The HOPE model for disaster nursing - A systematic literature review

Nurses under fire: Insights from testimonies of community nurses and midwives in nonhospital settings in the southern Israel conflict zone

Nurses-with or without prehospital care training-may find themselves delivering immediate care to injured individuals outside a healthcare facility, sometimes even in situations where their own life is at risk. This study explores the experiences of community nurses and midwives who provided immediate care during the Hamas militant movement's attack in southern Israel. The researchers collected and analyzed eight nurse and midwife survivors' testimonies published in digital media to gain a deeper understanding of their perspectives. Through qualitative content analysis, common themes, patterns, and insights were identified. The study aimed to contribute valuable knowledge in this field and followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist for methodological rigor. Two themes emerged from the testimonies, focusing on the nurses' swift realization of necessary action under fire and resilience and ingenuity in practice. Despite lacking training and resources, the nurses professionally assessed the situation and improvised creative solutions to care for the wounded. Although they had no prehospital emergency care background, community nurses and midwives were able to respond effectively, providing lifesaving care. The findings highlight the nurses' resilience, adaptability, and dedication in unprecedented situations. However, the study also emphasizes the importance of providing all nurses with baseline prehospital care training and structured planning of this care to empower them to deliver optimal patient care in uncertain and dangerous conditions, especially in and around conflict and disaster zones.

Overcoming challenges in nursing disaster preparedness and response: an umbrella review

Disaster nursing plays a vital role in addressing the health needs of vulnerable populations affected by large scale emergencies. However, disaster nursing faces numerous challenges, including preparedness, logistics, education, ethics, recovery and legalities. To enhance healthcare system effectiveness during crises, it is essential to overcome these issues. This umbrella review, conducted using the Joanna Briggs Institute (JBI) methodology, synthesizes data from 24 studies to identify key strategies for improving disaster nursing. The review highlights nine key themes: Education and Training, Research and Development, Policy and Organizational Support, Technological Advancements, Psychological Preparedness and Support, Assessment and Evaluation, Role-Specific Preparedness, Interprofessional Collaboration and Cultural Competence, and Ethics and Decision-Making. The review emphasizes the importance of education, technological advancements, psychological support, and interprofessional collaboration in bolstering disaster nursing preparedness and response efforts. These elements are crucial for enhancing patient outcomes during emergencies and contributing to a more resilient healthcare system. This comprehensive analysis provides valuable insights into the various aspects essential for enhancing disaster nursing. By implementing evidence-based strategies within these nine themes, the nursing profession can enhance its capacity to effectively manage and respond to the complex needs of disaster-affected populations, ultimately improving patient care and outcomes during emergencies.

Experiences of intensive care nurses providing care to the victims of Kahramanmaraş earthquakes

BACKGROUND

Two earthquakes of magnitude 7.7 and 7.6 occurred in the Turkish province of Kahramanmaraş in 2023. The earthquakes resulted in serious losses of life and property in 11 provinces, and the injured were transferred to other provinces for treatment and care. To date, no studies on the experiences of intensive care nurses providing care to earthquake victims after the Kahramanmaraş earthquake sequence have been identified.

AIM

The aim of the present study is to explore the experiences of intensive care nurses providing care to earthquake victims who were transferred to other provinces.

STUDY DESIGN

A qualitative descriptive research design with conventional content analysis was used. Snowball sampling was used in the selection of intensive care nurses. Data saturation was achieved with 20 nurses. In-depth interviews were conducted with the participants through phone between March 8 and March 15, 2023. MAXQDA 20 software was used for data analysis. The COREQ checklist was used to guide the reporting of the study.

RESULTS

Twenty nurses were recruited. Four themes emerged from the data: challenges in caregiving processes; psychological challenges; ethical situations; urgent need for training and support.

CONCLUSIONS

After the Kahramanmaraş earthquake sequence, described by some as the disaster of the century, nurses encountered patients with unique needs that they had never encountered before and tried to cope with the constantly changing health conditions. For this reason, they were affected psychologically and experienced challenges in caregiving processes.

