Physician Emergency Preparedness: A National Poll of Physicians

Barriers faced by primary healthcare providers in addressing emergencies in the Northern region of Palestine before and during the Gaza war

INTRODUCTION

Physicians working in primary health care (PHC) centers are the first contact for patients and expected to deal with emergencies. Emergency care training in PHC settings has been neglected globally, especially in low to middle income countries. Adequate preparation becomes especially important during periods of conflict. The study objectives are to identify the barriers facing PHC physicians when dealing with emergency cases in the northern region of Palestine during the current conflict.

METHODS

A cross-sectional study was conducted with 179 physicians working in the 10 PHC centers distributed among 5 northern governances in Palestine. The study period was from July through December 2023. Data were collected electronically using a self-administered questionnaire, which was adapted from a comprehensive literature review. The questionnaire's internal validity was confirmed by a Cronbach's alpha coefficient of [0.85], indicating high reliability.

RESULTS

The ages of the physicians ranged from 25 to 60 years, with a mean ± SD of 35.3 ± 8.15 years. A significant majority (91.6%) were not boarded in any specialty. Most physicians (85.5%) had attended Basic Life Support (BLS) courses, whereas 45.2% and 72% had never attended Advanced Cardiovascular Life Support (ACLS) or Advanced Trauma Life Support (ATLS) courses, respectively. Physicians with emergency department experience (P = 0.002) and those who had attended ACLS courses (P < 0.001) reported significantly higher perceived competence in managing emergency cases.

CONCLUSION

Emergency services at PHC centers in northern Palestine are operational but require significant enhancements. There is a critical need for increased availability of essential equipment, supplies, and medications. Additionally, implementing comprehensive training programs in emergency management, particularly ACLS, is essential to improve the competence and performance of PHC physicians in emergency situations.

Pre-COVID-19 Physician Awareness of Mental Health Resources During and After Natural and Human-Made Disasters

OBJECTIVE

Physician mental health is critical during the recovery of natural and human-made disasters (NHDs), yet the accessibility of mental health resources to physicians has not been characterized. This study examined emergency medicine and trauma physician knowledge of and access to mental health resources in NHD settings.

METHODS

The survey was electronically disseminated to the American College of Emergency Physicians and the American Association of the Surgery of Trauma between February 4, 2020, and March 9, 2020. The 17-question survey assessed physician awareness and access to emergency preparedness resources at their institutions.

RESULTS

Of the responders, 86% (n = 229) were aware of written emergency response plans for their facility. While 31% were aware of the hospital's mental health policies and resources outside of the emergency response plan, only 25% knew how to access these resources during and after NHDs. Finally, 10% reported the incorporation of mental health resources during institutional practice drills.

CONCLUSIONS

Physicians reported knowledge of emergency preparedness policies; however, significant gaps remain in physician knowledge and access to mental health resources NHD settings. As NHDs increase on a global scale, it is critical for health systems to ensure accessible infrastructure to support the mental well-being of health professionals.

Attitudes and Response Capacities for Public Health Emergencies of Healthcare Workers in Primary Healthcare Institutions: A Cross-Sectional Investigation Conducted in Wuhan, China, in 2020

OBJECTIVES

Response capacities for public health emergencies (PHEs) amongst healthcare workers play important roles in the prevention and control of PHEs. This study assessed the attitudes and response capacities of PHE workers in primary healthcare (PHC) institutions.

METHODS

An online anonymous questionnaire survey of 803 healthcare workers sampled from 13 PHC institutions in Wuhan, China, was conducted from April to June 2020. The Kruskal-Wallis test and linear regression model were used to analyze the response capacities of PHE workers and associated factors.

RESULTS

The healthcare workers with longer working years, particularly 30 years and above, had higher knowledge (OR = 7.323, p < 0.001) and practical ability scores (OR = 8.012, p < 0.001) when compared to those with less than 5 working years. The nurses had higher practical ability scores (OR = 2.188, p = 0.049), and pharmacists had lower practical ability scores (OR = 0.166, p = 0.007), when compared to doctors. Moreover, the healthcare workers who had never participated in educational activities related to PHE management in the past two years (OR = 0.540, p = 0.038; OR = 0.282, p = 0.001), had not participated in a PHE drill activity (OR = 0.327, p < 0.001; OR = 0.340, p = 0.004), and had never been involved in emergency management of PHEs (OR = 0.254, p < 0.001; OR = 0.174, p < 0.001) had lower knowledge and practical ability scores.

CONCLUSION

The healthcare workers with longer working years had better response capacities, and nurses had better practical abilities when compared to doctors. More emergency management education and chances to be involved in PHE drill activities were encouraged amongst healthcare workers in PHC institutions for better prevention and control of PHEs. Moreover, inter-institution cooperation, a flexible response system, and dynamic adjustment of healthcare workers were suggested during PHEs.

Quality of life and emergency preparedness of MHO staff: role of psychological capital and perceived organizational support

PURPOSE

Enhancing the initiative and enthusiasm of emergency preparedness behaviors among Medical and Health Organization (MHO) staff is an effective measure to prevent and reduce losses from emergencies. In this study, emergency preparedness behavioral intentions were divided into noncooperative behavioral intentions (EPNCBI) and cooperative behavioral intentions (EPCBI) to discuss the impact brought by quality of life (QoL). The mediating effects of psychological capital (PsyCap) and perceived organizational support (POS) were also considered.

