presentasi DMAT JAPAN

7/30/2019 presentasi DMAT JAPAN

1/15

2012/4/

Activities of The Japanese Nursing Association

in The Great East Japan Earthquake

1

Kumiko Ii

Executive Officer

Classification and Characteristics of Disasters

Natural disasters: typhoon, torrential rain, flooding,earthquake, tsunami, snow damage, volcanic eruption, etc.

Man-made disasters: traffic accident (aircraft, car, train, ship),collapsing (building, bridge, coal pit, etc.), explosion, fire

Special disasters: terrorism, war, extended contamination ofradio activities and poisonous substances, combined naturaland man-made disaster

Geography: urban/local

wide area/localized type

Length: Short/Long


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Outbreak

Assessment &preparation

stage

Responsestage Disaster Cycle

Recoverystage

Health Needs arising at Natural DisastersProblems of the decreased health level at disasters causedby environmental factors, compromised vital functions andself-control of health.

Immediately after the disaster, health needs emerge withmedical needs.

a n nee s are ve oo suppor n:Diet Exercise Sanitary, hygieneTemperature, noiseRehabilitation Health care and education

Health needs are diverse.Health needs may persist for a mid to long period o f time,depending on the prolonged evacuation and the time

required until the reconstruction of livelihood.


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2012/4/

Psychological Consequences of Disasters

Extreme anxiety Mental paralysis

Psychological recovery process

Heroic phase: Immediately after disasters

Honeymoon phase: 1 week 6 months

Disillusionment phase: 2 months 1-2 years

Reconstruction phase: Several years

Heroic phaseDisaster-affected people behave courageouslywithout regard for their own safety, in order to protect

,neighbors.


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2012/4/

Honeymoon phase

The affected people, who share the catastrophicexperience and have survived the disaster together,

.the support they receive, they help each other andclean up rubbles and wreckage. The community ofaffected area is filled with warm and hopefulatmosphere.

Disillusionment phaseThe affected people reached the end of theirpatience, and their dissatisfaction with delayed

.They tend to feel unfocused anger and causetroubles such as fighting. Alcohol problems mayoccur. As the affected people are busy struggling toreconstruct their own livelihood and to solvepersonal problems, the community bonding and

mu ua sympa y are os .


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2012/4/

Reconstruction phase

Usual life is returning to the affected area, where theaffected people gain the courage to reconstruct their

. -confidence by participating in the reconstructionefforts of their community. However, those who arebehind the reconstruction or have lost their spiritualsupport, continue to suffer stressful life.

Recovery as a CommunityNot only the people affected by the disaster but also thewhole community are damaged and paralyzed by the shockof the disaster. Usual life is lost in the communit wherethe familiar scenery is destroyed and the industry isdamaged. And the community is divided geographically bythe disrupted transportation system.)

Consequently, people and the community have to recoverjointly from the damage of disasters.

The disaster assistance system should ocus not only onassisting the affected people but also on helping thecommunity and the residents regain the power to rise bythemselves.


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What is disaster assistance?

Assisting the process to recover

New start (no turning back)

Japanese Nursing Association (JNA)s

Relief Network Systems in Times of Disasters

A mutual partnership & assistance system, under whichJ NA and prefectural nursing associations, including thosen e a ec e pre ec ures, wor o n y o organze adisaster nursing assistance system smoothly and provideeffective assistance activities at the occurrence of large-scale disasters.

When large-scale disasters occur, upon the request bythe nursing association in the affected prefectures, the

Nurse in each prefectural nursing association aredispatched to the affected areas, whose number anddestination are coordinated by the J NA in cooperationwith the prefectural nursing associations.


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Relevant

organizations/bodies

Japanese Nursing Prefecturalnursing

Communicating the situation of disaster

and the damage to the prefectural nursingassociation in the affected areas, making

request for the support, etc.

Informationexchange and

ll

JNAsSupport Network Systems in Times of Disasters

,Labour andWelfare,etc.

Association associations

Neighboringprefecturalnursingassociations intheaffectedprefecture

Reportsonthedamageandrequestsforsupport

Providingthesupport inresponse totherequest

Communicating the

disaster relief nurses

to be dispatched

Coordinating thedispatch ofdisaster reliefnurses (fromneighboring prefecturesornationwide, depending onthescaleofthe disaster)

collaboration

Medicalfacilities,

Communicating therequestfordispatching disasterreliefnurses

Local g overnments,

Disasterresponseheadquarters prefectural

nursing

associations inthe

affectedprefecture

etc.

