Date of Award

Fall 2024

Project Type

Thesis

College or School

CHHS

Department

Nursing

First Advisor

Deborah Simonton

Second Advisor

Kate Considine

Abstract

Abstract Background: The practice of debriefing has been an important process in critical care settings to promote team unity as well as best care practices. Literature has shown that debriefing can not only influence quality care and improved operations, but the process can also influence the emotional support staff receive. These implications are particularly important for nurses that work in critical care settings as the job can often be stressful and lead to moral distress as well as the need for evidence-based care practices is crucial when a patient’s life is on the line. Literature supports that any form of debriefing is better than no form of debriefing. Local Problem: In a critical access Emergency Department, 100% of staff nurses that were evaluated reported experiencing multiple critical incidents in a three month span with none being formally debriefed. Staff nurses also expressed the desire to debrief critical incidents and improve communication as well as safety in the microsystem. Methods: In this quality improvement project, personal interviews as well as the assessment with the Perceived Stress Scale were completed with Emergency Department staff nurses to assess the perceptions on debriefing and perceived stress levels in April 2024 and then again in June of 2024. Intervention: Education on what debriefing is, the current guidelines for debriefing at the macrosystem, formal debriefing models such as STOP5, and the benefits of debriefing was provided at the June 2024 staff meeting to the attending Emergency Department staff. The microsystem was also supplied with the STOP5 debriefing model for encouragement of the use of the practice following critical incidents. Results: The results revealed that perceptions that debriefing could be completed in the microsystem improved by 66% and moderate to high perceived stress levels decreased by 43% from initial evaluation in April 2024 to following the implementation in June of 2024. Conclusion: The findings of this quality improvement project support the literature that there are many benefits to debriefing in critical care settings. There was also an improvement debriefing perceptions and perceived stress in the microsystem following the completion of a full Plan, Do, Study, Act (PDSA) cycle in the Emergency Department. The continued support of the key stakeholders in the microsystem including the staff nurses, nurse managers, quality services department, and education department should propel the findings in this project forward to make more improvements in the microsystem’s debriefing practices increasing the use and improving communication and safety.

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