DESIGN/METHODOLOGY/APPROACH

A web-based questionnaire was used for MHO staff in China, and a structural equation analysis of the data collected from 243 participants was conducted to test the hypotheses.

FINDINGS

The empirical results reveal that: (1) QoL had a positive effect on EPNCBI, PsyCap and POS; (2) PsyCap had a positive effect on EPNCBI and EPCBI; (3) POS had a positive effect on PsyCap and EPCBI; (4) PsyCap mediated the relationship between QoL and EPNCBI, and the relationship between POS and EPNCBI; (5) PsyCap and POS mediated the relationship between QoL and EPCBI.

PRACTICAL IMPLICATIONS

Improving MHO staff's QoL is an effective way to enhance positive behavioral outcomes. Furthermore, these findings could provide managers with valuable insight focusing their limited resources on enhancing the emergency preparedness of MHO staff by reinforcing the level of PsyCap and POS.

ORIGINALITY/VALUE

This study provides important updated considerations for the application of positive psychology in the field of emergency preparedness.

Evaluation of Disability Education and Emergency Preparedness Curricula of Physician Assistant Programs

OBJECTIVE

The purpose of this pilot study was to evaluate whether physician assistant (PA) programs in the Midwest integrate both disabilities and emergency preparedness education into 1 curriculum.

METHODS

A convenience sample was utilized to survey program directors and deans of PA programs. Emails were obtained from the Physician Assistant Education Association. A 26, closed-ended question Qualtrics survey was based on an original study by Tanenhaus et al.

RESULTS

Out of 43 accredited physician assistant programs surveyed, 9 programs replied (21%), and 1 program did not complete the survey. Six of the 10 programs (66%) responded that their program provided lectures specific to emergency preparedness. All 9 programs responded they do not offer a graduate-level track or concentration in emergency/disaster preparedness, and they do not offer a dual degree or a multidisciplinary program that highlights emergency/disaster preparedness.

CONCLUSIONS

This study was conducted to bring awareness to physician assistant students' education regarding disabilities and emergency preparedness. As public health crises continue to arise, such as coronavirus disease (COVID-19), it is critical to have appropriately trained health care professionals. The study revealed that most programs lack a graduate-level track or concentrations, dual degrees, or extracurricular opportunities related to disabilities and emergency and disaster preparedness.

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.

'It's our job': Constraints to investigation of atypical disease events-Opinions of Australian veterinarians

Frontline health practitioners need to be adequately prepared to recognize and respond to atypical disease presentations, some of which may have zoonotic potential. Data from previous research have suggested that veterinarians may face challenges in investigation of disease events due to time and money constraints. As part of an Australia-wide survey project, veterinarians were asked to answer an open-ended question regarding potential constraints in investigation of atypical disease events where there may be concern about a zoonosis or emerging infectious disease. Qualitative data were analysed using thematic content analysis with the consideration of the respondent's area of practice and level of experience. Five main themes were identified which encapsulated constraints to disease investigation described by participants, namely: (a) financing of disease investigations, including client willingness/ability to pay in absence of alternative government schemes; (b) client-related factors, including willingness to consent to investigation and comply with instructions; (c) professional preparedness to act, related to practitioner knowledge and technical competency; (d) workplace environment, impacted by physical, logistical and managerial aspects of workplaces; and (e) access to external technical support, primarily from government veterinary services. Successful investigation and management of atypical diseases, including potential zoonoses, requires preparedness of all veterinarians. Continuing professional education for veterinarians in infection prevention and control and biosecurity, alongside adequate government funding and support will help facilitate optimal health and biosecurity outcomes. Both state and federal governments need to review existing animal health structures to ensure cohesive responses for future disease events.

How Do Doctors and Nurses in Emergency Departments in Hong Kong View Their Disaster Preparedness? A Cross-Sectional Territory-Wide Online Survey

Objectives

To assess the level of all-hazards disaster preparedness and training needs of emergency department (ED) doctors and nurses in Hong Kong from their perspective, and identify factors associated with high perceived personal preparedness.

Design

This study was a cross-sectional territory-wide online survey conducted from 9 September to 26 October, 2015.

Participants

The participants were doctors from the Hong Kong College of Emergency Medicine and nurses from the Hong Kong College of Emergency Nursing.

Methods

We assessed various components of all-hazards preparedness using a 25-item questionnaire. Backward logistic regression was used to identify factors associated with perceived preparedness.

Results

A total of 107 responses were analyzed. Respondents lacked training in disaster management, emergency communication, psychological first aid, public health interventions, disaster law and ethics, media handling, and humanitarian response in an overseas setting. High perceived workplace preparedness, length of practice, and willingness to respond were associated with high perceived personal preparedness.

Conclusions

Given the current gaps in and needs for increased disaster preparedness training, ED doctors and nurses in Hong Kong may benefit from the development of core-competency-based training targeting the under-trained areas, measures to improve staff confidence in their workplaces, and efforts to remove barriers to staff willingness to respond. (Disaster Med Public Health Preparedness. 2018; 12: 329–336)