Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-27T23:20:59.639Z Has data issue: false hasContentIssue false
  • English
  • Français

Postresuscitation debriefing in the pediatric emergency department: a national needs assessment

Published online by Cambridge University Press:  04 March 2015

Naminder Sandhu ,
Walter Eppich ,
Angelo Mikrogianakis ,
Vincent Grant ,
Traci Robinson ,
Adam Cheng  and
for the Canadian Pediatric Simulation Network (CPSN) Debriefing Consensus Group
Naminder Sandhu*
Affiliation:
KidSim-Aspire Simulation Research Program, Section of Emergency Medicine, Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, AB
Walter Eppich
Affiliation:
Division of Emergency Medicine, Children's Memorial Hospital, Northwestern University, Chicago, IL
Angelo Mikrogianakis
Affiliation:
KidSim-Aspire Simulation Research Program, Section of Emergency Medicine, Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, AB
Vincent Grant
Affiliation:
KidSim-Aspire Simulation Research Program, Section of Emergency Medicine, Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, AB
Traci Robinson
Affiliation:
KidSim-Aspire Simulation Research Program, Section of Emergency Medicine, Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, AB
Adam Cheng
Affiliation:
KidSim-Aspire Simulation Research Program, Section of Emergency Medicine, Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, AB
for the Canadian Pediatric Simulation Network (CPSN) Debriefing Consensus Group
Affiliation:
The CPSN Debriefing Consensus Group includes Rod Lim, MD, Allan Shefrin, MD, Jonathan Pirie, MD, Arielle Levy, MD, Farhan Bhanji, MD, and Seen Chung, MD
*
Section of Emergency Medicine, Alberta Children's Hospital, 2888 Shaganappi Trail NW, Calgary, AB T3B 6A8; [email protected]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objectives:

The objectives of this study were to assess current postresuscitation debriefing (PRD) practices in Canadian pediatric emergency departments (EDs) and identify areas for improvement.

Methods:

A national needs assessment survey was conducted to collect information on current PRD practices and perspectives on debriefing practice in pediatric EDs. A questionnaire was distributed to ED nurses, fellows, and attending physicians at 10 pediatric tertiary care hospitals across Canada. Summary statistics are reported.

Results:

Data were analyzed from 183 participants (48.7% response rate). Although 88.8% of the participants believed that debriefing is an important process, 52.5% indicated that debriefing after real resuscitations occurs less than 25% of the time and 68.3% indicated that no expectation exists for PRD at their institution. Although 83.7% of participants believed that facilitators should have a specific skill set developed through formal training sessions, 63.4% had no previous training in debriefing. Seventy-two percent felt that medical and crisis resource management issues are dealt with adequately when PRD occurs, and 90.4% indicated thatED workload and time shortages are major barriers to effective debriefing. Most responded that a debriefing tool to guide facilitators might aid in multiple skills, such as creating realistic debriefing objectives and providing feedback with good judgment.

Conclusion:

PRD in Canadian pediatric EDs occurs infrequently, although most health care providers agreed on its importance and the need for skilled facilitators.

Keywords

debriefingemergency departmentpediatricsresuscitation
Type
Original Research • Recherche originale
Information
Canadian Journal of Emergency Medicine , Volume 16 , Issue 5 , September 2014 , pp. 383 - 392
Copyright
Copyright © Canadian Association of Emergency Physicians 2014

