Debriefing following specific critical events in a department of anaesthesiology

Abstract

Background: Critical events occur commonly in anaesthesiology. Stress experienced by anaesthetists following such events may be overwhelming. Debriefing, as a part of a Critical Incident Stress Management (CISM) strategy, has been shown to alleviate stress following critical events. Methods: A contextual, prospective, descriptive study was conducted using convenience sampling. A questionnaire was distributed in the Department of Anaesthesiology at the University of the Witwatersrand exploring critical events and debriefing practices. Results: Data from 148 participants were included for analysis. Of these, 98.6% remembered at least one critical event occurring in the last year and 79.1% were interested in debriefing. Only 68.9% of the included participants have received some form of debriefing and 81.4% found debriefing useful. Significantly more juniors than seniors participated in debriefing (p = 0.0006) and found it useful (p = 0.0319) but were less likely to feel supported by the department following a critical event (p = 0.0042). Participants ranked barriers to debriefing which included theatre pressure (80.4%), time constraints (77.0%), fear of blame (70.3%), lack of critical event reporting (66.2%) and no trained facilitator (62.8%). Conclusion: This study illustrates that many critical events occur which are stressful and have an impact on anaesthetists. There is an interest in debriefing following critical events which, if implemented consistently, may improve the perception of departmental support. Improving these support structures may protect the mental wellbeing of anaesthetists in the workplace. Further work should focus on the practical implementation of CISM strategies following critical events in this setting