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Research article
Baseline Well-being, Perceptions of Critical Incidents, and Openness to Debriefing in Community Hospital Emergency Department Clinical Staff Before COVID-19, a Cross-Sectional Study
Laura Cantu
Quinnipiac University Frank H Netter MD School of Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8272-6168
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Emergency Medicine.
Background: Emergency department personnel routinely bear witness to traumatic experiences and critical incidents that can affect their own well-being. Peer support through debriefing has demonstrated positive impacts on clinicians’ well-being following critical incidents. This study explored community hospital emergency department staff’s perceptions of critical incidents, assessed openness to debriefing and measured baseline well-being. Our analysis provides a baseline of provider well-being immediately prior to the local onset of COVID-19. The potential need for additional resources to support frontline providers during the pandemic can be evaluated.
Method: We conducted a cross-sectional study for 4-weeks prior to the first COVID-19 case in Connecticut using a survey offered to an interprofessional group of emergency department clinical staff. The main outcome measures were the Hospital Anxiety and Depression Scale (HADS) and the Professional Quality of Life (ProQOL) scale. Pearson’s chi-square test was used to identify significant differences in perceptions of critical incidents and debriefings between professional categories. One-way ANOVA and Tukey’s test were used to analyze significant differences in well-being between professional categories.
Results: Thirty-nine clinical personnel from St. Vincent’s Emergency Department responded to the survey. Events frequently selected as critical incidents were caring for critically ill children (89.7%), mass casualty events (84.6%), and death of a patient (69.2%). Critical incidents were commonly reported (81.6%) as occurring once per week. Additionally, 76.2% of participants reported wanting to discuss a critical incident with their team. Across all respondents, 45.7% scored borderline or abnormal for anxiety, 55.9% scored moderate for burnout, and 55.8% scored moderate to high for secondary traumatic stress.
Conclusions: At baseline, providers reported caring for critically ill children, mass casualty events, and death of a patient as critical incidents, which typically occurred once per week. Death of a patient occurs at increased frequency during the protracted mass casualty experience of COVID-19 and threatens provider well-being. Receptiveness to post-event debriefing is high but the method is still underutilized. With nearly half of staff scoring borderline or abnormal for anxiety, burnout, and secondary traumatic stress at baseline, peer support measures should be implemented to protect frontline providers’ well-being during and after the pandemic.
Keywords
debriefing, peer support, well-being, HADS, ProQOL, critical incident, COVID-19, secondary traumatic stress, burnout
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CURRENT STATUS: Published
Version 2
Posted 09 Sep, 2020
Published
On 15 Oct, 2020
Published
On 15 Oct, 2020
No community comments so far
Editorial decision: Accept
On 28 Sep, 2020
Review #2 received
Received 25 Sep, 2020
Reviewer #1 agreed
On 24 Sep, 2020
Reviewer #2 agreed
On 24 Sep, 2020
Review #1 received
Received 24 Sep, 2020
Reviewers invited
Invitations sent on 23 Sep, 2020
Editor assigned
On 07 Sep, 2020
Submission checks complete
On 06 Sep, 2020
Editor invited
On 06 Sep, 2020
No comments provided
Editorial decision: Major revision
On 31 Jul, 2020
Review #2 received
Received 30 Jul, 2020
Reviewer #2 agreed
On 29 Jul, 2020
Editor assigned
On 17 Jun, 2020
Reviewers invited
Invitations sent on 17 Jun, 2020
Reviewer #1 agreed
On 17 Jun, 2020
Review #1 received
Received 17 Jun, 2020
Submission checks complete
On 16 Jun, 2020
Editor invited
On 16 Jun, 2020
First submitted
On 08 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Critical Care & Emergency Medicine
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This preprint is under consideration at BMC Emergency Medicine. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Baseline Well-being, Perceptions of Critical Incidents, and Openness to Debriefing in Community Hospital Emergency Department Clinical Staff Before COVID-19, a Cross-Sectional Study
Laura Cantu
Quinnipiac University Frank H Netter MD School of Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8272-6168
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 2
Posted 09 Sep, 2020
Published
On 15 Oct, 2020
Published
On 15 Oct, 2020
No community comments so far
Editorial decision: Accept
On 28 Sep, 2020
Review #2 received
Received 25 Sep, 2020
Reviewer #1 agreed
On 24 Sep, 2020
Reviewer #2 agreed
On 24 Sep, 2020
Review #1 received
Received 24 Sep, 2020
Reviewers invited
Invitations sent on 23 Sep, 2020
Editor assigned
On 07 Sep, 2020
Submission checks complete
On 06 Sep, 2020
Editor invited
On 06 Sep, 2020
No comments provided
Editorial decision: Major revision
On 31 Jul, 2020
Review #2 received
Received 30 Jul, 2020
Reviewer #2 agreed
On 29 Jul, 2020
Editor assigned
On 17 Jun, 2020
Reviewers invited
Invitations sent on 17 Jun, 2020
Reviewer #1 agreed
On 17 Jun, 2020
Review #1 received
Received 17 Jun, 2020
Submission checks complete
On 16 Jun, 2020
Editor invited
On 16 Jun, 2020
First submitted
On 08 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Critical Care & Emergency Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Emergency Medicine.
Background: Emergency department personnel routinely bear witness to traumatic experiences and critical incidents that can affect their own well-being. Peer support through debriefing has demonstrated positive impacts on clinicians’ well-being following critical incidents. This study explored community hospital emergency department staff’s perceptions of critical incidents, assessed openness to debriefing and measured baseline well-being. Our analysis provides a baseline of provider well-being immediately prior to the local onset of COVID-19. The potential need for additional resources to support frontline providers during the pandemic can be evaluated.
Method: We conducted a cross-sectional study for 4-weeks prior to the first COVID-19 case in Connecticut using a survey offered to an interprofessional group of emergency department clinical staff. The main outcome measures were the Hospital Anxiety and Depression Scale (HADS) and the Professional Quality of Life (ProQOL) scale. Pearson’s chi-square test was used to identify significant differences in perceptions of critical incidents and debriefings between professional categories. One-way ANOVA and Tukey’s test were used to analyze significant differences in well-being between professional categories.
Results: Thirty-nine clinical personnel from St. Vincent’s Emergency Department responded to the survey. Events frequently selected as critical incidents were caring for critically ill children (89.7%), mass casualty events (84.6%), and death of a patient (69.2%). Critical incidents were commonly reported (81.6%) as occurring once per week. Additionally, 76.2% of participants reported wanting to discuss a critical incident with their team. Across all respondents, 45.7% scored borderline or abnormal for anxiety, 55.9% scored moderate for burnout, and 55.8% scored moderate to high for secondary traumatic stress.
Conclusions: At baseline, providers reported caring for critically ill children, mass casualty events, and death of a patient as critical incidents, which typically occurred once per week. Death of a patient occurs at increased frequency during the protracted mass casualty experience of COVID-19 and threatens provider well-being. Receptiveness to post-event debriefing is high but the method is still underutilized. With nearly half of staff scoring borderline or abnormal for anxiety, burnout, and secondary traumatic stress at baseline, peer support measures should be implemented to protect frontline providers’ well-being during and after the pandemic.
Figure 1
Figure 2