Disaster nursing: a retrospective review

A plethora of information exists in the literature regarding emergencies and disasters. Nevertheless, significant gaps in the science related to nurses working during disasters are revealed. Few studies have addressed the perspective of nurses and their intent to respond to future disasters. Because nurses are invaluable to disaster response efforts, more research is essential to validate current findings and elucidate the needs of nurses who respond to disasters and other health emergencies. There is a paucity of research in the literature describing nurses' lived experiences of working during hurricanes. Natural disasters inevitably inflict human suffering, and nurses are expected to respond and provide services during these catastrophic times. Lost within this expectation are the experiences and concerns of the nurses who are called upon and intend to respond to the disaster, and yet are themselves affected by the disaster. Understanding the experiences and needs of nurses who decide to respond to the call of duty and work during disasters remains unclear in the literature. Research in the area of disaster response intentions by nurses becomes the initial step in understanding the phenomenon of working during a disaster and creating innovative approaches that address working during disasters. Disaster policies have been developed and implemented at the international, national, state, local, and hospital level. Nevertheless, disasters continue to adversely impact communities and hospitals at all levels causing injuries, death, and destruction of infrastructure. To reduce the impact of disasters, continued research is needed to inform and strengthen future disaster policies. Knowledge gained from future research has great potential to inform nursing education, research, and practice, as well as health policy related to the care of individuals and responders before, during, and after disasters.     

Disaster preparedness among nurses: a systematic review of literature

Aim

This review explored peer‐reviewed publications that measure nurses’ preparedness for disaster response.

Background

The increasing frequency of disasters worldwide necessitates nurses to adequately prepare to respond to disasters to mitigate the negative consequences of the event on the affected population. Despite growing initiatives to prepare nurses for any disasters, evidence suggests they are under prepared for disaster response.

Methods

This is a systematic review of scientific articles conducted from 2006 to 2016 on nurses’ preparedness for disasters. SCOPUS, MEDLINE, PubMed, CINAHL and PsychINFO were the primary databases utilized for search of literature. Keywords used in this review were as follows: ‘emergency’, ‘disaster’, ‘disaster preparedness’, ‘disaster competencies’, ‘disaster nursing’, ‘disaster role’ and ‘nurse’. Seventeen (17) articles were selected for this review.

Findings

Factors that increase preparedness for disaster response include previous disaster response experience and disaster‐related training. However, it is widely reported that nurses are insufficiently prepared and do not feel confident responding effectively to disasters.

Conclusion

The findings of this review contribute to a growing body of knowledge regarding disaster preparedness in nurses and have implications for academia, hospital administration and nursing educators. The findings of this review provide evidence that could be used by nurse educators and nurse administrators to better prepare nurses for disaster response.

Implications for nursing and health policy

The findings from this review place an emphasis on hospitals to implement policies to address lack of preparedness among their employees. Furthermore, this review highlights the benefit of further research and provision of well‐grounded disaster exercises that mimic actual events to enhance the preparedness of the nursing workforce.     

两所军队医院军人及聘任制护士灾害救护知识与技能的调查

目的分析军队医院军人护士及聘任制护士灾害救护知识与技能掌握现状及需求,为开展针对性培训提供依据。方法采用自行设计的调查问卷,通过目的抽样法对上海市两所军队三级甲等综合性医院106名护士的灾害救护知识与技能掌握程度、灾害救护知识与技能获取途径及需求进行调查。结果共98名护士有效填答问卷,军人护士(17名)与聘任制护士(81名)的灾害救护知识及技能总体得分差异有统计学意义(P0.05),在灾害应急处置、心理评估及干预知识等知识维度,以及灾害救护基本技能、灾后疫病预防、护理管理等技能维度,军人护士得分均高于聘任制护士(P0.01)。目前护士获取和提高灾害知识与技能的主要途径是观看视频资源(62.5%),64.2%的护士认为培训是最有利于护士提高灾害救护水平的途径。结论应强化军队医院聘任制护士的灾害救护培训,有针对性地拓宽军人护士灾害救护知识的培训范围,并丰富灾害救护培训途径。     

Development of a model of moral distress in military nursing

The purpose of this article is to describe the development of a model of moral distress in military nursing. The model evolved through an analysis of the moral distress and military nursing literature, and the analysis of interview data obtained from US Army Nurse Corps officers (n = 13). Stories of moral distress (n = 10) given by the interview participants identified the process of the moral distress experience among military nurses and the dimensions of the military nursing moral distress phenomenon. Models of both the process of military nursing moral distress and the phenomenon itself are proposed. Recommendations are made for the use of the military nursing moral distress models in future research studies and in interventions to ameliorate the experience of moral distress in crisis military deployments.     

