Disaster nursing: a retrospective review

Disaster preparedness perception, pyschological resiliences and empathy levels of nurses after 2023 Great Turkiye earthquake: Are nurses prepared for disasters: A risk management study

OBJECTIVE

The purpose of the study is to determine the disaster preparedness perceptions, psychological resilences and empathy levels of nurses after 2023 Great Turkiye Earthquake.

METHOD

This descriptive study was conducted in 2023 using with E-Anket. This study was carried out with voluntary participation of 464 nurses living in different geographical regions of Turkiye. The data of the study were obtained utilizing Nurses' Disasters Prepardeness Perception Scale (NDPPS), Pyschological Resileince Scale (PRS) and Empathy Scale (ES).

RESULTS

In this study, the disaster preparedness perception of the nurses was found to be at medium level. More than half of the nurses (65.1%) reported that they did not received any disaster training before. A meaningful was found between the nurses' disaster preparedness perceptions and their empathy levels and psychological resilence.

CONCLUSIONS

As in many countries, it is possible to state that also in Turkiye, the training of nurses for disasters are inadequate and that the studies on this subject are limited. This study will provide a theoretical platform to develop nurses' awareness of disaster preparedness and pyschological resilience and empathic approach programs to increase disaster resilience, and to conduct future research on disaster nursing.

Home-Based Care and Mental Health during a Disaster: A Qualitative Analysis

Disasters adversely affect individuals' mental health; yet, research is scant on the mental health needs of frontline workers during and immediately after disasters. Our study explored this gap through the perspectives of home-based care providers (HBCP) who provided care during and after Hurricanes Irma and Harvey. In this qualitative study, five in-person focus groups were held between January and November 2019 with 25 HBCP drawn from home health care agencies in southern Florida and the Greater Houston Area. Four themes were identified using an abductive analytic approach: HBCPs' disaster-related mental health needs; HBCP resilience in the context of disaster; psychological tensions associated with simultaneously caring for self, family, and patients; and supporting patients' mental health needs during and after disaster. Our data suggest that HBCP may benefit from formal training and interventions to support their own mental health as well as that of their patients in the context of disasters.

Nursing skills required across natural and man-made disasters: A scoping review

AIMS

To map the nursing skills required for different types of disasters.

DESIGN

This was a scoping review of research studies conducted between July and August 2021. We conducted a systematic literature search of nine electronic databases from inception till July 2021, and an updated search was done in April 2022. This review is based on the methodological framework of Arksey and O'Malley (2005), which was further refined by the Joanna Briggs Institute.

DATA SOURCES

A range of electronic databases was searched systematically, including CINAHL, Cochrane, Embase, MEDLINE, PsycINFO, PubMed, Web of Science, CNKI and Ichushi-Web. Articles published in Chinese, English and Japanese were selected for the review.

REVIEW METHODS

The PCC model was used to frame the inclusion criteria. Studies were screened, appraised and extracted by two reviewers, and the study findings were narratively synthesized.

RESULTS

We identified nursing skills for five types of natural disasters including (1) earthquakes, (2) typhoons, (3) tsunamis, (4) marine disasters and (5) infectious diseases and three man-made disasters: (1) radiation disasters, (2) bioterrorism and (3) war. Among these, there are five types of common professional skills nurses are required to possess including casualty triage, observation and monitoring, basic first aid techniques, psychological care and communication skills. In addition, it was shown that different disasters require different specific professional skills.

CONCLUSION

This scoping review explored the disaster nursing skills required for eight types of disasters and provides evidence for future education and training. Further research is needed to build more accurate scenario-based simulation training programs to provide more insights into future disaster precision nursing.

IMPACT

This scoping review provides evidence for future education and training in disaster nursing to improve nurses' knowledge and competencies in dealing with the different types of disaster situations.

Disaster Relief Nurses: Exploring the Impetus to Respond to Multiple Efforts

Little is known about the impact that disaster volunteerism has on nurses. It is important to hear the experiences of those who return again to better understand the reasons that call them back. Using grounded theory methodology, 20 nurses who responded to more than one disaster event participated in semistructured interviews. Capacity for the art of nursing, confidence in performing the role, fostering the team among the chaos, and humanistic symbiosis emerged, leading to a core category, facilitating self-transcendence, guided by Reed's middle-range theory. With repeat deployments come enhanced personal rewards that provide meaningful opportunities for self-transcendence.

Disaster Response in Italian Nursing Homes: A Qualitative Study during the COVID-19 Pandemic

Nursing homes (NHs) have been among the care settings most affected by both the virus itself and collateral damage through infection protection and control measures (IPC). However, there is a paucity of research regarding disaster response and preparedness of these institutions. The present study aimed to analyze disaster response and management and to develop prospective strategies for disaster management in NHs. A qualitative survey including (i) residents, (ii) nursing staff, (iii) relatives of residents, and (iv) NHs’ medical leads was performed. Data were collected by 45 in-depth interviews. Our results indicate that the shift from resident-centered care towards collective-protective approaches led through the suspending of established care principles to an emergency vacuum: implementable strategies were lacking and the subsequent development of temporary, immediate, and mostly suboptimal solutions by unprepared staff led to manifold organizational, medical, and ethical conflicts against the background of unclear legislation, changing protocols, and fear of legal consequences. IPC measures had long-lasting effects on the health and wellbeing of residents, relatives, and professionals. Without disaster preparedness protocols and support in decision-making during disasters, professionals in NHs are hardly able to cope with emergency situations.