Disaster reliefnursesCommunicating therequestfordispatching disasterreliefnurses

Liaisonandcollaboration

1313 J apanese Nursing Association

What is a Disaster Relief Nurse?Definition

of Disaster Relief NurseRole

of Disaster Relief Nurse

The nurse who has beenregistered in the prefecturalnursing association anddispatched to the affectedarea as a member of therofessional nursin bodies

To provide appropriatemedical and nursing care tohelp the affected peoplemaintain the health level.

based on the Disaster ReliefNetwork System.

o s rve o re uce e men aand physical burden of theaffected nurses.


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Requirements for a Disaster Relief Nurse

Essential requirements Preferable requirements

. nurse w o s a mem er oJ NA

2. A nurse who has beenregistered as a disaster reliefnurse on the prefecturalnursing association.

3. A nurse who has completed

. nurse w o par c pa es nthe disaster nursing trainingregularly (once a year) or thecoalition emergency drill

Drills held by JNA and prefectures

2. A nurse who is employed at

the disaster nursing training

Training conducted by prefectural

association and J NA

any facility (which has anagreement with the

prefectural nursingassociation)

Timing and Duration of Dispatch ofDisaster Relief Nurse

Timing Duration

3days after theoutbreak of disaster till1 month

3 nights 4 days

(including travel time)


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Guarantee of Disaster Relief Nurse

By the J apanese Nursing Association and prefectural nursingassociations in collaboration, excluding the case in which the nurseis dispatched as business assignment by the facility of his/her own

.

Roles of the J apanese Nursing Association

To buy insurance as accident coverage (including own-injurycoverage during the act of nursing) for entire journey between theplace of departure and the affected area.

To pay actual expense oftravel and accommodation (maximum\20,000 per nurse)

Roles of the Prefectural Nursing Associations

To prepare goods and materials required for disaster nursing

To bear other necessary expenses

Coordination of the Dispatch of Disaster Relief Nurses Roles of nursing associations in the affected and other prefectures

Roles of the nursing assoc iation

in the affected prefecture

Roles of the prefectural nursing

associations

. ssessmen o nee s ancoordination with localgovernment

2. Coordination of dispatch withinthe prefecture

3. Request to the J NA for dispatch

4. Coordination with the facilities

1. Recruiting and registration, provision oftraining necessary for disaster relief nurses

2. Ensuring accountability and exchangingagreement between disaster relief nurse andthe facility he/she belongs to at theregistration

3. Preparation for necessary supplies andgoods for the nurses to be dispatched.

(2) Roles atdisasters

5. Tasks required after the dispatch.1. Request to the nurses for working in the

affected area and selection of the nurses tobe dispatched.

2. Orientation for the nurses to be dispatched

3. Tasks required after the dispatch


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2012/4/

Activities of Disaster Relief Nurses andFeatures of the Activities

Disaster relief nurses are those who have received training on disaster relief, andplay a role to provide the affected people with necessary medical and nursingcare so that the people can maintain the health levels, as well as to help theaffected nurses relieve their physical and mental burden.

Disaster relief nurses are unpaid volunteers who take leave from their workplaceand participate in the support activities.

As of J une 2011, 6,182 disaster relief nurses are registered on 47 prefecturalnursing associations (4,803 nurses were registered in fiscal 2010).

Disaster relief nurses gathered at the Japanese Nursing Association and traveledby coach to the affected areas. Relief supplies were transported also by thecoach.

sas er re e nurses carre re e supp es y emseves o con uc e rsupport activities based on the self-contained principle.

On-site disaster response headquarters was established at the MiyagiPrefectural Nursing Association in the affected area, where coordinators were incharge of assessment of support needs and coordination of nurse allocation,technical support and communication with government offices.


Situation of Dispatching Disaster Relief NursesFrom Nationwide From neighboring

prefectures

Prefec-

tureMarch April No. of nurses

(total)Completed

on May 17Completed on

May 17

Iwate960

Within

prefecture

only

Miyagi2,306

Aki ta

Yamagata

Miyagi

Fuku-

March 21

March 22

March 29 Apri l 1 Apri l 4 7

shima408

Tochigi ChibaFukushima

Total 3,674 3,770

Apr il 7-



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Dispatching of Disaster Relief Nurses

Hokkaido 40 Kyoto 15Aomori 16 Osaka 84Akita 40 Hyogo Yamagata 4 Nara 19Ibaraki 1 Wakayama 25Tochigi 35 Tottori

Prefecturalnursingassociationsdispatchingthenurses (3,770intotalfromMarch21tillMay17)

IwatePref.

Akita

Pref.

Miyako

Yamada

Kamaishi

Ofunato

Rikuzentakata

Kesennuma

Kitakami

Gunma 36 Shimane 1Saitama 42 Okayama 15Chiba 35 Hiroshima 9Tokyo 67 Yamaguchi 12Kanagawa 8 Tokushima Niigata 29 Kagawa 15Toyoma Ehime 15Ishikawa 19 Kochi 5Fukui 9 Fukuoka 16Yamanashi 11 Saga 3Nagano 17 Nagasaki 3

YamagataPref.