Military nursing research: translation to disaster response and day-to-day critical care nursing

Where to begin? How do you identify nursing care requirements for military operations, disaster, and humanitarian response, and how do you modify care under these unique conditions? This article presents a framework for identifying areas of critical care nursing that are performed on a day-to-day basis that may also be provided during a contingency operation, and discusses how that care may be changed by the austere conditions associated with a contingency response. Examples from various disasters, military operations, and military nursing research are used to illustrate the use of this framework. Examples are presented of how the results of this military nursing research inform disaster nursing and day-to-day critical care nursing practice.     

Emergencies,Disasters, and Catastrophic Events: The Role of Rehabilitation Nurses in Preparedness,Response, and Recovery

Rehabilitation nurses play an integral role in helping patients and communities plan for, respond to, and recover from disasters. This article provides an overview of various types of disasters, the terminology used by planners and responders, and the structure that governs the delivery of services, resources, and patient care. Information about specialized training in disaster response and volunteer opportunities through national and state humanitarian relief programs are provided. Although each nursing specialty lends expertise to emergency and disaster situations, rehabilitation nurses are particularly well‐suited to help during times of complex, multifaceted medical and emotional responses.     

Chinese nurses' experience in the Wenchuan earthquake relief

YANG Y.‐N., XIAO L.D., CHENG H.‐Y., ZHU J.‐C. & ARBON P. (2010) Chinese nurses' experience in the Wenchuan earthquake relief. International Nursing Review 57 , 217–223 Aim: The purpose of this qualitative study is to provide an understanding of how Chinese nurses acted in response to the 2008 Wenchuan earthquake. Background: The literature has reported that Chinese nurses played a key role in the Wenchuan earthquake. Although these nurses' intentions were well meaning, and they made enormous efforts to save lives, they considered that disaster relief practice was beyond the scope of normal daily nursing practice and found the challenges they confronted overwhelming. China is a country prone to both natural and man‐made disasters that demand a good deal of preparedness for those involved in disaster nursing. However, few studies have been conducted to investigate the knowledge, skill, experience and attitudes required for nurses responding to disasters. Methods: Gadamer's philosophical hermeneutics was used as a framework to underpin and interpret the qualitative accounts of the practice of the ten registered nurses in this study. Findings: Three themes were identified from semi‐structured interviews with the participants. These are described as (1) feeling under‐prepared; (2) perceived challenges and coping strategies; and (3) the rediscovery of the helping and caring role. By analysing these nurses' experiences in the Wenchuan earthquake relief operation, this study has identified the numerous roles and attributes required of nurses in response to disasters. Conclusion: Without education and training in disaster nursing, nurses may not be prepared to function in disaster relief, especially in a manner that is productive, efficient, collaborative and less stressful. Findings suggest that a systematic, educational approach to develop the skills required in disaster nursing is essential.     

急诊护士应对灾难的现状分析及对策

通过阐述急诊护士参加灾难救护人数比例低、缺乏检伤分类培养、对灾难护理学重要性认识不足、未接受正规灾难护理学教育、缺乏继续教育培训等现状,提出了建立灾难教育体系和强化灾害护理协作网络的建议,以推动我国医学救援事业的发展。     

Evaluation of a collaborative project in disaster preparedness

Nurses play an important role in responding to disasters. Preparing nurses to participate in planning for and responding to a disaster is integral to undergraduate nursing education. The authors describe the evaluation of a collaborative learning model that has been used to teach undergraduate nursing students about disaster preparedness.     

