Disaster preparedness: A concept analysis and its application to the intensive care unit

ObjectivesThe aim of the study is to understand the concept of disaster preparedness in relation to the intensive care unit through the review and critique of the peer-reviewed literature.Review method usedRodgers' method of evolutionary concept analysis was used in the study.Data sourcesHealthcare databases included in the review were Cumulative Index to Nursing and Allied Health Literature, Public MEDLINE, Scopus, and ProQuest.Review methodsElectronic data bases were searched using terms such as “intensive care unit” OR “critical care” AND prep1 OR readiness OR plan1 AND disaster1 OR “mass casualty incidents” OR “natural disaster” OR “disaster planning” NOT paed1 OR ped1 OR neonat1. Peer-reviewed articles published in English between January 2000 and April 2020 that focused on intensive care unit disaster preparedness or included intensive care unit disaster preparedness as part of a facility-wide strategy were included in the analysis.ResultsEighteen articles were included in the concept analysis. Fourteen different terms were used to describe disaster preparedness in intensive care. Space, physical resources, and human resources were attributes that relied on each other and were required in sufficient quantities to generate an adequate response to patient surges from disasters. When one attribute is extended beyond normal operational capacities, the effectiveness and capacity of the other attributes will likely be limited.ConclusionThis concept analysis has shown the varied language used when referring to disaster preparedness relating to the intensive care unit within the research literature. Attributes including space, physical resources, and human resources were all found to be integral to a disaster response. Future research into what is required of these attributes to generate an all-hazards approach in disaster preparedness in intensive care units will contribute to optimising standards of care.     

汶川地震后广元地区创伤后应激障碍调查

目的了解汶川地震9年后广元地区高二学生创伤后应激障碍(PTSD)阳性检出情况,为进一步分析震后PTSD持续存在的影响因素、对存在PTSD的学生进行心理干预提供参考。方法采用整群抽样方法,选取广元地区地震重灾区和一般灾区的1 492名高二学生为研究对象。采用创伤后应激障碍自评量表(PTSD-SS)和社会支持量表(PSSS)调查PTSD发生率和社会支持情况。结果广元地区高二学生PTSD阳性检出率为3.69%,男生和女生PTSD阳性检出率比较差异有统计学意义(2.24%vs. 5.82%,χ~2=12.47,P0.01),重灾区和一般灾区PTSD阳性检出率比较差异有统计学意义(4.89%vs. 2.84%,χ~2=4.27,P0.05);男生和女生PTSD-SS评分比较差异有统计学意义[(12.71±9.01)分vs.(14.02±8.52)分,t=-6.43,P0.01];PTSD阳性者和非阳性者PSSS评分比较差异有统计学意义[(57.52±7.53)分vs.(61.11±8.19)分,t=-5.36,P0.01]。结论汶川地震后9年,广元地区部分高二学生仍存在PTSD症状,创伤暴露程度、性别和社会支持可能与现患PTSD相关。     

护士灾难准备及相关培训的研究进展

我国幅员辽阔，自然灾害频发，伴随着中国的快速城市化，70%以上的城市分布在气象、地震、地质、海洋等自然灾害严重的区域，除了自然灾害近年来大规模突发事件、恐怖袭击的发生频率也有上升的趋势，灾难应对以及防范形势更显严峻。护士被认为是灾难救援中不可或缺的一支队伍，护士的贡献贯穿整个灾难期，其中灾难发生前的预防和准备显得尤为重要，因为灾前的准备程度是灾难护理能力的重要体现。     

Major incidents

A major incident is one that causes casualties on a scale beyond the usual capabilities of the emergency and healthcare services usual ability to manage. Major incident planning and rehearsal is vital to ensuring an appropriate response. Delivery of a major incident response requires command and co-ordination within and between emergency services, hospitals and specialist charitable organizations. Casualty management will require the set up of major incident infrastructure on scene to effectively extricate, triage, treat and transport casualties to appropriate facilities. There is a role for specialist doctors within the pre-hospital phase of managing a major incident, either within the ambulance command structure or operationally. Debrief and reviewing previous major incidents may identify individual, local and systemic factors that could be altered to improve the response to a future incident.     

The Reciprocal Relationship Between Work Characteristics and Employee Burnout and Engagement: A Longitudinal Study of Firefighters

The paradigm of this study is positive occupational psychology, with the job demands‐resources model as the research model and the Conservation of Resources theory as the general stress theory. The research design analyses the job demands‐resources model's dynamic nature with normal and reversed causation effects between work characteristics and psychological well‐being among Portuguese firefighters. In addition, we analyse a positive (engagement) dimension and a negative (burnout) dimension in the firefighters' well‐being, because previously, studies have merely focused on the strain or stress of these professionals. The research questionnaire was distributed to a sample of 651 firefighters, and a two‐wave full panel design was used. Cross‐lagged panel analyses indicated that the causal direction of the relationship between organizational demands and burnout is reciprocal. Also, we found that the reciprocal model, including cross‐lagged reciprocal relationships between organizational demands/supervisory support and burnout/engagement, respectively, is what fits the data best. Practical implications to develop organizational change programmes and suggestions for future research regarding the promotion of occupational health are discussed. Copyright © 2013 John Wiley & Sons, Ltd.