Document Type
DNP Project
Publication Date
2026
Degree Name
Doctor of Nursing Practice
Faculty Advisor
Dr. Kerry A. Milner, DNSc, APRN, FNP-BC, EBP-C
Practice Mentor
Antonio O’nofrio, MHA, BSN, RN
Abstract
Problem and Local Context
High‑acuity events such as cardiac arrests place significant cognitive, emotional, and operational demands on emergency department (ED) teams. Inconsistent or absent post‑event debriefing limits opportunities to improve team performance, patient safety, and staff well‑being. At this academic medical center ED, debriefing practices following cardiac arrests were variable, informal, and not standardized, contributing to missed learning opportunities and reduced team support.
Evidence-Based Practice Change
Evidence supports structured, brief, post-event debriefings as an effective strategy to improve teamwork, communication, and clinical performance following resuscitation events. Guided by best practices in team-based debriefing and psychological safety, the STOP5 debriefing tool was selected to standardize post-cardiac arrest debriefings and promote consistent reflection on clinical, teamwork, and emotional elements of care.
EBQI Approach and Implementation
This project was guided by Melnyk & Fineout‑Overholt’s EBP steps 0–6 and the Institute for Healthcare Improvement’s Model for Improvement, using iterative Plan-Do-Study-Act cycles to test and refine implementation of the STOP5 tool within existing ED workflows. The project was conducted in a high-volume, Level-1 trauma ED and involved interdisciplinary stakeholders included nurses, physicians, advanced practice providers, trauma staff, and nursing professional development specialists. Implementation strategies included staff education, workflow integration, QR‑code decision‑support tools, and ongoing feedback to support adoption and fidelity.
Measures and Evaluation
Process measures included frequency of STOP5 debriefing completion and adherence to core tool elements. Outcome measures focused on fidelity to the tool, defined as completion of at least 80% of STOP5 components. Balancing measures included staff feedback and feasibility of workflow integration. Data were reviewed regularly to guide iterative refinements throughout the implementation period.
Outcomes and Impact
Over the three-month implementation period, STOP5 utilization increased progressively (Month 1: 37.3±8.5%, Month 2: 42.5±21.8%, Month 3: 51.5±42.2%) and completion of at least 80% of tool elements was consistently achieved, demonstrating strong fidelity. Qualitative findings reflected improved interdisciplinary communication, psychological safety, and shared learning following cardiac arrests. Conservative estimates demonstrated a positive return on investment through potential avoidance of adverse events, improved operational efficiency, and reduced burnout-related turnover. The value of investment was further reflected in staff-reported emotional closure, enhanced readiness for future resuscitations, and strengthened team culture.
Sustainability and Practice Implementation
Sustainability strategies include integration of STOP5 education into nurse orientation and simulation training, ongoing monitoring through nursing governance and trauma committees, and a formal handoff of oversight to Nursing Professional Development Specialists. This project demonstrates the value of structured debriefing as a sustainable practice change and provides a scalable model for improving team performance, safety culture, and staff support in emergency care settings.
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.
Recommended Citation
MacNamara, B. (2026). Implementing interdisciplinary debriefings post cardiac arrest in the emergency department: An evidence-based quality improvement project [Unpublished DNP project]. Sacred Heart University.
Comments
A DNP project submitted in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice, Sacred Heart University Davis & Henley College of Nursing.