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Abstract

BACKGROUND: Healthcare is a stressful profession where in addition to routine stressors, there are critical incident (CI) events which are occurrences capable of overwhelming an individual’s normal coping mechanisms. The purpose of this quality improvement project was to improve the process by which certified registered nurse anesthetists (CRNAs) exposed to critical incident events are provided post-critical incident support thus mitigating the potential for CI stress

METHODS: We created a CI stress management pilot program for nurse anesthetists employed by an academic hospital located in the Southeastern United States. The program was based upon concepts introduced by Medically Induced Trauma Support Services and the Scott Three-Tiered Interventional Model of Second Victim Support. The program goal was to offer 100% of CRNAs exposed to a CI event supportive measures prior to assuming care for a patient other than the patient involved in the CI event. The program was piloted for five months as data was collected regarding the number and type of critical incident occurrences as well as the percentage of individuals offered said support post-critical incident. The National Institute for Healthcare Improvement’s Plan-Do-Study-Act methodology was utilized throughout the pilot period to evaluate for any changes needed to the program as issues arose.

RESULTS: Over the five month period, three CI events occurred. Two of the three individuals involved in the events received support as prescribed. Failure of the third individual to receive timely support was due to facility and staff limitations. Nevertheless, the initial receptivity to the program was positive. Future improvement of the program’s processes are intended to yield support offered to 100% of individuals involved in a critical incident in a more timely manner.

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