Psychological Debriefing of Hospital Emergency Personnel: Review of Critical Incident Stress Debriefing

Abstract

Emergency department providers are subjected to cumulative exposure to critical incidents, which may predispose them to Post-Traumatic Stress Disorder (PTSD). Critical Incident Stress Debriefing (CISD) is aimed at remediating the effects of a critical incident. Defusing and CISD are two components of the Critical Incident Stress Debriefing (CISM) model. A literature review was performed to include published, peer-reviewed, English-language articles. Ten publications were identified and included in this review. Findings suggest hospital emergency personnel view psychological debriefing to be important and valuable; however, training and education in psychological debriefing is insufficient. There are mixed results regarding the efficacy of psychological debriefing in reducing PTSD on hospital emergency personnel. Studies indicate that poor adherence to the debriefing process, lack of training and education for hospital nurses and other personnel, and unsubstantiated fears that CISD will exacerbate PTSD symptoms may explain low utilization of the CISM model. Although the effect of critical incidents on urban emergency personnel is available, there is only limited data concerning the impact on those in rural communities.