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Jamsahar M, Ahmadi F, Khoobi M, Vaismoradi M. Managing the process of patient transfer by emergency care providers: A qualitative study. Int Emerg Nurs 2024; 75:101473. [PMID: 38850643 DOI: 10.1016/j.ienj.2024.101473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 05/13/2024] [Accepted: 05/25/2024] [Indexed: 06/10/2024]
Affiliation(s)
- Maryam Jamsahar
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Fazlollah Ahmadi
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Mitra Khoobi
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway; Faculty of Science and Health, Charles Sturt University, Orange, NSW, Australia.
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Baikmohammadi S, Amirheidari B, Dehesh T, Moghadam MN, Yazdi-Feyzabadi V, Hassani E, Habibzadeh H. A qualitative study on barriers and strategies to hospital preparedness against chemical, biological, radiological, and nuclear incidents. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:3. [PMID: 38525212 PMCID: PMC10959262 DOI: 10.4103/jehp.jehp_1827_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 01/29/2023] [Indexed: 03/26/2024]
Abstract
BACKGROUND The effects of chemical, biological, radiological, and nuclear (CBRN) incidents on human society can be irreparable. Preparing the health system for these incidents is essential. This study aims to identify obstacles to hospital preparedness against CBRN incidents and provide solutions. MATERIALS AND METHODS This qualitative study was conducted using semi-structured interview method in 2022. The research community included experts in the fields of CBRN, and 17 persons were included in the study through purposive sampling. The interviews were collected by interview guide and recorded face-to-face and online and were analyzed using thematic content analysis method in MS Word 2016. RESULTS The interviews' analysis was classified into two main categories and 34 sub-categories. Some of the most important obstacles to the hospital preparedness against CBRN incidents were the lack of proper crisis management, the lack of specialist staff, the stress of employees, the lack of turnover and sufficient rest for employees, legal gaps, and so on. The main strategies were determining the type and extent of the risk factor, strong crisis management, the lack of parallelism, continuous monitoring, having a protocol and road map, appropriate training programs, having skilled personnel, rapid response of personnel, positive attitude of the staff, and the favorable condition of the building. CONCLUSION The appointment of an expert in the field of CBRN and having a specialized unit, the existence of specialized and trained staff along with access to the required facilities, clear instructions, and intra-departmental and inter-departmental cooperation affect the readiness of hospitals against CBRN incidents.
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Affiliation(s)
- Saeid Baikmohammadi
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Bagher Amirheidari
- Department of Pharmaceutical Biotechnology, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran
| | - Tania Dehesh
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahmood Nekoei Moghadam
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Vahid Yazdi-Feyzabadi
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ebrahim Hassani
- Department of Anesthesiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Hossein Habibzadeh
- Department of Nursing, School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
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Kerola A, Hirvensalo E, Franc JM. The Impact of Exposure to Previous Disasters on Hospital Disaster Surge Capacity Preparedness in Finland: Hospital disaster surge capacity preparedness. Disaster Med Public Health Prep 2024; 18:e15. [PMID: 38291961 DOI: 10.1017/dmp.2024.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
OBJECTIVE As disasters are rare and high-impact events, it is important that the learnings from disasters are maximized. The aim of this study was to explore the effect of exposure to a past disaster or mass casualty incident (MCI) on local hospital surge capacity planning. METHODS The current hospital preparedness plans of hospitals receiving surgical emergency patients in Finland were collected (n = 28) and analyzed using the World Health Organization (WHO) hospital emergency checklist tool. The surge capacity score was compared between the hospitals that had been exposed to a disaster or MCI with those who had not. RESULTS The overall median score of all key components on the WHO checklist was 76% (range 24%). The median surge capacity score was 65% (range 39%). There was no statistical difference between the surge capacity score of the hospitals with history of a disaster or MCI compared to those without (65% for both, P = 0.735). CONCLUSION Exposure to a past disaster or MCI did not appear to be associated with an increased local hospital disaster surge capacity score. The study suggests that disaster planning should include structured post-action processes for enabling meaningful improvement after an experienced disaster or MCI.
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Affiliation(s)
- Anna Kerola
- Department of Orthopedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Center for Research and Training in Disaster Medicine (CRIMEDIM), Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy
| | - Eero Hirvensalo
- Department of Orthopedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jeffrey M Franc
- Center for Research and Training in Disaster Medicine (CRIMEDIM), Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy
- Department of Emergency Medicine, University of Alberta, Edmonton, Alberta, Canada
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Purabdollah M, Zamanzadeh V, Valizadeh L, Ghahramanian A, Mousavi S, Ghasempour M. Comparison of the Iranian and Scandinavian bachelor of nursing curriculum (Sweden): A scoping review. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:389. [PMID: 38333170 PMCID: PMC10852164 DOI: 10.4103/jehp.jehp_1445_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 12/14/2022] [Indexed: 02/10/2024]
Abstract
BACKGROUND The comparison of the educational curriculum improves the content and quality of the curriculum and needs to be revised and modified in line with the current needs of society. Development of nursing knowledge, the emergence of emerging diseases requires that the nursing curriculum be codified and provide the necessary skills to provide quality and safe care. MATERIALS AND METHODS The study aimed to Comparison of Iranian and Scandinavian Bachelor of Nursing Curriculum (Sweden). This descriptive-comparative study was conducted based on the Bereday model in four stages: Description, Interpretation, Juxtaposition, Comparison, and Analysis in 2022. We use relevant electronic databases such as PubMed, CINAHL, Web of Science, Iran Medex, SID, Magiran, Google Scholar, Iran Doc, and Science Direct databases. RESULTS The results showed that despite the similarities, the Swedish nursing curriculum had special features in most of the mentioned dimensions. Including decentralized admission, Fits the need, competency-based curriculum, attention to holistic care and intercultural care, use of new digital technologies in education, and clinical training and evaluation. CONCLUSION It seems that the Iranian nursing curriculum is far from the mentioned perspective. Using the experiences of the world's top universities, such as Sweden, can improve the quality of nursing undergraduate programs and improve the nursing profession by eliminating current shortcomings.
