Implementing Debriefing After Codes
Code communications are essential in any hospital set-up including my current area of practice of gynecology cancer hospital unit that contains well patients as well as those who are terminally as well as those with other conditions which may require urgent interventions. My suggestion of implementing debriefing after codes would be part of taking into account the skills learned from advanced resuscitation training program. The implementation of the debriefing is feasible in our unit in that the staffs are trained for being prepared for trauma events as well as the existence of incidences where there is need to attend to specific instances with the quickest time possible and as a team, since the labor required is high(Villanueva-Reiakvam).
Besides, with the occurrences in the hospital setups especially with the nature of our unit, the staff reported decrease in having thoughts and feelings of the event after 24 hours (Copeland & Liska, 2016). This was a recent event where a patient succumbed to death after collapsing from a heart attack but could not be resuscitated because she had signed a Do Not Resuscitate card. At the same time, the daughter was having a power of attorney but was not applicable to the patient was not yet pronounced incapacitated.
The debriefing will take the form of facilitating a structured form of giving feedback. In this case, it will allow the individuals as well as the team to do a reflection of an event where they will understand the issues and talk about areas that need improvement. In doing the implementation, rules will be laid down that will be guiding the debriefing, for instance, no mentioning of names or no blaming of individuals but giving suggestion or dwelling on actions rather than the actors(Weinschreider, & Dadiz, 2013). It will then entail creating a safe environment for the staff, e.g., a boardroom and not the nursing station or patient’s rooms. The staff will also be guided to focus on the primary goals and objectives of the debriefing directed toward improving patient care and safety as well as changing behaviors for adjustment in a similar future occurrence.
In addition to the above implementation guidelines, the implementation needs a balanced staff participation to get suggestions from all the team members and end to the solution (Weinschreider, & Dadiz, 2013). While doing the questioning, open-ended questions should be asked to dig deep into the issue to allow proper understanding.
The debriefing after the codes will follow a set-up of identifying a case such as a medical error or near miss in the gynecology unit. The facilitator of the session is then notified to mobilized and inform the team members for preparation of the session. Time and location will be secured together with the personnel. The debrief will then be conducted in the strict following of the guideline as well as rules governing it. Opportunities that need improvement will be captured (Blankenship et al., 2016). The entire process will then end with sharing, implementing and track opportunities that came out from the session.
Debriefing after code will impact the nursing practice in the unit as well as the individual staffs. A platform will be created where the staff members will be able to conduct a reflection for the events that have occurred in the unit. It will also lead to improvement of care regarding quality and safety especially when handling an event similar to one that debriefs was conducted (Wolfe et al., 2014).
Debriefing is essential as it allows for development not only in the nursing profession but in the entire sector of healthcare which requires reflection. This brings about the need to determine events that require debriefing, having rules for a guideline as well as embracing the programs of debriefing. The implementation of the debriefs will positively impact both the staff members as well as the patients and improve their health status.
Blankenship, A. C., Fernandez, R. P., Joy, B. F., Miller, J. C., Naguib, A., Cassidy, S. C., … &
Yates, A. R. (2016). Multidisciplinary Review of Code Events in a Heart Center.
American Journal of Critical Care, 25(4), e90-e97.
Chan, P. S., Krein, S. L., Tang, F., Iwashyna, T. J., Harrod, M., Kennedy, M., … & Nallamothu,
- K. (2016). Resuscitation practices associated with survival after in-hospital cardiac
arrest: a nationwide survey. JAMA cardiology, 1(2), 189-197.
Copeland, D., & Liska, H. (2016). Implementation of a Post-Code Pause: Extending Post-Event
Debriefing to Include Silence. Journal of Trauma Nursing, 23(2), 58-64.
Couper, K., & Perkins, G. D. (2013). Debriefing after resuscitation. Current opinion in critical
care, 19(3), 188-194.
Kassutto, S. M., Kayser, J. B., Kerlin, M. P., Lipschik, G., Upton, M., & Schweickert, W. D.
(2016). Analysis Of Recording Methods To Facilitate Debriefing After Cardiac Arrest
Resuscitation. In B35. INNOVATIONS IN MEDICAL EDUCATION (pp. A3208-
A3208). American Thoracic Society.
Runnacles, J., Thomas, L., Sevdalis, N., Kneebone, R., & Arora, S. (2014). Development of a
tool to improve performance debriefing and learning: the paediatric Objective Structured
Assessment of Debriefing (OSAD) tool. Postgraduate medical journal, 90(1069), 613-
Villanueva-Reiakvam, S. The ART of Resuscitation.
Weinschreider, J., & Dadiz, R. (2013). Coming to the Table: Debriefing for Patient Safety.
Journal of Obstetric, Gynecologic, & Neonatal Nursing, 39(s1).
Wolfe, H., Zebuhr, C., Topjian, A. A., Nishisaki, A., Niles, D. E., Meaney, P. A., … & Apkon,
- (2014). Interdisciplinary ICU cardiac arrest debriefing improves survival outcomes.
Critical care medicine, 42(7), 1688.