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Recommended Citation
Sheehy T, Mackenzie J, Hlebichuk J. Cracking the Code: Lessons Learned from Nurse-Led Hot and Cold Debriefing Implementation . Quality Improvement poster presented at Transforming Practice: The Intersection of Technology and Nursing Excellence; Advocate Health Nursing Research and Professional Development Conference 2025; November 12, 2025; Virtual.
Presentation Notes
Quality Improvement poster presented at Transforming Practice: The Intersection of Technology and Nursing Excellence; Advocate Health Nursing Research and Professional Development Conference 2025; November 12, 2025; Virtual.
Abstract
Background
Registered nurses (RNs) in intensive care units (ICU) experience increased patient mortality and critical events leading to moral distress. Debriefing after critical events promotes communication, teamwork, and performance improvement. This project’s purpose was to develop and implement nurse-led structured debriefing following resuscitation events. Debriefing occurred in two parts: hot debriefing immediately after post-event and cold debriefing 2-7 days later.
Local Problem
In the cardiovascular ICU, debriefing was inconsistent and lacked a standard approach. Prior to implementation hot debriefs occurred
Method Clear description of the intervention(s)
This project’s purpose was to develop and implement nurse-led structured debriefing following resuscitation events. Debriefing occurred in two parts: hot debriefing immediately after post-event and cold debriefing 2-7 days later. Debriefing education and a pre-survey were provided to RNs. Concurrently, audit materials, a hot debrief form and cold debrief email with resources (employee assistance, chaplain services, peer support program) were developed by clinical RN leaders. The new workflow was piloted. Immediately following an event, the code RN conducted a hot debrief with the team and notified the champions who then contacted RNs involved, providing a cold debrief within scope of role and resources. Pre/post surveys addressed participants' comfort in code, role delineation, and occurrence of debriefs.
Results/Conclusions
Baseline training had (n= 98) participants, with (n=76) completing the survey (77.5% response rate). Comfort (1-10) of being a member of the code team increased from 6.97 to 8.31 on average. Following the education and workflow, this increased to 78% (n=57). Overall RNs reported hot debriefs were beneficial with a mean score of 8.2, on a scale of 1 (not beneficial at all) to 10 (extremely beneficial). The majority identified opportunities for improvement. Cold debriefs occurred (n=117) 88.3% of the time and were beneficial (M= 8.46) (1-not beneficial at all, 10- extremely beneficial).
Implications for Practice
Formal evaluation of hot debriefs after code events increased the practice and efficacy. Cold debriefs by RN peers were beneficial. Both aided in identifying areas of improvement. Future opportunities include ICU expansion, spiritual support sessions, and enhancing informal peer support networks.
Document Type
Poster
Publication Date
11-12-2025
Cracking the Code: Lessons Learned from Nurse-Led Hot and Cold Debriefing Implementation
Background
Registered nurses (RNs) in intensive care units (ICU) experience increased patient mortality and critical events leading to moral distress. Debriefing after critical events promotes communication, teamwork, and performance improvement. This project’s purpose was to develop and implement nurse-led structured debriefing following resuscitation events. Debriefing occurred in two parts: hot debriefing immediately after post-event and cold debriefing 2-7 days later.
Local Problem
In the cardiovascular ICU, debriefing was inconsistent and lacked a standard approach. Prior to implementation hot debriefs occurred
Method Clear description of the intervention(s)
This project’s purpose was to develop and implement nurse-led structured debriefing following resuscitation events. Debriefing occurred in two parts: hot debriefing immediately after post-event and cold debriefing 2-7 days later. Debriefing education and a pre-survey were provided to RNs. Concurrently, audit materials, a hot debrief form and cold debrief email with resources (employee assistance, chaplain services, peer support program) were developed by clinical RN leaders. The new workflow was piloted. Immediately following an event, the code RN conducted a hot debrief with the team and notified the champions who then contacted RNs involved, providing a cold debrief within scope of role and resources. Pre/post surveys addressed participants' comfort in code, role delineation, and occurrence of debriefs.
Results/Conclusions
Baseline training had (n= 98) participants, with (n=76) completing the survey (77.5% response rate). Comfort (1-10) of being a member of the code team increased from 6.97 to 8.31 on average. Following the education and workflow, this increased to 78% (n=57). Overall RNs reported hot debriefs were beneficial with a mean score of 8.2, on a scale of 1 (not beneficial at all) to 10 (extremely beneficial). The majority identified opportunities for improvement. Cold debriefs occurred (n=117) 88.3% of the time and were beneficial (M= 8.46) (1-not beneficial at all, 10- extremely beneficial).
Implications for Practice
Formal evaluation of hot debriefs after code events increased the practice and efficacy. Cold debriefs by RN peers were beneficial. Both aided in identifying areas of improvement. Future opportunities include ICU expansion, spiritual support sessions, and enhancing informal peer support networks.
Affiliations
St Luke's Medical Center