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Affiliation(s)
- Majid Purabdollah
- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahid Zamanzadeh
- Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Leila Valizadeh
- Department of Pediatric Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Akram Ghahramanian
- Medical Education Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saeid Mousavi
- Department of Epidemiology and Biostatistics, School of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mostafa Ghasempour
- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
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Naderi M, Khoshdel AR, Sharififar S, Moghaddam AD, Zareiyan A. Respond quickly and effectively! Components of the military health surveillance system in natural disasters: A qualitative study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:383. [PMID: 38333165 PMCID: PMC10852165 DOI: 10.4103/jehp.jehp_1592_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 12/22/2022] [Indexed: 02/10/2024]
Abstract
BACKGROUND The systematic collection, analysis, and interpretation of health data by health surveillance systems provide timely and comprehensive surveillance of public health, identification health priorities, and, consequently, a quick and timely response to reduce damage during natural disasters. Since military forces appear as first responders at the scene of accidents, the present study aimed to identify the components of the military health care system during natural disasters. MATERIALS AND METHOD Qualitative data collected through semi-structured interviews were analyzed via the conventional content analysis approach to identify the components of the military health care system in natural disasters. The participants consisted of 13 experts who were experienced in providing health services in the military and the civilian health care system during natural disasters in January 2022 to June 2022. RESULT The identified components were classified into four main categories, namely, pre-requisite components (comprehensive health care, defined position, and providing information), driving components (system efficiency, effective communication), operational components (contingent performance, effective response), and promotional components (purposeful support, pre-disaster preparation). CONCLUSION In conclusion, the military health surveillance system is a cooperative service for the national health system in which data is essential for making decisions on health and treatment measures during disasters. This study-by identifying four categories of the important components in the design, implementation, and development of the military health surveillance system-provides a comprehensive view of an appropriate and evidence-based military surveillance system in disasters.
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Affiliation(s)
- Maryam Naderi
- Department of Health in Disasters and Emergencies, Nursing Faculty, AJA University of Medical Sciences, Tehran, Iran
| | | | - Simintaj Sharififar
- Department of Health in Disasters and Emergencies, AJA University of Medical Sciences, Tehran, Iran
| | - Arasb Dabbagh Moghaddam
- Department of Health in Disasters and Emergencies, AJA University of Medical Sciences, Tehran, Iran
| | - Armin Zareiyan
- Department of Health in Disasters and Emergencies, Nursing Faculty, AJA University of Medical Sciences, Tehran, Iran
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Rostami M, Babajani-Vafsi S, Ziapour A, Abbasian K, Mohammadimehr M, Zareiyan A. Experiences of operating room nurses in disaster preparedness of a great disaster in Iran: a qualitative study. BMC Emerg Med 2023; 23:138. [PMID: 37996807 PMCID: PMC10668482 DOI: 10.1186/s12873-023-00903-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 10/30/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND In recent years, Iran has encountered a growing frequency of earthquake disasters. Given that nurses constitute the largest group of healthcare providers, it is imperative that they possess adequate disaster preparedness skills, irrespective of the location or time. Despite the operating room nurses' roles in disasters, their experiences and challenges in disaster preparedness have been overlooked. Consequently, this study aimed to investigate the experiences, challenges, perspectives, and factors influencing the disaster preparedness of operating room nurses during the 2017 earthquake in Kermanshah, Iran. METHODS The present qualitative research was carried out in Iran In 2022 utilizing conventional content analysis. The study involved conducting semi-structured interviews with 16 operating room nurses who had participated in disaster preparedness during the Kermanshah earthquake. The participants were selected using a purposive sampling approach that aimed to achieve maximum diversity. The interviews were continued until the point of data saturation was reached, and the verbatim transcripts were analyzed using conventional content analysis in MAXQDA software. To ensure the rigor of the research, Guba and Lincoln's criteria were employed. RESULTS The study conducted data analysis to identify the main theme as "insufficient disaster preparedness due to a faded preparedness", along with six major categories and eighteen subcategories related to earthquake disaster preparedness. The major categories included: knowledge and perception of preparedness for disasters; educational and training programs for disaster preparedness; equipment preparedness for disasters; managerial-organizational preparedness for disasters; clinical skills for responding to disasters; and resilient ability in disaster response situations. CONCLUSION The findings of the study provide valuable insights into the dimensions of disaster preparedness in earthquake disasters among operating room nurses. Nursing managers can utilize these findings to develop effective strategies and provide support in areas such as improving knowledge and educational level, equipment preparedness, strengthening plans and managerial structures, enhancing skills, and explaining resilience strategies to improve the disaster preparedness of operating room nurses and medical organizations' disaster response teams.
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Affiliation(s)
- Mohammad Rostami
- Department of Surgical Technology, AJA University of Medical Sciences, Tehran, Iran
| | - Saeed Babajani-Vafsi
- Department of Surgical Technology, Faculty of Paramedical Sciences, AJA University of Medical Sciences, Tehran, Iran
| | - Arash Ziapour
- Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Kourosh Abbasian
- Management and Health Economics Department, AJA University of Medical Sciences, Tehran, Iran
| | - Mojgan Mohammadimehr
- Department of Laboratory Sciences, Faculty of Paramedical Sciences, AJA University of Medical Sciences, Tehran, Iran
| | - Armin Zareiyan
- Public Health Department, Health in Disaster and Emergencies Department, AJA University of Medical Sciences, Tehran, Iran.
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Aminafshar A, Sartipi M, Pakzad A. The perceived self-efficacy of senior, middle, and operations managers of the incident command system dealing with emergencies and disasters during the COVID-19 pandemic. BMC Emerg Med 2023; 23:133. [PMID: 37946145 PMCID: PMC10636973 DOI: 10.1186/s12873-023-00904-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Natural disasters, health, terrorism, infectious diseases, and social unrest affect more than 200 million people worldwide each year. The present study is an attempt to evaluate the self-efficacy of senior, middle, and operational managers of the Incident Command System (ICS) of Zahedan University of Medical Sciences in Iran. METHODS The study examined the perceived self-efficacy of 103 senior, middle, and operational managers of the Incidence Command System (ICS) of Zahedan University of Medical Sciences in 2021. Sampling was done by census using a designed questionnaire based on Bandura's self-efficacy concepts. Based on Factor Analysis, 4 factors were extracted. The factors were labeled and analyzed. RESULTS The number of people who had passed the crisis management course was 57. Seventy-one participants reported their participation in crisis management. The score obtained by men in Factor 3 (F3) was significantly higher than women, but not in other factors. People with stable employment scored far higher in Factor 1 (F1) than those with unsustainable employment conditions. Those who had passed the Crisis Management courses had a higher average score, but only in the three factors 1, 2, and 4, this difference was significant. CONCLUSION Even training the temporary staff is an organizational investment that can return benefits to the system. This enhances their perceived self-efficacy and promotes their commitment to the organization. Therefore, empowering these managers should be a priority.