Using tabletop exercises to evaluate nurses' clinical performance of hazardous materials disaster management: A cross-sectional study

BackgroundHazardous materials (Hazmat) disaster is a specific event with low probability but may be a heavy burden on public health. Competence in Hazmat disaster emergency management is necessary for nurses who care about mass casualties in the first line, especially for nurses in military hospitals. However, less attention has been paid to evaluation of competence of Hazmat disaster emergency responses using tabletop exercises.ObjectiveTo identify competence in Hazmat disaster emergency response and factors influencing performance on tabletop exercises.MethodsA cross-sectional design was employed in this study. Competence of nurses responding to a hazardous materials invasion was evaluated by a tabletop exercise. In each case the “Task Based Checklist” was used for evaluation. Multivariate analysis of covariance was conducted to detect the effects of traditional training on performance in Hazmat disaster tabletop exercises.ResultsA total of 161 nurses were recruited for this study. A checklist with 12 items comprised of two dimensions of disaster management was created and validated (CVI = 0.90). Inter-rater reliability for the evaluators ranged from 0.88 to 1. Performance on Hazmat site control, debris management and individual skills in decontamination were found to be suboptimal. Traditional disaster nursing training had no significant influence either on performance on Hazmat site control or patient care after controlling for differences in education level, age and gender.ConclusionsThe tabletop exercise is an innovative method for disaster nursing educators seeking to evaluate response competence in Hazmat disaster simulation exercises. It is necessary to consider the characteristics of the participants when designing the training program and educational strategies. Participants from the military hospital were shown to have limited competence in Hazmat disaster emergency management.     

Mental health nurses’ disaster nursing competencies: A cross-sectional study

The unprecedented and prolonged coronavirus disease 2019 (COVID-19) pandemic has escalated the gravity of disasters in the field of mental health. Nurses are health care providers who play a pivotal role in all phases of disaster management and psychiatric nurses are required to be prepared and equipped with competencies to respond to such disasters. This cross-sectional study aimed to investigate the effects of mental health nurses’ professional quality of life on disaster nursing competencies. This study adhered to the STROBE checklist for observational research. Data were collected from 196 mental health nurses working in various settings, including hospitals and communities in South Korea. Compassion satisfaction and compassion fatigue were measured using the Korean version of the Professional Quality of Life Scale. Disaster nursing competencies were measured using the Disaster Nursing Preparedness-Response Competencies Scale. Multiple regression analysis showed that compassion satisfaction (β = 0.36, P < 0.001) was the most potent predictor of disaster nursing competencies of mental health nurses, followed by participation in disaster nursing (β = 0.15, P = 0.023) and disaster nursing-related education (β = 0.15, P = 0.026); these factors explained 30.1% of the variance. Education programmes ensuring that mental health nurses are adequately prepared for disaster management should include theoretical content as well as simulation training using virtual situations that resemble actual disasters. Further, supportive leadership and work environments that encourage cohesive teamwork are needed to increase compassion satisfaction of nurses.     

Disaster nursing and primary school teachers' disaster-related healthcare knowledge and skills

The World Bank has ranked Taiwan as the 5th highest risk country in the world in terms of full-spectrum disaster risk. With volatile social, economic, and geologic environments and the real threat of typhoons, earthquakes, and nuclear disasters, the government has made a public appeal to raise awareness and reduce the impact of disasters. Disasters not only devastate property and the ecology, but also cause striking and long-lasting impacts on life and health. Thus, healthcare preparation and capabilities are critical to reducing their impact. Relevant disaster studies indicate children as a particularly vulnerable group during a disaster due to elevated risks of physical injury, infectious disease, malnutrition, and post-traumatic stress disorder. Primary school teachers are frontline educators, responders, and rehabilitators, respectively, prior to, during, and after disasters. The disaster prevention project implemented by the Taiwan Ministry of Education provides national guidelines for disaster prevention and education. However, within these guidelines, the focus of elementary school disaster prevention education is on disaster prevention and mitigation. Little guidance or focus has been given to disaster nursing response protocols necessary to handle issues such as post-disaster infectious diseases, chronic disease management, and psychological health and rehabilitation. Disaster nursing can strengthen the disaster healthcare response capabilities of school teachers, school nurses, and children as well as facilitate effective cooperation among communities, disaster relief institutes, and schools. Disaster nursing can also provide healthcare knowledge essential to increase disaster awareness, preparation, response, and rehabilitation. Implementing proper disaster nursing response protocols in Taiwan's education system is critical to enhancing disaster preparedness in Taiwan.     

