Directions for disaster nursing education in the United States

The Unique Perspective of an Expert Humanitarian Nurse: A Case Study

Nurses perform a key role in national and international humanitarian efforts. This case study of a highly experienced Registered Nurse who has engaged in international humanitarian projects for more than 30 years provides unique insight into the way nurses care for underserved populations. This nurse constructed knowledge and derived meaning from her practice by utilizing Carper's Patterns of Knowing. Many previous studies have proposed that Aesthetic Knowing is the dominant form of knowledge most nurses use to synthesize their understanding. However, in her personal account, this nurse identified Ethical Knowing as the overarching framework she used to construct all her other forms of knowledge and to derive meaning from her experiences. Findings from this case study identify significant themes related to the role of nurses in humanitarian work, and provide new insight into prevailing Western theoretical frameworks and how nurses can address health disparities among marginalized populations.

Investigation and Analysis of Disaster Preparedness among Nurses in Chinese Non-First-tier (Inland) Cities: A Case Study from Yongcheng City, Henan Province

OBJECTIVES

Compared with first-tier cities in China that are of abundant funds and resources like legions of high-level hospitals, the degree of nurses' disaster nursing preparedness in non-first-tier cities (inland) is relatively lower. For example, nurses' knowledge reserve of specific disasters is not comprehensive enough. And nurses are diffident when it comes to the skills of handling disaster rescue. Furthermore, their understanding of the roles to take in disaster coordination management is ambiguous. Conquering these challenges could be conducive to the improvement of local medical staffs' confidence and capabilities in disaster relief. Consequently, the objective of this research is to probe for approaches of improving the strategies of disaster nursing in Chinese small cities.

METHODS

In order to ascertain the factors that influence disaster preparedness, a cross-sectional study with SPSS 25.0 data analysis method is adopted. The sample of the study is nursing personnel from 4 comprehensive hospitals at or above the second level in Yongcheng, Henan Province, China, as nurses are first-line responders in disasters and pandemics and the largest group in disaster rescue.

RESULTS

From 813 distributed questionnaires, 784 completed questionnaires were returned, for a response rate of 96.43%. The total average score of the Disaster Preparedness Evaluation Tool is 146.76 ± 34.98, and the average score of all the entries is 3.26 ± 0.45, indicating moderate performance. The results indicate that age affects post disaster management ( P < 0.05), meaning that as age increases, the scores also tend to be higher. Work experience, professional titles, disaster relief experience, and disaster training significantly differ in terms of knowledge, skills, post disaster management, and total scores (P < 0.01). The result of multivariate analysis indicates that titles, disaster relief experiences, and disaster training are the main factors affecting the disaster preparedness of nurses in Chinese non-first-tier (inland) cities( P < 0.05).

CONCLUSIONS

For the sake of upgrading the efficiency of disaster nursing preparedness in Chinese non-first-tier (inland) cities with limited funds and resources, it is very important to formulate training and education methods that are suitable for the local area, conduct characteristic simulation exercises, and expand experience exchange between hospitals. It's certain that the local government will also play an important role in coordinating and organizing the division of labor, resource allocation, and management of hospitals at all levels in different phases of disasters, which can help nursing staff have a clearer understanding of their roles when preparing for disasters.

How does integrating 'disaster nursing' into nursing curricula impact nursing students' perception of disaster literacy and preparedness?

BACKGROUND

Disaster nursing involves systematic and professional care provided to communities affected by natural or man-made disasters. With limited resources in global disaster settings, nurses play a crucial role in disaster management. The aim of this study is to investigate the impact of integrating 'Disaster Nursing' into nursing curricula on nursing students' perceptions of disaster literacy and preparedness.

METHODS

This quasi-experimental one-group pretest-posttest study was conducted at a public university in Izmir, Turkey. The pre-test took place on September 27, 2021, and the post-test on January 7, 2022. The study population comprised 66 nursing students enrolled in the elective "Disaster Nursing" course, with 62 volunteering for participation. Data collection tools included an individual introduction form, the Disaster Literacy Scale, and the Perception of Disaster Preparedness in Nurses Scale. The 14-week "Disaster Nursing" course served as the intervention. Data were collected online and analyzed using descriptive statistics, paired sample t-tests, and Pearson correlation.

RESULTS

Of the students, 51.6% were aged 22-23, and 62.9% were female. Additionally, 54.8% reported previous disaster experience. The mean pre-test score on the Disaster Literacy Scale was 32.97 ± 6.47, which increased significantly to 40.58 ± 5.95 post-test (p < 0.05). The mean pre-test score on the Perception of Disaster Preparedness in Nurses Scale was 81.66 ± 4.61, rising significantly to 90.64 ± 6.25 post-test (p < 0.05). A statistically significant positive correlation was found between the total scores of the Disaster Literacy and Disaster Preparedness in Nurses scales (r = 0.79).

