It has taken at least six months to have tangible progress to report from the Debriefing Committee
First event occurs
Then, the clinical event must be reviewed by the debriefing committee
Committee meets once a month
Changes take time to implement
Changes include literature reviews, consultation with clinical experts, collaboration with other departments
Dissemination of information is challenging
Concern is that if information is not shared and clinicians do not perceive that their ideas are being heard/acted upon, then they will not be motivated to participate in future INFO debriefs
Goal is to have numerous methods to disseminate information
Information printed on badge buddies
Presentations at staff meetings
Email communication
Updates at change of shift report
Flyers posted in MD and RN lounges
Physician champion reporting to peers at committee meetings
Debriefing champion hypothesized that obtaining buy in from stakeholders would be the biggest barrier to implementation
Many factors contributed to successful implementation of pilot
The Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Health Care
Support and mentorship from nurse scientists at the University of Iowa Advanced Practice Institute
Support and mentorship from AWHONN
Nursing Director completely supportive of INFO debrief
Instructed labor and delivery staff to debrief even if some of the multidisciplinary team members refused to participate
Debriefing change champions were influential nursing peers
Debriefing committee formed to implement recommendations/feedback
Organized roll out, including multidisciplinary education sessions and debriefing tools
Debriefing script provided
Debriefing champion also believed that changing the unit's culture to prioritize a debrief after a critical obstetric event would be a challenge
Nurses are observed as flexible, offering to alter assignments and provide direct patient care in order to ensure that debriefs occur
Additional anecdotal observations
All disciplines are requesting debriefs
Multidisciplinary participation, including physicians calling in by telephone
As critical events occur and other units and disciplines are involved, labor and delivery charge nurses invite other hospital personnel to INFO debriefs.
Regular attendance noted
Discussing critical events immediately after they happen is therapeutic because one does not need to question his/her actions alone.
