Intensive care unit nurses' perceptions of debriefing after critical incidents: A qualitative descriptive study.

Clinical debriefing Crisis intervention Critical care nursing Critical incident stress debriefing Hot debriefing Intensive care units Occupational stress Reflection

Journal

Australian critical care : official journal of the Confederation of Australian Critical Care Nurses
ISSN: 1036-7314
Titre abrégé: Aust Crit Care
Pays: Australia
ID NLM: 9207852

Informations de publication

Date de publication:
01 Aug 2023
Historique:
received: 02 10 2022
revised: 22 05 2023
accepted: 03 06 2023
medline: 4 8 2023
pubmed: 4 8 2023
entrez: 3 8 2023
Statut: aheadofprint

Résumé

Intensive care unit (ICU) nurses are exposed to critical incidents daily at their workplace, which may have long-term physical and psychological impacts. Despite the growing evidence supporting clinical debriefing in health care to prevent these impacts, a scarcity of literature exists to support its use in the adult intensive care setting. The objective of this study was to explore nurses' perceptions of clinical debriefing after critical incidents in an adult ICU. A qualitative descriptive design was utilised. Thematic analysis of data from individual semistructured interviews with six ICU nurses was undertaken. In this study, two themes were identified. Firstly, participants valued hot debriefing after critical incidents for the key reasons of having an opportunity to reflect on and learn from a critical incident and reduce normalisation of stressful situations. Secondly, when logistical factors such as communication, timing, and location were not considered, the attendance at debriefings was negatively influenced. Participants identified that ICU nurses commonly prioritised patient tasks over attending a debrief; therefore, teamwork and flexibility with logistics was crucial. Hot debriefing, of a short duration and close to the time of the event, was valued and played an important role in staff wellbeing and self-care, contributing to preventing self-blame and normalisation of stressful situations. A clearer definition of the term along with greater recognition of types of events that could be considered critical incidents is required for staff support after critical incidents in the complex intensive care setting.

Sections du résumé

BACKGROUND BACKGROUND
Intensive care unit (ICU) nurses are exposed to critical incidents daily at their workplace, which may have long-term physical and psychological impacts. Despite the growing evidence supporting clinical debriefing in health care to prevent these impacts, a scarcity of literature exists to support its use in the adult intensive care setting.
OBJECTIVES OBJECTIVE
The objective of this study was to explore nurses' perceptions of clinical debriefing after critical incidents in an adult ICU.
METHODS METHODS
A qualitative descriptive design was utilised. Thematic analysis of data from individual semistructured interviews with six ICU nurses was undertaken.
FINDINGS RESULTS
In this study, two themes were identified. Firstly, participants valued hot debriefing after critical incidents for the key reasons of having an opportunity to reflect on and learn from a critical incident and reduce normalisation of stressful situations. Secondly, when logistical factors such as communication, timing, and location were not considered, the attendance at debriefings was negatively influenced. Participants identified that ICU nurses commonly prioritised patient tasks over attending a debrief; therefore, teamwork and flexibility with logistics was crucial.
CONCLUSIONS CONCLUSIONS
Hot debriefing, of a short duration and close to the time of the event, was valued and played an important role in staff wellbeing and self-care, contributing to preventing self-blame and normalisation of stressful situations. A clearer definition of the term along with greater recognition of types of events that could be considered critical incidents is required for staff support after critical incidents in the complex intensive care setting.

Identifiants

pubmed: 37537123
pii: S1036-7314(23)00085-1
doi: 10.1016/j.aucc.2023.06.002
pii:
doi:

Types de publication

Journal Article

Langues

eng

Informations de copyright

Copyright © 2023 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

Auteurs

Kristie Berchtenbreiter (K)

Alfred Health, 55 Commercial Road, Prahran, Victoria, 3004, Australia; Monash University, Monash Nursing and Midwifery, Wellington Road, Clayton, Victoria, 3800, Australia. Electronic address: kristie.berchtenbreiter@gmail.com.

Kelli Innes (K)

Monash University, Monash Nursing and Midwifery, Wellington Road, Clayton, Victoria, 3800, Australia. Electronic address: kelli.innes@monash.edu.

Jason Watterson (J)

Monash University, School of Public Health and Preventative Medicine, Wellington Road, Clayton, Victoria, 3800, Australia; Peninsula Health, 2 Hastings Rd, Frankston, VIC 3199 Australia. Electronic address: jwatterson@phcn.vic.gov.au.

Christopher Peter Nickson (CP)

Alfred Health, 55 Commercial Road, Prahran, Victoria, 3004, Australia; Monash University, School of Public Health and Preventative Medicine, Wellington Road, Clayton, Victoria, 3800, Australia. Electronic address: c.nickson@alfred.org.au.

Pauline Wong (P)

Monash University, Monash Nursing and Midwifery, Wellington Road, Clayton, Victoria, 3800, Australia. Electronic address: pauline.wong1@monash.edu.

Classifications MeSH