Factors influencing readiness to deploy in disaster response: findings from a cross-sectional survey of the Department of Veterans Affairs Disaster Emergency Medical Personnel System

Are we prepared to care for the children? An assessment of pediatric-specific pre-deployment training provided by non-governmental organizations operating in disaster zones

INTRODUCTION

Children have specific vulnerabilities during crises that necessitate specialized care. This study assessed the adequacy of pediatric-specific pre-deployment training provided by Non-Governmental Organizations (NGOs) operating in crisis zones.

METHOD

To identify NGOs active in disaster response, a list of organizations that responded to the 2023 Turkey-Syria earthquake were selected from Charity Watch's top-rated NGOs in the International Relief & Development category. A comprehensive analysis of their public websites was performed, and the NGOs were contacted for information on their pediatric-specific training. NGO response rates and the content of the programs were analyzed to evaluate the current state of pediatric pre-deployment training.

FINDINGS

Twelve of the 23 (52.1 %) NGOs responded to inquiries. Of the responding NGOs, only one required any pediatric-specific training: a baseline minimum requirement for both pediatric and neonatal life support certificates (or the equivalent) for all clinical staff. The NGO stipulated that its staff also receive mandatory training on safeguarding child welfare, as well as Integrated Management of Neonatal and Childhood Illness training. The non-pediatric specific courses offered by this specific NGO include Personal Safety and Security, Psychological First Aid and Hostile Environment Awareness Training.

CONCLUSION

There is a critical lack of pediatric training provided by NGOs. This underscores the crucial need for standardized and comprehensive pre-deployment training for healthcare personnel in disaster zones, with a particular focus on pediatric care. The analysis of NGO responses and practices revealed inconsistencies in training content, strategies and programs. Establishing best practices and collaboration between NGOs, healthcare experts, and authorities is vital to ensuring the proper care of pediatric patients in disaster zones.

Composition and influencing factors of professionals' capacity in public health emergency rescues: a qualitative study

Objective

To explore the composition and influencing factors of professionals' capacity in public health emergency rescues.

Methods

A descriptive qualitative design was used in this study. Medical workers, managers, and members of an emergency rescue team in Hangzhou, Zhejiang, were recruited for participation through a purposive sampling method. The data were collected using semi-structured interviews and analyzed using a conventional content analysis method.

Findings

A total of 2 themes and 13 sub-themes emerged from the analysis: ability composition (knowledge reserve, early warning assessment, information reporting, emergency response, self-protection, personal ability, coordination and cooperation, health education) and influencing factors (educational background, region, experience, hospital level, human resources, and financial investment).

Conclusion

These findings offer a basis for the construction of a related indicator system and provide a reference for relevant departments to further optimize their emergency education and training, strengthen their emergency drills, and improve their emergency rescue abilities. The findings indicate that it is necessary to pay attention to the construction of an emergency rescue team, adjust the ratio of personnel, improve their remuneration, and promote work enthusiasm to improve the emergency rescue ability of an organization.

Emergency and Disaster Handling Preparedness Among Front Line Health Service Providing Nurses and Associated Factors at Emergency Department, at Amhara Regional State Referral Hospitals, Ethiopia

Introduction

Globally around 1.6 million individuals have died as a result of disasters per year. These disruptive events that happen in the world each day result in damage to individuals, families, and communities.

Methods

An institution-based cross-sectional study was conducted. All frontline health-care providers at the emergency departments of Amhara Regional State Referral Hospitals during the study period were considered as studied subjects. Data were collected through a self-administered technique. Once all essential data were collected, data were coded and entered into epidata manager (v4.6.0.2) statistical software. SPSS version 26 was used to analyze the findings of this paper.

Results

The result of this research study showed that 66.7% were males and 33.3% were females with mean age of respondents being 31.2 ± 5.8. Among respondents, 54% (52.9) % did not have an understanding of disaster preparedness. As a result, the majority of participants, 52 (51%), have inadequate knowledge. Most respondents have adequate attitude (57.8%) and only a few, 12 (11.8%), of respondents were very familiar with regard to disaster and disaster handling preparedness. In multivariate logistic regression, receiving training on the subject (P = 0.000, AOR: 15.109. 95% CI: 3.525–64.769), respondents receiving simulation in the subject of disaster (P = 0.015, AOR: 4.855, 95% CI: 1.366–17.260) and having a direct personal/professional experience of disaster (P = 0.003, AOR: 5.703, 95% CI: 1.825–17.823) were significantly associated.

Conclusion and Recommendation

Disaster handling preparedness, knowledge and familiarity levels were below those expected for emergency department nurses. Capacity building through training, education and simulation is essential.

Training Package for Emergency Medical Teams Deployed to Disaster Stricken Areas: Has 'TEAMS' Achieved its Goals?

In spite of their good intentions, Emergency Medical Teams (EMTs) were relatively disorganized for many years. To enhance the efficient provision of EMT's field team work, the Training for Emergency Medical Teams and European Medical Corps (TEAMS) project was established. The purpose of this study was to assess the effectiveness and quality of the TEAMS training package in 2 pilot training programs in Germany and Turkey. A total of 19 German and 29 Turkish participants completed the TEAMS training package. Participants were asked to complete a set of questionnaires designed to assess self-efficacy, team work, and quality of training. The results suggest an improvement for both teams' self-efficacy and team work. The self-efficacy scale improved from 3.912 (± 0.655 SD) prior to training to 4.580 (± 0.369 SD) after training (out of 5). Team work improved from 3.085 (± 0.591 SD) to 3.556 (± 0.339 SD) (out of 4). The overall mean score of the quality of the training scale was 4.443 (± 0.671 SD) (out of 5). In conclusion, The TEAMS Training Package for Emergency Medical Teams has been demonstrated to be effective in promoting EMT team work capacities, and it is considered by its users to be a useful and appropriate tool for addressing their perceived needs.

