Emergency nurses and disaster response: An exploration of South Australian emergency nurses’ knowledge and perceptions of their roles in disaster response

Evaluation of an On-Site Disaster Medical Management Course in Nepal

The great 2015 Nepal earthquake of magnitude 7.6 killed about 9000 people. To better ensure a more coordinated disaster response, a Basic On-Site Disaster Medical Support (BOS-DMS) course was designed in 2017. This study evaluates the effectiveness of the BOS-DM course. The course was conducted twice and attended by 135 participants, of whom 113 (83.7%) answered pre-test and post-test based multiple-choice questions. Qualitative and quantitative feedback was provided by 94 participants (69.6%). Mean test scores for the participants increased from 4.24 ± 1.42 to 6.55 ± 2.16 (p-value < 0.0001; paired t-test). More than 92.0% of participants felt that the course prepared healthcare workers to manage acute medical situations at a disaster site. Subject knowledge scores increased from 34.8% to 90.2%. A three-day BOS_DMS course has the potential to improve on-site disaster management knowledge. Our study noted that precise scheduling, making attendance compulsory, translating course materials into the local language, inclusion of disaster exercises and training local master trainers can enhance course effectiveness.

Experiences of Nurses Providing Care to Individuals in Earthquake-Affected Areas of Eastern Turkey: A Phenomenological Study

PURPOSE

The aim of this study is to examine the experiences of nurses who provide care to individuals in earthquake-affected areas of eastern Turkey.

DESIGN

A phenomenological design from qualitative research methods was utilized in this study.

METHODS

The study was conducted between May 29, 2023, and August 15, 2023, with 11 nurses working in the western region of Turkey's provinces through one-on-one semi-structured interviews. The interviews were conducted online and recorded on video. Content analysis was performed using the MAXQDA software package.

FINDINGS

Themes and sub-themes were identified from the expressions of nurses in line with research findings. Accordingly, 5 themes were determined for nurses providing care to individuals in the earthquake. zone: "challenges they face,""emotions they felt,""coping methods,""knowledge and skills"and "effects of earthquake".

CONCLUSION

The results obtained from this study demonstrated that nurses experienced difficulties due to environmental (hygiene, cold weather, shelter) and work-related (lack of coordination, psychosocial issues) conditions during the earthquake event. While providing care to individuals in earthquake-affected areas of eastern Turkey, nurses reported feelings of sadness, inadequacy, anxiety, and fear. They employed coping methods such as talking to family/friends, attempting not to dwell on thoughts, and turning to religious practices to manage these negative emotions. Nurses emphasized the necessity of having professional knowledge and crisis management skills to care for individuals during the earthquake period. In accordance with the findings of the research, it is recommended that nurses are provided with realistic training through simulations and drills in disaster management, as well as psychological support interventions.

The Effects of a Disaster Preparedness app on Community Knowledge and Intentional Behavior in Hurricane Risk Areas

OBJECTIVE

With the advancement of technology, disaster preparedness related to hurricane hazards can be taught through an app. This study aimed to examine the effect of using an android-based disaster preparedness app on community knowledge and intentional behavior in hurricane risk areas.

METHODS

A quasi-experimental study was conducted from October to November, 2020 and a total of 80 respondents were recruited using cluster sampling. The treatment group was given the intervention in the form of the disaster preparedness app for 2 weeks. Meanwhile, the control group received home visits and conventional education about hurricane disasters twice throughout the same period. We then used a Wilcoxon Signed Rank test to analyze the pre-test and post-test and a Mann-Whitney U test to compare between treatment and control groups.

RESULTS

After the implementation of the SiBen app, we found a statistically significant difference in knowledge between treatment and control groups (P < 0.003) and intentional behavior between treatment and control groups (P < 0.001).

CONCLUSION

The findings indicate that the disaster preparedness app was an effective educational program able to improve the knowledge and intentional behavior among community members in a hurricane risk area.

Disaster preparedness and core competencies among emergency nurses: A cross-sectional study

Aim

With the rise in frequency and severity of disasters in recent decades, it is essentially important that nurses must be adequately prepared to handle them. This study was aimed to evaluate the levels of disaster core competencies and preparedness of nurses in the emergency department.

Design

A cross‐sectional survey design was used.

Methods

This cross‐sectional research was conducted from August 2020 to December 2020 among 271 nurses in the emergency departments of six hospitals in Qazvin, Iran. The participants completed the “Nurses Perceptions of Disaster Core Competencies Scale” (NPDCC) (45 items) and the disaster preparedness (a single‐item visual scale). Data were analysed by one‐way analysis of variance, independent t‐tests and multiple linear regression analysis.

Results

The mean scores of disaster preparedness and core competencies of nurses were 6.75 out of 10 (SD = 1.63) and 2.88 out of 5 (SD = 0.80), respectively. "Technical skills" (mean = 3.24, SD = 0.91) were the highest and "communication skills" (mean = 2.57, SD = 0.95) were the lowest across the subscales of the scale. A significant association was found between disaster core competencies and preparedness of nurses (p < .001). Regression analysis results indicated that nursing disaster core competencies were perceived betted by older nurses (B = −0.405) who had experience in the disaster stage (B = 0.228) and nurses with disaster response experience (B = 0.223) and lower professional experience (B = 0.309). Nurses with a postdiploma degree (B = −0.480) and bachelor's degree (B = −0.416) were perceived to have lower disaster core competency than nurses with a master's or PhD degree.

