Volume 29, Issue 3-4 pp. 330-346
REVIEW

Psychological outcomes of debriefing healthcare providers who experience expected and unexpected patient death in clinical or simulation experiences: A scoping review

Nicole Harder RN, PhD, CHSE, CCSNE

Corresponding Author

Nicole Harder RN, PhD, CHSE, CCSNE

Mindermar Professor in Human

Rady Faculty of Health Sciences, College of Nursing, University of Manitoba, Winnipeg, MB, Canada

Correspondence

Nicole Harder, Rady Faculty of Health Sciences, College of Nursing, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.

Email: [email protected]

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Jocelyne Lemoine MA

Jocelyne Lemoine MA

Research Project Coordinator

College of Nursing, University of Manitoba, Winnipeg, MB, Canada

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Rae Harwood BN, EdD

Rae Harwood BN, EdD

Instructor II

College of Nursing, University of Manitoba, Winnipeg, MB, Canada

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First published: 29 October 2019
Citations: 52

Abstract

Aims and objectives

To synthesise and map the literature on the psychological outcomes reported following debriefing of healthcare providers who experience expected and unexpected patient death in either clinical practice or simulation setting.

Background

Patient death occurs in both the clinical and simulation environments and can result in psychological stress in healthcare providers and students. While debriefing following patient death has demonstrated the ability to promote positive psychological outcomes, addressing the psychological or emotional stress of the event is inconsistently addressed.

Design

A scoping review was conducted using the Arksey and O'Malley framework.

Method

The Cochrane Library, MEDLINE, CINAHL, PsycINFO, JBI and Scopus databases were searched with English language constraints and no limit on publication date. The Scoping Reviews (PRISMA-ScR) Checklist was used (Annals of Internal Medicine, 2018, 169, 467) (see Appendix S1).

Results

Eighteen articles (16 research papers and 2 review papers) met the inclusion criteria. Of the 16 research papers, 9 reported on debriefing models in the simulation environment and 7 in the clinical setting. The types of debriefing models found in the simulation setting tended to focus on healthcare providers' learning, while those in the clinical setting typically focused on healthcare providers' emotional reactions and resulted in positive psychological effects.

Conclusion

Debriefing has the potential to positively affect psychological outcomes of healthcare providers who experience patient death. The type of debriefing that is selected is a key component to achieving these positive outcomes.

Relevance to Clinical Practice

This scoping review identified the debriefing frameworks used in both simulation and clinical environments following patient death events, and any associated psychological outcomes. There is a need for debriefing to occur after each death in either environment; however, there is a lack of evidence-based debriefing frameworks that can be used in both the clinical and simulation environments to promote positive psychological outcomes.

CONFLICT OF INTEREST

The authors declare that they have no conflicts of interest. All authors contributed to the development and writing of this paper, and confirm that this paper is not under consideration anywhere else. None of the findings from this paper have been previously presented in any format.

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