Research Critiques and PICOT Statement: Debriefing After Codes
Debriefing after codes refers to the creation of platforms where staff members share their experiences after specific events to improve on their practices in the recurrence of such events. It can also be carried out to relieve the staff of the stress and exhaustion that comes about with tiresome activities. This paper dwells on PICOT statement and research critiques related to debriefing after codes which are a significant practice in the clinical setting.
The format acts as a fixed formula that is used by researchers to come up with researchable and answerable questions. The arrangement entails fives aspects that involve population, interventions, comparison, outcome and timeframe for the observation of the change employed.
(P) – Population/Patient refers to age, ethnicity, genders, and individuals that have a disorder or form the center of focus by the researcher. In this case, the target population is the nurses in the inpatient units within the hospital.
(I) – Intervention/indicator refers to the treatment or activity that the subjects that are participating in the study undertaken. Debriefing after codes forms the variable of interest that impacts the nursing practice.
(C) – Comparison which determines the plan on using it as a reference group and compared with the subjects of study. It can be a placebo or ‘the business as usual.’ It various studies, it can be referred to as the control group. It is a comparison group in the instances where observation of specific standards in making the two teams.
(O) – Outcome refers to the results that accrue from the intervention which is measured by the research to determine the impact of the interventions.
(T) – Time entails the duration that the researcher collects data in determining the changes that have occurred from the interventions.
Among the nurses in the inpatient units, how do code debriefing enhance the patient care and improve the nurses’ needs when compared to other nurses in other units where no debriefings after codes are carried out in the case such event happens six months after the intervention?
Qualitative research critique
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 the study
Patient safety and care quality improvement are dependants on proper training which can be achieved via simulation. According to Kihlgren, Spanager & Dieckmann (2015), the simulation process provides a platform for the learner to improve skills especially when debriefing is conducted after the simulation learning. The gap that the study aims to fill is the existence of few tools that are used in the debriefings and education after simulation of a critical situation in the pediatric care.
Runnacles et al. (2014) established the significance of the study on the basis that in spite of many care centers practicing debriefing after codes, inadequate tools exists to be used in the improvement of the already existing practices. At the same time, many medical errors occur in the care units although debriefing is being used in such centers. The study would then come up with a tool that would guide, monitor and evaluate the debriefings after simulations of critical incidences in a pediatric unit.
The research questions included:
- What is the impact of debriefing after codes?
- What are the effects of assessing debriefings?
- What are the features of a debriefing assessment tool?( Cheng et al., 2015)
By answering the questions, the study will be able to determine the elements of a standard debriefing that will be useful in developing a tool for evaluating the debriefing simulation and make it efficient to impact nursing practice.
Method of study
Runnacles et al. (2014) used literature review and semi-structured interviews to identify the features of pediatric simulation debriefing. Both methods were appropriate in answering the research questions. Majority of the references used in the literature review were current with only a few quantitative studies that were older than five years. The information from the references was significantly substantial and formed of conclusion and recommendation.
Results of the study
The literature review conducted by Runnacles et al. identified 34 relevant studies and interviewed 16 pediatricians (2014). 307 features of a debriefing process were determined and grouped into eight aspects that formed the components of a standard pediatric debriefing. The Objective Structured Assessment of Debriefing (OSAD) tool had dimensions that were to be scored on a five-point Likert Scale. The scale had explanations on one column and scores in the other column that would be the basis of matching. Fey & Jenkins, reiterates that the application of the tool exposes the learners and facilitators to multiple forms of debriefing hence apply in the clinical areas to influence the patient care (2015).
The privacy of both the patients and the respondents were maintained throughout the study. Codes were used in the questionnaires with no names indicated in them. By using references and citations, acknowledgment was provided to the articles used in the literature review
The need for a structured approach to assessing the debriefing process led Runnacles et alto to develop the OSAD tool. The tool can impact the nursing practice by ensuring efficiency is achieved by adhering it to it hence promoting the care and quality of services to patients.
Quantitative research critiques
Debriefing is usually carried out after critical events that require analysis. However, the process can be done on a daily basis or even without an occurrence of a code event. The debriefing can either be formal or informal. Sandhu et al. (2016) carried out a study on the development of a process of a daily intensive care unit multidisciplinary operational debriefing.
Background of the study
There are various organizations that have programs in place for the management of stress and other critical events. However, there is need to have approaches that are unit-based to meet their specific needs. The absence of such procedures is what led to the study to determine a process of daily intensive care unit multidisciplinary operational debriefing that would fit the unit which in most cases has staff with high levels of stress.
- What attitudes does the staff indicate for the implementation of daily debriefings?
- What is the significance of the debriefing after codes fitting specific care centers(Henrich et al., 2017)?
The research questions reflect the importance of daily debriefing since they seek information and attitude of the staff members relating to the process.
Method of study
Sandhu et al. used voluntary surveys in collecting data in this study (2016). After six months of implementation of daily debriefing after codes, they carried out the survey. There existed no risks participating in the study. The participants and the patient s, in general, were to benefit due to the relief of stress and improved care concerning quality and safety. Data collection encompassed the obtaining of consent from the identified staff members of the critical care unit.
Results of the study
Out of the 47 potential participants, 42 of them completed the survey. Majority of the respondents felt that the daily multidisciplinary debriefings provide an adequate support system that is unit-based. Besides, the process also indicated commitment towards togetherness and well being of others. About 50% felt a reduction of the stress out of the process with about 98% urging for the process to continue being used in the setting.
The findings indicate a reflection of occurrences of intensive care unit. I have confidence in the results because they are in congruence with the purpose of the debriefing process about the setting of the study. The study by Sandhu et al. used a small target population hence the results cannot be generalized to other care units or intensive care centers (Creswell and Creswell, 2017).
During the entire period of the study, Sandhu et al. maintained the privacy of the participants. The surveys used to collect data were anonymous and voluntary. Articles used in literature review were cited and referenced to acknowledge their authors.
The existence of debriefing approaches in various care centers are not enough but require modification to meet the needs of each unit using them. Determining the attitudes of staff members in a department give an overview and importance of the modified debriefing process.
Link between the PICOT statement, research articles, and nursing practice
The PICOT statement which enquires on the impact of debriefing after codes in care centers provides a question that the research critiques answers in their studies. The development of the OSAD tool as well as the determination of the attitudes of staff members towards daily debriefing indicates the positive impact of the process is not only the care of patients but also the wellbeing of the staff. The results answer the PICOT question since the process impacts care delivery to the patients in comparison to centers not using the OSAD tool or not using the daily multidisciplinary debriefings.
Debriefing after code events is essential in improving care patients as well as relieving the staff members of stress and exhaustion that comes about with the nature of their jobs. Care centers ought to use OSAD tool to assess the use of debriefing after codes. This move makes debriefing efficient hence enhances its purpose in improving the well-being of patients and healthcare providers.
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