A systematic review of de-escalation strategies for redeployed staff and repurposed facilities in COVID-19 intensive care units (ICUs) during the pandemic

BACKGROUND

Intensive care units (ICUs) experienced a surge in patient cases during the COVID-19 pandemic. Demand was managed by redeploying healthcare workers (HCWs) and restructuring facilities. The rate of ICU admissions has subsided in many regions, with the redeployed workforce and facilities returning to usual functions. Previous literature has focused on the escalation of ICUs, limited research exists on de-escalation. This study aimed to identify the supportive and operational strategies used for the flexible de-escalation of ICUs in the context of COVID-19.

METHODS

The systematic review was developed by searching eight databases in April and November 2021. Papers discussing the return of redeployed staff and facilities and the training, wellbeing, and operational strategies were included. Excluded papers were non-English and unrelated to ICU de-escalation. Quality was assessed using the mixed methods appraisal tool (MMAT) and authority, accuracy, coverage, objectivity, date, and significance (AACODS) checklist, findings were developed using narrative synthesis and thematic analysis.

FINDINGS

Fifteen papers were included from six countries covering wellbeing and training themes encompassing; time off, psychological follow-up, gratitude, identification of training needs, missed training catch-up, and continuation of ICU and disaster management training. Operational themes included management of rotas, retainment of staff, division of ICU facilities, leadership changes, traffic light systems, and preparation for re-expansion.

INTERPRETATION

The review provided an overview of the landscape of de-escalation strategies that have taken place in six countries. Limited empirical evidence was available that evaluated the effectiveness of such strategies. Empirical and evaluative research from a larger array of countries is needed to be able to make global recommendations on ICU de-escalation practices.

Hospice Emergency Planning and COVID-19

Objectives: Centers for Medicare and Medicaid Services requirements for Emergency Preparedness Planning (EPP) by hospice organizations significantly increased in 2017. This study seeks to assess the involvement of various hospice personnel in EPP before and since the onset of the novel coronavirus disease COVID-19 pandemic. Methods: A link to an anonymous online survey was sent to members of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association, targeting members involved in hospice care in the United States. A descriptive analysis of the data was performed. Results: Prior to the pandemic, 39.8% of respondents were "moderately" or "very" involved with the development and revisions of the Emergency Preparedness Plan. Since the beginning of the pandemic, this increased to 59%, which largely occurred among physicians. Clinical Nurse and Nurse Practitioner involvement in development/revisions remained low. Approximately 30% of respondents desired more involvement across the areas of EPP. Conclusion: The involvement of personnel of various disciplines is varied and the involvement of physicians appears to have increased with the onset of the COVID-19 pandemic. A notable portion of personnel desired more involvement across all aspects of EPP. More research is needed in this important but little-understood area.

How are healthcare provider systems preparing for health emergency situations?

Natural disasters, disease outbreaks, famine, and human conflict have strained communities everywhere over the course of human existence. However, modern changes in climate, human mobility, and other factors have increased the global community's vulnerability to widespread emergencies. We are in the midst of a disruptive health event, with the COVID-19 pandemic testing our health provider systems globally. This study presents a qualitative analysis of published literature, obtained systematically, to examine approaches health providers are taking to prepare for and respond to mass casualty incidents around the globe. The research reveals emerging trends in the weaknesses of systems' disaster responses while highlighting proposed solutions, so that others may better prepare for future disasters. Additionally, the research examines gaps in the literature, to foster more targeted and actionable contributions to the literature.

Successfully Deploying Your Valuable Resources:: Staffing Implications and Prioritization During Crisis

Whether your facility is standalone or part of a multihospital system, meeting operational demand for patient care under routine circumstances can be challenging. Vacancies, prolonged recruitment time to fill positions, and unscheduled absences and leaves, combined with increased acuity and volume, can strain and overwhelm a facility's resources during noncrisis circumstances. This article explores the challenges of staffing during a crisis and patient surge, providing strategies that can be utilized to optimize resources.

UK rehabilitation professionals' experiences undertaking short-term responses after sudden-onset disaster

Background/Aims

Rehabilitation professionals can be members of international emergency responding medical teams after a natural disaster or following conflict. There is little research that explores the experiences of rehabilitation professionals who participate in these short-term emergency responses. The aim of this study was to explore the experiences of rehabilitation professionals, specifically those of occupational therapists and physiotherapists. Objectives included examining personal and professional development opportunities, and how these experiences might inform future responses and the rehabilitation professional role.

Methods

A phenomenological approach was undertaken. Eight semi-structured interviews were carried out with rehabilitation professionals who had worked as part of short-term response following conflict or sudden-onset disaster. Transcriptions were analysed using thematic analysis.