MiyagiPref.

Minamisanriku

SendaiShiogama

Onagawa

OnagawaNuclearPowerPlant

Ishinomaki

Yamamoto

J apanese Nursing Association21

Gifu 21 Kumamoto 4Shizuoka 45 Oita 8Aichi 128 Miyazaki 18Mie 33 Kagoshima 9Shiga 16 Okinawa 10

(Actualnumberofnursesdispatchedis938intotal.)*Excludingthosewhoweredispatchedunderthecooperationschemeofeachprefecture.

FukushimaPref.Minamisouma

FukushimaDaiichiNuclearPowerPlant

FukushimaDainiNuclearPowerPlane

HiratamuraSaigomura

Koriyama

Otamamura

Nurse Dispatch under the schemes other than

JNA Relief Network Systems in Times of Disasters

Prefecture Dispatch schemeRecipientprefecture

No. ofnurses

dispatched

Totalnumber

Prefecture Dispatch systemRecipientprefecture

No. ofnurses

dispatched

Totalnumber

IwateIwate Disaster MedicalSupport Network

Iwate 64 279 Toyama J MAT Fukushima 11 66

Fukui Prefecture

Miyagi Within prefecture Miyagi 119 365 Fukui

Disaster VolunteersCouncil

(Rikuzentakadacity)

29 31

Yamagata

Request by YamagataPrefectural government

Miyagi 3 9 KyotoKyoto P refectureDisaster NursingVolunteers

Fukushima 14 16

Yamagata NursingAssociation

Yamagata 108 240 HyogoUnion of KansaiGovernments (as of

J une 30)Miyagi 136 871

Fukushima Within prefecture Fukushima 14 56 Wakayama J MAT Iwate 2 10

Ibaraki Within prefecture Ibaraki 36 89 Hiroshima Hiroshima J MAT Miyagi 12 66

SaitamaSaitama MedicalAssociation

Miyagi 1 5 Yamaguchi J MAT Miyagi 2 8

22

Chiba

u ua agreemen on

medical support activitiesat disasters with ChibaPrefecture

Chiba 18 72 Tokushima Tokushima Prefecture(Union of KansaiGovernments )

Miyagi 44 220

TokyoRequest by TokyoGovernment

Tokyo 2 65

NiigataJ MAT Miyagi 3 9 TotalWithin Prefecture Niigata 134 134 17 prefectures 752 2,611


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J apan Nursing Association & Prefectural Nursing Associations

Activities of Disaster Relief NursesPrinciple of activity

* To stay in the evacuation centers and medical institution, etc., for 24 hours and provideevacuees with direct support. To mitigate the workload of the nurses in the affected area.

Main activities

To deal with medical crisis (evacuation centers, medical institutions receiving patients from the affected

facilities, etc.)

To provide care for the evacuees requiring medical and nursing care

Assessment of infectious diseases, environment hygiene, prevention of infectious diseases from spreading

Support the night/midnight shift as required at the evacuation centers, medical institutions, etc.

Monitoring of living conditions of evacuees and evacuation centers, and collection and distribution of the

information

Procurement and provision of supplies that are found to be insufficient

Dealing with increased medical needs at emergency units in hospital, elderly care homes, etc.

* In order to assess the needs for support and summarize them, to send coordinators at

on-site disaster response headquarters, where they coordinate the allocation of disasterrelief nurses, submit requests to the government office and negotiate with thegovernment for the improvement of support.


J apan Nursing Association & Prefectural Nursing Associations

Specific Activities

Mid to

Disaster reliefnurse

How to deal with medical crisis of evacuees

Cases in which we assisted the transfer of severe patients to medical institution

Severe dehydration, sudden dyspnea, suspected osteomyelitis (bedsore), hypoglycemic attack, etc.

moderate case institution

Medical team

Disaster reliefnurse

Examples of moderate cases we directly handled in cooperation with medical team

Fever, acute respiratory infection, influenza, acute diarrhea, etc.

Follow-up of evacuees health status, monitoring the diet and water intake of the patients, helping withtaking medicine, isolation of patients with infectious diseases and care for isolated patients, prevention ofinfection from spreading via vomitus and feces, etc.



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Evacuees requiring Medical and Nursing Care(Identified through the Disaster Relief Nurses activities)

EvacueesrequiringEvacueesrequiring

medicalcaremedicalcare 411

EvacueesEvacueesrequiringrequiring

nursingcarenursingcare47

4765evacueesin4765evacueesin

17evacuation17evacuation

centersincentersin

Ishinomaki CityIshinomaki City

ThosewithmentalThosewithmentaldisorderdisorder 24

Photo was taken and used with theconsent of the patient and her family.