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Affiliation(s)
- Asiye Aminafshar
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Majid Sartipi
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
- Department of Biostatistics and Epidemiology, School of Health, Zahedan University of Medical Sciences, Zahedan, Iran.
| | - Abdolrazzagh Pakzad
- Health Safety and Environmental Management (HSE), Zahedan University of Medical Sciences, Zahedan, Iran
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Tan MZY, Prager G, McClelland A, Dark P. Healthcare resilience: a meta-narrative systematic review and synthesis of reviews. BMJ Open 2023; 13:e072136. [PMID: 37730383 PMCID: PMC10514640 DOI: 10.1136/bmjopen-2023-072136] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 08/24/2023] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVES The COVID-19 pandemic has tested global healthcare resilience. Many countries previously considered 'resilient' have performed poorly. Available organisational and system frameworks tend to be context-dependent and focus heavily on physical capacities. This study aims to explore and synthesise evidence about healthcare resilience and present a unified framework for future resilience-building. DESIGN Systematic review and synthesis of reviews using a meta-narrative approach. SETTING Healthcare organisations and systems. PRIMARY AND SECONDARY OUTCOME MEASURES Definitions, concepts and measures of healthcare resilience. We used thematic analysis across included reviews to summarise evidence on healthcare resilience. RESULTS The main paradigms within healthcare resilience include global health, disaster risk reduction, emergency management, patient safety and public health. Definitions of healthcare resilience recognise various hierarchical levels: individual (micro), facility or organisation (meso), health system (macro) and planetary or international (meta). There has been a shift from a focus on mainly disasters and crises, to an 'all-hazards' approach to resilience. Attempts to measure resilience have met with limited success. We analysed key concepts to build a framework for healthcare resilience containing pre-event, intra-event, post-event and trans-event domains. Alongside, we synthesise a definition which dovetails with our framework. CONCLUSION Resilience increasingly takes an all-hazards approach and a process-oriented perspective. There is increasing recognition of the relational aspects of resilience. Few frameworks incorporate these, and they are difficult to capture within measurement systems. We need to understand how resilience works across hierarchical levels, and how competing priorities may affect overall resilience. Understanding these will underpin interdisciplinary, cross-sectoral and multi-level approaches to healthcare resilience for the future. PROSPERO REGISTRATION NUMBER CRD42022314729.
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Affiliation(s)
- Mark Z Y Tan
- Humanitarian and Conflict Response Institute, The University of Manchester, Manchester, UK
| | - Gabrielle Prager
- Department of International Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Andrew McClelland
- Alliance Manchester Business School, The University of Manchester, Manchester, UK
| | - Paul Dark
- Humanitarian and Conflict Response Institute, The University of Manchester, Manchester, UK
- Clinical Research Network, National Institute for Health and Care Research, London, UK
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Yazdi F, Chaboksavar F, Malekzadeh R, Ziapour A, Yoosefi Lebni J, Janjani P, Hamidipour N, Fard Azar AAE, Darabi F, Garosi VH, Kianipour N. Role of demographic variables in investigating occupational stress of disaster and emergency medical management center. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:289. [PMID: 37849883 PMCID: PMC10578552 DOI: 10.4103/jehp.jehp_1300_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 10/25/2022] [Indexed: 10/19/2023]
Abstract
BACKGROUND Emergency medical services face stressful environments such as departments dealing with injuries and sick patients that pose challenging situations for the healthcare staff. This present study investigates the role of demographic variables in investigating occupational stress of disaster and emergency medical management center in 2021. MATERIALS AND METHODS This present descriptive study selected a sample size of 200 medical personnel associated with disaster and emergency medical management center in Iran, according to the inclusion chosen criteria. The study used a tool consisting of two parts, including demographic information and a job stress Health and Safety Executive (HSE) standard questionnaire. The study selected respondents through Cochran's sample size formula using stratified random sampling with a cross-sectional research design for data collection. This present study has analyzed received data using performed the descriptive and inferential information (t-test and one-way ANOVA) at a significance level P < 0.05. The participants of the survey were males only. RESULTS The study results specified that the mean age of respondents was 30.14 ± 5.96. The study results exhibited that the mean score of total occupational stress was 3.41 ± 0.26. The results showed the highest (4.34 ± 0.35) and the lowest (2.72 ± 0.86) stress levels were related to role dimensions. CONCLUSIONS The study findings revealed a significant relationship between stress level and participants' age, marital status, educational level, type of base, workplace, and the number of work hours per month. Emergency medical personnel experience a high level of occupational stress. Senior managers can use similar studies to implement measures to reduce the experience of employees' stress.
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Affiliation(s)
- Fateme Yazdi
- School of Nursing and Midwifery, Dezful University of Medical Sciences, Dezful, Iran
| | - Fakhreddin Chaboksavar
- Nursing Care Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R. Iran
| | - Roya Malekzadeh
- Department of Public Health, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Arash Ziapour
- Cardiovascular Research Center, Health Institute, Imam-Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Javad Yoosefi Lebni
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Parisa Janjani
- Cardiovascular Research Center, Health Institute, Imam-Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nasim Hamidipour
- School of Nursing and Midwifery, Dezful University of Medical Sciences, Dezful, Iran
| | | | - Fatemeh Darabi
- Department of Public Health, Asadabad School of Medical Sciences, Asadabad, Iran
| | - Vahid Hatami Garosi
- Cardiovascular Research Center, Health Institute, Imam-Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Neda Kianipour
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Miri K, Sabbaghi M, Mazlum SR, Namazinia M. The trend of change in the role of pre-hospital emergency medical services in Iran's healthcare system: a situational analysis. BMC Emerg Med 2023; 23:99. [PMID: 37648986 PMCID: PMC10468862 DOI: 10.1186/s12873-023-00861-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/02/2023] [Indexed: 09/01/2023] Open
Abstract
INTRODUCTION Following the significant changes in healthcare systems over the last century, the role of pre-hospital emergency medical services (EMS) has been drawn against numerous challenges. In view of this, the present study aims to reflect on the trend of change in the role of pre-hospital EMS to meet new situations and needs, thereby providing a clear picture of this process. METHODS Respecting the intricate concept of development and the major changes in Iran's healthcare system, this study was fulfilled using situational analysis (SA), developed by Clarke (2018), in Iran within 2022-2023. For this purpose, the data were collected through semi-structured, in-depth individual interviews with four faculty members, two managers involved in EMS, and six highly skilled EMS personnel in various positions. Moreover, the relevant articles published from 1950 to 2023 were reviewed. The data analysis was then performed via SA in the form of open coding as well as simultaneous analysis through three types of maps, viz., situational, social worlds/arenas, and positional maps, along with constant comparative analysis. RESULTS Pre-hospital EMS in Iran has thus far had two turning points from 1970 to 2023, wherein academic components, need for equipment and resources, in conjunction with basic needs in the modern society, have been the main propellers. As well, the complexity of care for non-communicable diseases (NCDs), demand for managed care, and technological advancement has gradually resulted in further development in EMS. This trend describes the EMS situation in Iran from 1973 to 2023, as well as the EMS emergence stages, quantitative growth and infrastructure, and clinical education development in 2002-2023, indicating the lack of funding and inadequate scientific infrastructure in proportion to the population receiving such services. CONCLUSION Considering the trend of change in the approaches adopted by healthcare systems across the world, and given the breakthroughs in nursing and medicine, along the education of professionals during the last thirty years, the descriptions of duties and performance in EMS have moved from primary care and patient transfer to specialized services and outpatient care. In addition, the cultural context specific to Iran, the challenges of women working in EMS centers, the disconnection of service providers, namely, the Iranian Red Crescent Society (IRCS) Relief and Rescue Organization (R&RO), Iran's National Police Force (INPF), and Iran's National Medical Emergency Organization (INMEO), as well as lack of resources and equipment, and the geographical distribution of human resources (HRs) based on population dispersion, are thus among the significant issues facing pre-hospital EMS in this country.
