Research Appraisal.
Debriefing after codes entails the creation of a platform where the staff members in a unit come to share the experiences after a critical event. Despite the fact that this clinical issue is usually carried out after code events, it can also be done either on a daily basis as well as when there is no code event as this acts to promote the practice of the staff in subsequent studies. In areas where debriefing after codes is practiced, both formal and formal ways can be used to achieve the same objective. Runnacles et al. conducted a study on the development of a tool that was meant to improve the performance debriefing and learning: the pediatric Objective Structured Assessment of Debriefing (OSAD) tool (2014).
Background of Study:
Simulation form a critical tool that can be used to impart knowledge and skills relating to debriefing after codes to enhance medical training hence improve the quality of care and the patient safety as well. When debriefing is conducted after a simulation learning, the learner maximizes what was learned during the simulation process and integrates it to the clinical area with the aim of improving such practice (Kihlgren, Spanager, and Dieckmann, 2015). The will assist in reducing of medical errors as well as embracing of the best practices learned from previous processes and debriefings. The gap that leads to the study entails the presence of only a few tools that are used to improve the performance debriefing and learning following a simulation of a critical situation in the pediatric care.
The authors established the significance of this study on the basis that despite the fact that many facilities embrace the use of debriefings after codes, there are inadequate tools that can be used to improve the performance of the already existing practice. Furthermore, there still exist medical errors that occur in the clinical setup in spite of the use of debriefing after codes. With the medical errors, the patient safety has been breached with the quality of care deteriorating day by day. All these demonstrate the inefficiency of the practice as well as the tools meant to improve its performance.
This reason for this study was to come up with a tool that would guide, monitor and evaluate the debriefings after simulations of critical incidences in a pediatric unit. This was going to be achieved via the use of user-based research as well as the application of current evidence base. The components of the tool identified would then be used to achieve its intended purpose in various settings.
The research questions included:
- a) What is the impact of debriefings after codes?
- b) What is the effect of assessing the debriefings?
- c) What forms the features of a debriefing assessment tool?
Both the research purpose and the research questions addressed the problem of concern. This so because they related to the assessment of performance debriefings and the standard features that the assessment tools ought to contain. By answering the questions, the study will be able to determine the elements of a standard debriefing which can be used to make a tool that will then address the issue of efficiency of the debriefing simulation to impact the practice in clinical settings.
Method of Study:
The method used by the authored was appropriate to answer the research questions. They used literature review to determine the features of a pediatric simulation briefing. They also used semi-structured interviews with the debriefing facilitators and learners. With the two perspectives, they would be able to get information that is substantial enough to determine the intended features. The authors also cited various articles that they used during the study. These included research articles that were based on an evaluation of the views of pediatricians and nurses in the care units towards the use of debriefing and its efficiency in improving patient care and reducing the medical errors.
Majority of the used references were currents while some quantitative studies were older than five years. The authors, however, did not indicate the weaknesses of the resources but only considered them relevant to their study. The information obtained from the identified articles, however, provided substantial information that was used to develop the basis for their conclusion.
Results of Study
From the literature review, 34 relevant studies were determined. At the same time, interviews were conducted with 16 pediatricians which included both the debriefing facilitators as well as the learners. From the two, 307 features of a debriefing process were identified. The features were then grouped into eight aspects that represented components of a standard pediatric debriefing. The dimensions included the facilitator’s approach, engagement of learners, learning environment, descriptive reflection, reaction, analysis, diagnosis, and application. They were used to develop a tool –the Objective Structured Assessment of Debriefing (OSAD). The dimensions were then to be scored on five-point Likert Scale. The scale was top contains the descriptions that would anchor the features and assist in the scoring of their assessment. The descriptions were to match the scores of 1, 3 and 5.
The development of the tool provided a structured and comprehensive method of assessing the debriefing simulation and processes for their performance. This would impact the nursing profession by adding to the existing evaluator tools to enhance the performance of the debriefing simulations. The use of the tools will also improve the nursing training and education since both the learners, and the facilitators will be exposed to a detailed and comprehensive assessment tool making them able to apply it into practice in the clinical areas (Fey and Jenkins, 2015). In the long haul, the care of patients will be improved regarding quality and safety since the debriefings will be efficiently preventing the medication errors.
Specifically, the developed OSAD tool provides a structured approach towards the debriefing following incidences among the pediatrics. This approach is based on evidence from published articles as well as the opinions of facilitators and leaners of debriefing simulations. This matches the nursing profession that is gearing all its practices to evidence-based practice to improve care.
Ethical Considerations
Throughout their study, the patient, as well as the respondents’ privacy, were maintained. The participants were not identified during the interviews with the information obtained from them only coded. The authors also recognized the authors of the articles they used in the literature review. Moreover, the study was approved and published by the BMJ Publishing Group Limited.
Conclusion.
Indeed, there is a need for a structured approach to the assessment of debriefing process to ensure efficiency of its performance. This has been provided by this study through the development of the Objective Structured Assessment of Debriefing (OSAD) tool. With study meeting various research requirements for research studies, this research work forms a concrete base for nursing application of its findings as well as the tool. The tool can be used in pediatric units and also modified to fit other units to act as a guide in the simulation process of debriefing. It can also be applied by both the student nurses as well as the already practicing nurses.
References:
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Runnacles, J., Thomas, L., Sevdalis, N., Kneebone, R., & Arora, S. (2014). Development of a
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