1
|
Assessment of Emergency Department Staff Awareness of Policy and Expert Opinion Protocol Regarding Active Shooter Events. Disaster Med Public Health Prep 2022; 17:e168. [PMID: 35765151 DOI: 10.1017/dmp.2022.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Active shooter incidents (ASI) have continued to increase over the years, with the majority of attacks occurring in the workplace. Workplace violence in the hospital setting is a growing concern in the emergency department (ED). While ASI are inherently unpredictable by nature, it is prudent to be prepared for these scenarios in the hospital to prevent fatalities. The goal of this study is to access the level of familiarity of emergency department staff with ASI hospital policy and response protocol. METHODS A survey of ED employees was distributed using the Qualtrics® platform via an electronic link. The study was approved by the University of Central Florida College of Medicine's IRB. RESULTS Only 10% had participated in an ASI drill in the past year. Personnel who answered "no" to the question, To your knowledge, is there a hospital-based emergency action plan in the event of ASI?, were significantly more likely to feel unprepared for an ASI (P < 0.0001). Those who did not receive training for a hospital-based emergency action plan were similarly less likely to feel prepared (P = 0.0002). CONCLUSION Most ED providers in the survey reported feeling unprepared to handle an ASI in the emergency department. This study underscores the need to implement regular training on ASIs for ED staff.
Collapse
|
2
|
Kim JJ, Howes D, Forristal C, Willmore A. The Code Silver Exercise: a low-cost simulation alternative to prepare hospitals for an active shooter event. Adv Simul (Lond) 2021; 6:37. [PMID: 34674767 PMCID: PMC8529569 DOI: 10.1186/s41077-021-00190-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 10/09/2021] [Indexed: 11/24/2022] Open
Abstract
Mass-shooting incidents have been increasing in recent years and Code Silver—the hospital response to a person with a weapon such as an active shooter in many Provinces or States in North America—is quickly shifting from a theoretical safety measure to a realistic scenario for which hospitals must prepare their staff. A Code Silver Exercise (CSE) involving an independent mental practice exercise with written responses to scenarios and questions, followed by a facilitated debrief with all participants, was conceptualized and trialled for feasibility and efficacy. The CSE was piloted as a quality improvement and emergency preparedness initiative in three different settings including in situ within a hospital Emergency Department or Intensive Care Unit, offsite in a large conference room workshop, and online via virtual platform. These sessions took place in 4 different cities in Canada and included 3 academic teaching hospitals. Participants of the in situ and virtual CSE completed pre- and post-simulation surveys which showed improved understanding of Code Silver protocols following participation. The CSE is a reproducible simulation alternative, designed to operationalize a Code Silver policy at a large healthcare institution in a sustainable way. This training model can be administered in multiple settings in-person (in situ or offsite), and virtually, making it versatile and easily accessible for participants. This exercise enables participants to mentally rehearse practical responses to an active shooter in their unique work environments and to discuss ethical and medical-legal implications of their responses during a facilitated debrief with fellow healthcare providers. Implementation of a CSE for training in hospitals may help staff to create a mental schema prior to an active shooter event, and thus indirectly improve the chances of survivability in the event of a real active shooter situation.
Collapse
Affiliation(s)
- Julie J Kim
- Department of Medicine, Division of Emergency Medicine, Lawson Research Institute, Western University, London, Ontario, Canada. .,Department of Emergency Medicine, London Health Sciences Centre, Victoria Hospital Campus, 800 Commissioners Road East, Room E1-125, London, Ontario, N6A 5W9, Canada.
| | - Daniel Howes
- Department of Critical Care Medicine, Queens University, 76 Stuart Street, Kingston, Ontario, K7L 2V7, Canada
| | - Chantal Forristal
- Department of Medicine, Division of Emergency Medicine, Lawson Research Institute, Western University, London, Ontario, Canada.,Department of Emergency Medicine, London Health Sciences Centre, Victoria Hospital Campus, 800 Commissioners Road East, Room E1-125, London, Ontario, N6A 5W9, Canada
| | - Andrew Willmore
- Department of Emergency Medicine, University of Ottawa, 1053 Carling Avenue, Ottawa, Ontario, K1Y 4E9, Canada.,Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada
| |
Collapse
|