Obstetrical Nurse Perceptions of Debriefing Following Emergencies

Background and Purpose: Debriefing is a strategy that can help improve communication and teamwork. This study explored obstetrical (OB) nurses' perceptions and practices of real-time (clinical) debriefing following OB emergencies and how debriefing impacts their practices and unit policies. Methods: A cross-sectional quantitative study was based on a descriptive nonexperimental design with qualitative components about the debriefing practices in the OB units. A convenience sample of OB nurses participated in this study. Among the 150 nurses who received the survey, 69 completed the questionnaire (response rate = 46). The OB-Registered Nurse Debriefing Survey was developed to gather data from OB nurses about debriefing following OB emergencies. Donabedian's model "structure, process, and outcome" was used to guide data collection and analysis. Results: OB nurses defined debriefing as a formal discussion of what happened, what went well, what improvement is needed, and identifying resources. Nurses reported multiple perceived benefits of debriefings, including the opportunity to learn, celebrate success and appraisal, improve teamwork, promote patient safety, and identify opportunities for improvement. Several barriers to OB debriefing were reported, including increased nursing workload, emotional distress, lack of confidence, and limited nursing staffing. Conclusions and Implications: Real-time (clinical) debriefing may improve OB outcomes, promote patient safety, and address organizational/structural failures. Despite being beneficial, implementing debriefings is challenging due to various barriers. It also addresses and resolves psychological distress resulting from clinical events. Increased nursing and provider staff engagement and ongoing training would enhance debriefing facilitation. Empowering nurses to lead clinical debriefing that promotes safety and communication and improves OB outcomes is required.