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Affiliation(s)
- Kheizaran Miri
- Department of Nursing, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Mohammadreza Sabbaghi
- Department of Medical Emergency, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Seyyed Reza Mazlum
- Department of Medical - Surgical Nursing, School of Nursing and Midwifery, Mashhad University Medical of Medical Sciences, Mashhad, Iran
| | - Mohammad Namazinia
- Department of Nursing, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.
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Hosseini SE, Jafari M, Nemati A, Rahmani K, Mahmoudian P, Ferdosi M. Training needs assessment of hospital CEOs in a developing country: the example of Iran. BMC MEDICAL EDUCATION 2023; 23:602. [PMID: 37620813 PMCID: PMC10464028 DOI: 10.1186/s12909-023-04463-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 06/20/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND It is essential to identify the necessary competencies of hospital CEOs in order to improve the quality and efficiency of services they provide. Expert leadership skills and competencies can have a significant impact on the success of an organization, benefiting both patients and staff. This study aimed to assess the competencies and training needs of hospital CEOs in Iran public hospitals. METHODS We conducted this cross-sectional analytical study through a self-assessment questionnaire, which was a web-based platform developed by the WHO country office in Iran, between July 2018 and September 2018. The questionnaire was completed by 180 hospital CEOs and included a core set of 81 items based on Assessing the Competency of Hospital CEO. These items were categorized into five superordinate categories: leadership, personality and quality of individual behavior, knowledge and business skills, social responsibility, and healthcare environment. In addition, we conducted focus groups with 30 hospital CEOs, supervisor assessments with 10 hospital managers, and interviews with 10 supervisors. RESULTS Of the 180 questionnaires distributed, 78% were returned, and most respondents were medical specialists. The need for leadership competencies such as individual behavior skills and change management received the highest priority. Most respondents required training in management skills, including financial management, governance, strategic thinking, quality improvement, and disaster management. CONCLUSION Providing needs-based education is crucial, especially in developing countries. In this study, leadership and strategic thinking were found to be the most needed competencies among hospital CEOs in Iran. These findings serve as reference points for developing countries with similar backgrounds and healthcare environments as Iran.
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Affiliation(s)
- Seyede-Elahe Hosseini
- Health Management and Economics Research Center, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehdi Jafari
- Department of health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Nemati
- Department of Health Service Management, School of Management and Medical Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Keyvan Rahmani
- Health Management Development Institute, Ministry of Health and Medical Education, Tehran, Iran
| | - Payam Mahmoudian
- Health Management and Economics Research Center, School of Management and Medical Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Masoud Ferdosi
- Health Management and Economics Research Center, Department of Health Services Management, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
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Alruwaili AS, Islam MS, Usher K. Factors Influencing Hospitals' Disaster Preparedness in the Eastern Province of Saudi Arabia. Disaster Med Public Health Prep 2023; 17:e301. [PMID: 36785527 DOI: 10.1017/dmp.2022.261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
OBJECTIVE The study aimed to identify the factors that influence the disaster preparedness of hospitals and validate an evaluation framework to assess hospital disaster preparedness (HDP) capability in the Eastern Province of Saudi Arabia. METHODS A cross-sectional survey of all hospitals (n = 72) in the Eastern Region of Saudi Arabia was conducted. A factor analysis method was used to identify common factors and validate the evaluation framework to assess HDP capacity. RESULTS Sixty-three (63) hospitals responded to the survey. A 3-factor structure was identified as key predicators of HDP capacity. The first factor was the most highly weighted factor, which included education and training (0.849), monitoring and assessing HDP (0.723), disaster planning (0.721), and command and control (0.713). The second factor included surge capacity (0.708), triage system (0.844), post-disaster recovery (0.809), and communication (0.678). The third factor represented safety and security (0.638) as well as logistics, equipment, and supplies (0.766). CONCLUSION The identified 3-factor structure provides an innovative approach to assist the operationalization of the concept of HDP capacity building and service improvement, as well as serve as a groundwork to further develop instrument for assessing HDP in future studies.
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Affiliation(s)
- Abdullah Saleh Alruwaili
- Emergency Medical Services Program, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Al Ahsa, Saudi Arabia
- King Abdullah International Medical Research Center, Al Ahsa, Saudi Arabia
| | - Md Shahidul Islam
- School of Health, University of New England, Armidale, 2350, Australia
| | - Kim Usher
- School of Health, University of New England, Armidale, 2350, Australia
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Tang Z, Ye C, Fu Z, Zhang J, Gong Z. Primary medical and health preparedness and people's life satisfaction in China: The mediating role of satisfaction with medical and health services. Front Public Health 2023; 11:1037574. [PMID: 36815154 PMCID: PMC9939693 DOI: 10.3389/fpubh.2023.1037574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 01/16/2023] [Indexed: 02/08/2023] Open
Abstract
Objective To examine the association between primary medical and health preparedness (PMHP), satisfaction with medical and health services (SMHS), and life satisfaction (LS). Methods Using the latest national representative data from the 2019 Chinese Social Survey and the 2018 Health Statistics Yearbook for each province in China, we conducted multi-level models to test the effect of three aspects of PMHP (the number of primary medical and health institutions (PMHIs), the number of beds in PMHIs, and the number of staff in PMHIs) on LS, and the mediation role of SMHS in this effect. Results The number of staff in PMHIs has a significant positive effect on people's LS. Besides, this effect is mediated completely by SMHS. However, the number of PMHIs and the number of beds in PMHIs do not affect LS significantly. Conclusions PMHP has a positive impact on LS, but this impact is associated only with the number of staff in PMHIs. Therefore, governments should focus on optimizing human resources in PMHIs to meet the LS needs of individuals.
