Review article: Debriefing critical incidents in the emergency department

Abstract

The impact of work related stressors on emergency clinicians has long been recognized, yet there is little formal research into the benefits of debriefing hospital staff after critical incidents, such as failed resuscitation. This article examines current models of debriefing and their application to emergency staff through a review of the literature. The goal being, to outline best practice, with recommendations for guideline development and future research directives. An electronic database search was conducted in Ovid and Psychinfo. All available abstracts were read and a hand search was completed of the references. Included articles were selected by a panel of two experts. Models and evidence relating to their efficacy were identified from the literature, and detailed evaluation included. The reviewed literature revealed a distinct paucity regarding the efficacy of debriefing of clinicians post CI and in particular randomized controlled trials. Despite this debriefing is perceived as important by emergency clinicians. However evidence presents both benefits and disadvantages to debriefing interventions. In the absence of evidence based practice guidelines, any development of models of debriefing in the emergency healthcare setting should be closely evaluated. And future research directives should aim towards large randomized control trials.