Preparing for Emergencies

Kristin Botzer

Emergency Preparedness

Emergency preparedness is the “comprehensive skills, abilities, knowledge, and actions that are needed to respond and prepare for a threat, actual or suspected, chemical, radiological, nuclear, biological, or explosive in nature” (Baack & Alfred, 2013, p. 282).

Types of Emergencies

• Natural Disasters – any disaster not man-made, including health disasters

Floods, hurricanes, earthquakes, wildfires

Health disasters: AIDS, Ebola virus, epidemics, pandemics

• Man-made disasters – accidental or intentional

Accidental: industrial accidents, structural collapse, power outages

Intentional: terrorist attacks, mass shootings, anthrax

(Sullivan, 2013)

Levels of Disaster

• Level I – Local response

• Level II – Regional response

• Level III – Statewide or National response(Sullivan, 2013)

Where does healthcare fit in?

“The healthcare system is now viewed as a foundation of national security that must provide care anytime,

anywhere, without fail and in an ever-expanding role” (Cagliuso, 2014/2015, p. 160).

Popular Disasters

• September 11, 2001

• Indian Ocean Earthquake and Tsunami 2004

• Hurricane Katrina 2005

• Haiti Earthquake 2010

• Sandy Hook Elementary School 2012

• Ebola 2014

The Role of Nursing During Disaster

• Caring for the sick and injured

• Infection control

• Planning to prevent further damage

• Triage

• Mass immunizations

• Mass evacuations

• Treatment for mass casualties( Baack & Alfred, 2013, p. 282)

Challenges for Nurses

• Lack of preparation

• Lack of education in school

• Lack of understanding disaster communication methods

• Lack of understanding the formal disaster plan

• Perception of what constitutes disaster preparedness( Baack & Alfred, 2013, p. 282)

Disasters can affect nurses in all areas of care: Community Health Centers, Schools, Hospitals, Nursing

Homes, Home Care, Management and Administration

Challenges to Institutions

• Lack of performance metrics

• Lack of funding

• Limited surge capacity

• Unclear federal guidelines and requirements for accreditation

• Lack of Coordination

(Cagliuso, 2014/2015, p. 156)

Ways to Prepare

• Develop and maintain a current disaster plan (American College of Healthcare Executives, 2014).

• Focus the plan to address “likely” events (ACHE, 2014).

• Develop a command system (ACHE, 2014).

• Assess available resources (ACHE, 2014).

• Plan for operations (ACHE, 2014).

• Develop resource protocols (ACHE, 2014).

• Assess safety of employees, patients, and families (ACHE, 2014).

• Enhance communication protocols (ACHE, 2014).

• Control and report disease (ACHE, 2014).

• Staff education and training (Sullivan, 2013).

• Practice EOP biannually (Sullivan, 2013).

Emergency Operations Plan Components

• Activation response

• Communication plan

• Patient care and coordination plan

• Security plan

• Traffic flow plan

• Data management strategy

• Resource availability

(Sullivan, 2013)

National Preparedness Goal• Prevention. Prevent, avoid or stop an imminent, threatened or actual act of terrorism.

• Protection. Protect our citizens, residents, visitors, and assets against the greatest threats and hazards in a manner that allows our interests, aspirations, and way of life to thrive.

• Mitigation. Reduce the loss of life and property by lessening the impact of future disasters.

• Response. Respond quickly to save lives, protect property and the environment, and meet basic human needs in the aftermath of a catastrophic incident.

• Recovery. Recover through a focus on the timely restoration, strengthening and revitalization of infrastructure, housing and a sustainable economy, as well as the health, social, cultural, historic and environmental fabric of communities affected by a catastrophic incident

(Federal Emergency Management Agency [FEMA], 2015, para. 7)

Factors Affecting Nurses

• Exhaustion and fatigue

• Personal safety concerns

• Illness

• Leaving families to care for others

• Grief counseling

• Professional accountability(Sullivan, 2013)

Disaster Nursing Video

Additional Resources

• American Nurses Association Disaster Prepared-ness and Response: http://www.nursingworld.org/ MainMenuCategories/WorkplaceSafety/DPR

•  Federal Emergency Management Agency, U.S. Government: http://www.fema.gov/  International Council of Nurses Disaster Response Network: http://www.icn.ch/networks/disaster-response-network/

•  International Nursing Coalition for Mass Ca-sualty Education Educational Competencies for Registered Nurses Responding to Mass Ca-sualty Incidents: http://www.aacn.nche.edu/ leading-initiatives/education-resources/INCMCECompetencies.pdf

•  The Joint Commission: www.jointcommission.org/ standards

•  National Center for Emergency Preparedness: http://www.ncep.vanderbilt.edu/index.html

•  World Association for Disaster and Emergency Medicine Nursing Section: http://www.wadem.org/nursing.html

References

• American College of Healthcare Executives. (2014). Healthcare executives’ role in emergency preparedness. Healthcare Executive, 29(4), 90-91. Retrieved from http://www.ebscohost.com/

• Baack, S., & Alfred, D. (2013). Nurses’ preparedness and perceived competence in managing disasters. Journal of Nursing Scholarship, 45(3), 281-287. http://dx.doi.org/10.1111/jnu.12029

• Cagliuso, N. (2014/2015). Stakeholders’ experiences with US hospital emergency preparedness: Part 1. Journal of Business Continuity & Emergency Planning, 8(2), 156-168. Retrieved from http://www.ebscohost.com/

• Federal Emergency Management Agency. (2015). National preparedness goal. Retrieved from http://www.fema.gov/

• Feuerstein, C. (2012, November 6). Disaster nursing [Video file]. Retrieved from https://youtu.be/W-S2BXTPKHs

• Sullivan, E. J. (2013). Effective leadership and management in nursing (8th ed.). Boston, MA: Pearson.