CONCLUSIONS

The integration of "Disaster Nursing" into nursing curricula positively enhanced the disaster literacy and preparedness perceptions of nursing students. The results demonstrated that higher levels of disaster literacy were associated with increased disaster preparedness among nurses. These findings can inform the development of educational policies for disaster nursing education in Turkey.

Enhancing Emergency Nurses' Disaster Nursing Ability and Psychological Resilience: A Randomized Controlled Trial

Objective

This study aimed to investigate emergency nurses' disaster nursing ability and psychological resilience, validate the effectiveness of a training system for disaster nursing ability based on psychological resilience, and verify the relationship between psychological resilience and disaster nursing ability among emergency nurses.

Methods

A training system was developed to enhance psychological resilience and disaster nursing ability. A multicenter, randomized controlled experiment was conducted in five Grade III hospitals in Sichuan Province. A total of 93 emergency nurses were randomly assigned to the following three groups: the blank group, intervention group, and control group. The corresponding interventions were as follows: no intervention, psychological resilience, and nurses' disaster nursing ability training. Personal information forms, the Connor-Davidson Resiliency Scale, and the Nurses' Disaster Nursing Ability Assessment Scale were used in the survey.

Results

There was no significant difference in the scores of psychological resilience and disaster nursing ability in the blank group in the pretest and posttest (P > 0.05). The disaster nursing ability of both the intervention and control groups significantly improved in the posttest (P < 0.05). Compared with the control group, the intervention group demonstrated significant improvement in psychological resilience in the posttest (P < 0.05). However, there was no statistical difference in psychological resilience scores in the control group in the pretest and posttest (P > 0.05).

Conclusion

The study concluded that the psychological resilience and disaster nursing ability of emergency nurses could be enhanced through the implemented training system.

Disaster Training for Nurses in Indonesia: Balancing Physical, Psychological, and Managerial Competencies

BACKGROUND

Indonesian nurses receive training for disasters when they take an undergraduate nursing program at the university, but there have been variations in the curriculum. Moreover, there is still limited informal training available specifically for disaster nursing. Therefore, needs assessments are necessary to identify the gap between Indonesian disaster nurses' existing and expected competencies. This study was conducted to identify competencies needed by disaster nurses.

METHOD

A descriptive qualitative approach was used in this study. Data were collected from August to September 2019 from three areas in Indonesia: Yogyakarta, Lombok, and Jakarta. These areas frequently experience natural disasters, such as volcanic eruptions, earthquakes, and floods. Thirty-two nurses were interviewed. Data were analyzed with a descriptive qualitative approach.

RESULTS

The study highlighted three main competencies needed by Indonesian nurses, which are physical, psychological, and managerial.

CONCLUSION

Training for disaster nurses needs to balance the achievement of competencies related to physical, psychological, and managerial needs. [J Contin Educ Nurs. 2023;54(8):378-384.].

Nursing skills required across natural and man-made disasters: A scoping review

AIMS

To map the nursing skills required for different types of disasters.

DESIGN

This was a scoping review of research studies conducted between July and August 2021. We conducted a systematic literature search of nine electronic databases from inception till July 2021, and an updated search was done in April 2022. This review is based on the methodological framework of Arksey and O'Malley (2005), which was further refined by the Joanna Briggs Institute.

DATA SOURCES

A range of electronic databases was searched systematically, including CINAHL, Cochrane, Embase, MEDLINE, PsycINFO, PubMed, Web of Science, CNKI and Ichushi-Web. Articles published in Chinese, English and Japanese were selected for the review.

REVIEW METHODS

The PCC model was used to frame the inclusion criteria. Studies were screened, appraised and extracted by two reviewers, and the study findings were narratively synthesized.

RESULTS

We identified nursing skills for five types of natural disasters including (1) earthquakes, (2) typhoons, (3) tsunamis, (4) marine disasters and (5) infectious diseases and three man-made disasters: (1) radiation disasters, (2) bioterrorism and (3) war. Among these, there are five types of common professional skills nurses are required to possess including casualty triage, observation and monitoring, basic first aid techniques, psychological care and communication skills. In addition, it was shown that different disasters require different specific professional skills.

CONCLUSION

This scoping review explored the disaster nursing skills required for eight types of disasters and provides evidence for future education and training. Further research is needed to build more accurate scenario-based simulation training programs to provide more insights into future disaster precision nursing.