Conclusion

There are still gaps in disaster preparedness and core competencies for emergency nurses that need to be addressed. Nursing managers must support an improvement in nursing disaster core competencies. This may be done by conducting sessions for routine disaster scenarios and providing formal disaster preparedness training.

A Survey Study of Public Health Nurses’ Knowledge in Disaster Management in Indonesia

AIM: This descriptive survey study examines the level of public health nurses’ (PHNs) knowledge regarding disaster management. The knowledge was examined according to three disaster phases, including preparedness, response, and recovery phase. MATERIALS & METHODS: A stratified proportionate random sampling method was employed to recruit 252 PHNs of Aceh Province, Indonesia. The data were collected during November and December of 2010 by using the questionnaire developed by the researchers. They were analyzed using frequencies, percentages, means, standard deviations, and minimum and maximum scores. Additional analyses were performed to identify potential contributing factors to the PHNs' knowledge using the Spearman rank correlation (rs) and the Mann-Whitney U test. RESULTS: The finding showed that PHNs' knowledge in disaster management was moderate (M=70.73%, SD=8.41), and nearly half of the subjects (42.5%) were categorized in this level. The lowest mean score was found in the response phase (64.75%), and four items with the lowest percentage of correct answers were also found in this phase. CONCLUSION: The low level of knowledge for the response phase can be used to flag health policymakers and public health centers (PHC) to develop appropriate educational training and disaster drills for PHNs in collaboration with stakeholders in the community.

Nurses' knowledge, skills and preparedness for disaster management of a Megapolis: Implications for nursing disaster education

As frontline health caregivers, nurses must be adequately prepared to respond effectively to disasters. Therefore, it is necessary to assess nurses' disaster management capacity to know their preparedness levels, especially for a densely populated Megapolis like Dhaka, which is at high risk of disasters. Thus, the study aimed to examine Dhaka city nurses' knowledge, skills, preparedness (KSP) for disasters and explore the factors influencing the KSP levels. A self-explanatory descriptive survey questionnaire was developed adopting the Disaster Preparedness Evaluation Tool (DPET) in Bangla language for quantitative data collection. Following multistage sampling, 410 nurses' data were collected from eight hospitals in Dhaka city. The nurses in Dhaka city had moderate levels of knowledge, skills, and preparedness for disaster management, reflecting that they need more development to deal with disasters effectively. Moreover, multiple linear regression analyses indicate that nurses' disaster knowledge, skills, and preparedness scores were significantly positively associated with training on disaster management (p < 0.001) and disaster response experience (p < 0.001). In addition, one-half of the respondents demanded more drills and exercises on disaster management in their workplaces to enhance their disaster skills and preparedness. Furthermore, disaster education should be incorporated into the nursing curriculum, which would play a seminal role in preparing them for future disaster management.

Effect of Case-Based Small-Group Learning on Care Workers' Emergency Coping Abilities

This study aimed to develop and implement an emergency coping education program using a case-based small-group learning method and verify its effect on care workers’ emergency coping abilities. The study was conducted with 72 care workers in older adult care facilities and home care centers. Using a nonequivalent control group pretest–posttest design, 36 participants were assigned to each group (i.e., experimental and control groups). The collected data were analyzed through χ^²-test and independent t-test using SPSS for Windows, version 25.0. Compared to the control group, a statistically significant increase in knowledge and performance levels in emergencies, emergency coping abilities, self-efficacy in coping with emergencies, and confidence in communication was observed in the experimental group. This study was able to verify the effectiveness of the emergency coping education program in care workers and recommends its use. To maximize the learning effects of educational programs, future research should develop and apply programs that incorporate simulation education.

The Effect of Disaster Management Education on Mother’s Under Five Preparedness Facing Floods In Aceh Province

BACKGROUND: The flood disaster has had various impacts on the people in Aceh. One of the groups prone to flooding is mothers with toddlers. Efforts should be made to increase capacity, understanding, and knowledge through education and education for disaster preparedness to reduce the risk of occurring. AIM: Analyzing the effect of disaster management education on the Preparedness of mothers under five in Aceh. METHODS: This type of research is a quasi-experimental study using the One-Group Pretest-Posttest. The sample in this study was 51 mothers of children under five who were willing to sample and resided in two flood-affected villages. Data collection on the Preparedness of mothers under five in this study was carried out using pre-test and post-test questionnaires before and after the provision of disaster education. Data analysis using bivariate used dependent T-test and correlation analysis used Rank Spearman correlation. RESULTS: The results showed a significant difference in the mean value of knowledge, attitudes, and Preparedness of under-five mothers before and after receiving education about disasters, as evidenced by statistical tests using the dependent t-test p < 0.05. Measurement of the pre-test and post-test scores on the average increase in knowledge from before 89.45 to 94.53 after education provision. The attitude variable also increased on average from 39.43 to 48.40 after the provision of education. The preparedness variable also increased on average from 50.69 to 58.28 after the provision of education. CONCLUSION: Disaster management education has provided increased knowledge, attitudes, and Preparedness for mothers under five to flood disasters.

