Occupational Health Interventions for Critical Incident Stress in Emergency Care Nursing: A Decision-Oriented Scoping Review

This scoping review examined occupational health interventions addressing critical incident stress in emergency care nursing, with particular attention to the timing and focus of interventions (pre-incident and post-incident), to describe current practice patterns and identify priority areas for occupational health decision-making.

This review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. Literature searches were conducted in PubMed, CINAHL, and Google Scholar for studies published from January 2015 to April 2025. Peer-reviewed English-language articles examining interventions for critical incident stress among nurses in emergency, trauma, or intensive care settings were included. Data on study characteristics, intervention timing, content, and outcomes were extracted and synthesized descriptively.

Seven studies met the inclusion criteria. Most interventions focused on post-incident strategies, with only 1 study evaluating a preventive approach. Three studies included elements of critical incident stress management, but these were used as partial or reactive solutions rather than comprehensive systems. Critical incident stress debriefing was the most common post-incident method reported to reduce isolation and facilitate emotional processing, although its effectiveness was inconsistent. Quantitative evidence was scarce, with most results being qualitative. The reported benefits included enhanced coping skills, increased well-being, and resilience.

This review indicates that current approaches to critical incident stress in emergency care nursing are largely reactive, despite critical incident stress being a predictable occupational hazard. Preventive and organization-level interventions were rarely identified, highlighting an imbalance in existing occupational health practices. Although the evidence base remains limited, these findings help to describe priority areas for future occupational health planning and research, rather than recommend specific interventions.