Perceived Knowledge, Skills, and Preparedness for Disaster Management Among Military Health Care Personnel

Disaster preparedness knowledge and its relationship with triage decision-making among hospital and pre-hospital emergency nurses - Ardabil, Iran

Background

Hospital and pre-hospital emergency nurses are at the forefront of disaster response. Disaster incidents continue to pose a threat to healthcare systems by exposing them to an overwhelming surge of patients.

Methods

This descriptive cross-sectional study was performed on 472 hospital and pre-hospital emergency nurses in Ardabil province, in the northwest Iran, from March to April 2021, were recruited by convenience sampling method. Data were collected using valid and reliable self-reported questionnaires, including the Emergency Preparedness Information questionnaire (EPIQ) and Triage Decision-making Inventory (TDMI). Data were analyzed using SPSS (Version 22) software using descriptive statistics, Pearson correlation coefficient test, t-test, ANOVA test, and multiple linear regression analysis.

Results

Emergency nurses’ disaster preparedness knowledge was low according to the mean score of total disaster preparedness knowledge. Furthermore, multiple linear regression analysis showed triage decision-making, age, residence, disaster preparedness training, working on duty during a disaster, and training organization variables were predictors of disaster preparedness knowledge in hospital and pre-hospital emergency nurses (p < 0.05).

Conclusion

Emergency nurses who have higher disaster preparedness knowledge have higher triage decision-making skills. It is suggested that the managers of educational and medical centres and professional organizations provide favourable conditions for training and increasing disaster preparedness of emergency nurses according to their age and residence.

Disaster risk management challenges in military hospitals: A qualitative study

BACKGROUND

Disaster can pose significant challenges to the health infrastructure in the community. Hospitals are the central unit for providing health services in the disaster response plan. With regard to the vital role of military hospitals in health response to disaster, this study was carried out with the aim of investigating the disaster risk management (DRM) challenges in military hospitals in Iran.

MATERIALS AND METHODS

The current study was qualitative research performed in 2020 in military hospitals in Iran. Participants consisted of 12 managers and staff of the military hospitals in Tehran and professionals in health in emergencies and disasters who were included in the study by the purposive sampling technique. Semistructured individual interviews based on the interview guide were exploited for the data collection, and a content analysis method was used to analyze them.

RESULTS

DRM challenges in military hospitals were explained in the form of six categories: "management and leadership, planning, prevention and mitigation, preparedness, response, and recovery" and 22 subcategories.

CONCLUSION

Managers' awareness of DRM challenges in hospitals, particularly military hospitals, and the design and implementation of solutions can lead to the promotion of hospital DRM and hospital preparedness to deal with disasters.

Training Military Psychiatrists to Adapt and Overcome: How COVID-19 Highlighted the Unique Flexibility of Military Psychiatry in Training and in the Fleet

PURPOSE OF REVIEW

Born out of necessity, military medicine continues to find itself at the forefront of medical innovation. This generation of military physicians has never previously been challenged with continuing to provide top notch medical support to servicemembers in a variety of operational settings in the midst of a global pandemic. While military medicine has always been able to uniquely meet the educational goals of residency training, COVID-19 brought new challenges to the forefront.

RECENT FINDINGS

While the threat presented by COVID-19 was different from the historical battlefield threats and challenges that have given birth to military medicine, it was nevertheless ready to pivot and adjust course, focusing on how to best meet the medical needs of the military patient population in an ever-changing geopolitical environment while continuing to meet and exceed the educational standards that training programs are held to. Historically and currently, mental health remains one of the most common reasons that servicemembers are evacuated from combat zones. The COVID-19 pandemic provided an opportunity for modern military psychiatry to showcase its ability to adjust the educational focus in certain areas of residency training to prepare the next generation of military psychiatrists to be able to face the newest threat to force wellness.

Disaster Preparedness and Associated Factors Among Emergency Nurses in Guangdong Province, China: A Descriptive Cross-Sectional Study

OBJECTIVE

The purpose of this study was to examine the prevalence of disaster preparedness and to explore associated factors among emergency nurses in Guangdong Province, China.