The Effectiveness of Disaster Education for Undergraduate Nursing Students' Knowledge, Willingness, and Perceived Ability: An Evaluation Study

As future healthcare professionals, nursing students should possess the appropriate knowledge, skills, and positive attitude to respond to public health emergencies or disasters worldwide. This study evaluated the effectiveness of a disaster management training course at improving Hong Kong nursing students' disaster knowledge, willingness, and perceived ability. A mixed-method design using a single group with pre- and post-intervention comparisons followed by qualitative focus group interviews, was conducted. A 45-h disaster management training course with theoretical and practical inputs was conducted. A total of 157 students participated in and completed the pre- and post-intervention questionnaires. Positive significant results in disaster knowledge (t(156) = -8.12, p < 0.01, d = -0.84) and perceived ability (t(156) = -7.95, p < 0.01, d = -0.72) were found, but no substantial change in willingness to respond to disasters was observed. The participants expressed various concerns regarding their willingness to respond, which can be summarized and grouped as (1) personal risk perceptions, (2) contextual factors of the disaster events, and (3) organizational support. Incorporating disaster training into the tertiary education curricula for basic nursing professionals' training could be a long-term strategy to prepare and expand the competent workforce for future disasters. Government or healthcare organizations are recommended to provide strategies and adequate support to alleviate nursing professionals' concerns and enhance their willingness.

Perspective and experience of newly graduated registered nurses with standardized training in the emergency department: A qualitative study in Shanghai, China

BACKGROUND

The standardized training system for newly graduated registered nurses (NGRNs) in China is different from that of other countries in the world, especially when frequent disasters occur, emergency department (ED) training is particularly important. However, the work experience of new Chinese nurses in standardized training in the emergency department still remained unclear.

OBJECTIVES

To explore the experience of newly recruited nurses in standardized training in the emergency department.

DESIGN

Qualitative research.

SETTING

A 3rd level hospital in Shanghai, China.

PARTICIPANTS

Fifteen NGRNs undergoing standardized training in the ED.

METHODS

Semi-structured face-to-face interviews were conducted between August and September 2020. Colaizzi seven-step framework was applied for data analysis.

RESULTS

Three main themes emerged: high occupational pressure, competency enhancement in ED and high satisfaction with standard training.

CONCLUSIONS

It is very important and necessary for NGRNs to have a training period in the emergency department. This not only helps NGRNs to improve their abilities in emergency care, but also reserve talents during emergency responses. At the same time, the training methods for NGRNs should be refined and improved, and effective support should be provided. This can help NGRNs relieve from work pressure, better and rapidly adapt to the clinical environment and enter the nursing role.

Emergency healthcare workers' preparedness for disaster management: An integrative review

BACKGROUND

Around 2 billion people globally were affected by natural disasters between 2008-2018. The World Health Organization requires countries and governments to have disaster plans and emergency health workers ready and prepared at all times.

OBJECTIVES

To conduct an integrative review of literature of emergency healthcare workers' perceived preparedness for disaster management.

METHODOLOGY

An integrative literature review using the PRISMA checklist guidelines was conducted to explore physicians, nurses, emergency medical services and allied medical professionals' preparedness for disasters. Literature was searched from 2005, published in the English language and from MEDLINE (PubMed), Google Scholar, EMBASE, PsycINFO, SCOPUS, ProQuest and CINAHL databases. Reviews, case reports, clinical audits, editorials and short communications were excluded. Studies were critically appraised using the Mixed Methods Appraisal Tool.

RESULTS

The initial search yielded 9589 articles. Twenty-seven articles were included following application of the eligibility criteria. Included studies were geographically diverse including North America, the Middle East and the Asia Pacific. Most studies (n = 24) assessed the knowledge of healthcare workers in general disasters. Studies using the Disaster Preparedness Evaluation Tool reported moderate disaster preparedness and knowledge, while studies using other instruments largely reported inadequate disaster preparedness and knowledge. Regional variations were recorded, with high-income countries' reporting a higher perceived preparedness for disasters than low-income countries.

CONCLUSION

The majority of the emergency healthcare workers appear to have inadequate disaster preparedness. Previous disaster experience and training improved disaster preparedness. Future research should focus on interventions to improve emergency healthcare workers preparedness for disasters.

Emergency Response: A Cross-sectional Study of Core Competencies for Nurses Regarding Major Infectious Disease Outbreaks

INTRODUCTION

The core competencies of nursing personnel have been identified as a main factor affecting nursing effectiveness. This study examined core emergency response competencies of Chinese nursing personnel related to the outbreak of major infectious diseases.

METHODS

A survey was conducted among 960 nurses working in a tertiary hospital in Shanghai, China. Data were collected on core emergency response competencies of nursing personnel caring for patients with major infectious diseases, measuring overall competency as well as by dimensions of prevention ability, rescue ability, and preparation ability. A t-test and one-way analysis of variance were first analyzed for differences between groups, followed by multiple linear regression to analyze main influencing factors for core emergency response competencies.

