Hawaii Physician and Nurse Bioterrorism Preparedness Survey

Effects of a mobile-based bioterrorism response program among clinical nurses: A quasi-experimental study

BACKGROUND

To respond to unstable international security and the outbreak of new infectious diseases, clinical nurses should be equipped with bioterrorism response competencies.

OBJECTIVES

This study developed a mobile-based bioterrorism response program for clinical nurses and examined its effectiveness on their knowledge of bioterrorism, attitude toward bioterrorism response, and bioterrorism response competencies.

DESIGN

A quasi-experimental study design was used.

SETTING

General or tertiary general hospitals in South Korea were considered.

PARTICIPANTS

Participants were 45 clinical nurses (23 in the experimental group and 22 in the control).

METHODS

The mobile-based bioterrorism response program was conducted over three weeks in 10 sessions (total of 300 min). The knowledge of bioterrorism, attitude toward bioterrorism response, and bioterrorism response competencies were compared between two groups using paired t-test, and Wilcoxon signed ranks test. Satisfaction with the program was measured in the experimental group.

RESULTS

Upon completion of the mobile-based bioterrorism response program, the experimental group showed significant increases in knowledge of bioterrorism, attitude toward bioterrorism response, and bioterrorism response competencies.

CONCLUSIONS

The mobile-based bioterrorism response program is expected to contribute to better preparedness for bioterrorism response systems in clinical practice. In addition, this program is expected to be of valuable use in bioterrorism education for nursing students as well as other healthcare professionals involved in bioterrorism response.

Determinants of health volunteer training in natural hazard management in Iran

Both natural and man-made dangers cause bodily harm, as well as social, economic and environmental harm. In order to minimise the complications of these threats, proper training and preparedness are crucial. The purpose of this study was to look at the factors that affect how well-trained healthcare volunteers are for natural hazards in Iran. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach, a systematic review of literature on the factors influencing the training of healthcare volunteers in natural hazard published between 2010 and 2020 was conducted. The Google Scholar search engine, PubMed (Medline and Central), Science Direct and Web of Science databases were searched using both individual and combined key phrases. The Strengthening the Reporting of Observational studies in Epidemiology checklist was used to select and evaluate 592 observational and quasi-experimental articles. Finally, the study comprised 24 papers that satisfied the research criteria and made good use of good technique, sample size and adequate tools for validity and reliability. The most useful variables for disaster preparedness were job self-efficacy, strategic decision-making and quality of work-life, job performance, job motivation, knowledge, awareness and health literacy.

Contribution

To avoid calamity, a thorough training program is required. Therefore, the most crucial objectives for health education specialists are to identify the factors that determine disaster preparedness, train volunteers and provide fundamental techniques to reduce natural dangers.

Predictors of bioterrorism preparedness among clinical nurses: A cross-sectional study

BACKGROUND

Bioterrorism is terrorism that causes death, injury, or illness by the intentional release of viruses, bacteria, fungi, or toxins. Bioterrorism cannot be prevented; therefore, having the ability to recognize and respond to the consequences of infection caused by biological agents is imperative. This study aimed to examine the level of bioterrorism preparedness and identify the influencing factors of bioterrorism preparedness among nurses, who are early responders to bioterrorism.

METHODS

This study had a predictive correlational study design. It surveyed 245 clinical nurses currently working in general hospitals. We used a structured questionnaire consisting of items about general characteristics, knowledge about bioterrorism, awareness of bioterrorism risk, perception of institutional bioterrorism preparedness, attitude toward bioterrorism, and bioterrorism preparedness. The collected data were analyzed using descriptive statistics and by performing a t-test, chi-square test, analysis of variance, post-hoc test, correlational analysis, and regression analysis.

RESULTS

Bioterrorism preparedness was significantly positively correlated with the perception of institutional and frontline bioterrorism preparedness and attitude toward bioterrorism. It was also significantly influenced by sex, undergraduate bioterrorism education, employee bioterrorism education, perception of governmental bioterrorism preparedness, and attitude toward bioterrorism. The greatest predictors of bioterrorism preparedness were attitude toward bioterrorism, perception of institutional bioterrorism preparedness, and undergraduate bioterrorism education, which explained 39 % of the variance of bioterrorism preparedness.