METHODS

In this descriptive, cross-sectional study, the mainland China version of the Disaster Preparedness Evaluation Tool was used to collect data from 633 nurses working in 26 emergency departments, in August 2018. Descriptive analyses were used to examine the disaster preparedness, and multiple linear regression analysis was used to investigate associated factors.

RESULTS

The perceived disaster preparedness of emergency nurses was at a moderate level. Among the 5 dimensions, the score for disaster management was lowest. Emergency nurses' disaster training (r = .26; P < 0.001) and drill experiences (r = .22; P < 0.001) were significantly correlated with disaster preparedness. Six significant factors associated with disaster preparedness were identified in this study: age, gender, disaster training experience, disaster drill experience, willingness, and educational level (R² = .14; F = 18.20; P < 0.001).

CONCLUSIONS

Hospitals and nurse managers should carry out interdisciplinary and multidisciplinary cooperation to improve emergency nurses' disaster preparedness, especially disaster management. Organizing disaster simulation exercises, providing psychological support and safety considerations, and formulating disaster nursing training programs may be beneficial for emergency nurses' disaster preparedness.

Emergency healthcare workers' preparedness for disaster management: An integrative review

BACKGROUND

Around 2 billion people globally were affected by natural disasters between 2008-2018. The World Health Organization requires countries and governments to have disaster plans and emergency health workers ready and prepared at all times.

OBJECTIVES

To conduct an integrative review of literature of emergency healthcare workers' perceived preparedness for disaster management.

METHODOLOGY

An integrative literature review using the PRISMA checklist guidelines was conducted to explore physicians, nurses, emergency medical services and allied medical professionals' preparedness for disasters. Literature was searched from 2005, published in the English language and from MEDLINE (PubMed), Google Scholar, EMBASE, PsycINFO, SCOPUS, ProQuest and CINAHL databases. Reviews, case reports, clinical audits, editorials and short communications were excluded. Studies were critically appraised using the Mixed Methods Appraisal Tool.

RESULTS

The initial search yielded 9589 articles. Twenty-seven articles were included following application of the eligibility criteria. Included studies were geographically diverse including North America, the Middle East and the Asia Pacific. Most studies (n = 24) assessed the knowledge of healthcare workers in general disasters. Studies using the Disaster Preparedness Evaluation Tool reported moderate disaster preparedness and knowledge, while studies using other instruments largely reported inadequate disaster preparedness and knowledge. Regional variations were recorded, with high-income countries' reporting a higher perceived preparedness for disasters than low-income countries.

CONCLUSION

The majority of the emergency healthcare workers appear to have inadequate disaster preparedness. Previous disaster experience and training improved disaster preparedness. Future research should focus on interventions to improve emergency healthcare workers preparedness for disasters.

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.

Psychometric Evaluation of the Disaster Preparedness Evaluation Tool© (DPET) on Emergency Nurses in Mainland China: Two Cross-Sectional Studies

BACKGROUND

Emergency nurses play a major role in disaster relief in mainland China, but there is no valid instrument to measure the extent of their disaster preparedness. The Disaster Preparedness Evaluation Tool© is a reliable instrument to assess the disaster preparedness of nurse practitioners. The tool has been translated and validated in Saudi Arabia, Taiwan, China and the United States of America.

OBJECTIVES

This study aimed at translating and adapting the Disaster Preparedness Evaluation Tool© (DPET) for emergency nurses in mainland China and determining its psychometric properties.

DESIGN, SETTINGS AND PARTICIPANTS

A total of 2 cross-sectional online surveys were conducted in the emergency departments of 26 public grade III-A hospitals in Guangdong, mainland China. In the first study, 633 emergency nurses were recruited from May to August, 2018. In the second study, 205 were recruited in April 2019.

METHODS

The instrument was adapted through rigorous forward-backward translation, face validity, and pre-test processes. Exploratory factor and parallel analyses were used in the first study. Confirmatory factor analysis, internal consistency and split-half reliability were used in the second study.

RESULTS

Exploratory factor and parallel analyses extracted a 5-factor solution comprising of 34 items that accounted for 64.06% of the total variance. The fit indices indicated a good model fit. The reliability was good, as indicated by a Cronbach's alpha of 0.97 and a split-half reliability coefficient of 0.97.

CONCLUSION

The mainland China version of the DPET (DPET-MC) was a reliable and valid instrument and can be used in practice.