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Santinha G, Forte T, Gomes A. Willingness to Work during Public Health Emergencies: A Systematic Literature Review. Healthcare (Basel) 2022; 10:healthcare10081500. [PMID: 36011158 PMCID: PMC9408569 DOI: 10.3390/healthcare10081500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/24/2022] [Accepted: 08/03/2022] [Indexed: 11/16/2022] Open
Abstract
The identification of the factors underlying the willingness or lack thereof to respond to public health emergencies is paramount to informing more capable health services. The interest in this topic appears renewed with each surge of threat, either referring to natural disasters, man-made violence, or epidemic and pandemics. However, there is no systematic approach to the research patterns and related main findings concerning individual and contextual determinants. The present article contributes to this theme through a systematic literature review of a sample of 150 articles published in the last 30 years on the subject of willingness and preparedness of health professionals to deal with public health threats. Our findings show that the research is mainly phenomena and contextual driven, responding to whichever emergency threat is more salient in a given period. Geographically, research on this topic is led by USA and China, mostly solely, while European countries invest in collaborations that are more international. Universities, including health institutes and schools, and researchers at hospitals conduct most of the research on the topic. The main research areas are medicine, psychology, and psychiatry. Pandemics, including COVID-19, influenza, and natural disasters, are the phenomena gauging more attention as opposed to terrorism events and biological accidents. The specific role of health professionals within the institution, their belief in ethical duties, preparation training, and concerns regarding infection of self and family are the main variables influencing the willingness and ability to report to work in public health emergencies.
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Affiliation(s)
- Gonçalo Santinha
- GOVCOPP, Department of Social, Political and Territorial, University of Aveiro, 3810-193 Aveiro, Portugal
- Correspondence:
| | - Teresa Forte
- Department of Social, Political and Territorial Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Ariana Gomes
- Department of Social, Political and Territorial Sciences, University of Aveiro, 3810-193 Aveiro, Portugal
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Gabbe BJ, Veitch W, Mather A, Curtis K, Holland AJA, Gomez D, Civil I, Nathens A, Fitzgerald M, Martin K, Teague WJ, Joseph A. Review of the requirements for effective mass casualty preparedness for trauma systems. A disaster waiting to happen? Br J Anaesth 2021; 128:e158-e167. [PMID: 34863512 DOI: 10.1016/j.bja.2021.10.038] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/14/2021] [Accepted: 10/19/2021] [Indexed: 01/06/2023] Open
Abstract
Mass casualty incidents (MCIs) are diverse, unpredictable, and increasing in frequency, but preparation is possible and necessary. The nature of MCIs requires a trauma response but also requires effective and tested disaster preparedness planning. From an international perspective, the aims of this narrative review are to describe the key components necessary for optimisation of trauma system preparedness for MCIs, whether trauma systems and centres meet these components and areas for improvement of trauma system response. Many of the principles necessary for response to MCIs are embedded in trauma system design and trauma centre function. These include robust communication networks, established triage systems, and capacity to secure centres from threats to safety and quality of care. However, evidence from the current literature indicates the need to strengthen trauma system preparedness for MCIs through greater trauma leader representation at all levels of disaster preparedness planning, enhanced training of staff and simulated disaster training, expanded surge capacity planning, improved staff management and support during the MCI and in the post-disaster recovery phase, clear provision for the treatment of paediatric patients in disaster plans, and diversified and pre-agreed systems for essential supplies and services continuity. Mass casualty preparedness is a complex, iterative process that requires an integrated, multidisciplinary, and tiered approach. Through effective preparedness planning, trauma systems should be well-placed to deliver an optimal response when faced with MCIs.