References

REFERENCES

1. Flin, R, O’Connor, P, Crichton, M. Safety at the sharp end: a guide to non-technical skills. Surrey (UK): Ashgate Publishing Limited; 2008.Google Scholar
2. Fleisher, GR, Ludwig, S. Textbook of pediatric emergency medicine. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2010.Google Scholar
3. Campbell, JO, Kuncel, NR. Individual and team training. In: Anderson, N, Ones, DS, Sinangil, HK, et al, editors, Handbook of work and organizational psychology. Vol. 1. London: Blackwell; 2001. p. 278–312.Google Scholar
4. Cannon-Bowers, JA. Individual and team decision making under stress: theoretical underpinnings. In: Cannon-Bowers, JA, Salas, E, editors. Making decisions under stress:implications for individual and team training. Washington, DC: American Psychological Association; 1998. p. 17–38.CrossRefGoogle Scholar
5. Kozlowski, SWJ, Bell, BS. Work groups and teams in organizations. In: Borman, WC, Ilgen, DR, Klimoski, RJ, editors. Handbook of psychology: industrial and organizational psychology. Vol. 12. London: Wiley; 2003. p. 333–75.Google Scholar
6. Salas, E, Klein, C, King, H, et al. Debriefing medical teams: 12 evidence-based best practices and tips. Jt Comm J Qual Pat Saf 2008;34:518–27.Google Scholar
7. Arafeh, JMR, Hansen, SS, Nichols, A. Debriefing in simulator-based learning: facilitating a reflective discussion. J Perinat Neonat Nurs 2010;24:302–9, doi:10.1097/JPN.0b013e3181f6b5ec.CrossRefGoogle Scholar
8. Mitchell, J. When disaster strikes: the critical incident stress debriefing process. J Emerg Med Serv 1983;8:36–9.Google ScholarPubMed
9. Tuckey, MR. Issues in the debriefing debate for the emergency services: moving research outcomes forward. Clin Psychol Sci Pract 2007;14:106–16, doi:10.1111/j.1468-2850.2007.00069.x.CrossRefGoogle Scholar
10. Devilly, GJ, Cotton, P. Psychological debriefing and the workplace: defining a concept, controversies and guidelines for intervention. Aust Psychol 2003;38:144–50, doi:10.1080/00050060310001707147.Google Scholar
11. Soar, J, Koenraad, GM, Ballance, JHW, et al. European Resuscitation Council Guidelines for Resuscitation 2010 Section 9. Principles of education in resuscitation. Resuscitation 2010;81:1434–44, doi:10.1016/j.resuscitation.2010.08.014.Google Scholar
12. Ireland, S, Gilchrist, J, Maconochie, I. Debriefing after failed paediatric resuscitation: a survey of current UK practice. Emerg Med J 2008;25:328–30, doi:10.1136/emj.2007.048942.Google Scholar
13. Theophilos, T, Magyar, J, Babl, FE. Debriefing critical incidents in the paediatric emergency department: current practice and perceived needs in Australia and New Zealand. Emerg Med Aust 2009;21:479–83, doi:10.1111/j.1742-6723.2009.01231.x.CrossRefGoogle ScholarPubMed
14. Burns, C, Harm, NJ. Emergency nurses’ perceptions of critical incidents and stress debriefing. J Emerg Nurs 1993;19:431–6.Google Scholar
15. Dillman, DA, Smyth, JD, Christian, LM. Internet, mail, and mixed-mode surveys: the tailored design method. 3rd ed. Hoboken (NJ): John Wiley & Sons; 2009.Google Scholar
16. Flanagan, B. Debriefing: theory and techniques. In: Riley, RH, editor. Manual of simulation in healthcare. New York: Oxford University Press; 2008. p. 155–70.Google Scholar
17. Weng, TI, Huang, CH, Ma, MH, et al. Improving the rate of return of spontaneous circulation for out-of-hospital cardiac arrests with a formal, structured emergency resuscitation team. Resuscitation 2004;60:137–42, doi:10.1016/j.resuscitation.2003.09.007.Google Scholar
18. Edelson, DP, Litzinger, B, Arora, V, et al. Improving inhospital cardiac arrest process and outcomes with performance debriefing. Arch Intern Med 2008;168:1063–9, doi:10.1001/archinte.168.10.1063.CrossRefGoogle ScholarPubMed
19. Bhanji, F, Mancini, M, Sinz, E, et al. 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science. Part 16; education, implementation, and teams. Circulation 2010;122(18 Suppl 3):S920-33, doi:10.1161/CIRCULATIONAHA.110.971135.Google Scholar