RELEVANCE TO CLINICAL PRACTICE

Conducting comprehensive training for diseases common among earthquake victims, developing new protocols for providing care to earthquake victims, developing more action plans for nurses, and psychologically supporting intensive care nurses would facilitate the caregiving processes.

Factors affecting nurses' emergency competencies in public health emergency: A cross-sectional study based on the stress-coping adaptation model

OBJECTIVES

To investigate the factors associated with stress, resilience, coping styles, and emergency competencies when nurses are faced with a public health emergency.

DESIGN

This study used a cross-sectional design.

SAMPLE

Study data came from a survey of 646 nurses who were from a tertiary hospital in Southern China in March-June 2022.

METHODS

Participants responded to self-report questionnaires through a web-based survey. Stress, resilience, emergency competencies, and response to public emergencies were assessed using the Perceived Stress Scale, Connor-Davidson Resilience Scale, the core competencies of nurses in public health emergencies, and a simplified coping style questionnaire.

RESULTS

A total of 646 nurses participated in this study. Slightly over half of the participants were ≤30 years old, and almost all were female. Resilience, positive coping, and negative coping were positively correlated with emergency competencies. Multiple linear regression analysis demonstrated that resilience, working years, and participation in the treatment of infectious diseases were significant predictors of emergency competencies.

CONCLUSION

The findings suggest that nurses require additional training in emergency management and clinical practice to enhance their emergency competencies. More interventions and social support should be provided to improve nurses' resilience and positive coping strategies when they encounter public health emergencies.

A Multisample Path Analysis Including a Novel Psychological Indicator, Attitude Toward Life, After the First Wave of COVID-19

Introduction

During the COVID-19 outbreak, China applied a unique volunteerism system in which nurses and physicians traveled to the epicenter to care for patients. During the same period, another group, nurse and physician nonvolunteers, stayed at their home hospitals outside of the epicenter and cared for patients without COVID-19. Yet only one Chinese study examined psychological responses comparing these groups.

Objective

To explore whether relationships among compassion satisfaction, general health, attitude toward life, satisfaction with life, perceived stress, and posttraumatic stress disorder (PTSD) symptomatology differ between volunteers and nonvolunteers. Attitude toward life is examined for the first time in COVID-19 research.

Methods

A cross-sectional study was conducted (259 nurse and physician volunteers, 330 nurse and physician nonvolunteers). Online survey data were analyzed using multisample path analysis.

Results

There was no significant difference between volunteer and nonvolunteer models. In the volunteer model, paths significantly related to PTSD symptomatology included compassion satisfaction (total effect, β = -0.12), general health (total effect, β = -0.09), attitude toward life (direct effect, β = -0.30; total effect, β = -0.30), and perceived stress (direct effect, β = 0.30; total effect, β = 0.30), and in nonvolunteers included general health (direct effect, β = -0.11; total effect, β = -0.11) and attitude toward life (direct effect, β = -0.47; total effect, β = -0.47).

Conclusion

No significant difference between models means both groups could benefit from psychological intervention. Within each model, significant paths were identified. For volunteers, counselors might focus on compassion satisfaction and perceived stress and, for both volunteers and nonvolunteers, on health and attitude toward life. Delivering counseling based on key indicators in China may help prevent or mitigate PTSD. Globally, researchers could identify factors to target and determine to whom long-term counseling might be directed. Findings about attitude toward life lay the groundwork for future research.

Intensive care nurses' lived experience of altruism and sacrifices during the Covid-19 pandemic: A phenomenological study

AIM

The aim of this study was to understand the lived experience of altruism and sacrifices among Swedish nurses working in intensive care units (ICU) during the COVID-19 pandemic.

DESIGN

This was a descriptive phenomenological study.