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Affiliation(s)
- Zhiwei Tang
- School of Public Affairs and Administration, University of Electronic Science and Technology of China, Chengdu, China,Shenzhen Institute for Advanced Study, University of Electronic Science and Technology of China, Shenzhen, China
| | - Changxiu Ye
- School of Public Affairs and Administration, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhuang Fu
- School of Public Affairs and Administration, University of Electronic Science and Technology of China, Chengdu, China
| | - Jingran Zhang
- Tianfu Co-innovation Center, University of Electronic Science and Technology of China, Chengdu, China
| | - Zepeng Gong
- School of Public Affairs and Administration, University of Electronic Science and Technology of China, Chengdu, China,Shenzhen Institute for Advanced Study, University of Electronic Science and Technology of China, Shenzhen, China,*Correspondence: Zepeng Gong ✉
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14
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Working in Emergency Conditions and COVID-19 Pandemic in Hospitals and Health Workforce Retentions. HEALTH SCOPE 2022. [DOI: 10.5812/jhealthscope-130983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Rezaei F, Keyvanara M, Yarmohammadian MH. Participation' goals of Community- based organizations in the COVID-19 pandemic based on capacity gaps: A cross-sectional study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:336. [PMID: 36567999 PMCID: PMC9768742 DOI: 10.4103/jehp.jehp_1672_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/03/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND There have been criticisms that local authorities develop disaster planning independently, which led to less sensitiveness and responsibility of community-based organizations (CBOs). Disasters planning should incorporate into CBOs' management processes. This study aims to set goals of a community-based plan based on preparedness capacities that CBOs need to have in the COVID-19 pandemic. MATERIALS AND METHODS This cross-sectional study used a prevalidated and reliable questionnaire assessing (CBOs). The tool assesses preparedness in the field of planning, training, and infrastructure. Forty CBOs met the inclusion criteria as assisting or cooperating agencies during the COVID-19 pandemic. Then, key informants, who simultaneously have been working in the health system and CBOs, prioritized low-scale items that have shown capacity gaps according to effects on the vulnerable group, sustainability, and capability of the health system. Descriptive statistics performed using SPSS18 software (SPSS Inc., Chicago, USA). RESULTS The results showed that the preparedness of CBOs was weak in the field of planning, training, and infrastructure. Besides, overlaps of CBOs' resources and covering the clients' medical needs in the COVID-19 pandemic were the most priority that needs to be intervened. CONCLUSION Providing medical needs by CBOs require legal legitimacy assigned by health authority, especially in epidemic-prone diseases. In addition, assigning a coordinator to set a priority list and mutual agreements authoried by health departments can solve the problem of overlapped resources. Therefore, functional roles of CBOs in the pandemic should focus mostly on resource allocation and the medical needs of clients to set goals and functional objectives.
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Affiliation(s)
- Fatemeh Rezaei
- Department of Health in Disasters and Emergencies, Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahmoud Keyvanara
- Department of Healthcare Management, Faculty of Management and Medical Informatics, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad H Yarmohammadian
- Department of Health in Disasters and Emergencies, Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Khalil M, Ravaghi H, Samhouri D, Abo J, Ali A, Sakr H, Camacho A. What is "hospital resilience"? A scoping review on conceptualization, operationalization, and evaluation. Front Public Health 2022; 10:1009400. [PMID: 36311596 PMCID: PMC9614418 DOI: 10.3389/fpubh.2022.1009400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 09/27/2022] [Indexed: 01/27/2023] Open
Abstract
Background COVID-19 underscored the importance of building resilient health systems and hospitals. Nevertheless, evidence on hospital resilience is limited without consensus on the concept, its application, or measurement, with practical guidance needed for action at the facility-level. Aim This study establishes a baseline for understanding hospital resilience, exploring its 1) conceptualization, 2) operationalization, and 3) evaluation in the empirical literature. Methods Following Arksey and O'Malley's model, a scoping review was conducted, and a total of 38 articles were included for final extraction. Findings and discussion In this review, hospital resilience is conceptualized by its components, capacities, and outcomes. The interdependence of six components (1) space, 2) stuff, 3) staff, 4) systems, 5) strategies, and 6) services) influences hospital resilience. Resilient hospitals must absorb, adapt, transform, and learn, utilizing all these capacities, sometimes simultaneously, through prevention, preparedness, response, and recovery, within a risk-informed and all-hazard approach. These capacities are not static but rather are dynamic and should improve continuously occur over time. Strengthening hospital resilience requires both hard and soft resilience. Hard resilience encompasses the structural (or constructive) and non-structural (infrastructural) aspects, along with agility to rearrange the space while hospital's soft resilience requires resilient staff, finance, logistics, and supply chains (stuff), strategies and systems (leadership and coordination, community engagement, along with communication, information, and learning systems). This ultimately results in hospitals maintaining their function and providing quality and continuous critical, life-saving, and essential services, amidst crises, while leaving no one behind. Strengthening hospital resilience is interlinked with improving health systems and community resilience, and ultimately contributes to advancing universal health coverage, health equity, and global health security. The nuances and divergences in conceptualization impact how hospital resilience is applied and measured. Operationalization and evaluation strategies and frameworks must factor hospitals' evolving capacities and varying risks during both routine and emergency times, especially in resource-restrained and emergency-prone settings. Conclusion Strengthening hospital resilience requires consensus regarding its conceptualization to inform a roadmap for operationalization and evaluation and guide meaningful and effective action at facility and country level. Further qualitative and quantitative research is needed for the operationalization and evaluation of hospital resilience comprehensively and pragmatically, especially in fragile and resource-restrained contexts.
