Disaster preparedness among Hong Kong nurses

Title.  Disaster preparedness among Hong Kong nurses
Aim.  This paper is a report of a survey to explore Hong Kong nurses' disaster preparedness.
Background.  Increasingly frequent global disasters are posing threats to human health and life. The World Health Organization has called for countries to have detailed plans at all levels in order to be prepared for disasters that may arise.
Method.  A questionnaire was distributed to convenience samples of practising Registered Nurses studying in Master's degree programmes at a Hong Kong university in 2007.
Results.  Of a possible 174, 164 questionnaires were returned (Response rate 94%). Almost all nurses (97·6%) considered the government health department to be the organization most involved in disastrous situations. The majority (84·8%) were aware of the existence of a protocol on disaster management at their workplace. About one-third would respond in accordance with protocol (38·4%) or rely on directions from their immediate supervisors (34·8%) if a disaster occurred. Almost all the nurses (97%) considered themselves not adequately prepared for disasters. They recognized that a protocol for disaster management (85·4%) and training and drills for disasters (both 84·1%) are useful tools.
Conclusion.  Nurses in Hong Kong are not adequately prepared for disasters, but are aware of the need for such preparation. Disaster management training should be included in the basic education of nurses.     

A proposed model for military disaster nursing

There is a dearth of literature examining models related to nursing disaster preparedness and response, particularly in military nursing. Several recent articles address lessons learned by nurses who worked through wars and disasters, and these experiences can be used as a basis for a proposed model of military disaster nursing. This article will (a) review the literature about disaster nursing, including general disaster responses by nurses, disaster responses in military nursing, and research about military nurses and disaster response, (b) describe the uniqueness of the military environment, and (c) propose a model for military disaster nursing that can be evaluated for future implementation. Research about individual nurse readiness for deployment during disasters is also incorporated into the proposed model. Future research is needed to test the model and examine its relevance to military, as well as civilian nursing for future 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.     

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.     

Investigating factors associate to nurses' attitudes towards perinatal bereavement care

Aim. The purpose of this study was to explore nurses’ attitudes towards perinatal bereavement care and to identify factors associate with such attitudes. Background. Caring for and supporting parents whose infant has died is extremely demanding, difficult and stressful. It is likely that the attitude of nursing staff can influence recovery from a pregnancy loss and nurses with positive attitude to bereavement care can help bereaved parents to cope during their grieving period. Method. Data were collected through a structured questionnaire; 334 nurses were recruited (63% response rate) from the Obstetrics and Gynaecology unit in five hospitals in Hong Kong during May–August 2006. Outcome measures including attitudes towards perinatal bereavement care, importance on hospital policy and training support for bereavement care. Results. Majority of nurses in this study held a positive attitude towards bereavement care. Results showed that only 39·3% (n = 130) of nurses had bereavement related training. By contrast, about 89·8% of nurses (n = 300) showed they need to be equipped with relevant knowledge, skills and understanding in the care and support of bereaved parents and more than 88·0% (n = 296) would share experiences with colleagues and seek support when feeling under stress. Regression model showed that age, past experience in handling grieving parents and nurses’ perceived attitudes to hospital policy and training provided for bereavement cares were factors associate with nurses’ attitudes towards perinatal bereavement care. Conclusions. Hong Kong nurses emphasized their need for increased knowledge and experience, improved communication skills and greater support from team members and the hospital for perinatal bereavement care. Relevance to clinical practice. These findings may be used for health policy makers and nursing educators to ensure delivery of sensitive bereavement care in perinatal settings and to enhance nursing school curricula respectively.     

Perceived adverse patient outcomes correlated to nurses’ workload in medical and surgical wards of selected hospitals in Kuwait