METHODS

The study was conducted between June 2020 and March 2021 and included 20 nurses who were directly involved in the ICU care of COVID-19 patients in Sweden during the pandemic. The text transcripts were analysed using Malterud's Systematic Text Condensation.

FINDINGS

The analysis revealed four themes. The work situation changed from 1 day to another-the nurses were brutally confronted with a new and highly demanding situation. Adapting to the chaotic situation-despite fear, anguish and exhaustion, the nurses adapted to the new premises. They shouldered the moral responsibility and responded to the needs of the patients and the health care system since they had the competence. Being confronted with ethical and moral challenges-the nurses were overwhelmed by feelings of helplessness and inadequacy because despite how hard they worked, they were still unable to provide care with dignity and of acceptable quality. The importance of supporting each other-collegiality was fundamental to the nurses' ability to cope with the situation.

CONCLUSIONS

Taken together, being exposed to a constantly changing situation, facing the anguish and misery of patients, families, and colleagues, and being confronted with a conflict between the moral obligation to provide care of high quality and the possibility to fulfil this commitment resulted in suffering among the nurses. Collegial back-up and a supportive culture within the caring team were important for the nurses' endurance.

IMPACT

The study contributes an understanding of nurses' lived experience of working during the COVID-19 pandemic and highlights the importance of protecting and preparing nurses and nursing organisation for potential future crises.

Battling extraordinary situations and conflicting emotions-A qualitative study of being a newly graduated Registered Nurse in the emergency department during the COVID-19 pandemic

Aim

To describe newly graduated registered nurses’ (NGRNs’) experiences of encountering stress in emergency departments (EDs) during the COVID‐19 pandemic.

Design

A qualitative descriptive study.

Methods

Data from 14 in‐depth interviews with NGRNs working in an ED for 3‐36 months after graduation was analysed by the means of qualitative content analysis as described by Graneheim and Lundman. Interviews were conducted from March to November 2020 covering the first two waves of the pandemic.

Results

Data revealed three categories and nine subcategories comprised in the theme Battling extraordinary situations and conflicting emotions. Empowered by acknowledging themselves as important caregivers during the pandemic NGRNs struggle against limitations and exert themselves beyond their known limit. External stressors due to work overload in combination with understaffing force NGRNs into the role of the experienced nurse prematurely and internal stressors derives from part taking in less qualitative care.

Does theme game-based teaching promote better learning about disaster nursing than scenario simulation: A randomized controlled trial

BACKGROUND

With the development of information technology, game-based teaching has continuously attracted the attention of nursing educators. It has been proven that games, as an auxiliary tool of traditional teaching, can improve students' learning motivation and learning effects. However, compared with the traditional scenario simulation teaching, whether game-based teaching has obvious advantages is still unknown.

OBJECTIVES

This study aimed to explore whether theme game-based teaching is more effective than scenario simulation in improving students' disaster nursing competency.

DESIGN

A randomized controlled trial.

SETTING

The study was conducted at a provincial vocational college in Xiaogan, Hubei, China.

PARTICIPANTS

A total of 104 sophomore nursing students (intervention group = 51, control group = 53) participated.

METHODS

After the participants were randomly assigned to the intervention group or control group, disaster-themed games were used in the intervention group, while multi-station disaster simulation was applied in the control group. Pre- and post-tests were conducted to assess the participants' disaster nursing competence using the Questionnaire of Disaster Rescue Ability.

RESULTS

After the intervention, disaster nursing competence levels were significantly higher in the intervention group than in the control group (4.04 ± 0.43 vs. 3.77 ± 0.45, P = 0.002). Three domains of disaster nursing competence, cognition (4.05 ± 0.56 vs. 3.75 ± 0.48, P = 0.004), skill (3.88 ± 0.50 vs. 3.62 ± 0.53, p = 0.008) and affective response (4.25 ± 0.42 vs. 4.02 ± 0.48, P = 0.010), were also significantly higher in the intervention group.