RESULTS

The average score for core emergency response competencies of nursing personnel delivering care to patients with major infectious diseases was 128.05 (SD 22.23) (range 36-180 points); or 71%, which is equivalent to moderate performance. Multiple linear regression analysis demonstrated that the main influencing factors for these nursing personnel were before participation in emergency drills for infectious diseases, current educational background, and working experience in the realm of infectious disease nursing. The final model explained 8.4% of the variance in core emergency response competencies.

DISCUSSION

These findings indicate that it is necessary to strengthen the training of nursing staff with educational background deficits or no prior work or drill experience related to infectious diseases to effectively improve the core emergency response competencies of nursing personnel relative to infectious diseases.

The Public Servants' Response When Facing Pandemic: The Role of Public Service Motivation, Accountability Pressure, and Emergency Response Capacity

(1) Background: Public servants are regarded as guardians of the public interest, and their pandemic response played a vital role in controlling the spread of the epidemic. However, there is limited knowledge of the factors that influence public servants' response (PSR) when facing pandemic prevention and control tasks. (2) Methods: Based on the theory of planned behavior (TPB), models were constructed and a regression method was employed with Chinese civil servant data to investigate how PSR is influenced by public service motivation (PSM), accountability pressure (AP), and emergency response capacity (ERC). (3) Results and discussion: PSM, AP, and ERC all have a positive effect on PSR, with AP having the greatest influence, followed by PSM and ERC. The effects of PSM, AP, and ERC on PSR have group heterogeneity, which had little effect on civil servants with very low levels of PSR and the greatest impact on civil servants with medium-level PSR. Job categories of civil servants also are a factor related to PSR; PSM and AP have the strongest effects on civil servants in professional technology, and ERC has the greatest influence on administrative law enforcement. Moreover, gender, administrative level, and leadership positions also have an impact on PSR. (4) Conclusions: Based on the factors of PSR, we found at least three important aspects that governments need to consider in encouraging PSR when facing a pandemic.

Planning for Chaos: Developing the Concept of Emergency Preparedness through the Experience of the Paramedic

OBJECTIVE

Emergency preparedness is a developing specialty with a limited evidence base. Published literature primarily offers a retrospective view of experience, with few studies examining and understanding the individual lived experience of practitioners prospectively. This study explores paramedics' lived experience of emergency preparedness and applies that learning.

METHODS

Thirteen paramedics were recruited through purposive sampling. Face-to-face semi-structured interviews explored their individual experiences of emergency preparedness, in line with the idiographic focus of Interpretative Phenomenological Analysis.

RESULTS

Through data analysis, the following superordinate themes were identified for further discussion: self-determination, control, and experience-based practice. Participants appeared to value their role and the unpredictable environment in which they worked. Personal resilience, an area that they suggested is not covered effectively within individual preparation, was viewed as important. The participants articulated that risk, threat, uncertainty, safety, trust, and control were important concepts within individual preparedness. These paramedics valued practice-based knowledge and education as credible and transferrable to their clinical work.

CONCLUSION

Evidence from this study suggests that standard emergency preparedness, with the focus at organizational level, is not sufficient for the individual workers or for an overall effective response. Dimensions of individual preparedness are presented, with the paramedic central to the experience within a conceptual model (the DiEP model), creating a new form of emergency preparedness that reflects the individual paramedic's experience.

Challenges for Nurses in Disaster Management: A Scoping Review

To reduce the impact of disasters, healthcare providers, especially nurses, need to be prepared to respond immediately. However, nurses face several challenges in all phases of disaster management. The findings of a literature review based on scoping approaches, which utilized the Joanna Briggs Institute methodology, indicated that the major barriers facing nurses include the following: (1) disaster nursing is a new specialty; (2) inadequate level of preparedness; (3) poor formal education; (4) lack of research; (5) ethical and legal issues; and (6) issues related to nurses’ roles in disasters. Educators, researchers, and stakeholders need to make efforts to tackle these issues and improve disaster nursing.

Nurses’ Readiness for Emergencies and Public Health Challenges—The Case of Saudi Arabia

This study was aimed at assessing the readiness of 200 emergency nurses in the southern part of Saudi Arabia in the management of public health emergencies, major incidents, and disasters by using quantitative research through a self-reporting validated questionnaire containing 10 different dimensions. All registered nurses working in emergency departments who were willing to participate, of all ages and gender groups, were included. Nurses who were not present during the study period because of vacation or maternity leave, nurses at the managerial level, and nursing aides were excluded. The participating nurses reported good knowledge in almost all investigated aspects of the theoretical dimensions of emergency management. However, they revealed perceived weaknesses in practical dimensions of emergency management and difficulties in assessing their own efforts. There was a significant correlation between qualification and the dimensions of emergency preparedness, epidemiology and surveillance, isolation and quarantine and critical resources, which indicates a need for strengthening their practical contribution as well as their theoretical knowledge. Educational initiatives combining theoretical and practical aspects of emergency management may provide an opportunity to examine nurses’ knowledge, skills, and abilities continuously in an environment with no harm to patients.

