60 nurses and providing pre-and post-evaluation following peer-led debriefing sessions, the authors Na and Roh (2021) offer a unique approach to nursing debriefing sessions. Na and Roh suggest that if nurses were to lead debriefing sessions amongst their peers rather than a professional, they would be more likely to engage and participate in the debrief. The current best practice for debriefing is having a nurse practitioner or designated debriefing staff act as a leader to guide groups through debriefing sessions. While this study provides a fresh take on debriefing best practices for the nursing community, it lacks in some areas due to its overarching look at the entirety of debriefing practices.
References
Yoon Hee Na, Young Sook Roh (2021). Effects of Peer-led Debriefing on Cognitive Load, Achievement Emotions, and Nursing Performance, Clinical Simulation in Nursing, Volume 55, 2021, Pages 1-9, ISSN 1876-1399, https://doi.org/10.1016/j.ecns.2021.03.008.
Ugwu C V, Medows M, Don-Pedro D, et al. (2020). Critical Event Debriefing in a Community Hospital. Cureus 12(6): e8822. doi:10.7759/cureus.8822