From Code to Calm: Hot, Cold, and Spiritual Debriefing Implementation.

BACKGROUND

Debriefing after critical clinical events is recognized as essential for supporting health care providers' emotional well-being and improving clinical care, yet its implementation remains inconsistent due to competing demands and logistical challenges.

OBJECTIVES

This quality improvement project aimed to evaluate the outcomes of nurse-led hot, cold, and spiritual debriefing practices in a surgical cardiovascular intensive care unit following resuscitation events.

METHODS

The project was conducted in 2 plan-do-study-act cycles: cycle 1 introduced nurse-led hot debriefs (immediate postevent) and cold debriefs (delayed peer support), while cycle 2 added monthly spiritual care debrief sessions led by the unit chaplain. Outcome measures included the frequency of debriefs, nurse participation, nurses' comfort in code roles, perceived benefit of debriefs, and nurses' resilience scores.

RESULTS

Since project initiation, there has been an increase in hot debriefing frequency, improved nurse comfort in code roles, and self-reported perceived benefits for both hot and cold debriefs. Fourteen spiritual debrief sessions were held, with resilience scores remaining consistent over 1 year and positive anecdotal feedback.

DISCUSSION: Nurse-led debriefing practices enhanced emotional support, team cohesion, and unit culture, highlighting the importance of structured, adaptable approaches to foster psychological safety and well-being in critical care settings.