Relationship Between Nurses' Decision-Making Style and Their Disaster Response Competencies

Nurses are the first respondents to the critical situations and therefore must be able to effectively manage the critical situations using their competencies. Given that the decision-making style under the stressful critical situations is an important component of the care process in these situations, this study was conducted with the aim of determining the relationship between decision-making style and nurses' disaster response competencies.This descriptive, analytical study was conducted in Shahr-e Kord city in 2018. A total of 300 nurses were selected from Ayatollah Kashani and Hajar hospitals by multistage sampling and from the Emergency Medical Services Center by the census method. Data were collected using the Disaster Nursing Competence Assessment and the decision-making style questionnaires and analyzed with SPSS 21 (IBM Corp, Armonk, NY).Most of the nurses used the intuitive decision-making style and the total score of disaster nursing competencies was 162.58 ± 22.70. Pearson's correlation coefficient indicated that there was a positive relation between decision-making style and nurses' disaster response competencies.The results show that decision-making style affects nurses' competencies for disaster response and provides evidence for the development of educational policies in disaster nursing education.

Identification of Patterns and Influential Factors on Civil Protection Personnel Opinions and Views on Different Aspects of Flood Risk Management: The Case of Greece

The views and perceptions of the civil protection community have a central position in any risk management process or initiative, and are crucial to its success. However, knowledge of the views and perceptions of officials, and what affects them remains limited in the current literature. This work uses questionnaires to explore the views of civil protection personnel in Greece on different elements of flood risk management and identify factors that influence them. Results provide a basic understanding of officials’ views, indicating certain shortcomings in various sectors and dissatisfaction in several aspects of everyday practice. Interestingly, responses of participants to perception- and knowledge-related questions show a pattern, relating to respondents’ attributes and characteristics, such as experience, age, qualifications, and others. On the contrary, their views on everyday practice issues of flood risk management are associated with the type of position they have in the civil protection community. The findings contribute to the overall effort to improve the understanding of the characteristics of civil protection organizations across Europe, as a means to enhance cooperation.

Nurses' job satisfaction during the mass gathering of the Hajj 2018 in Saudi Arabia

AIM

To explore job satisfaction of nurses during the Hajj season 2018 in Saudi Arabia, determine predictors of nurses' job satisfaction and inform future healthcare provision and policy.

BACKGROUND

Mass gatherings of large numbers of people inevitably pose unique public health concerns and challenges for organizers. A mass gathering happens annually in Saudi Arabia during the Hajj pilgrimage. There was a paucity of evidence regarding nurses' experiences during Hajj. This gap in knowledge needed to be addressed.

METHODS

A cross-sectional survey was conducted in 198 nurses across 12 healthcare settings along the Hajj pilgrimage route. A 24-item Nurses' Job Satisfaction Questionnaire was developed exploring six domains: supervision, nature of work, retention, communication, workload and co-workers.

RESULTS

Nurses reported a high level of job satisfaction. All six domains were strong predictors of job satisfaction. Nurses reported the lowest level of job satisfaction when assessed against the items 'multiple policies and procedures that were perceived as complicating nursing work', 'incompetence of other people they work with' and 'too much burden at work'.

CONCLUSION

Job satisfaction levels for nurses during Hajj 2018 appeared higher than during previous Hajj pilgrimages, probably influenced by the additional healthcare measures put in place during Hajj 2018, such as improved technology.

IMPLICATIONS FOR NURSING POLICY AND PRACTICE

Hajj-specific skills training must be designed to enhance the knowledge, competencies and capabilities of nurses. Policies and procedures must prevent heavy workloads and avoid complicating nurses' work during Hajj. Improvements to the nurse work environment should focus on evidence-based interventions promoting effective resource planning, interprofessional relationships and communication, for instance via innovative, technological approaches. These findings can be shared with organizers of other mass gatherings worldwide.

Expectations of survivors towards disaster nurses in Indonesia: A qualitative study

Objective

This study aims to explore the expectations of survivors towards disaster nurses.

Methods

The study used qualitative content analysis. Data were collected in 2017 through three focus group discussions with 21 survivors and in-depth interviews with three community leaders; the respondents had experienced one of the following events: a) an earthquake in Padang 2009, b) a volcanic eruption in Yogyakarta 2010, and c) flooding in Jakarta 2014.

Results

Four themes represented survivors' expectations of what nurses can do in responding to a disaster, including: a) provision of direct nursing care, b) provision of information of health service access, c) provision of resources through cross-sector coordination, and d) disaster preparedness activities for the community.

Conclusions

This study suggests the importance of disaster nurses having the competency to update information regarding healthcare access, particularly the utilization of health insurance and providing culturally competent care to the survivors. Disaster nurses are also expected to be able to train the community and families about preparedness-related activities. Besides, these disaster nurses should improve their competency in disaster risk reduction. More broadly, such nurses should have the ability to advocate and coordinate with the local government and other stakeholders regarding access to healthcare services and continuous rapid assessment, so that survivors receive immediate and appropriate treatment.