20. Gururaja, RP, Yang, T, Paige, JT, Chauvin, SW. Examining the effectiveness of debriefing at the point of care in simulation-based operating room team training. In: Henriksen, K, Battles, JB, Keyes, MA, Grady, ML, editors. Advances in patient safety: new directions and alternative approaches. Vol 3. Performance and tools. Rockville (MD): Agency for Healthcare Research and Quality; 2008.Google Scholar
21. Papaspyros, SC, Javangula, KC, Adluri, RK, O’Regan, DJ. Briefing and debriefing in the cardiac operating room. Analysis of impact on theatre team attitude and patient safety. Interact Cardiovasc Thorac Surg 2010;10:43–47, doi:10.1510/icvts.2009.217356.Google Scholar
22. Clay, AS, Que, L, Petrusa, ER, et al. Debriefing in the intensive care unit: a feedback tool to facilitate bedside teaching. Crit Care Med 2007;35:738–54, doi:10.1097/01.CCM.0000257329.22025.18.Google Scholar
23. Morgan, PJ, Tarshis, J, LeBlanc, V, et al. Efficacy of highfidelity simulation debriefing on the performance of practicing anaesthetists in simulated scenarios. Br J Anaesth 2009;103:531-7, doi:10.1093/bja/aep222.Google Scholar
24. Savoldelli, GL, Naik, VN, Park, J, et al. Value of debriefing during simulated crisis management: oral versus videoassisted oral feedback. Anesthesiology 2006;105:279–85, doi:10.1097/00000542-200608000-00010.CrossRefGoogle ScholarPubMed
25. Tan, H. Debriefing after critical incidents for anaesthetic trainees. Anaesth Intensive Care 2005;33:768–72.Google Scholar
26. Dine, CJ, Gersh, RE, Leary, M, et al. Improving cardiopulmonary resuscitation quality and resuscitation training by combining audiovisual feedback and debriefing. Crit Care Med 2008;36:2817–22, doi:10.1097/CCM.0b013e318186fe37.Google Scholar
27. Ahmed, M, Sevdalis, N, Paige, J, et al. Identifying best practice guidelines for debriefing in surgery: a tri-continental study. Am J Surg 2012;203:523–9, doi:10.1016/j.amjsurg.2011.09.024.Google Scholar
28. Arora, S, Ahmed, M, Paige, J, et al. Objective structured assessment of debriefing: bringing science to the art of debriefing in surgery. Ann Surg 2012;256:982–8, doi:10.1097/SLA.0b013e3182610c91.Google Scholar
29. Zigmont, JJ, Kappus, LJ, Sudikoff, SN. The 3D model of debriefing: defusing, discovering, and deepening. Semin Perinatol 2011;35:52–8, doi:10.1053/j.semperi.2011.01.003.Google Scholar
30. Rudolph, JW, Simon, R, Raemer, DB, Eppich, WJ. Debriefing as formative assessment: closing performance gaps in medical education. Acad Emerg Med 2008;15:1010–6, doi:10.1111/j.1553-2712.2008.00248.x.Google Scholar
31. Steinwachs, B. How to facilitate a debriefing. Simul Gaming 1992;23:186–95, doi:10.1177/1046878192232006.Google Scholar
32. Dieckmann, P, Reddersen, S, Zieger, J, Rall, M. Video-assisted debriefing in simulation-based training of crisis resource management. In: Kyle, RR, Murray, WB, editors. Clinical simulation: operations, engineering, and management. Burlington (VT): Academic Press; 2008. p. 667–76.Google Scholar
33. Dismukes, RK, Gaba, DM, Howard, SK. So many roads: facilitated debriefing in healthcare. Simul Healthc 2006;1:23–5.Google Scholar
34. Rudolph, JW, Simon, R, Rivard, P, et al. Debriefing with good judgment: combining rigorous feedback with genuine inquiry. Anesthesiol Clin 2007;25:361–76, doi:10.1016/j.anclin.2007.03.007.Google Scholar
35. Fanning, RM, Gaba, DM. The role of debriefing in stimulation-based learning. Soc Simul Health Care 2007;2:115–25, doi:10.1097/SIH.0b013e3180315539.Google Scholar
36. McGaghie, WC, Issenberg, SB, Petrusa, ER, Scalese, RJ. A critical review of simulation-based medical education research: 2003-2009. Med Educ 2010;44:50–63, doi:10.1111/j.1365-2923.2009.03547.x.Google Scholar
37. Royal College of Physicians and Surgeons of Canada. Objectives of training in pediatric emergency medicine. Available at: (accessed March 11, 2013).Google Scholar
38. Cheng, A, Hunt, EA, Donoghue, A, et al. Examining Resuscitation Education Using Simulation and Scripting Debriefing: a multicenter randomized trial. JAMA Pediatr 2013;167:528–36, doi:10.1001/jamapediatrics.2013.1389.Google Scholar