As of Apr il 14


Photos of Disaster Relief Nurses at Work



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2012/4/

Impacts of Disaster Relief Nurse Activities/Voicesfrom of the Nurses and Others

Able to transfer the patients with urgent needs to a medicalteam promptly

Able to prevent the spread of infectious diseases

Presence of disaster relief nurses for 24 hours areencouraging particularly during night, thus the number ofambulance calls was reduced significantly. (a manager ofevacuation center) .

The nurses flexibly dealt with our system. (a manager of thehos ital

27

As we always worked in the same evacuation center, ithelped us understand the characteristics and the routines ofthe place, and provided the evacuees with a sense of security.(a relief nurse)

J apanese Nursing Association

Category Item Quantity Category Item Quantity

Drugs

Peptic ulcer drug 11 boxes

Nutritional

supplements

Baby formula ca. 100 cans

Bronchodilator agent 9 boxes Formula in cube, stick 12 boxes

Oral anticoagulant 1 boxSupplements (jelly, oral rehydration,

etc.) (7 types)ca. 14,000

Enteral nutrients (2 types) ca. 100Anti-in flamm atory d rug 1 box

Analgesic antipyr etics 1 box

Common food

Sna cks (ch ocol ate, ri ce cake, etc .) ca. 3,80 0 b oxes

Oral antidiabetics 1 box Canned food (fruit, fish) ca. 1,200 cans

List of Relief

Supplies

Distributed to: Evacuation c enters, hospitals, prefectural nursing associations inthe affected prefectures that receive affected people, government offices and

related bodies, to which disaster relief nurses are dispatched.

, . ,

Antih ypertens ive dr ug 3 boxes Instant cup no odles 360

Medical

products &

supplies

Blood sugar measurement ch ip , etc. 3 1000 boxes each

Daily use

products

B ot tl ed wat er (330m l, 500m l, 2 l) c a. 1,400

Bedsore care product 7-20 boxes each Toilet paper ca. 300 roles

Medical compression stocking ca.2,800 pairs Tissue, wet tissue 720 boxes

Blood pressure gauge ca. 1,050Womens sanitary products ca. 3,200 packs

Thermometer ca. 7,400

Stethoscope 50 Portable toilet 10,000

Mouthwash 1,000 Diaper (for adults and baby) ca. 80 boxes

Various types of gown

(isolation, care, etc.)1,000 each

Towel, handkerchief 700

Tooth brush 25,200

Legging cover 25 packages Disposable body warmer ca. 190 packs

Mask ca. 70,000 Battery 1,320

28

Sanitary

productsDisposable glove ca. 2,000 boxes Candle ca. 1,200

Delivery mat and pad 4,650 Cooking gel sheet ca. 10,000

Nursing care sheet 3 boxesClothing (underwear, T-shirt, winter clot h,

etc.)ca. 1,800

Adhesive tape 47 boxes Cosmeti cs (lot ion, emul sion) 80

Hygiene set (Thermometer, mask,

mouthwash, hand sanitizer)72 sets Stationery, toy ca. 50 boxes

Disinfectant

Ethanol gel disinfectant, hand sanitizer ca. 4,500 boxesOther goods (rubbish bin, paper glass,

slippers, etc.)ca. 7,900

Wet tissue for sterilization, alcohol

sterilization towel82 boxes The content (or units) per box diff ers depending on the product.


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In response to the leakage of radioactive substances from theFukushima Dai-Ichi Nuclear Power Plant, Dr. Kusama, VicePresident of J NA, developed teaching materials. These

Information on Nuclear Power Plant DisastersDevelopment of Teaching Material

ma era s are a me a en anc ng un ers an ng on eradiation effects on human health and how nurses should dealwith this matter. The video is being broadcasted on the J NAsofficial website.

List of web-based streaming video materials

Nuclear disasters and roles of nurses Correct understanding of the radiation

29

effects on human health (60 min.)

How to estimate exposure dose Health effects depend on the exposure

dose!! (21 min)

Health counseling for expecting mothers - To remove unnecessary anxiety(25 min)

Urgent Proposals to the Government1. Professionals in the fields of public health, medical and nursing,

and nursing care for the elderly should be included in thereconstruction design council at the local governments of

.

2. Professional nurses should be stationed at the Elderly SupportCenter to be constructed in the temporary housing area, inorder to help the quake-affected elderly stay healthy and to takemeasures to prevent them from becoming bedridden or dyingunattended.

3. Establishment of a system to stably provide round-the-clock

30

nurs ng servce to t e patents at ome an ac tes1) Support to reconstruct the affected visiting nurse stations2) Establishment of satellite offices of visiting nurse station

Recovering of healthcare service by reconstructingadministrative functions promptly

To help the affected nurse find a place of employmentJ apanese Nursing Association

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