Disaster Preparedness in Hospitals in the Middle East: An Integrative Literature Review

Disasters occur rarely but have significant adverse consequences when they do. Recent statistics suggest that millions of lives and billions of US dollars have been lost in the last decade due to disaster events globally. It is crucial that hospitals are well prepared for disasters to minimize their effects. This integrative review study evaluates the preparedness level of hospitals in the Middle East for disasters using the Preferred Reporting Items for Systematic and Meta-Analyses (PRISMA) guidelines. The key terms include disaster preparedness OR disaster management OR emergency response AND Middle East AND hospitals. The study reviews articles published between January 2005 and December 2015, which focused on the hospitals’ preparedness for disasters in the Middle East nations. Based on their meeting 5 eligibility criteria, 19 articles were included in the review. Twelve of the articles focused on both natural and man-made disasters, whereas 6 of them were based on mass casualty events and 1 on earthquake. Thirteen of the reviewed articles ranked the level of preparedness of hospitals for disasters to be generally “very poor,” “poor,” or “moderate,” whereas 6 reported that hospitals were “well” or “very well prepared” for disasters. Factors affecting preparedness level were identified as a lack of contingency plans and insufficient availability of resources, among others. (Disaster Med Public Health Preparedness. 2019;13:806–816).

Midwives' Professional Competencies for Preventing Maternal Mortality in Disasters: A Cross-Sectional Study in Iran

OBJECTIVE

Maternal mortality may increase after a disaster. Because midwives are at the frontline of offering reproductive health care services in disasters, they should be competent.

METHODS

This was a cross-sectional, descriptive study carried out in 2015 in Tehran. The sample consisted of 361 midwives selected by use of a cluster random sampling method. Data were collected by using a questionnaire on professional competency for preventing maternal mortality in disasters.

RESULTS

The midwives' mean professional competency score was 177.74±31, which was an average level of professional competency. The level of knowledge and skills of the midwives was reported as inadequate for most items, particularly for the items of "managing mothers affected by chronic diseases," "physical trauma," "recognizing patients who needed to be referred," and "stabilizing mothers when referring them." Statistically significant relationships were observed between the midwives' competencies and age (P=0.001), work experience (P=0.054), educational level (P= 0.043), previous experience in a disaster (P=0.014), and workplace (P=0.006). These data were drawn by using Spearman's correlation, t-test, and ANOVA, respectively.

CONCLUSIONS

Given the average scores for midwives' professional competency in disasters and the inadequacy of prior training courses, extra educational programs for midwives are recommended. (Disaster Med Public Health Preparedness. 2018; 12: 305-311).

Factors influencing disaster nursing core competencies of emergency nurses

Background

Emergency nurses are expected to provide required nursing services by using their professional expertise to reduce the risk posed by disasters. Thus, emergency nurses' disaster nursing core competencies are essential for coping with disasters. The purpose of the study reported here was to identify factors influencing the disaster nursing core competencies of emergency nurses.

Methods

A survey was conducted among 231 emergency nurses working in 12 hospitals in South Korea. Data were collected on disaster-related experience, attitude, knowledge, and disaster nursing core competencies by means of a questionnaire.

Results

In multiple regression analysis, disaster-related experience exerted the strongest influence on disaster nursing core competencies, followed by disaster-related knowledge. The explanatory power of these factors was 25.6%, which was statistically significant (F = 12.189, p < 0.001).

Conclusions

These findings indicate that the disaster nursing core competencies of emergency nurses could be improved through education and training programs that enhance their disaster preparedness. The nursing profession needs to participate actively in the development of disaster nursing education and training programs.

•

Emergency nurses' disaster nursing core competencies are essential for coping with disasters.

•

Disaster-related experience and knowledge were found to influence disaster nursing core competencies.

•

Findings highlight the importance of disaster education and training programs for emergency nurses.

Emergency nurse disaster preparedness during mass gatherings: a cross-sectional survey of emergency nurses' perceptions in hospitals in Mecca, Saudi Arabia

OBJECTIVES

To assess hospital emergency nurses' self-reported knowledge, role awareness and skills in disaster response with respect to the Hajj mass gathering in Mecca.

DESIGN

Cross-sectional online survey with primary data collection and non-probabilistic purposive sample conducted in late 2014.

SETTING

All 4 public hospitals in Mecca, Saudi Arabia.

PARTICIPANTS

106 registered nurses in hospital emergency departments.

MAIN OUTCOME MEASURE

Awareness, knowledge, skills and perceptions of emergency nurses in Mecca with regard to mass gathering disaster preparedness.

RESULTS

Although emergency nurses' clinical role awareness in disaster response was reported to be high, nurses reported limited knowledge and awareness of the wider emergency and disaster preparedness plans, including key elements of their hospital strategies for managing a mass gathering disaster. Over half of the emergency nurses in Mecca's public hospitals had not thoroughly read the plan, and almost 1 in 10 were not even aware of its existence. Emergency nurses reported seeing their main role as providing timely general clinical assessment and care; however, fewer emergency nurses saw their role as providing surveillance, prevention, leadership or psychological care in a mass gathering disaster, despite all these broader roles being described in the hospitals' emergency disaster response plans. Emergency nurses' responses to topics where there are often misconceptions on appropriate disaster management indicated a significant knowledge deficit with only 1 in 3 nurses at best or 1 in 6 at worst giving correct answers. Respondents identified 3 key training initiatives as opportunities to further develop their professional skills in this area: (1) hospital education sessions, (2) the Emergency Management Saudi Course, (3) bespoke short courses in disaster management.