Aim. This study was carried out to identify the perceived adverse patient outcomes as related to nurses’ workload. It also assessed nurses’ perception of variables contributing to the workload and adverse patient outcomes. Background. Several studies have been published on adverse patient outcomes in which a correlation was found between nurses’ workload and some adverse patient outcomes. Design. A cross‐sectional survey was conducted between registered nurses (n = 780) working in medical and surgical wards of five general governmental hospitals in Kuwait. Data collection instruments. Data were collected using a self‐administered questionnaire consisting of three sections to elicit information about the sample characteristics, perception of workload and perceived adverse patient outcomes during the last shift and last working week. Results. The three major perceived adverse outcomes reported by the nurses while on duty during their last shift were: complaints from patients and families (2%), patients received a late dose or missed a dose of medication (1·8%) and occurrences of pressure ulcer (1·5%). Similarly, the reported adverse outcomes over the past week were complaints from patients and families (5%), patients received a late dose or missed a dose of medication (5·3%) and discovery of a urinary tract infection (3·7%). Increases in nurse‐patient load, bed occupancy rate, unstable patients’ condition, extra ordinary life support efforts and non‐nursing tasks; all correlated positively with perceived adverse patient outcomes. Conclusion. This study sheds light on an important issue affecting patient safety and quality of care as perceived by the nurses themselves as caregivers. Relevance to clinical practice. Nurses’ perception of variables contributing to adverse patient outcomes and their workload could significantly affect the provided nursing care and nursing care recipients. The findings could help in policy formulation and planning strategies to decrease adverse patient outcomes in many countries with a health care structure similar to that of Kuwait.     

Retracted: Investigating factors associated with nurses’ attitudes towards perinatal bereavement care: a study in Shandong and Hong Kong

Aims. To explore nurses’ attitudes towards perinatal bereavement care and to identify factors associated with these attitudes. Background. It is likely that the attitude of nursing staff can influence recovery from a pregnancy loss and that nurses with positive attitudes to bereavement care can help bereaved parents to cope during their grieving period. Design. Survey. Method. Data were collected through a structured questionnaire; 657 nurses were recruited from Obstetrics and Gynaecology units in Hong Kong and Shandong during 2006. Outcome measures included attitudes towards perinatal bereavement care, importance of hospital policy and training support for bereavement care. Results. The majority of nurses in this study had a positive attitude to bereavement care. Results show that only 21·6% (n = 141) of the nurses surveyed had bereavement‐related training. In contrast, about 89·8% (n = 300) believed they needed to be equipped with relevant knowledge, skills and understanding in the care and support of bereaved parents and more than 88·5% (n = 592) would share their experiences with their colleagues and seek support when feeling under stress. A regression model showed that age, past experience in handling grieving parents, recent ranking and nurses’ perceived attitudes to hospital policy and training provided for bereavement care were the factors associated with nurses’ attitudes to perinatal bereavement care. Conclusions. Nurses in both cities emphasised their need for increased knowledge and experience, improved communication skills and greater support from team members and the hospital for perinatal bereavement care. Relevance to clinical practice. These findings may be used by nursing educators to educate their students on issues related to delivery of sensitive bereavement care in perinatal settings and to enhance nursing school curricula.     

Attributes of nursing work environment as predictors of registered nurses’ job satisfaction and intention to leave

Aim To examine how front-line registered nurses’ perception of their work environment associates with and predicts nurse outcomes in terms of job satisfaction and turnover intention. Background Mounting evidence has pointed to an inseparable link between attributes of the nursing work environment and nurse outcomes. However, there is a paucity of research examining nurses’ perception of their work environment beyond the Western context. Methods This cross-sectional survey involved 1271 registered nurses working in 135 inpatient units in 10 public hospitals in Hong Kong. The instrument comprised items developed from in-depth interviews with front-line nurses that explored nurses’ perception of their work environment. Results Factor analysis identified five dimensions (professionalism, co-worker relationship, management, staffing and resources, and ward practice) of the nursing work environment. Logistic regression analysis further identified professionalism, management and ward practice as significant factors in predicting nurses’ turnover intention, and staffing and resources as an additional factor in predicting their job satisfaction. Conclusions Attributes of the nursing work environment have a significant bearing on nurses’ job satisfaction and intention to leave. Implications for nursing management Managerial effort should focus on improving nurses’ work conditions through detailed resource planning, effective management and removal of work constraints that affect nursing practice.     

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.     

Cross‐sectional survey of the disaster preparedness of nurses across the Asia–Pacific region

Healthcare workers who have received disaster preparedness education are more likely to report a greater understanding of disaster preparedness. However, research indicates that current nursing curricula do not adequately prepare nurses to respond to disasters. This is the first study to assess Asia–Pacific nurses' perceptions about their level of disaster knowledge, skills, and preparedness. A cross‐sectional survey was conducted with 757 hospital and community nurses in seven Asia–Pacific countries. Data were collected using the modified Disaster Preparedness Evaluation Tool. Participants were found to have overall low‐to‐moderate levels of disaster knowledge, skills and preparedness, wherein important gaps were identified. A majority of the variance in disaster preparedness scores was located at the level of the individual respondent, not linked to countries or institutions. Multilevel random effects modelling identified disaster experience and education as significant factors of positive perceptions of disaster knowledge, skills, and management. The first step toward disaster preparedness is to ensure frontline health workers are able to respond effectively to disaster events. The outcomes of this study have important policy and education implications.     