CONCLUSION

This study found that clinical nurses' awareness and attitude toward bioterrorism are important factors in their bioterrorism preparedness and that attention to and education about bioterrorism are crucial to enhance clinical nurses' bioterrorism preparedness. Continued research is needed to establish a bioterrorism response system and relevant educational programs.

Effects of bloom's mastery learning model based on CBRN preparedness program on learning skills of nursing students: A randomized controlled trial

BACKGROUND

Exposure to chemical, biological, radiological and nuclear (CBRN) threats and hazards can have fatal or disabling consequences. One of the most risky groups in terms of secondary contamination in CBRN exposure is healthcare workers. Nurses need to have several competencies to be able to respond correctly to people exposed to CBRN agents and to protect themselves from secondary contamination.

AIM

This study aimed to investigate the effectiveness of a Bloom's Mastery Learning Model-based Chemical, Biological, Radiological, Nuclear Threat and Hazards Preparedness Program for nursing students (MLM-CBRN Preparedness Program) as a means for improving knowledge, attitudes, self-efficacy and skills.

DESIGN

A parallel-group trial design was used.

METHODS

A total of 104 4th-year nursing students were randomized into intervention and control groups. The data from the participants were collected before the intervention, immediately after the intervention and in the 1st and 3rd months after the intervention.

RESULTS

After the intervention, a significant difference was observed between the groups in terms of knowledge, attitude and self-efficacy scores. It was seen that there was a significant difference between the pre-intervention measurement (1st measurement) and the 2nd, 3rd and 4th measurements (Table 2). This was due to the increasing scores of the intervention group (p < 0.05).

CONCLUSIONS

It shows that the MLM-CBRN Preparedness Program is effective in increasing the knowledge, attitude, self-efficacy and skill development of student nurses about CBRN threats and dangers.

Factors Influencing Preparedness for Bioterrorism among Koreans

Bioterrorism is destructive enough to cause a societal collapse, and preparation for bioterrorism is imperative. This study aims to identify the factors influencing preparedness for bioterrorism among Koreans. A total of 1050 subjects were included in the study, which were allocated according to region and age in proportion to population. An online survey was used to examine the following factors: participants' general characteristics; cognitive factors including perceived probability, perceived seriousness, perceived personal impact, perceived coping efficacy, and perceived resilience; social-contextual factors including perceived governmental preparedness and perceived front-line preparedness; affective responses including affective response to terrorism and anxiety; and bioterrorism preparedness. The factors influencing the level of preparedness for bioterrorism included age, marital status, experience of bioterrorism education, perceived personal impact, perceived coping efficacy, perceived resilience, and perceived front-line preparedness. The factors that most significantly affected the level of preparedness for bioterrorism were perceived coping efficacy and perceived front-line preparedness, with an R2 of 41.4%. Relevant education and public relations programs should be strengthened to help citizens minimize their exposure and known to inform relevant institutions in the event of suspected bioterrorism, and front-line responders should cultivate their ability to respond to bioterrorism quickly and accurately.

Knowledge and preparedness of healthcare providers towards bioterrorism

Background

Several emergent circumstances require healthcare providers to recognize the unusual and dangerous and pathogenic agents. An in-depth literature review showed that studies about bioterrorism preparedness amongst healthcare providers are lacking. Therefore, this study aimed to investigate the knowledge and preparedness level of first emergency respondents towards bioterrorism events.

Methods

This study has a cross-sectional design and was carried out at the Emergency departments and poison control centers/clinical laboratories three in major tertiary care hospitals in Riyadh, Saudi Arabia. The subjects were randomly selected to complete the self-administered questionnaire to collect study outcomes.

Results

A total of 1030 participants were included in the final data analysis. The mean knowledge score in the basic concepts of bioterrorism and introductory clinical presentations of bioterrorism-related agents was 4.92 ± 1.86 out of 12 points.

Moreover, the findings showed a mean knowledge score of 22.80 ± 3.92 out of 38 in the bioterrorism preparedness and governing policies and procedures. Respondents who received previous training in bioterrorism preparedness had a significantly higher number of perceived benefits than those not sure and without prior training (z = − 2.67, p = 0.008) and (z = − 4.4, p < 0.0001), respectively. About 79.4% of participants did not have previous training in bioterrorism preparedness, but 68.7% expressed willingness in the institution’s response and control to assist in a bioterrorist attack incident.