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Affiliation(s)
- Belinda J Gabbe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Health Data Research UK, Swansea University Medical School, Swansea, UK.
| | - William Veitch
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Anne Mather
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Kate Curtis
- School of Medicine, University of Sydney, Sydney, Australia; Susan Wakil School of Nursing and Midwifery, University of Sydney, Sydney, Australia
| | - Andrew J A Holland
- Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney School of Medicine, Westmead, Australia
| | - David Gomez
- Division of General Surgery, St. Michael's Hospital, Unity Health Toronto, University of Toronto, Toronto, Canada
| | - Ian Civil
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Avery Nathens
- Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Mark Fitzgerald
- Department of Surgery, Central Clinical School, Monash University, Melbourne, Australia; Trauma Service, The Alfred, Melbourne, Australia
| | - Kate Martin
- Department General Surgical Specialties, Royal Melbourne Hospital, Parkville, Australia
| | - Warwick J Teague
- Trauma Service, Royal Children's Hospital, Parkville, Australia; Surgical Research, Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Anthony Joseph
- Royal North Shore Hospital Clinical School, School of Medicine, University of Sydney, St Leonards, Australia
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Simulating a Vertical Evacuation of a NICU and PICU to Examine the Relationship Between Training and Preparedness. Disaster Med Public Health Prep 2021; 16:1811-1813. [PMID: 34462040 DOI: 10.1017/dmp.2021.201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The aim of this study was to implement pediatric vertical evacuation disaster training and evaluate its effectiveness by using a full-scale exercise to compare outcomes in trained and untrained participants. METHODS Various clinical and nonclinical staff in a tertiary care university hospital received pediatric vertical evacuation training sessions over a 6-wk period. The training consisted of disaster and evacuation didactics, hands-on training in use of evacuation equipment, and implementation of an evacuation toolkit. An unannounced full-scale simulated vertical evacuation of neonatal intensive care unit (NICU) and pediatric intensive care unit (PICU) patients was used to evaluate the effectiveness of the training. Drill participants completed a validated evaluation tool. Pearson chi-squared testing was used to analyze the data. RESULTS Eighty-four evaluations were received from drill participants. Forty-three (51%) of the drill participants received training and 41 (49%) did not. Staff who received pediatric evacuation training were more likely to feel prepared compared with staff who did not (odds ratio, 4.05; confidence interval: 1.05-15.62). CONCLUSIONS There was a statistically significant increase in perceived preparedness among those who received training. Recently trained pediatric practitioners were able to achieve exercise objectives on par with the regularly trained emergency department staff. Pediatric disaster preparedness training may mitigate the risks associated with caring for children during disasters.
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Abstract
Children are affected by all types of disasters disproportionately compared with adults. Despite this, planning and readiness to care for children in disasters is suboptimal locally, nationally, and internationally. These planning gaps increase the likelihood that a disaster will have a greater negative impact on children when compared with adults. New voluntary regional coalitions have been developed to fill this gap. Some are pediatric focused or have pediatrics well integrated into the greater coalition. This article discusses key points of pediatric disaster planning, specific vulnerabilities, and the care of children in general and in specific disaster situations.
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Affiliation(s)
- Mitchell Hamele
- Department of Pediatrics-Critical Care, Tripler Army Medical Center, Honolulu, HI 96859, USA.
| | - Ramon E Gist
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, SUNY Downstate Medical Center, 450 Clarkson Avenue, Box 49, Brooklyn, NY 11203, USA
| | - Niranjan Kissoon
- Department of Pediatrics and Emergency Medicine, BC Children's Hospital, Sunny Hill Health Centre for Children, UBC, Child and Family Research Institute, B245 - 4480 Oak Street, Vancouver, British Columbia V6H 3V4, Canada
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Mortamet G, Lode N, Roumeliotis N, Baudin F, Javouhey E, Dubos F, Naud J. Disaster preparedness in French paediatric hospitals 2 years after terrorist attacks of 2015. Arch Dis Child 2019; 104:322-327. [PMID: 29860227 DOI: 10.1136/archdischild-2017-314658] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 03/19/2018] [Accepted: 05/02/2018] [Indexed: 11/04/2022]
Abstract
OBJECTIVE We aimed to determine paediatric hospital preparedness for a mass casualty disaster involving children in both prehospital and hospital settings. The study findings will serve to generate recommendations, guidelines and training objectives. DESIGN AND SETTING The AMAVI-PED study is a cross-sectional survey. An electronic questionnaire was sent to French physicians with key roles in specialised paediatric acute care. RESULTS In total, 81% (26 of 32) of French University Hospitals were represented in the study. A disaster plan AMAVI with a specific paediatric emphasis was established in all the paediatric centres. In case of a mass casualty event, paediatric victims would be initially admitted to the paediatric emergency department for most centres (n=21; 75%). Paediatric anaesthesiologists, paediatric surgeons and paediatric radiologists were in-house in 20 (71%), 5 (18%) and 12 (43%) centres, respectively. Twenty-three (82%) hospitals had a paediatric specialised mobile intensive care unit and seven (25%) of these could provide a prehospital emergency response. Didactic teaching and simulation exercises were implemented in 20 (71%) and 22 (79%) centres, respectively. Overall, physician participants rated the level of readiness of their hospital as 6 (IQR: 5-7) on a 10-point readiness scale. CONCLUSION Paediatric preparedness is very heterogeneous between the centres. Based on the study findings, we suggest that a national programme must be defined and guidelines generated.