CONCLUSIONS

Recommendations are suggested to help enhance clinical and educational efforts in disaster preparedness.

Disaster management: Emergency nursing and medical personnel's knowledge, attitude and practices of the East Coast region hospitals of Malaysia

BACKGROUND

Disaster management is critical, as its insight could diminish the impact of a disaster, and participation of emergency medical personnel is crucial. This study explores emergency medical personnel's knowledge, attitude and practice towards disaster management.

METHODOLOGY

This study utilised a cross-sectional study design, and the data collected from 194 emergency nursing and medical personnel (staff nurses, doctors and assistant medical officers), using a questionnaire.

RESULTS

Majority of the personnel had an adequate knowledge and practices, and portrayed a positive attitude towards disaster management. Amongst the sociodemographic factors studied, gender and education level were significantly associated with increased knowledge and practice scores. Working experience, involvement in disaster response and attended disaster training had a significant association with higher practice scores. None of the sociodemographic factors studied had an effect on attitude scores.

CONCLUSION

Despite the diversity of their backgrounds, respondents exhibited their adequate knowledge and practice, and had positive attitudes towards disaster management. It is substantial for emergency nursing and medical personnel, to inhibit the severity of the impacts of the disasters. Their knowledge, attitude and practice studies could assist in the implementation of programmes relevant to disaster management to ensure their preparedness to assist the affected communities.

Senior Undergraduate Nursing Students' Perceptions of Disaster Preparedness: A Descriptive Study

OBJECTIVE

This descriptive study aimed to determine the disaster preparedness of a senior class of undergraduate nursing students.

METHODS

The study sample was composed of 73 undergraduate nursing school students from Ankara, Turkey. Data were collected by using a questionnaire developed by the researchers and were evaluated with descriptive statistics.

RESULTS

More than half (56.1%) of the students stated that the disaster competencies of nurses should include leadership, manager, and coordinator skills; 42.4% of them indicated the competencies of decision-maker, critical thinking, autonomy, and planning skills. Regarding education, 56.4% of the students considered their education on disaster nursing as "efficient"; however, 35.9% of them considered their education as "partly efficient" or "inefficient."

CONCLUSIONS

Many correct concepts related to the definition, features, competencies, and roles of disaster nurses were stated by students. However, low percentages and insufficient statements showed low preparedness for disasters. Curriculum development or redesign is necessary to include content and clinical experiences related to disasters. (Disaster Med Public Health Preparedness. 2016;0:1-5).

Emergency Nurses' Requirements for Disaster Preparedness

BACKGROUND

Natural and man-made disasters affect people, communities, and health systems. Nurses play a key role in the health system and must be prepared for appropriate response in disasters.

OBJECTIVES

This study was done to assess the current knowledge of nurses in emergency departments for disaster preparedness.

PATIENTS AND METHODS

This cross-sectional study was conducted on 110 emergency nurses working in teaching hospitals affiliated to Iran University of Medical Sciences, Tehran, Iran. A questionnaire was used to collect data and the data were then analyzed using descriptive and inferential statistics with SPSS software version 16.0.

RESULTS

Based on the findings, most of the participants (64.5%) were aged 30 - 39 years old. 84% of the cases were female and 97.3% had a bachelor's degree. The average perceived knowledge of nurses was 2.43 ± 1.01. The nurses had the highest familiarity with triage and lowest knowledge in epidemiology and decision-making.

CONCLUSIONS

Lack knowledge of nurses regarding response to disaster situations indicates inefficiencies in the current system. Therefore, it is recommended to organize more workshops, annual training courses, and maneuvers based on staff needs and formulate continuous education courses for nurses.

A grounded theory study of 'turning into a strong nurse': Earthquake experiences and perspectives on disaster nursing education

BACKGROUND

While Asia has the dubious distinction of being the world's most natural disaster-prone area, disaster nursing education and training are sparse in many Asian countries, especially China where this study took place.

OBJECTIVE

To explore the earthquake disaster experiences of Chinese nurses and develop a substantive theory of earthquake disaster nursing that will help inform future development of disaster nursing education.

DESIGN

A qualitative study employing grounded theory, informed by symbolic interactionism.

PARTICIPANTS AND SETTING

Fifteen Chinese registered nurses from five hospitals in Jiangxi Province who undertook relief efforts after the 2008 Wenchuan Earthquake.

METHODS

Data were collected in 2012-2013 in digitally-recorded, semi-structured, in-depth interviews and reflective field notes, and analyzed using Glaser's grounded theory method.

RESULTS

Participants were unprepared educationally and psychologically for their disaster work. Supporting the emergent theory of "working in that terrible environment", was the core category of "turning into a strong nurse", a process of three stages: "going to the disaster"; "immersing in the disaster"; and "trying to let disaster experiences fade away". The participants found themselves thrust in "terrible" scenes of destruction, experienced personal dangers and ethical dilemmas, and tried the best they could to help survivors, communities and themselves, with limited resources and confronting professional work.

CONCLUSIONS

Our rich findings confirm those of other studies in China and elsewhere, that attention must be paid to disaster education and training for nurses, as well as the mental health of nurses who work in disaster areas. Emergent theory helps to inform nurse educators, researchers, leaders and policy makers in China, and elsewhere in developing strategies to better prepare nurses for future disasters, and assist communities to prepare for and recover after earthquake disasters.