Results

Two main themes and subsequent subthemes emerged. Theme 1 was challenges, with subthemes: an emotional journey; have I made a difference; and cultural and contextual awareness. Theme 2 was opportunities, with subthemes: a short-term response; working together; and developing skills and knowledge.

Conclusions

The experiences of UK-based rehabilitation professionals on short-term rotational responses as part of an emergency specialised rehabilitation team were overall positive. Challenges have implications for developing future pre- and post-response training and support. Further research is recommended to determine the contribution of these responses and to continue to develop understanding of the rehabilitation professional role in a responding specialised rehabilitation team.

Mental health of nurses after the Fukushima complex disaster: a narrative review

Work-related mental health impairment is recognized as a real problem in the context of helping responders, including health professionals, due to adverse health outcomes after a severe disaster. The Great East-Japan Earthquake, which occurred on 11 March 2011, was an unprecedented complex disaster that caused a nuclear accident at the Fukushima Daiichi Nuclear Power Plant (NPP). In addition to disaster stress and daily work, medical and health-care professionals, particularly nurses, provided counseling services to residents concerned about radiation health risks or mental health issues. This review focuses on the psychological aspects of the complex nuclear disaster, which was a combined artificial nuclear accident and natural disaster, and we investigated the psychological effects on hospital nurses associated with their experiences during the disaster. We looked at several investigations into the mental health of nurses after a nuclear disaster and in other situations. It was shown that mental health of nurses is impacted, not only after nuclear disasters but also in other circumstances. Furthermore, we noted the effects of extended periods of a heavy workload and daily life. Regarding anxiety about radiation exposure, nurses who had more knowledge of radiation tended to have better mental health, suggesting that education about the health risks of radiation exposure is important for health-care professionals. In summary, it is essential that nurses are provided with education about radiation exposure and its associated health risks, and also that there is a comprehensive approach to mental health care for nurses during the chronic phase of a disaster.

A Strategy to Enhance Student Experiences in Public Health Emergency Preparedness and Response: Medical Reserve Corps Nursing Student Summer Externship

Development of the public health nursing workforce is crucial to advancing our nation's health. Many organizations, including the American Association of Colleges of Nursing, Centers for Disease Control and Prevention, and the US Department of Health and Human Services, have identified the need for strengthening academia's connection to public health and tailoring experiences to enhance workforce competency. The Oklahoma Medical Reserve Corps (OKMRC) Nursing Student Summer Externship was developed as a strategy to provide nursing students with strengthened knowledge and skills in disaster response through a structured summer volunteer experience with nurse educators within the OKMRC. The Medical Reserve Corps is a national organization with more than 200 000 volunteers dedicated to strengthening public health, improving emergency response capabilities, and building community resiliency. In the summer of 2015, the OKMRC offered a 10-week public health emergency preparedness and response externship pilot program to 8 nursing students. In the summer of 2016, the program expanded to include 3 Oklahoma baccalaureate nursing programs. Students completed trainings and participated in activities designed to provide a broad base of knowledge, an awareness of the local disaster plans, and leadership skills to assist their communities with preparedness and disaster response.

Readiness of hospital nurses for disaster responses in Taiwan: A cross-sectional study

BACKGROUND

Because patients in disaster areas require the most critical care, mobilising hospital nurses has become a pivotal strategy. Given the importance of disaster nursing training programmes, understanding how well prepared hospital nurses are to provide disaster care is vital.

OBJECTIVES

This paper analyses the perceived readiness of hospital nurses for a disaster response and the factors influencing their report for work outside the hospital environment.

DESIGN

A cross-sectional research design was used.

SETTINGS

This study was conducted at a military hospital in Taiwan.

PARTICIPANTS

A sample of 311 registered nurses participated in this study.

METHODS

Data were collected on readiness for disaster responses using a 40-item researcher-designed, self-administered questionnaire found to have satisfactory reliability and validity. The questionnaire has four domains: personal preparation (16 items), self-protection (11 items), emergency response (6 items), and clinical management (7 items). Data were analysed using descriptive statistics, independent t-tests and generalised linear models.

RESULTS

The majority of hospital nurses demonstrated poor readiness for disaster responses. Scores on the four domains were most associated with nurses' disaster-related training, experience in disaster response and emergency/intensive care experience.

CONCLUSIONS

Our results indicate that disaster-related training should be included in undergraduate programmes and continuing education courses to help hospital nurses recognise and improve their own readiness for disaster responses outside the hospital environment. Future research is needed to improve hospital nurses' disaster-response readiness in Taiwan and other countries.

Nursing Education for Disaster Preparedness and Response

Catastrophic mass casualty events (MCEs), such as pandemic influenza outbreaks, earthquakes, or large-scale terrorism-related events, quickly and suddenly yield thousands of victims whose needs overwhelm local and regional health care systems, personnel, and resources. Such conditions require deploying scarce resources in a manner that is different from the more common multiple casualty event. This article presents issues associated with providing nursing care under MCE circumstances of scarce resources and the educational needs of nurses to prepare them to effectively respond in these emergencies. J Contin Educ Nurs. 2015;46(x):xxx-xxx.

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.