Neonatal nursing care issues following a natural disaster: lessons learned from the Katrina experience

The massive evacuation of sick and at-risk infants from a large metropolitan area following a natural disaster provides many lessons for neonatal nurses. Planning and education are of utmost importance, and disaster education and training are essential for all nurses. Unit-specific disaster plans can serve as a guide for nurses but the real test occurs during and after the event. Nurses must learn to adapt neonatal care to the rapidly changing environment during a disaster. Supporting high-risk infants without the aid of technology requires a back-to-the-basics approach. The ability to maintain communication and facilitate transportation of neonates out of a disaster area is essential. Nurses must also consider their own well-being in the aftermath of a disaster. Planning for future disasters should include lessons learned from the past events. This article addresses nursing care issues and lessons learned from the events that unfolded in the New Orleans area neonatal units during and after Hurricane Katrina, and guidance in support of disaster education for neonatal nurses.     

Earthquake relief: Iranian nurses' responses in Bam, 2003, and lessons learned

BACKGROUND: Man-made or natural disasters appear to be occurring more frequently around the world. It is important that nurses in all specialties should be prepared to care for people affected by disasters. AIM: To explore Iranian Registered Nurses' experiences in disaster relief in the Bam earthquake, Iran in 2003. METHODS: This study was qualitative with 13 participant nurses. Data were obtained through semi-structured serial interviews and analysed using the latent content method. FINDINGS: Three general themes emerged: (a) the need for previously prepared practical protocols, (b) the need for qualified and real teamworking in the situation, and (c) the need to establish periodic comprehensive training programmes in disaster relief nursing. CONCLUSION: It has become urgent for health agencies and related public services to collaborate, and for all health professionals to become knowledgeable about disaster preparedness. Crisis management, which has become more prevalent for many organizations, is an important strategic initiative for nursing, helping them provide the infrastructure to respond effectively to emergencies and unpredictable events. It is important in today's world that hospital and nursing organizations develop a strategic system to handle disaster situations.     

We Stop for No Storm: Coping with an Environmental Disaster and Public Health Research

Coping with natural disasters is part of the public nurses' role, and the public health nursing (PHN) researcher is doubly challenged with continuing to conduct community‐based research in the midst of the disaster. The PHN may provide service along with attempting to continue the research. The challenges faced by public/community health nurse researchers as a result of hurricane Ike are discussed to provide lessons for other public/community health researchers who may be affected by natural disasters in the future. It is important to consider challenges for recruitment and retention of research subjects after a disaster, impact of natural disasters on ongoing research, and opportunities for research to be found in coping with natural disasters. A community‐based study that was in progress at the time of hurricane Ike will be used as an example for coping with a natural disaster. We will present “lessons learned” in the hope of helping researchers consider what can go wrong with research studies in the midst of natural disasters and how to proactively plan for keeping research reliable and valid when natural disasters occur. We will also discuss the opportunities for collaborations between researchers and the community following any disaster.     

文献回顾分析法总结灾害救援中的护理能力

目的探索灾害救援中护士应具备的能力,并提出灾害救援护理能力的框架。方法检索2001-2011年《中国医院知识仓库(CHKD)》、《维普信息资源系统》以及《万方数据库》中有关灾害救援护理能力的文献并进行分析。结果筛选出的16篇文献中,所有文献均提出专业素质、心理素质、身体素质、护理救援基本技能等能力要求,提出灾害救援应急预案知识的掌握、伦理及法律知识的掌握、野外生存、预防疾病、终身学习意识、开展相关的灾害教育等能力的较少。结论国内对灾害救援护理能力的研究越来越深入,但针对灾害救援护理能力的具体框架研究还不够全面,需要进一步的科学研究,制定出符合我国国情的灾害救援护理能力框架。