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Affiliation(s)
- Merette Khalil
- Department for Universal Health Coverage and Health Systems, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt,*Correspondence: Merette Khalil
| | - Hamid Ravaghi
- Department for Universal Health Coverage and Health Systems, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Dalia Samhouri
- Health Emergencies Programme, World Health Organization, Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - John Abo
- Asian Disaster Preparedness Center, Bangkok, Thailand
| | - Ahmed Ali
- Health Emergencies Programme, World Health Organization, Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Hala Sakr
- Department of Healthier Populations, World Health Organization, Regional Office for the Eastern Mediterranean, Cairo, Egypt
| | - Alex Camacho
- Health Emergencies Programme, World Health Organization, Regional Office for the Americas, Washington, DC, United States
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Establishing the Domains of a Hospital Disaster Preparedness Evaluation Tool: A Systematic Review. Prehosp Disaster Med 2022; 37:674-686. [PMID: 36052843 PMCID: PMC9470528 DOI: 10.1017/s1049023x22001212] [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] [Indexed: 11/26/2022]
Abstract
Introduction: Recent disasters emphasize the need for disaster risk mitigation in the health sector. A lack of standardized tools to assess hospital disaster preparedness hinders the improvement of emergency/disaster preparedness in hospitals. There is very limited research on evaluation of hospital disaster preparedness tools. Objective: This study aimed to determine the presence and availability of hospital preparedness tools across the world, and to identify the important components of those study instruments. Method: A systematic review was performed using three databases, namely Ovid Medline, Embase, and CINAHL, as well as available grey literature sourced by Google, relevant websites, and also from the reference lists of selected articles. The studies published on hospital disaster preparedness across the world from 2011-2020, written in English language, were selected by two independent reviewers. The global distribution of studies was analyzed according to the World Health Organization’s (WHO) six geographical regions, and also according to the four categories of the United Nations Human Development Index (UNHDI). The preparedness themes were identified and categorized according to the 4S conceptual framework: space, stuff, staff, and systems. Result: From a total of 1,568 articles, 53 met inclusion criteria and were selected for data extraction and synthesis. Few published studies had used a study instrument to assess hospital disaster preparedness. The Eastern Mediterranean region recorded the highest number of such publications. The countries with a low UNHDI were found to have a smaller number of publications. Developing countries had more focus on preparedness for natural disasters and less focus on chemical, biological, radiological, and nuclear (CBRN) preparedness. Infrastructure, logistics, capacity building, and communication were the priority themes under the space, stuff, staff, and system domains of the 4S framework, respectively. The majority of studies had neglected some crucial aspects of hospital disaster preparedness, such as transport, back-up power, morgue facilities and dead body handling, vaccination, rewards/incentive, and volunteers. Conclusion: Important preparedness themes were identified under each domain of the 4S framework. The neglected aspects should be properly addressed in order to ensure adequate preparedness of hospitals. The results of this review can be used for planning a comprehensive disaster preparedness tool.
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Ahmadi C, Karampourian A, Samarghandi MR. Explain the challenges of evacuation in floods based on the views of citizens and executive managers. Heliyon 2022; 8:e10759. [PMID: 36193530 PMCID: PMC9525901 DOI: 10.1016/j.heliyon.2022.e10759] [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: 05/04/2022] [Revised: 07/20/2022] [Accepted: 09/21/2022] [Indexed: 11/28/2022] Open
Abstract
Background Flood is one of the natural hazards that causes a lot of human and financial losses. Emergency evacuation in the response phase is necessary to reduce damage. The present study was conducted to explain the challenges related to evacuation in floods based on the views of citizens and executive managers. Materials and methods In this study, a qualitative research method with a contractual content analysis approach was used. 27 participants including 10 citizens and 17 executive managers were included in the study by purposive sampling. Semi-structured interviews were used to collect data. In order to have confidence the validity of the results, rigor was certified by using the guidelines suggested by Guba and Lincoln for making trustworthiness. The duration of the interview was between 45 min and 60 min. The interviews were handwritten by line-by-line content analysis and then analyzed. Results Data analysis led to the extraction of 6 main categories with 14 sub-categories including: lack of primary warning system (with 2 sub-categories, lack of national early warning system and lack of attention to early warning), insufficient resources (with 4 sub-categories, lack of equipment, lack of manpower Human resources, inadequate allocation of financial resources and lack of information resources), problems related to unpreparedness (having 2 sub-categories, lack of pre-determined program and lack of attention to public education), problems related to emergency housing (having 2 sub-categories, lack of housing program and lack of attention to indigenous culture in housing), lack of risk perception (has 2 sub-categories of people's belief in floods and officials' belief in flood) and problems related to lack of coordination (has 2 sub-categories of internal disharmony and external disharmony). Conclusion To increase evacuation, it is necessary to identify the relevant challenges. Establishing an early warning system and evacuation plan, supply of resources, and increase risk perception and coordination can increase the speed of evacuation and reduce the financial and human losses caused by floods.
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Affiliation(s)
| | - Arezou Karampourian
- Urology and Nephrology Research Center, Chronic Diseases (Home Care) Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Reza Samarghandi
- Department of Environmental Health, School of Health, Health Sciences Research Center, Health Sciences & Technology Research Institute, Hamadan University of Medical Sciences, Hamadan, Iran
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Mousavi SH, Khankeh H, Atighechian G, Yarmohammadian MH, Memarzadeh M. Challenges of prehospital aerial operations in response to earthquake hazards: A qualitative study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:268. [PMID: 36325237 PMCID: PMC9621378 DOI: 10.4103/jehp.jehp_1302_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 11/22/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUNDS Due to the severity of the earthquake, it may need immediate treatment and transfer of the injured people to advanced medical centers, as well as dispatch of the expert team and specialized health equipment to the accident-affected area. Aerial emergency is an important responsibility of the health care system in this situation. The study aimed to extract the prehospital emergency challenges of Iran aerial operations emergency in response to the earthquake. MATERIALS AND METHODS The study was qualitative content analysis with conventional approach. Sampling was done in a purposive method and data were collected through semi-structured interview. The panel involved consists of 26 health professionals in medical emergencies. Recorded interviews were transcribed into written and then conventional content analysis was used to derive coding categories directly from the text data. RESULTS Content analysis is provided 97 initial codes, 20 subcategories and 4 main categories including challenges of "response assessment," "support," "pre-hospital staff-management," and "response operation," respectively. CONCLUSIONS The results showed that the necessity to assess the affected area, staffing, and management actions, including integrated operations command and the development of a dedicated response plan, as well as the use of strategies inter-organizational coordination in the response phase to earthquake. This study also emphasized that providing standard equipment, support actions, and strengthening communication infrastructure, and updating the aerial emergency system should be considered as one of the priorities of the emergency organization of Iran to provide a desired response to the earthquake.
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Affiliation(s)
- Seyed Hossein Mousavi
- Department of Health in Disaster and Emergencies, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamidreza Khankeh
- Research Center for Emergency and Disaster Health, The University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Golrokh Atighechian
- Department of Health in Emergencies and Disasters, Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Mehrdad Memarzadeh
- Department of Surgery, School of Medicine Craniofacial and Cleft Research Center, Imam Hossein Children Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
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Azizpour I, Mehri S, Soola AH. Disaster preparedness knowledge and its relationship with triage decision-making among hospital and pre-hospital emergency nurses - Ardabil, Iran. BMC Health Serv Res 2022; 22:934. [PMID: 35854268 PMCID: PMC9296334 DOI: 10.1186/s12913-022-08311-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 07/07/2022] [Indexed: 11/17/2022] Open
Abstract
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.
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Affiliation(s)
- Islam Azizpour
- Department of Emergency nursing, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Saeid Mehri
- Department of Nursing, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Aghil Habibi Soola
- Department of Nursing, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran.
