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From Code to Calm: Hot, Cold, and Spiritual Debriefing Implementation
Cailin Ford1, Taryn Sheehy1, Julie Mackenzie2
1Cardiovascular Intensive Care Unit, Aurora St. Luke's Medical Center, Milwaukee, WI.
Dimensions of Critical Care Nursing : DCCN
|July 28, 2026
Summary
Nurse-led debriefing practices, including hot, cold, and spiritual sessions, improved healthcare providers' well-being and team cohesion in a cardiovascular intensive care unit. These structured approaches enhance psychological safety and clinical care following critical events.
Area of Science:
- Critical care medicine
- Quality improvement initiatives
- Healthcare provider well-being
Background:
- Debriefing is crucial for healthcare providers' emotional health and clinical care quality.
- Implementation of debriefing is often inconsistent due to logistical challenges and competing demands.
Purpose of the Study:
- To evaluate nurse-led hot, cold, and spiritual debriefing practices.
- To assess outcomes following resuscitation events in a surgical cardiovascular intensive care unit.
Main Methods:
- A quality improvement project using two plan-do-study-act cycles.
- Cycle 1: Introduced immediate (hot) and delayed (cold) nurse-led debriefs.
- Cycle 2: Added monthly spiritual care debriefs; measured debrief frequency, participation, role comfort, perceived benefits, and resilience.
Main Results:
- Increased frequency of hot debriefs and improved nurse comfort in code roles.
- Self-reported benefits for hot and cold debriefs; consistent resilience scores over one year.
- Positive anecdotal feedback from 14 spiritual debrief sessions.
Conclusions:
- Nurse-led debriefing enhances emotional support, team cohesion, and unit culture.
- Structured and adaptable debriefing approaches foster psychological safety.
- These practices are vital for well-being in critical care settings.
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