CONCLUSIONS

Compared with scenario simulation, theme game-based teaching is more effective in improving the disaster nursing competence of nursing students.

Nurses' core disaster-response competencies for combating COVID-19-A cross-sectional study

The core competencies in disaster nursing, nurses’ roles in disaster management and the potential barriers are assessed with a view to developing disaster nursing in Slovenia. Despite training and experience, many indicators show nurses are deficient in skills involving emergency and disaster-preparedness competencies. Nurses report little familiarity with disaster-planning skills, the implementation of disaster guidelines and assessment of patients subject to a disaster circumstance. A cross-sectional descriptive study was conducted based on data collected through an online survey. 118 registered nurses from different clinical settings in Slovenia participated in the study. Data were collected according to the Slovenian version of the Disaster Nursing Core Competencies Scale (Sl-DNCC-Scale). The scale was limited to a 7-point Likert response format (from 1 = strongly disagree to 7 = strongly agree). The results show the registered nurses perceive the core competencies of disaster nursing to be important to their preparedness for disaster situations (median = 161; range 74–189). Registered nurses who work in nursing homes and nurse managers are more aware of the importance of acquiring the listed competencies for unexpected events (p = 0.011 and 0.060 respectively) and the importance of their active role in disaster management (p = 0.027 and p = 0.004, respectively). To effectively deal with a disaster, nurses must be well prepared for unexpected events and more actively involved in disaster management. This study demonstrates that nurses regard the core disaster nursing competencies as important and greatly needed in various healthcare facilities. Future studies in this area should focus on ways to implement these competencies in nursing education.

Reflecting on the challenges encountered by nurses at the great Kermanshah earthquake: a qualitative study

Background

Iran has experienced an increasing number of earthquake in the past three decades. Nurses are the largest group of healthcare providers that play an important role in responding to disasters. Based on previous studies, they experienced challenges providing care in the previous disasters. Therefore, this study aimed to explore the nursing challenges to provide care to the injured in the Kermanshah earthquake, Iran.

Methods

This is a qualitative study with conventional content analysis using Granheim and Landman approach. In this study, 16 nurses involved in providing care to the injured in the Kermanshah earthquake were selected by purposeful sampling method. Data were collected using in-depth semi-structured interviews. The criteria proposed by Guba and Lincoln were used to ensure the validity of the study.

Results

Data analysis led to the emergence of 453 primary codes, 14 subcategories, and 5 categories. The five categories were as follows: (a) organizational and managerial challenges; (b) human resources; (c) infrastructure; (d) educational preparations; (e) and ethical.

Conclusions

The results of this study showed that nurses faced several challenges in providing care to earthquake victims. Based on these findings, better educational management and planning, infrastructure reform, and establishment of a crisis nursing national team seem necessary.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00605-3.

Nurses' Roles in Nursing Disaster Model: A Systematic Scoping Review

Background:

Nurses have a continuous presence and crucial role in response to disasters. During disasters, nurses apply specific knowledge and skills to minimize victims’ health and life-threatening risks. Nurses’ roles in crisis are not clearly stated in resources. Thus, this study aimed to explore nurses’ role in the nursing disaster model.

Methods:

A scoping review was conducted using Joanna Briggs Institute framework. The review considered primary research and reviewed literature from following databases, including Web of Science, Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMed, Scopus, and Google Scholar, as well as the reference lists of articles identified for full-text review. Eligibility criteria were outlined as a priori to guide the literature selection.

Results:

Eight of 60 eligible articles met the inclusion criteria. The studies were conducted in different countries with no limit of time of published articles. The publications’ design were three systematic reviews, one meta-synthesis, two qualitative types of research, one quasi-experimental, and one case study. The results showed nurses’ roles in the three stages before, during, and after the crisis.

Conclusion:

This review provided a comprehensive understanding of the concept of the nursing role in the crisis, and nurses could be useful to save victims through preparing and implementing effective care at different stages of a crisis.