Workforce preparedness for disasters: perceptions of clinical and non-clinical staff at the U.S. Department of Veterans Affairs

Background

Most U.S. studies on workforce preparedness have a narrow scope, focusing primarily on perceptions of clinical staff in a single hospital and for one type of disaster. In contrast, this study compares the perceptions of workplace disaster preparedness among both clinical and non-clinical staff at all U.S. Department of Veterans Affairs (VA) medical facilities nationwide for three types of disasters (natural, epidemic/pandemic, and manmade).

Methods

The VA Preparedness Survey used a stratified simple random, web-based survey (fielded from October through December 2018) of all employees at VA medical facilities. We conducted bivariate and multivariate logistic regression analyses to compare the sociodemographic characteristics and perceptions of disaster preparedness between clinical and non-clinical VA staff.

Results

The study population included 4026 VA employees (2488 clinicians and 1538 non-clinicians). Overall, VA staff were less confident in their medical facility’s ability to respond to epidemic/pandemics and manmade disasters. Depending on the type of disaster, clinical staff, compared to non-clinical staff, were less likely to be confident in their VA medical facility’s ability to respond to natural disasters (OR:0.78, 95% CI:0.67–0.93, p < 0.01), pandemics (OR:0.82, 95% CI:0.70–0.96, p < 0.05), and manmade disasters (OR: 0.74, 95% CI: 0.63–0.86, p < 0.001). On the other hand, clinicians, compared to non-clinicians, were 1.45 to 1.78 more likely to perceive their role in disaster response to be important (natural OR:1.57, 95% CI:1.32–1.87; pandemic OR:1.78, 95% CI:1.51–2.10; manmade: OR:1.45; 95% CI: 1.23–1.71; p’s < 0.001), and 1.27 to 1.29 more likely to want additional trainings to prepare for all three types of disasters (natural OR:1.29, 95% CI:1.10–1.51; pandemic OR:1.27, 95% CI:1.08–1.49; manmade OR:1.29; 95% CI:1.09–1.52; p’s < 0.01). Clinicians were more likely to be women, younger, and more educated (p’s < 0.001) than non-clinicians. Compared to clinicians, non-clinical staff had been employed longer with the VA (p < 0.025) and were more likely to have served in the U.S. Armed Forces (p < 0.001).

Conclusions

These findings suggest both a desire and a need for additional training, particularly for clinicians, and with a focus on epidemics/pandemics and manmade disasters. Training programs should underscore the importance of non-clinical roles when responding to disasters.

Veterans Health Administration's Disaster Emergency Medical Personnel System (DEMPS) Training Evaluation: Potential Implications for Disaster Health Care Volunteers

OBJECTIVE

The US Veterans Health Administration's Disaster Emergency Medical Personnel System (DEMPS) is a team of employee disaster response volunteers who provide clinical and non-clinical staffing assistance when local systems are overwhelmed. This study evaluated attitudes and recommendations of the DEMPS program to understand the impact of multi-modal training on volunteer perceptions.

METHODS

DEMPS volunteers completed an electronic survey in 2012 (n=2120). Three training modes were evaluated: online, field exercise, and face-to-face. Measures included: "Training Satisfaction," "Attitudes about Training," "Continued Engagement in DEMPS." Data were analyzed using χ2 and logistic regression. Open-ended questions were evaluated in a manner consistent with grounded theory methodology.

RESULTS

Most respondents participated in DEMPS training (80%). Volunteers with multi-modal training who completed all 3 modes (14%) were significantly more likely to have positive attitudes about training, plan to continue as volunteers, and would recommend DEMPS to others (P-value&lt;0.001). Some respondents requested additional interactive activities and suggested increased availability of training may improve volunteer engagement.

CONCLUSIONS

A blended learning environment using multi-modal training methods, could enhance satisfaction and attitudes and possibly encourage continued engagement in DEMPS or similar programs. DEMPS training program modifications in 2015 expanded this blended learning approach through new interactive online learning opportunities. (Disaster Med Public Health Preparedness. 2018;12:744-751).

The Development of a Veterans Health Administration Emergency Management Research Agenda

INTRODUCTION

The Veterans Health Administration (VHA), the largest integrated healthcare delivery system in the United States, is charged with ensuring timely access to high-quality care for veterans during disasters, and supporting national, state, local, and tribal emergency management and homeland security efforts. In 2008, the VHA Office of Public Health (OPH) sponsored the first VHA Emergency Management Research Agenda-setting conference to develop research priorities that address the needs of veterans and to position VHA as a national leader in emergency management by having VHA serve as a "laboratory" for the development of evidence-based emergency management practices.

METHODS

We focused on four steps: #1: Appraising the emergency management research portfolio of VHA-based researchers; #2: Obtaining systematic information on VHA's role in emergency management and the healthcare needs of veterans during disasters; #3: Based upon gaps between the current research portfolio and the existing evidence base, identifying strategic priorities using a research agenda-setting conference; and #4: Laying the groundwork to foster the conduct of emergency management research within VHA.

RESULTS

Identified research priorities included how to prevent and treat behavioral health problems related to a disaster, the efficacy of training programs, crisis communication strategies, workforce resilience, and evacuating veterans from health care facilities. Conclusion: VHA is uniquely situated to answer research questions that cannot be readily addressed in other settings. VHA should partner with other governmental and private entities to build on existing work and establish shared research priorities.