The competence of nurses caring for COVID-19 patients regarding disaster management: Structural equation modeling of knowledge, attitude, and performance

Background

The outbreak of COVID-19 as a global disaster has required nurses, as front-line providers of safe and quality care to patients with this disease, for proper disaster management to have a high level of competence, which demands an acceptable level of knowledge, attitude, and performance. Therefore, this study was conducted to model the relationship between knowledge, attitude, and performance with the competence of nurses caring for patients with COVID-19 regarding disaster management.

Methods

This descriptive-correlational study was conducted on 291 hospital nurses using the structural equation modeling approach in three provinces of Iran, including Kerman, Hormozgan, and Fars, from June to December 2021. Data were collected through a researcher-made questionnaire that provided information on demographics, knowledge, attitude, performance, and competence regarding disaster management. Data analysis, which included descriptive and inferential statistics, was performed using SPSS and AMOS software. Moreover, the structural equation modeling method was based on the covariance to examine the proposed model of the relationship between knowledge, attitude, and performance with nurses' competence.

Results

The study revealed that the nurses had average knowledge, acceptable attitudes, high performance, and acceptable competence scores. A positive and significant relationship was found between knowledge, attitude, and performance with nurses' competencies (P < 00.05). Furthermore, the coefficient of determination of nurses' competence in the modified structural model indicates that exogenous variables, namely knowledge, attitude, and performance, could predict 36 % of the changes in nurses' competence. Finally, the path coefficient of the effect of knowledge, attitude, and performance on nurses' competence was higher than 1.96.

Conclusions

According to the study, although the knowledge, attitude, performance, and competence of nurses caring for patients with COVID-19 were at an acceptable level, there were obstacles to improving their competence. Hence, identifying and prioritizing educational needs and learning preferences based on their cultural backgrounds are also emphasized.

Establishing the Domains of a Hospital Disaster Preparedness Evaluation Tool: A Systematic Review

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.