Conclusion

Although healthcare professionals have reported their desire to help in bioterrorism events, they need to enhance their knowledge of bioterrorism preparedness.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-021-06442-z.

Disaster preparedness amongst pharmacists and pharmacy students: a systematic literature review

Objectives

In the aftermath of a disaster, the services provided by pharmacists are essential to ensure the continued health and well-being of the local population. To continue pharmacy services, it is critical that pharmacists are prepared for disasters. A systematic literature review was conducted to explore pharmacists’ and pharmacy students’ preparedness for disasters and the factors that affect preparedness.

Methods

This review was conducted in April 2020 through electronic databases CINAHL, MEDLINE, Embase, PubMed, Scopus and PsycINFO, and two disaster journals. Search terms such as ‘pharmacist*’, ‘disaster*’ and ‘prepared*’ were used. The search yielded an initial 1781 titles. Articles were included if they measured pharmacists or pharmacy students’ disaster preparedness. After screening and quality appraisal by two researchers, four articles were included in final analysis and review. Data were extracted using a data collection tool formulated by the researchers. Meta-analysis was not possible; instead, results were compared across key areas including preparedness ratings and factors that influenced preparedness.

Key findings

Three articles focused on pharmacy students’ preparedness for disasters, and one on registered pharmacists’ preparedness. Preparedness across both groups was poor to moderate with &lt;18% of registered pharmacists found to be prepared to respond to a disaster. Factors that potentially influenced preparedness included disaster competency, disaster interventions and demographic factors.

Conclusion

For pharmacists, the lack of research around their preparedness speaks volumes about their current involvement and expectations within disaster management. Without a prepared pharmacy workforce and pharmacy involvement in disaster management, critical skill and service gaps in disasters may negatively impact patients.

Disaster Knowledge, Skills, and Preparedness Among Nurses in Bengkulu, Indonesia: A Descriptive Correlational Survey Study

INTRODUCTION

Registered nurses have to adequately prepare to respond to disasters, as they have become increasingly frequent worldwide. The aim of this study was to identify the factors influencing registered nurses' disaster preparedness in Bengkulu, Indonesia.

METHODS

This study used a descriptive correlational study design. A total of 130 registered nurses working in 2 governmental hospitals in Bengkulu, Indonesia, were recruited by using a convenience sampling technique. A self-administered questionnaire, the Disaster Preparedness Evaluation Tool, was used to determine their current levels of registered nurses' disaster preparedness.

RESULTS

The registered nurses reported a moderate level of disaster knowledge, skills and preparedness. Their knowledge and skills were significantly correlated with disaster preparedness (r = 0.39-0.71, P < 0.01). Three significant factors associated with disaster preparedness were identified in this study: educational level, disaster knowledge, and disaster skills (R² = 0.31, F = 12.60, P < 0.001).

DISCUSSION

Continuing disaster drills training and implementing a formal disaster educational program into nursing curriculum and professional development are recommended to achieve effective disaster preparedness in the hospital setting.

Disaster Management: Knowledge, Attitude, Behavior, Willingness, and Preparedness among Nigerian Dentists

Objective:

This study’s objective was to explore the disaster management knowledge, attitude, behavior, willingness, and assistance among Nigerian dentists.

Methods:

This cross-sectional, questionnaire-based study was conducted in Edo State (Nigeria) among selected Nigerian dentists that attended the Annual Scientific Conference of School of Dentistry, University of Benin (Benin City, Nigeria) between 2016 and 2017. The 54-item, modified Chhabra, et al disaster management questionnaire, which elicited information on demographic characteristics, disaster management knowledge, attitude, preparedness, and willingness, was the data collection tool.

Results:

A total of 126 dentists participated in the study, giving a 68.1% retrieval rate. The willingness to render assistance in the case of disaster among the participants was 95.2%. More than three-quarters (81.0%) reported that they had not received any disaster management training and 92.9% reported that they were not familiar with any government paper on response to disaster. The mean disaster management knowledge and attitude scores were 16.95 (SD = 0.40) and 34.62 (SD = 0.56), respectively. Disaster management knowledge had positive significant correlation with attitude and behavior. The disaster management attitude had positive significant correlation with behavior and negative significant correlation with preparedness. Disaster management behavior had positive significant correlation with preparedness and willingness to render assistance. Willingness to render assistance had significant correlation with preparedness.

