Keith Couper1, Gavin D Perkins. 1. Academic Department of Anaesthesia, Critical Care, Pain and Resuscitation, Heart of England NHS Foundation Trust, Birmingham, UK.
Abstract
PURPOSE OF REVIEW: Evidence of suboptimal cardiopulmonary resuscitation (CPR) delivery in practice has driven interest in strategies to improve CPR quality. Early data suggest that debriefing may be an effective strategy. In this review, we analyse types of debriefing and the evidence to support their usage. RECENT FINDINGS: There is a general lack of standardization in terminology and methods used for debriefing that limits evaluation. Debriefing interventions generally take two different formats. Hot debriefing is one where individuals or teams are provided with debriefing immediately after the event. Although perhaps the most widely used and easiest to implement, research evidence for its effectiveness is scant. Cold debriefing, where individuals or teams are provided with feedback sometime after the event, is associated with improvements in process and patient outcomes. Such feedback usually involves the use of objective performance data, such as defibrillator downloads or videotape records. Before and after cohort studies have found that both verbal debriefing in groups and individual written feedback seem to be associated with an improvement in performance. SUMMARY: Debriefing is a useful strategy to improve resuscitation performance, but the optimal delivery method remains unclear. Future high-quality research is required to identify the most effective form of debriefing.
PURPOSE OF REVIEW: Evidence of suboptimal cardiopulmonary resuscitation (CPR) delivery in practice has driven interest in strategies to improve CPR quality. Early data suggest that debriefing may be an effective strategy. In this review, we analyse types of debriefing and the evidence to support their usage. RECENT FINDINGS: There is a general lack of standardization in terminology and methods used for debriefing that limits evaluation. Debriefing interventions generally take two different formats. Hot debriefing is one where individuals or teams are provided with debriefing immediately after the event. Although perhaps the most widely used and easiest to implement, research evidence for its effectiveness is scant. Cold debriefing, where individuals or teams are provided with feedback sometime after the event, is associated with improvements in process and patient outcomes. Such feedback usually involves the use of objective performance data, such as defibrillator downloads or videotape records. Before and after cohort studies have found that both verbal debriefing in groups and individual written feedback seem to be associated with an improvement in performance. SUMMARY: Debriefing is a useful strategy to improve resuscitation performance, but the optimal delivery method remains unclear. Future high-quality research is required to identify the most effective form of debriefing.
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