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Charge nurse facilitated clinical debriefing in the emergency department

  • Stuart Rose (a1) and Adam Cheng (a1) (a2)
Abstract

This paper describes the development and implementation of the INFO (immediate, not for personal assessment, fast facilitated feedback, and opportunity to ask questions) clinical debriefing process. INFO enabled charge nurses to facilitate a group debriefing after critical events across three adult emergency departments (EDs) in Calgary, Alberta. Prior to implementation at our institutions, ED critical event debriefing was a highly variable event. Post-implementation, INFO critical event debriefings have become part of our ED culture, take place regularly in our EDs (254 documented debriefings between March 2016 and September 2017), with recommendations arising from these debriefings being introduced into clinical practice. The INFO clinical debriefing process addresses two significant barriers to regular ED clinical debriefing: a lack of trained facilitators and the focus on physician-led debriefings. Our experience shows that a nurse-facilitated debriefing is feasible, can be successfully implemented in diverse EDs, and can be performed by relatively inexperienced debriefers. A structured approach means that debriefings are more likely to take place and become a routine part of improving team management of high stakes or unexpected clinical events.

Il sera question, dans le présent article, de l’élaboration et de la mise en œuvre du processus de réunion-bilan clinique, appelée INFO (d’après l’anglais Immediate, Not for personal assessment, Fast facilitated feedback and Opportunity to ask questions). La formule INFO permet à des infirmières responsables d’animer des réunions de bilan clinique après des événements très graves, dans trois services des urgences (SU) pour adultes, à Calgary (Alberta, Canada). Avant la mise en œuvre du processus dans les établissements en question, la tenue de réunions-bilan consécutives à des événements gravissimes au SU était très variable; depuis la mise en œuvre de la démarche, ces réunions font partie intégrante de la culture du personnel de soins et ont lieu fréquemment dans les trois SU participants (254 réunions-bilan documentées entre mars 2016 et septembre 2017). De plus, les recommandations formulées au cours de ces réunions trouvent maintenant écho en pratique clinique. Le processus des séances INFO vise à surmonter deux obstacles importants à la tenue habituelle de réunions-bilan clinique au SU, soit le manque d’animateurs formés et le point de mire sur les réunions animées par les médecins. L’expérience montre qu’il est possible de tenir des réunions-bilan animées par des infirmières, d’implanter ce type de réunion dans divers SU et de confier la conduite de ces réunions à des animateurs ayant relativement peu d’expérience. Le processus structuré d’INFO rend plus probable la tenue de réunions-bilan et fait de celles-ci un composant de l’amélioration de la gestion collective d’événements à grands enjeux ou d’événements cliniques imprévus.

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Copyright
Corresponding author
Correspondence to: Stuart Rose, 58 Discovery Ridge View, SW, Calgary, AB T3H 4P9; Email: scrose02@gmail.com
References
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Canadian Journal of Emergency Medicine
  • ISSN: -
  • EISSN: 1481-8035
  • URL: /core/journals/canadian-journal-of-emergency-medicine
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