Conclusion:

Data from this study revealed high-level of willingness to render assistance in disaster, high disaster management attitude, but with low disaster management knowledge, behavior, and preparedness. The significant correlation between knowledge, attitude, behavior, and preparedness implies that training will offer immense benefit.

Odai ED, Azodo CC, Chhabra KG. Disaster management: knowledge, attitude, behavior, willingness, and preparedness among Nigerian dentists.Prehosp Disaster Med. 2019;34(2):132–136

Nurses' and Medical Officers' Knowledge, Attitude, and Preparedness Toward Potential Bioterrorism Attacks

Terrorist attacks are increasingly becoming more lethal and less discriminate. The threat of bioterrorism is increasing daily. The ease of production and the broad availability of biological agents and technical know-how have led to a further spread of biological weapons and an increased desire among nations as well as terrorists to have them. Health professionals in emergency departments are expected to play crucial roles in the management of victims of bioterrorism when bioterrorism occurs. This study explored the knowledge, attitudes, and preparedness of emergency department nurses and medical officers (MOs) toward potential bioterrorist attacks in Ghana. This qualitative study utilized focus group discussions and semistructured interviews to explore the knowledge, attitudes, and preparedness of emergency department nurses and MOs toward potential bioterrorist attacks in Ghana. Data were subjected to a qualitative content analysis in which three main thematic categories were developed. These thematic categories are as follows: (a) differences in bioterrorism knowledge between emergency department nurses and emergency department MOs, (b) unprepared emergency department nurses and MOs for care during bioterrorism attacks, and (c) positive attitudes of emergency department nurses and MOs toward bioterrorism preparedness. Although emergency MOs had better knowledge of bioterrorism than their nursing counterparts, both groups of health professionals were unprepared to respond to any form of bioterrorism. Both nurses and MOs indicated the need for staff education and infrastructure readiness to be able to respond effectively to a bioterrorist attack. A well-prepared emergency department and health professionals against bioterrorism could prevent high casualty rates in a bioterrorist attack and also serve a dual purpose of dealing with other natural disasters when they occur.

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)

Physician Emergency Preparedness: A National Poll of Physicians

OBJECTIVE

To provide a more comprehensive view than previously available of US physician preparedness for public health emergencies, this study examined physicians' assessments of their preparedness, training, participation in institutional activities, information practices, and experiences with patient education. Four kinds of public health emergencies were considered: natural disasters, major airborne infections, major foodborne illness outbreaks, and chemical, biological, radiological, nuclear, or explosives (CBRNE) incidents.

METHODS

Between October 19, 2011, and January 11, 2012, researchers conducted a national poll among 1603 practicing physicians in a range of specialties in hospital and nonhospital settings.

RESULTS

More than one-half of physicians felt prepared to handle a natural disaster, a major outbreak of an airborne infection, or a major foodborne illness outbreak, whereas one-third (34%) felt prepared to handle a CBRNE incident. About one-half of physicians (55%) had participated in training or a conference related to emergencies in the past 2 years. Sizable fractions of physicians were unaware of emergency response tools in their care setting. For example, nearly one-half in hospitals (44%) did not know whether their care setting had an emergency response plan, and less than one-quarter had participated in a drill using such a plan in the past 2 years. Less than one-third (31%) of physicians had signed up to receive alerts in the case of future emergencies. One in 10 reported sharing emergency information with patients at least "sometimes."

CONCLUSIONS

Significant gaps remain in physician preparedness for public health emergencies, as well as in related training and participation in institutional activities. New efforts, with a focus on possible collaborations between public health institutions and health system leaders combined with effective use of online resources, are needed to bring more physicians on board and to develop relevant and useful key tools. New approaches, including those that rely on different types of care providers, may be needed to enhance patient education regarding emergency preparedness.