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Affiliation(s)
| | - Noella Lode
- Pediatric Transport Team, SMUR Robert Debré, SAMU de Paris, Hôpital Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Nadia Roumeliotis
- Pediatric Intensive Care Unit, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Florent Baudin
- Pediatric Intensive Care Unit, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France.,UMR T_9405, UMRESTTE, Ifsttar, Université Claude Bernard Lyon 1, Lyon, France
| | - Etienne Javouhey
- Pediatric Intensive Care Unit, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France.,UMR T_9405, UMRESTTE, Ifsttar, Université Claude Bernard Lyon 1, Lyon, France
| | - François Dubos
- Pediatric Emergency Unit and Infectious Diseases, Hôpital Roger Salengro, CHU Lille, Lille, France
| | - Julien Naud
- Pediatric Transport Team, SMUR Bordeaux, CHU Bordeaux, Bordeaux, France
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Zagory JA, Jensen AR, Burke RV, Upperman JS. Planning for the Pediatric Patient During a Disaster. CURRENT TRAUMA REPORTS 2016. [DOI: 10.1007/s40719-016-0064-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
AbstractIntroductionChildren, with their specific vulnerabilities and needs, make up to more than 20% of society, so they are at risk of getting involved in disasters. Are the specialists treating them for medical problems in daily life also capable to deal with them in disaster situations?Hypothesis/ProblemThe goals of this study were to evaluate perceived knowledge and capability of tertiary pediatricians to deal with disasters, to identify promoting factors, and to evaluate education need and willingness to work.MethodsA survey looking for demographics, hospital disaster planning, estimated risk and capability for disasters, training, and willingness to work, and a set of six content assessment questions to evaluate knowledge, were presented to emergency pediatricians and pediatric emergency physicians in specialized tertiary centers.ResultsThe response rate was 51%. Thirty-five percent had disaster training and 53% felt that disaster education should be obligatory in their curriculum. Risk for disasters was estimated from 2.4/10 for nuclear incidents to 7.6/10 for major trauma. Self-estimated capability for these situations ranged from 1.8/10 in nuclear incidents to 7.6/10 in major trauma. Unconditional willingness to work ranged from 37% in nuclear situations to 68% in pandemics. Mean score on the questions was 2.06/6. Training, knowledge of antidote and personal protective equipment (PPE) use, self-estimated capability, and exposure were significant predictors for higher scores. Willingness to work correlated significantly with age, self-estimated capability, and risk estimation. In case of chemical and nuclear incidents, there was correlation with knowledge on the use of decontamination, PPE, and radio-detection devices.ConclusionDespite a clear perception of the risks and a high willingness to work, preparedness is limited. The major conclusion is that basics of disaster management should be included in pediatric training.MortelmansLJM, MaebeS, DieltiensG, AnseeuwK, SabbeMB, Van de VoordeP. Are tertiary care paediatricians prepared for disaster situations?Prehosp Disaster Med. 2016;31(2):126–131.
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