Disaster nursing in Iran: challenges and opportunities

BACKGROUND AND OBJECTIVE

Disaster nursing was one of the first forms of nursing practice in Iran, and nurses have long served voluntarily in disasters. Despite their key role throughout a disaster management cycle, few studies have examined nurses' unique role in the management of disasters in this region of the world.

METHODS

An integrative narrative analysis of international research published in English and Persian studies between years 2000 and 2013 was conducted.

RESULTS

Analysis of the 32 articles yielded two major: organisational and managerial challenges, and challenges linked to the educational system. The most significant factors linked to the role of nurses in disasters included the lack of identification of those who educated nurses to serve in critical conditions, defects in university's educational systems and lack of in-service training for nurses with regard to disasters.

CONCLUSIONS

The integration of dedicate organisational units to educate human workforces, formalising a relationship between nursing staff and the disaster organisations, creative educational content, and effective economical systems to educate nurses may further enable disaster preparedness and response.

What are the research needs for the field of disaster nursing? An international Delphi study

BACKGROUND

Internationally there is an increasing amount of peer-reviewed literature pertaining to disaster nursing. The literature includes personal anecdotes, reflections, and accounts of single case studies. Furthermore, issues such as the willingness of nurses to assist in disasters, the role of nurses in disasters, leadership, competencies, and educational preparedness for nurses have been the focus of the literature.

AIM

The aim of this research was to determine the international research priorities for disaster nursing.

METHOD

This research used a three-round Delphi technique. The first round used a face-to-face workshop to generate research statements with nursing members of the World Association for Disaster and Emergency Medicine (WADEM). The second and third rounds included the ranking of statements on a 5-point Likert scale with nursing members of WADEM and the World Society of Disaster Nursing (WSDN). Statements that achieved a mean of four or greater were considered a priority and progressed.

RESULTS

Participants were from multiple countries. Research statements were generated in the areas of: education, training, and curriculum; psychosocial; strategy, relationship, and networking; and clinical practice. Psychosocial aspects of disaster nursing ranked the highest, with five statements appearing in the top ten research areas, followed by statements relating to: education, training, and curriculum; clinical practice; and finally, strategy, relationship, and networking.

CONCLUSIONS

Future disaster nursing research should focus on the area of psychosocial aspects of disaster nursing, in particular, both the psychosocial needs of a disaster-affected community and the psychosocial wellbeing of nurses who assist in disaster health activities.

Wildfire disasters: implications for rural nurses

BACKGROUND

As natural disasters are increasing globally, nursing's role in responding to disasters is evolving. Disaster nursing has emerged as a specialty that focuses on the care of groups and communities during disaster response. The role of rural nurses in disasters is less well defined.

METHODS

A review of peer-reviewed literature combined with the International Council of Nurses framework of Disaster Nursing Competencies was conducted to understand the roles and functions of nurses in rural areas that experience disasters. The authors' findings from investigating the effects of four wildfires in rural Canadian communities are also discussed.

RESULTS

Six major themes derived from our wildfire studies were generated within the context of nursing practice and are useful in the preparation of rural nurses involved in disaster management and recovery. This adds to the current literature which by and large has not addressed nursing in rural catastrophes.

CONCLUSION

Well-prepared and educated rural nurses who combine theoretical knowledge with their understanding of a rural community potentially can reduce the impact of a disaster. Other nursing roles include mentoring nursing students in disaster preparation and assisting in initiatives to address community recovery in the aftermath of a disaster.

Beyond a clinical role: nurses were psychosocial supporters, coordinators and problem solvers in the Black Saturday and Victorian bushfires in 2009

AIM

This research explores the roles of nurses that participated in the Black Saturday and Victorian bushfires in February 2009, including aspects that influence nurses' roles, such as prior education, training and availability of resources.

BACKGROUND

It is acknowledged that nurses play an important role in disaster response and recovery. However, our understanding of nurses' roles is superficial and commonly based on descriptions of events in which specifics relating to the nurses' roles are embedded within other topics or issues. Similarly, aspects that support nurses in the disaster environment, including previous experience, education and the provision of resources, are not well understood.

METHOD

Single, semi-structured telephone interviews were conducted with 11 volunteer nursing members of St John Ambulance Australia. These interviews were electronically recorded, transcribed verbatim and thematically analysed using a well-recognised human science approach.

FINDINGS

The thematic analysis identified two broad themes: being prepared and having an expansive role. Participants indicated that they were educationally prepared and had adequate clinical experience. They outlined that they took many resources with them; however, they were used very little, as their role consisted of minimal clinical care. Additionally, nurses performed roles including a psychosocial supporter, a coordinator of care and resources, and problem solvers.

CONCLUSIONS

The nurses' role in providing health care during and/or following a disaster is more than a clinical care role. This understanding should be applied to the development of education programs, competencies and policies, with a particular focus on contextualising the education to the realities of possible disastrous scenarios that incorporates elements of coordination, problem solving and psychosocial care within a national framework. Additionally, this awareness education should be used to inform nurses about the realities of working in disaster environments.