Cross-sectional survey of the disaster preparedness of nurses across the Asia-Pacific region

Healthcare workers who have received disaster preparedness education are more likely to report a greater understanding of disaster preparedness. However, research indicates that current nursing curricula do not adequately prepare nurses to respond to disasters. This is the first study to assess Asia-Pacific nurses' perceptions about their level of disaster knowledge, skills, and preparedness. A cross-sectional survey was conducted with 757 hospital and community nurses in seven Asia-Pacific countries. Data were collected using the modified Disaster Preparedness Evaluation Tool. Participants were found to have overall low-to-moderate levels of disaster knowledge, skills and preparedness, wherein important gaps were identified. A majority of the variance in disaster preparedness scores was located at the level of the individual respondent, not linked to countries or institutions. Multilevel random effects modelling identified disaster experience and education as significant factors of positive perceptions of disaster knowledge, skills, and management. The first step toward disaster preparedness is to ensure frontline health workers are able to respond effectively to disaster events. The outcomes of this study have important policy and education implications.

A Comprehensive Evaluation System for Military Hospitals' Response Capability to Bio-terrorism

The objective of this study is to establish a comprehensive evaluation system for military hospitals' response capacity to bio-terrorism. Literature research and Delphi method were utilized to establish the comprehensive evaluation system for military hospitals' response capacity to bio-terrorism. Questionnaires were designed and used to survey the status quo of 134 military hospitals' response capability to bio-terrorism. Survey indicated that factor analysis method was suitable to for analyzing the comprehensive evaluation system for military hospitals' response capacity to bio-terrorism. The constructed evaluation system was consisted of five first-class and 16 second-class indexes. Among them, medical response factor was considered as the most important factor with weight coefficient of 0.660, followed in turn by the emergency management factor with weight coefficient of 0.109, emergency management consciousness factor with weight coefficient of 0.093, hardware support factor with weight coefficient of 0.078, and improvement factor with weight coefficient of 0.059. The constructed comprehensive assessment model and system are scientific and practical.

Undergraduate nursing students' perceptions about disaster preparedness and response in Istanbul, Turkey, and Miyazaki, Japan: a cross-sectional study

AIM

Although the awareness of disasters has increased among nurses, the concept of disaster preparedness and response has not been sufficiently explored with undergraduate nursing students. The aim of this study was to assess and compare the perceptions of students regarding disaster preparedness and response that live in different earthquake-prone cities; Istanbul, Turkey and Miyazaki, Japan.

METHODS

A cross-sectional study employing seven questions was conducted in a final group of 1053 nursing students from Istanbul, Turkey, and Miyazaki, Japan.

RESULTS

Most study respondents were female, aged 18-22 years, with a high proportion of second year students in both cities. Istanbul's students had more knowledge about disaster preparedness and response in relation to age and year of university, showing statistically significant differences. Istanbul's highest rated responses to disaster characteristics were on structural elements and injuries/deaths, while Miyazaki's was "unpredictable/sudden/disorganized". Respondents in Istanbul identified earthquakes as the disaster most likely to occur, while respondents in Miyazaki identified typhoon/hurricane. Study participants responded that they could provide caregiver roles during a disaster event rather than triage or managerial roles as disaster responders.

CONCLUSION

Disaster characteristics were not described by one third of the students. Of the two-thirds that were described, most were of events that were highly predictable because of their frequencies in the given areas. Universities need to target and then focus on high-risk factors in their areas and have disaster plans for students who can provide triage and managerial nursing roles as disaster responders.

When and why health care personnel respond to a disaster: the state of the science

OBJECTIVE

Emergency response relies on the assumption that essential health care services will continue to operate and be available to provide quality patient care during and after a patient surge. The observed successes and failures of health care systems during recent mass-casualty events and the concern that these assumptions are not evidence based prompted this review.

METHOD

The aims of this systematic review were to explore the factors associated with the intention of health care personnel (HCP) to respond to uncommon events, such as a natural disaster or pandemic, determine the state of the science, and bolster evidence-based measures that have been shown to facilitate staff response.

RESULTS

Authors of the 70 studies (five mixed-methods, 49 quantitative, 16 qualitative) that met inclusion criteria reported a variety of variables that influenced the intent of HCP to respond. Current evidence suggests that four primary factors emerged as either facilitating or hindering the willingness of HCP to respond to an event: (1) the nature of the event; (2) competing obligations; (3) the work environment and climate; and (4) the relationship between knowledge and perceptions of efficacy.

