Paediatric Emergency, Emergency Department, Royal Children's Hospital, Flemington Road, Parkville, Victoria 3052, Australia.
Emerg Med Australas. 2010 Dec;22(6):499-506. doi: 10.1111/j.1742-6723.2010.01345.x.
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.
工作相关压力源对急诊临床医生的影响早已得到认可，但对于 Critical Incidents（如复苏失败）后对医院工作人员进行 debriefing（即事后讨论）的益处，几乎没有进行正式的研究。本文通过文献回顾，检查了当前的 debriefing 模式及其在急诊人员中的应用。目标是概述最佳实践，为指南制定和未来的研究方向提供建议。在 Ovid 和 Psychinfo 中进行了电子数据库搜索。阅读了所有可用的摘要，并对手头的参考文献进行了搜索。由两名专家组成的小组选择了纳入的文章。从文献中确定了与有效性相关的模型和证据，并进行了详细评估。回顾的文献表明，关于 CI 后对临床医生进行 debriefing 的有效性，特别是关于随机对照试验的研究明显不足。尽管如此，事后讨论还是被急诊临床医生认为很重要。然而，事后讨论干预措施既有好处也有坏处。在缺乏循证实践指南的情况下，在紧急医疗保健环境中对 debriefing 模式的任何发展都应进行仔细评估。未来的研究方向应针对大型随机对照试验。
