Krystyna Ediger, Vanessa Godbout, Faith Trinh, Shannon Bartlett, Patricia Peckham, Stuart Rose, Brenda Hiu Yan Law
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引用次数: 0
Abstract
Background: Neonatal intensive care units (NICUs) often experience high acuity clinical events and can benefit from clinical event debriefing. Post-event team debriefs can reinforce success, identify areas for improvement, and support healthcare providers' (HCP) psychological coping. However, barriers exist to debriefing regularly.
Objective: To implement and evaluate a structured clinical event debriefing program in four NICUs within a regional neonatal program.
Methods: We assembled a multi-disciplinary team of clinicians and debriefing specialists, adapted an existing tool, and identified site champions. A database, debrief triggers, and feedback processes were developed. We chose charge nurses as facilitators. Facilitators were trained in 2-h virtual sessions. Debriefs were started and tracked. A post-implementation survey was conducted after 6 months.
Results: Eighty-one HCPs responded to the pre survey. Respondents identified time constraints and skill /availability of facilitators as barriers to clinical event debriefs. Most were comfortable with debriefs prior to implementation. Ninety-five debriefs were conducted over 6 months. Median 7 (IQR 5-8) HCPs attended. Most were led by trained nurse facilitators. Debriefs took a median 12 min (IQR 8-17), and generated recommendations for equipment, teamwork, and process issues. Barriers to implementation included availability of trained facilitators, time constraints and competing quality improvement (QI) priorities. The post-implementation survey showed positive views of structured debriefs. Participants still listed time constraints as the main barrier to debriefs, although less than prior.
Conclusion: Nurse-led, structured clinical event debriefing can be implemented in NICUs. Clinical event debriefs allow HCPs to participate in identifying systems issues and solutions.
期刊介绍：
The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development.
The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.
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