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21
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Emergency Response to a Hospital Fire: A Report From the Field. Disaster Med Public Health Prep 2022. [DOI: 10.1017/dmp.2022.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
As the most important centers providing medical services during disasters and emergencies, hospitals have special structural complexities. Furthermore, the hospitals are exposed to many intrinsic and extrinsic hazards, including fire. On November 28, 2018, at 9:25 am (local time), a fire started in Ayatollah Taleghani Hospital of Ilam, affiliated with Ilam University of Medical Sciences, Iran. Immediately, to save patients’ lives and prevent injuries to them, the horizontal and then vertical evacuation was performed to transfer patients to other hospitals by helping the support organizations. No physical injuries or deaths were reported in this incident. The results of this case study showed that hospitals should be sufficiently prepared to respond effectively to accidents and disasters, so it is needed to prepare and practice response programs and train hospital staff and managers.
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Yamamoto C, Yamada C, Onoda K, Takita M, Kotera Y, Hasegawa A, Oikawa T, Tsubokura M. Disaster response among hospital nurses dispatched to evacuation centers after the Great East Japan Earthquake: a thematic analysis. BMC Health Serv Res 2022; 22:848. [PMID: 35778722 PMCID: PMC9247954 DOI: 10.1186/s12913-022-08231-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 06/20/2022] [Indexed: 11/23/2022] Open
Abstract
Background Disaster relief operations involve a variety of components of healthcare efforts. The post-disaster recovery is a key component of hospital preparedness. This study aimed to investigate the role of hospital nurses in the disaster area and their challenges during the relief efforts after the Great East Japan Earthquake in 2011. Methods Semi-structured interviews were conducted with ten nurses who worked in a general public hospital before the Great East Japan Earthquake and were dispatched to the evacuation centers after the disaster. A qualitative approach with the thematic analysis method was employed. Three research queries (RQs) were prepared before the interview. Results The study participants played administrative roles as city employees in addition to performing nursing services as healthcare providers in evacuation centers. The first RQ on their challenges in evacuation centers gave us four themes: criticism by the evacuees, conflicts between multiple roles, difficulties in performing the first experience, and anxiety in working. The second RQ asking about motivation to accomplish disaster relief efforts raised three themes of carrying out the nursing role, acceptance by evacuees, and strengths of human connections. Two themes of awareness of disaster medicine and professional growth were raised from the third RQ of gains from the experiences in the evacuation centers. Conclusions The hospital nurses in the disaster area performed multiple roles in the relief efforts in the evacuation centers, which developed a psychological burden on them. A sense of competence supported the motivation to accomplish the disaster relief activities and professional growth as a specialist in disaster medicine. A study limitation is missing hospital nurses who resigned during the relief efforts. Further study is warranted to refine the disaster preparedness of hospital operations. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08231-8.
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Affiliation(s)
- Chika Yamamoto
- Department of Emergency, Minamisoma Municipal General Hospital, Fukushima, Japan. .,Department of Disaster and Radiation Medical Sciences, Fukushima Medical University, Fukushima, Japan.
| | - Chieri Yamada
- Department of Public Health Nursing for International Radiation, Fukushima Medical University, Fukushima, Japan
| | - Katsuko Onoda
- Department of Nursing, Minamisoma Municipal General Hospital, Fukushima, Japan
| | - Morihito Takita
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yasuhiro Kotera
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Arifumi Hasegawa
- Department of Radiation Disaster Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tomoyoshi Oikawa
- Department of Neurosurgery, Minamisoma Municipal General Hospital, Fukushima, Japan
| | - Masaharu Tsubokura
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan.,Research Center for Community Health, Minamisoma Municipal General Hospital, Fukushima, Japan
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Latent Profiles of Posttraumatic Growth: 17 years After the Bam Earthquake in Iran. Disaster Med Public Health Prep 2022; 17:e127. [PMID: 35331363 DOI: 10.1017/dmp.2022.36] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Posttraumatic growth (PTG) is a positive psychological change after challenging life events. The purpose of this study was to investigate the effects of positive and long-term psychological changes in people who experienced the Bam earthquake. METHODS A total of 916 adolescents were surveyed 17 years after the earthquake. Self-report questionnaires were administered to participants. A latent profile analysis (LPA) was conducted to extract the subgroups of adults. RESULTS The LPA identified 5 meaningfully profiles that were characterized based on the pattern of PTG dimensions. The common profile was profile, which perceived very low "relating to others" dimension and medium for other PTG dimensions. Also, the results showed significant differences among gender and age and nonsignificant differences in marital status and education level among the profiles of PTG. CONCLUSIONS For stressful situations, the different dimensions of PTG change indirectly in every person. In Bam, some patterns are seen according to PTG after 17 y. Among these dimensions, the part of "relating to others", has the greatest change. Another conclusion is that according to a relatively high profile for 5 clusters, it seems the impact of 17 y should be less on PTG as the number of extractive patterns is approximately high for the case.
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Safer Hospital Infrastructure Assessments for Socio-Natural Disaster - A Scoping Review. Prehosp Disaster Med 2021; 36:627-635. [PMID: 34284848 DOI: 10.1017/s1049023x21000650] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The aim of this review was to explore hospital socio-natural disaster resilience by identifying: studies assessing structural and non-structural aspects of building resilience; components required to maintain a safe and functional health facility; and if the checklists used were comprehensive and easily performed. METHODS A review systemic approach using PRISMA was taken to search the literature. The search focused on articles that discuss hospital disaster resilience. This includes assessments and checklists for facility structural and non-structural components. RESULTS This review identified 22 articles describing hospital assessments using checklists containing structural and non-structural elements of resilience. These studies identified assessments undertaken in ten countries, with eight occurring across Iran. A total of seven differing checklists were identified as containing aspects of structural or non-structural aspects of building resilience. The World Health Organization (WHO) has authored three checklists and four others were developed independently.The structural resilience domain includes building integrity, building materials, design standards, and previous event damages as important elements to determine resilience. Within the internal safety and resilience domains, 11 differing elements were identified as important to non-structural or internal infrastructure resilience. These included the safety of power, water, telecommunication, medical gas supply, and medical equipment resupply systems.Independent evaluation methods were reported in the majority of articles, with a small number highlighting the benefits of both self-evaluation and independent review processes. Implementation of training programs to evaluators was mentioned in three papers with the assessor's knowledge and understanding of all checklist elements being highlighted as important to the validity of the evaluation. CONCLUSION The review identified the assessment of hospital resilience as important for management to determine areas of vulnerability within the hospital's infrastructure and to inform improvement strategies. Assessment criteria must be comprehensive, highlighting structural and non-structural aspects of facility infrastructure. These assessments are best done as a multi-disciplinary collective of experts, involving hospital employees in the journey. This collaborative approach provides a key educational tool for developing disaster capacity, engaging ownership of the process, and the resulting improvements.The on-going development of health facility and wider health system resilience must remain a key strategic focus of national governments and health authorities. The development of standardized procedures and guidelines must be embedded into daily practice.
