Disaster management & response : DMR : an official publication of the Emergency Nurses Association最新文献

Background

To date, no systematic examination of the preparedness of individual health care providers and their response capabilities during a large-scale disaster has been conducted. As a result, very little is known about what knowledge, skills and abilities, or professional competencies are needed, or how professional competency requirements may change depending on the circumstances of a disaster. The objective of this pilot study was to collect, explore, and describe background data on professional competencies from health care providers who were involved in the Hurricanes Katrina and/or Rita disaster responses.

Methods

Utilizing an anonymous survey of a convenience sample, 200 health care providers attending 2 disaster conferences were asked to respond to open-ended questions about the competencies they needed and performed during their disaster response.

Results

Of the 200 respondents, registered nurses (37%) and physicians (24%) were the largest categories of providers. Basic clinical care (39%) and triage (26%) were the most frequent response skills reported; the areas wherein respondents felt least prepared were disaster-specific response skills (22%) and systems issues (34%). Only 22% of respondents reported that they did not know a specific skill. The 200 respondents made 495 individual recommendations for future responders, including actions to improve the respondent's personal preparedness (23%) and the need for training (25%). However, only 3% of the recommendations (n = 15) actually identified a specific type of training such as Advanced Cardiac Life Support or triage.

Conclusion

Few respondents reported knowledge deficits. Rather, what they described was an abrupt change or transition from their everyday practice worlds that required accommodation in order to practice effectively. Current training programs generally focus on providing skills information. Further research is required to determine if training programs should address facilitating the transition process.

Background

Fires that result in a large number of deaths and injuries are quite common in India, presenting many complex emergency management challenges. While significant improvement in disaster management has been noted in recent years, full integration of government emergency management initiatives at the provincial level is still in its infancy. This article presents the findings of a study of a school fire in India that resulted in the deaths of 93 children. The effective provincial level management of this fire, in the absence of a well-defined disaster management plan, was quite encouraging and provides guidance for other disaster managers in the country.

Methods

The purpose of the study was to analyze the factors leading to the tragedy, the response of the stakeholders, the relief and rehabilitation support provided to the affected families, and the perceptions of the affected parents regarding their level of satisfaction with the management of this disaster. Extensive visits were made to the damaged school, schools where the rescued and evacuated children were relocated, affected households, injured children, various stakeholders and institutions playing a significant role in managing the incident, and nongovernment organizations working in the field. The study methodology included structured interviews to determine the parents' level of satisfaction with the different elements of the response, participant observations, intensive interaction with the members of the affected families, and focused group discussion with different relevant government officials.

Results

The findings indicate a high level of parent and stakeholder satisfaction in the majority of response and relief efforts associated with the disaster. Also reinforced were the importance of adherence to school safety regulations; the role of effective relief and rehabilitation; public-private partnership in disaster management; and the importance of media management, humanitarian assistance during crisis management and response, gender sensitivity in relief and rehabilitation, and services provided to reduce mental health risks for the injured children and families who lost their children in the incident.

Conclusions

While the participants in the study perceived the management of the disaster as highly satisfactory, several disaster management elements, particularly disaster mental health services, require further attention at all levels.

Hospitals are required to have the capability of performing patient decontamination. Incorporating the incident command structure provided by the National Incident Management System and the Hospital Incident Command System into their decontamination plans will enable hospitals to be better organized and efficient in managing events producing contaminated patients. HAZMAT Branch incident command includes the leadership positions of a HAZMAT Branch director and a Victim Decontamination Unit leader, as well as managers for each zone, logistics, triage, medical monitoring, and support roles. Coupling a well-developed decontamination command structure with staff practice in their roles will help to ensure an organized response. This article describes the specific roles and responsibilities included in an incident command system–based hospital decontamination plan than has been used successfully in a multi-hospital system.

Background

Catastrophic events are an ongoing part of life, affecting society both locally and globally. Recruitment, development, and retention of volunteers who offer their knowledge and skills in the event of a disaster are essential to ensuring a functional workforce during catastrophes. These opportunities also address the inherent need for individuals to feel necessary and useful in times of crisis. Universities are a particularly important setting for voluntary action, given that they are based in communities and have access to resources and capabilities to bring to bear on an emergency situation.

Methods

The purpose of the study was to discern how one large private organization might participate and respond in the case of a large scale disaster. Using a 2-phase random sample survey, 337 unique respondents (5.7%) out of a sample of 6000 replied to the survey.

Results

These data indicate that volunteers in a private organization are willing to assist in disasters and have skills that can be useful in disaster mitigation.

Discussion

Much is to be learned related to the deployment of volunteers during disaster. These findings suggest that volunteers can and will help and that disaster preparedness drills are a logical next step for university-based volunteers.