Supporting Nurses to Navigate Critical Events
2015
Paper Presentation Purpose for the Program Labor and delivery staff at Sharp Mary Birch Hospital for Women & Newborns asked for a tool to be used after critical events. Teammates expressed a variety of emotions, including grief, anxiety, uncertainty, loss of confidence, and need to "close the loop" related to previous critical events. Previous practice in our department limited access to timely debriefs. A clinical nurse specialist group partnered with the labor and delivery staff to create a standardized debrief process that could be used by charge registered nurses acting as facilitators. The goal of the project was to empower the individual bedside nurse to request a critical incident debrief of any event that sparked an emotional response. The bedside nurse was chosen because the competing priorities of the charge nurses may limit in‐the‐moment awareness. Proposed Change The topic was introduced by respected teammates who had experienced trauma associated with critical events, and a video was created to address the navigation of a critical event and explain how a debrief could have made a difference. The purposed of the program was to help nurses deal with their emotions and create a culture of improvement by calling for and participating in critical event debriefs. The debrief would happen before the end of the shift, and all parties would be invited to be involved. Implementation, Outcomes, and Evaluation Small groups of staff were gathered at change of shift to view the video and discuss the didactic. One hundred and forty‐four nurses received the education. The commitment of leadership to support nurses to cope was emphasized. Surveys taken before and after the debrief were used to evaluate the three domains of learning. The results of the surveys indicated a significant change in knowledge and attitude about the topic. Implications for Nursing Practice The video and debrief process helped the team deal with critical events. Planned qualitative interviews of staff who have participated in the new process will be used to measure progress in improving practice and preventing staff from becoming second victims of critical events.
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