CONCLUSIONS

Findings of this study could influence and strengthen policy making by emergency response planners, staffing coordinators, health educators, and health system administrators.

Disaster preparedness: what training do our interns receive during medical school?

Disaster preparedness training is a critical component of medical student education. Despite recent natural and man-made disasters, there is no national consensus on a disaster preparedness curriculum. The authors designed a survey to assess prior disaster preparedness training among incoming interns at an academic teaching hospital. In 2010, the authors surveyed incoming interns (n = 130) regarding the number of hours of training in disaster preparedness received during medical school, including formal didactic sessions and simulation, and their level of self-perceived proficiency in disaster management. Survey respondents represented 42 medical schools located in 20 states. Results demonstrated that 47% of interns received formal training in disaster preparedness in medical school; 64% of these training programs included some type of simulation. There is a need to improve the level of disaster preparedness training in medical school. A national curriculum should be developed with aspects that promote knowledge retention.

Disaster preparedness in an Australian urban trauma center: staff knowledge and perceptions

INTRODUCTION

A substantial barrier to improving disaster preparedness in Australia is a lack of prescriptive national guidelines based on individual hospital capabilities. A recent literature review revealed that only one Australian hospital has published data regarding its current preparedness level.

OBJECTIVES

To establish baseline levels of disaster knowledge, preparedness, and willingness to respond to a disaster among one hospital's staff, and thus enable the implementation of national disaster preparedness guidelines based on realistic capabilities of individual hospitals.

METHODS

An anonymous questionnaire was distributed to individuals and departments that play key roles in the hospital's external disaster response. Questions concerned prior education and experience specific to disasters, general preparedness knowledge, perceived preparedness of themselves and their department, and willingness to respond to a disaster from a conventional and/or chemical, biological, or radiological incident.

RESULTS

Responses were received from 140 individuals representing nine hospital departments. Eighty-three participants (59.3%) had previously received disaster education; 53 (37.9%) had attended a disaster simulation drill, and 18 (12.9%) had responded to an actual disaster. The average disaster preparedness knowledge score was 3.57 out of 10. The majority of respondents rated themselves as "not really" prepared and were "unsure" of their respective departments' level of preparedness. Most respondents indicated a willingness to participate in both a conventional incident involving burns and/or physical trauma, and an incident involving chemical, biological or radiological (CBR) weapons.

CONCLUSIONS

Australian hospital staff are under-prepared to respond to a disaster because of a lack of education, insufficient simulation exercises, and limited disaster experience. The absence of specific national standards and guidelines through which individual hospitals can develop their capabilities further compounds the poverty in preparedness.

Factors Associated with Willingness to Respond to a Disaster: A Study of Healthcare Workers in a Tertiary Setting

Introduction: Due to recent disasters, disaster planners increasingly are focusing on healthcare worker preparedness and response in the event of a disaster. In this study, factors associated with pediatric healthcare workers’ willingness to respond are identified.

Hypothesis: It was hypothesized that personal factors may affect a pediatric healthcare worker’s willingness to respond to work in the event of a disaster.

Methods: Employees of a tertiary, pediatric care hospital in Los Angeles were asked to complete a brief, 24-question online survey to determine their willingness to respond in the event of a disaster. Information on demographics, employment, disaster-related training, personal preparedness, and necessary resources was collected. A logistic regression model was performed to derive adjusted odds ratios (OR) and their corresponding 95% confidence intervals (95% CI).

Results: Eight hundred seventy-seven pediatric healthcare employees completed the survey (22% response rate). Almost 50% (n = 318) expressed willingness to respond in the event of a disaster. Men were more likely to be willing to respond to a disaster than were women (OR = 2.4; 95%CI = 1.6–3.6), and single/divorced/widowed employees were more willing to respond than married or partnered employees (OR = 1.5; 95%CI = 1.1–2.1). An inverse relationship was observed between number of dependents and willingness to respond (OR = 0.45; 95%CI = 0.25–0.80, ≥3 dependents compared to 0). An inverse dose response relationship between commuting distance and number of necessary resources (ptrend = 0.0485 and 0.0001, respectively) was observed. There was no association between previous disaster experience, disaster training, or personal preparedness and willingness to respond.

Conclusions: Number of dependents and resources were major factors in willingness to respond. Healthcare facilities must clearly communicate their disaster plans as well as any provisions they may make for their employees’ families in order to improve willingness among hospital employees.