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.     

Use of non‐conventional nurses’ attire in a paediatric hospital: a quasi‐experimental study

Aims:  To test the impact of a multi‐coloured non‐conventional attire on a population of children admitted to a paediatric hospital. Design:  Quasi‐experimental before‐after controlled study. Background:  It has been suggested that non‐conventional nurses’ uniforms in paediatric settings may contribute to lowering children’s distrust towards healthcare providers and reduce fear. Little formal research has investigated on the impact of nursing attire in a paediatric setting. No study has so far analysed the effects in actual use of a non‐conventional, other than the traditional type of uniform, on a paediatric hospitalised population. Design:  A quasi‐experimental study. Methods:  We introduced multi‐coloured nurses’ attire in two wards of a paediatric hospital. Using open questions and semantic differential scales (SDS), we evaluated the effects of this non‐conventional attire on a group of hospitalised children, compared to sex‐and‐age‐matched controls interviewed before the introduction. Parents were also interviewed. Results:  One hundred and twelve hospitalised children and their parents (n = 112) were studied. The percentage of positive words used by children to define their nurse was higher in children interviewed after the introduction of non‐conventional uniforms (96·2% vs. 81·8%, p = 0·01). Children’s perception of nurses was significantly improved by the use of multi‐coloured attire (‘bad’–‘good’ SDS: p = 0·01; ‘disagreeable’–‘nice’ SDS: p = 0·001). Children’s perceptions regarding hospital environment did not change. Parents’ perception of nurses’ uniform adequacy to the role and capability to reassure resulted improved (p < 0·0001, p = 0·0003). Conclusions:  Multi‐coloured non‐conventional attire were preferred by hospitalised children and their parents. Their introduction improved the perception children have of their nurses. Moreover, the coloured uniforms improve the parents perception about the reliability of the nurse. Relevance to clinical practice:  The use of non‐conventional nurses’ attire can contribute to improve the child–nurse relation, which has the potential to ease the discomfort experienced by children due to hospitalisation.     

Teaching disaster nursing by utilizing the Jennings Disaster Nursing Management Model

Millions of people are affected by disasters or major incidents annually. Disaster preparedness has reached a new level of urgency in the UK and other countries around the world. Thus, nurses need to become involved in disaster management in order to function effectively in these types of situations. Exposing nurses to disaster nursing education may result in positive outcomes for populations involved in a disaster. Currently, there are few models or frameworks to guide nurses through the process of understanding disaster nursing. The purpose of this paper is to describe the Jennings Disaster Nursing Management Model and discuss its application in a Community Health Nursing course.     

临床男护士灾害护理核心能力及影响因素的分析

目的了解临床男护士灾害护理核心能力现状及影响因素,为开展男护士灾害护理继续教育与培训提供参考。方法对武汉市2所三级甲等医院的176名临床男护士灾害护理核心能力及其相关因素进行研究分析。结果临床男护士灾害护理核心能力得分为(2.69±0.64)分,得分最高维度为灾害过程护理(2.86±0.72)分,最低维度为灾害护理专业发展(2.28±0.80)分;有无灾害护理经历、是否参加过灾害护理培训是影响临床男护士灾害护理核心能力的主要因素。结论临床男护士灾害护理核心能力较低,突出表现为灾害护理专业发展方面能力较低。建议对临床男护士进行系统的灾害护理教育与培训,结合临床男护士有无灾害护理经历及灾害护理培训经历,有针对性地进行灾害护理救援培训,以促进其灾害护理核心能力的提升。     

