What's New
- •Our mixed methods needs assessment found varied reasons for debriefing, including patient case review, closure, and addressing staff welfare. In critical cases that involved CPR, intubation, or death, there was a desire and need for a debrief with clear objectives.
Abstract
Objective: The emergency department (ED) is a demanding environment and critical events have
been identified as contributors to stress. Debriefing is a possible intervention for
staff, but there is little information regarding formulation and implementation. A
needs assessment was conducted to describe the emotions of pediatric ED (PED) staff
following critical events and assess opinions regarding debriefing.
Method: This mixed methods study used convergent design for triangulation. After critical
cases, PED staff members were given the Peritraumatic Distress Inventory (PDI). Additionally,
a questionnaire with 2 open-ended questions on debriefing was administered. Themes
were extracted from the questionnaire using directed content analysis.
Results: A total of 719 responses were collected for 142 critical cases. Physical reactions were often endorsed in the PDI, and these reactions were mirrored in the qualitative
data, which included physiological responses such as stress, adrenaline high, anxiety,
fatigue, and overwhelm. Helplessness and grief were 2 of the emotional PDI items frequently endorsed, which were reflected in the
qualitative strand by themes such as helplessness, sadness, disheartenment, and regret.
There was considerable variability between critical cases such that not every critical
case created a desire for a debrief.
Conclusions: PED staff report measurable levels of stress after critical patient cases that warrant
follow up. Formal debriefing immediately after critical patient cases with specific
caveats may be valuable for the reduction of stress. Any formal debriefing program
will need to balance various goals with attention to the session length, setting,
and timing.
Keywords
Abbreviations:
ED (Emergency Department), PED (Pediatric Emergency Department), PEM (Pediatric Emergency Medicine), PDI (Peritraumatic Distress Inventory), PTSD (Post-Traumatic Stress Disorder), ESI (Emergency Severity Index), CPR (Cardiopulmonary Resuscitation)To read this article in full you will need to make a payment
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Article Info
Publication History
Accepted:
May 14,
2022
Received:
December 28,
2021
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
Copyright © 2022 by Academic Pediatric Association