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Rattanakanlaya K, Sukonthasarn A, Wangsrikhun S, Chanprasit C. Improving flood disaster preparedness of hospitals in Central Thailand: Hospital personnel perspectives. J Clin Nurs 2021; 31:1073-1081. [PMID: 34288175 DOI: 10.1111/jocn.15971] [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] [Received: 12/22/2020] [Revised: 06/20/2021] [Accepted: 07/05/2021] [Indexed: 11/29/2022]
Abstract
AIM To improve hospitals disaster preparedness during floods. BACKGROUND The Thai flood disaster in 2011 struck several sectors, including hospitals. It is necessary to build a disaster preparedness system that ensures that hospitals have the capacity to respond effectively to any kind of disaster. METHODS This qualitative study was conducted using content analysis. Purposive sampling was used to select 15 participants, including doctors, nurses and other staff involved in disaster preparedness, and semi-structured interviews were conducted with them. The study was reported according to COREQ guidelines. RESULTS Healthcare personnel identified several ways in which flood disaster preparedness of hospitals may be enhanced. Three themes and eight subthemes were identified during the data analysis. The three themes were as follows: 1) ongoing efforts for flood prevention and mitigation at a national level; 2) developing operational guidelines to effectively prevent and resolve flood problems at provincial levels; and 3) increasing the levels of flood readiness at the hospital level. CONCLUSIONS The results of this study indicate strategies to help policymakers and health personnel enhance flood disaster preparedness measures at hospitals based on the experiences of hospital personnel involved in one of the worst flood disasters worldwide. RELEVANCE TO CLINICAL PRACTICE Hospitals alone cannot deal with unpredictable events; they need additional assistance in disaster preparedness. There are three levels at which improving hospital flood disaster preparedness can take place: national, provincial and hospital levels. Nursing professionals participate in hospital disaster preparedness and work with multidisciplinary teams to provide services. Nurses should be prepared for such participation, as their involvement, through tailored services for hospital disaster preparedness, can expand the literature on nursing knowledge to improve clinical outcomes.
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Affiliation(s)
- Kanittha Rattanakanlaya
- Faculty of Nursing, Division of Surgical Nursing, Chiang Mai University, Chiang Mai, Thailand
| | - Achara Sukonthasarn
- Faculty of Nursing, Division of Surgical Nursing, Chiang Mai University, Chiang Mai, Thailand
| | - Suparat Wangsrikhun
- Faculty of Nursing, Division of Surgical Nursing, Chiang Mai University, Chiang Mai, Thailand
| | - Chawapornpan Chanprasit
- Faculty of Nursing, Division of Public Health Nursing, Chiang Mai University, Chiang Mai, Thailand
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Ow Yong LM, Xin X, Wee JML, Poopalalingam R, Kwek KYC, Thumboo J. Perception survey of crisis and emergency risk communication in an acute hospital in the management of COVID-19 pandemic in Singapore. BMC Public Health 2020; 20:1919. [PMID: 33334334 PMCID: PMC7745758 DOI: 10.1186/s12889-020-10047-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 12/10/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Emergency risk communication is a critical component in emergency planning and response. It has been recognised as significant for planning for and responding to public health emergencies. While there is a growing body of guidelines and frameworks on emergency risk communication, it remains a relatively new field. There has also been limited attention on how emergency risk communication is being performed in public health organisations, such as acute hospitals, and what the associated challenges are. This article seeks to examine the perception of crisis and emergency risk communication in an acute hospital in response to COVID-19 pandemic in Singapore and to identify its associated enablers and barriers. METHODS A 13-item Crisis and Emergency Risk Communication (CERC) Survey, based on the US Centers for Disease and Control (CDC) CERC framework, was developed and administered to hospital staff during February 24-28, 2020. The survey also included an open-ended question to solicit feedback on areas of CERC in need of improvement. Chi-square test was used for analysis of survey data. Thematic analysis was performed on qualitative feedback. RESULTS Of the 1154 participants who responded to the survey, most (94.1%) reported that regular hospital updates on COVID-19 were understandable and actionable. Many (92.5%) stated that accurate, concise and timely information helped to keep them safe. A majority (92.3%) of them were clear about the hospital's response to the COVID-19 situation, and 79.4% of the respondents reported that the hospital had been able to understand their challenges and address their concerns. Sociodemographic characteristics, such as occupation, age, marital status, work experience, gender, and staff's primary work location influenced the responses to hospital CERC. Local leaders within the hospital would need support to better communicate and translate hospital updates in response to COVID-19 to actionable plans for their staff. Better communication in executing resource utilization plans, expressing more empathy and care for their staff, and enhancing communication channels, such as through the use of secure text messaging rather than emails would be important. CONCLUSION CERC is relevant and important in the hospital setting to managing COVID-19 and should be considered concurrently with hospital emergency response domains.
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Affiliation(s)
- Lai Meng Ow Yong
- Medical Social Services, Singapore General Hospital, Singapore, 169608, Singapore.
| | - Xiaohui Xin
- Health Services Research Unit, Singapore General Hospital, Singapore, 169608, Singapore
| | | | | | | | - Julian Thumboo
- Health Services Research Unit, Singapore General Hospital, Singapore, 169608, Singapore
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Qualitative Study of Health System Preparedness for Successful Implementation of Disaster Exercises in the Iranian Context. Disaster Med Public Health Prep 2020; 16:500-509. [PMID: 33023696 DOI: 10.1017/dmp.2020.257] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Implementing disaster exercises in different parts of the health system is one of the important steps in providing and developing disaster risk management plans. Considering the importance of promoting health system preparedness through exercise, the present study aimed to identify and explain necessary and original components for successful implementation of preparedness exercises of the health-care system in disaster. METHODS The study was a qualitative content analysis. Data were collected by purposeful sampling through in-depth and semi-structured individual interviews with 25 health professionals in disaster. Directed content analysis was used to analyze the data, which extracted the initial codes after performing the recorded interviews on paper and immersing them in the data analysis. RESULTS The data analysis resulted in the production of 100 initial codes, 14 subcategories, 6 main categories of "coordination and information management," "standards and indicators," "conduction and control of the process," "logistic management and supplies," "management of treatment operation," and "management of health operation," under the original theme of "implementation of exercise." CONCLUSIONS The findings of this study can greatly increase the attention of senior managers to preparedness in all areas of the health system, especially managers of prehospitals and hospitals who are the forefront of the response to the disaster. The findings of this study can be considered as a guideline for the implementation of principle and standardized health system preparedness exercises.
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