A survey of the practice of nurses' skills in Wenchuan earthquake disaster sites: implications for disaster training

AIMS

To determine nursing skills most relevant for nurses participating in disaster response medical teams; make recommendations to enhance training of nurses who will be first responders to a disaster site; to improve the capacity of nurses to prepare and respond to severe natural disasters.

BACKGROUND

Worldwide, nurses play a key role in disaster response teams at disaster sites. They are often not prepared for the challenges of dealing with mass casualties; little research exists into what basic nursing skills are required by nurses who are first responders to a disaster situation. This study assessed the most relevant disaster nursing skills of first responder nurses at the 2008 Wenchuan earthquake disaster site.

METHOD

Data were collected in China in 2008 using a self-designed questionnaire, with 24 participants who had been part of the medical teams that were dispatched to the disaster sites.

FINDINGS

The top three skills essential for nurses were: intravenous insertion; observation and monitoring; mass casualty triage. The three most frequently used skills were: debridement and dressing; observation and monitoring; intravenous insertion. The three skills performed most proficiently were: intravenous insertion; observation and monitoring; urethral catheterization. The top three ranking skills most important for training were: mass casualty transportation; emergency management; haemostasis, bandaging, fixation, manual handling.

CONCLUSION

The core nursing skills for disaster response training are: mass casualty transportation; emergency management; haemostasis, bandaging, fixation, manual handling; observation and monitoring; mass casualty triage; controlling specific infection; psychological crisis intervention; cardiopulmonary resuscitation; debridement and dressing; central venous catheter insertion; patient care recording.

Nurses' ability and willingness to work during pandemic flu

AIM

The present study reports factors affecting nurses' ability and willingness to work during pandemic flu (PF).

BACKGROUND

Previous studies suggest some nurses may be unable or unwilling to work during PF.

METHOD

A questionnaire was mailed to nurses during October to December 2009, the second wave of the 2009 A/H1N1 flu pandemic.

RESULTS

Most (90.1%) reported they would work. Willingness decreased primarily as personal protective equipment (PPE) dwindled, family or nurse were perceived to be at risk and when vaccine or antiviral medication was not provided to both nurse and family although many other factors also affected willingness to work. Ability decreased primarily when the nurse was sick, a loved one needed care at home or transportation problems existed although many other factors also affected ability to work.

CONCLUSION

Certain factors can decrease willingness and ability of nurses to work during a flu pandemic.

IMPLICATIONS FOR NURSING MANAGEMENT

Managers can anticipate factors that may decrease nurse's ability and willingness to work during pandemic flu. Preparing for staffing during emergencies can retain the health care workforce when it is needed most.

Computerized bioterrorism education and training for nurses on bioterrorism attack agents

BACKGROUND

Biological agents have the ability to cause large-scale mass casualties. For this reason, their likely use in future terrorist attacks is a concern for national security. Recent studies show that nurses are ill prepared to deal with agents used in biological warfare. Achieving a goal for bioterrorism preparedness is directly linked to comprehensive education and training that enables first-line responders such as nurses to diagnose infectious agents rapidly.

METHODS

The study evaluated participants' responses to biological agents using a computerized bioterrorism education and training program versus a standard bioterrorism education and training program.

RESULTS

Both programs improved participants' ability to complete and solve case studies involving the identification of specific biological agents.

CONCLUSION

Participants in the computerized bioterrorism education and training program were more likely to solve the cases critically without reliance on expert consultants. However, participants in the standard bioterrorism education and training program reduced the use of unnecessary diagnostic tests.

Bioterrorism knowledge and educational participation of nurses in Missouri

BACKGROUND

Nurses are integral to bioterrorism preparedness, but nurses' bioterrorism preparedness knowledge has not been evaluated well.

METHODS

Missouri Nurses Association members (1,528) were studied in the summer of 2006 to assess their bioterrorism knowledge and the perceived benefits of education as well as barriers to education.