Stress and coping of Hong Kong Chinese family members during a critical illness

Aim. The present study aimed to investigate the stress and coping strategies of Hong Kong Chinese families during a critical illness and to examine the relationships between stress and coping. Background. Admissions to intensive care unit are usually an unanticipated event, which imposes stress on the family. Family's wellness is one of the significant factors affecting patient's well‐beings. Much work has been conducted in Western societies. Stress and coping in Chinese families of critically ill patients have rarely been discussed. Method. Structured face‐to‐face interviews were conducted, using the Impact of Events Scale and the Family Crisis Oriented Personal Evaluation Scales. A convenience sample of 133 participants was recruited from a regional hospital in Hong Kong. Many were patients’ children with age between 30 and 49. A total of 39·1% (n = 52) of the participants were males and 60·9% (n = 81) were females. Results. The participants experienced high level of stress (mean = 25·1, SD = 8·3). Higher level of stress were experienced by female (t = ?4·6; d.f. = 1, 131; P = 0·00), those with lower educational attainment (F = 3·0; d.f. = 2, 130; P = 0·05) and those whose relatives were admitted to the intensive care unit unexpectedly (t = ?2·2; d.f. = 1; P = 0·03). Patients’ length of stay in the unit was significantly correlated with levels of stress (r = 0·5, P < 0·00). Level of stress had significant correlation with coping strategies utilization (r = 0·5, P < 0·00). Reframing strategies were frequently used whereas the passive appraisal strategies were least used. Family members used positive‐coping strategies, which concurred with the Chinese stress–coping pattern ‘fatalistic voluntarism’. Relevance to clinical practice. This study contributes to the understanding of Hong Kong Chinese families’ stress and coping during a critical illness. Comprehensive assessments of family members’ psychosocial needs are important to plan appropriate interventions to alleviate their stress and strengthen their coping skills. The findings will serve as guidance for nurses in delivering culturally sensitive and competent interventions.     

Perceptions of ethical practices in Hong Kong public hospitals: inter- and intra-professional similarities and differences

hui e.c. (2010) Journal of Nursing Management  18 , 746–756
Perceptions of ethical practices in Hong Kong public hospitals: inter- and intra-professional similarities and differences Aim To investigate similarities and differences in the perception of hospital ethical practices using different seniority of doctors, nurses and administrators, and between these healthcare professionals (HCPs). Importance Intra- and inter-professional similarities and differences had implications for HCPs’ morale, hospital ethics climate and quality of patient care. Method HCPs (n = 1.910) with different levels of seniority in 14 Hong Kong public hospitals were randomly surveyed between November 2004 and April 2005. Results Intra-professional differences in perception between senior and junior doctors or nurses were found in nine ethical themes including: quality of care, patient satisfaction, disagreements among HCPs and between HCPs and patient family, end-of-life care, professional incompetence and misconducts and communication. Inter-professional similarities in perception were also found among different HCPs in senior positions and as a group they differ from the perceptions of junior HCPs. Conclusions Significant intra-professional and inter-professional polarizations of perception of ethical practices between senior and junior HCPs were found and they potentially undermine the trusting relationships between HCPs. Implications As nursing managers were found to align with senior doctors and administrators, junior nurses might feel unsupported, isolated and frustrated, creating a nursing management challenge that must be faced.     

Perceptions of the benefits and challenges of the role of advanced practice nurses in nurse‐led out‐of‐hours care in Hong Kong: a questionnaire study

Aims and objectives. The aim of the study was to identify the factors that nurses perceive may facilitate or hinder the development of advanced practice nurse roles in Hong Kong. Background. Advanced practice nurses are increasingly prominent in nurse‐led out‐of‐hours care in Hong Kong in response to changes to junior doctors’ hours of work. Setting. Three five‐day workshops for Hong Kong‐based advanced practice nurses were offered in partnership with UK clinicians. The aim of the workshops was to share UK experiences of implementation of the ‘Hospital at Night’ model of care delivery. The questionnaire study undertaken was not part of the workshop programme. However, the workshops gave the authors a unique opportunity to access relatively large numbers of Hong Kong‐based advanced practice nurses. Participants. The workshops were attended by experienced nurses who had been or were about to be appointed as advanced practice nurses. All nurses who attended one of the three workshops (n = 120) agreed to participate in the study. Methods. Responses to two open questions posed in the questionnaire were the subject of a content analysis. Results.  A prominent finding of the study was that respondents viewed the benefits of introducing advanced practice nurse roles in Hong Kong as outweighing any challenges. One of the main features of the perceived benefits relates to improving the quality and safety of patient care. The greatest challenges associated with the role related to acceptance of the role by other healthcare professionals, and difficulties associated with the general public’s traditional attitudes to healthcare provision in Hong Kong. Conclusions. Education of the public concerning the implementation of such roles is of crucial importance. Relevance to clinical practice. Findings from this study enhance understanding of the factors that hinder or facilitate advanced practice roles in out‐of‐hours care in Hong Kong.