RESULTS

The response rate was 31%. Most respondents (60%, n = 284) received no bioterrorism education. Nurses who were nurse practitioners (t = -2.42, p < .05), were male (t = -2.99, p < .01), or were on a planning committee (t = -1.96, p = .05) had received more education than other nurses. The most commonly cited barrier to education (46.6%, n = 221) was not knowing where to obtain training. One third of respondents (31.2%) reported no interest in receiving bioterrorism education in the future. Nurses' average score on the knowledge test was 73%. The most commonly missed questions pertained to infection control and decontamination procedures.

CONCLUSION

Bioterrorism preparedness training should be offered through continuing education and nursing school curricula.

Public health systems research in emergency preparedness: a review of the literature

BACKGROUND

Despite the acknowledged promise of developing a public health systems research (PHSR) agenda for emergency preparedness, there has been no systematic review of the literature in this area. The purpose of this study was to conduct a systematic literature review in order to identify and characterize the PHSR literature produced in the U.S. in the past 11 years in the field of public health emergency preparedness.

EVIDENCE ACQUISITION

Articles were searched in MEDLINE and EMBASE, as well as in the gray literature. Two independent reviewers classified the articles according to study design and IOM public health emergency preparedness (PHEP) research goal areas.

EVIDENCE SYNTHESIS

From January 1, 1997, through December 31, 2008, there were 547 articles that met the inclusion criteria that were published. It was possible to classify 314 (57%) articles into at least one of the four IOM PHEP research goal areas. Of these, 61 (11%) addressed Research Area 1 (usefulness of training); 39 (7%) addressed Research Area 2 (communications in preparedness and response); 193 (35%) addressed Research Area 3 (sustainable preparedness and response systems); and 39 (7%) addressed Research Area 4 (criteria and metrics to measure effectiveness and efficiency). Twenty-one studies (4%) could be classified into more than one category. The majority of the articles (81%), including commentaries/reviews and case studies, were based on qualitative analysis. Commentaries/review articles were the most common study types (62%).

CONCLUSIONS

Since 2001, the PHSR literature on PHEP issues has grown at about 33% per year. However, most studies lack a rigorous design, raising questions about the validity of the results.

Bioterrorism: Evaluating the preparedness of pediatricians in Michigan

OBJECTIVE

There is a paucity of literature in the United States regarding preparedness for a bioterrorist attack on children. The main objective of this study was to assess the self-reported level of bioterrorism preparedness of pediatricians practicing in Michigan.

METHODS

We conducted a survey that was mailed to 1000 pediatricians practicing in Michigan from July through December 2006. Survey questions were designed to evaluate the overall level of preparedness, as defined by the American Academy of Pediatrics, in dealing with a possible biological event and to describe key demographic variables.

RESULTS

Of the 590 pediatricians who responded (59%), a majority (80%) were general pediatricians, whereas 20% were pediatric subspecialists. Sixty percent of responders believe terrorism is a threat, with biological agents (52%; 95% confidence interval (CI), 48.00-56.12) as the most likely cause of an event. Half of the pediatricians who responded had a workplace disaster plan, but only 12% feel their preparedness for a biological attack/event was good. Sixty-six percent (392/590) were not currently Pediatric Advanced Life Support certified, 38% (95% CI,34.63-42.51) have never attended a lecture based on bioterrorism, 85% (95% CI, 82.00-87.78) have never participated in a bioterrorism training exercise, and 89% (95% CI, 87.00-91.95) do not provide disaster-oriented anticipatory guidance to their patients. Seventy-six percent (95% CI, 73.10-79.98) of all responders indicated their desire for more bioterrorism training, with 42% preferring diagnostic algorithms and 37% (95% CI, 32.79-40.59) preferring a prepared lecture on video format.

CONCLUSIONS

Surveyed pediatricians in Michigan consider bioterrorism a significant threat but are overwhelmingly underprepared to deal with an event. There is a perceived need for a coordinated educational program to improve level of preparedness.

Directions for disaster nursing education in the United States

Because of their diverse education, experience, and practice settings, nurses are uniquely qualified to be first receivers, care givers, and leaders in any large-scale public health emergency. Many nurses, however, continue to feel inadequately prepared to function effectively in these types of situations. Great strides have been made since 2001, but much work remains to be accomplished. This article focuses on newer approaches used to teach nurses the principles of disaster preparedness. It also addresses the need to incorporate mass casualty care and disaster management skills into undergraduate curricula, continuing nurse education, and advanced degree programs for nurses in the United States.