IMPACT

This scoping review provides evidence for future education and training in disaster nursing to improve nurses' knowledge and competencies in dealing with the different types of disaster situations.

Teaching Disaster Evacuation Management Education to Nursing Students Using Virtual Reality Mobile Game-Based Learning

The purpose of this study was to explore the effectiveness of a virtual reality mobile game-based application for teaching disaster evacuation management education to nursing students. A pre-test, post-test, and final-test study design was used to compare traditional lecture group and game group instructional knowledge delivery effectiveness and instructional mode satisfaction. The statistical comparison of pre-test and post-test knowledge and decision-making scores did not reveal significant group differences for short-term improvement (P ≥ .05); however, final test scores revealed that the virtual reality mobile game-based application group had significantly higher knowledge and decision-making retention scores compared with the traditional lecture group (P = .000). The game group also had significantly higher instructional mode satisfaction scores for course interest and cooperation with others (P < .05). The virtual reality mobile game-based application was more effective for teaching nursing students about disaster evacuation management educational training than lecture instruction. The greater satisfaction expressed by nursing students when using this instructional mode suggests that it may better facilitate self-initiated lifelong disaster evacuation learning behaviors.

Lessons Learned in a Large-Scale Mass Casualty Simulation

BACKGROUND

Traditional Nursing Programs are required to provide student instruction regarding disaster care. The Brigham Young University College of Nursing, in conjunction with campus emergency medical services (EMS), holds two large-scale mass casualty simulations each year. Nursing students work alongside EMS to provide initial care to the victims.

METHOD

After the mass casualty simulation, nursing students completed an anonymous survey evaluating their preparation and experience during the simulation. Students were also prompted to reflect on future implications of the exercise and give suggestions for simulation improvement.

RESULTS

Nursing students felt the triage and communication skills they learned during this simulation will help them as future registered nurses. Interdisciplinary communication between nursing and EMS students presented a barrier to effective disaster response.

CONCLUSION

Data gathered from this postsimulation survey will be used to improve future nursing student preparation and simulation participation. [J Nurs Educ. 2022;61(1):50-52.].

The Effectiveness of Disaster Education for Undergraduate Nursing Students' Knowledge, Willingness, and Perceived Ability: An Evaluation Study

As future healthcare professionals, nursing students should possess the appropriate knowledge, skills, and positive attitude to respond to public health emergencies or disasters worldwide. This study evaluated the effectiveness of a disaster management training course at improving Hong Kong nursing students' disaster knowledge, willingness, and perceived ability. A mixed-method design using a single group with pre- and post-intervention comparisons followed by qualitative focus group interviews, was conducted. A 45-h disaster management training course with theoretical and practical inputs was conducted. A total of 157 students participated in and completed the pre- and post-intervention questionnaires. Positive significant results in disaster knowledge (t(156) = -8.12, p < 0.01, d = -0.84) and perceived ability (t(156) = -7.95, p < 0.01, d = -0.72) were found, but no substantial change in willingness to respond to disasters was observed. The participants expressed various concerns regarding their willingness to respond, which can be summarized and grouped as (1) personal risk perceptions, (2) contextual factors of the disaster events, and (3) organizational support. Incorporating disaster training into the tertiary education curricula for basic nursing professionals' training could be a long-term strategy to prepare and expand the competent workforce for future disasters. Government or healthcare organizations are recommended to provide strategies and adequate support to alleviate nursing professionals' concerns and enhance their willingness.

The COVID-19 Crisis: Skills That Are Paramount to Build into Nursing Programs for Future Global Health Crisis

The COVID-19 pandemic started at the end of 2019 and can be considered one of the most difficult health crises of the past century. It has had a devastating effect around the world, not only for public health, but also for the economy, labor market, and other facets of individual and societal life. Health systems have been put under high strain, and health professionals have experienced unusual and stressful work circumstances. With the aim of drawing lessons for nursing education, the present study analyzed, during the weeks of peak infection in Spain, the stress experience and coping strategies of a sample of 403 nurses from the Spanish health system. Specifically, we analyzed how tenure, stress appraisal, problem-focused coping, and support-seeking coping predicted nurses’ awareness of their education needs, both in terms of technical-professional knowledge and skills and transversal skills. Structural equation modeling analysis revealed that more tenure (years of experience) was related to lower stress appraisal (workload, −0.12, p < 0.05; insufficient preparation, −0.33, p < 0.001; and fear of contagion −0.36, p < 0.001) and more problem focused coping (PFC) strategies were related to higher awareness of professional (0.18, p < 0.01) and transversal educational needs (0.17, p < 0.01) while support seeking strategies just related to transversal training needs (0.10, p < 0.05). Moreover, the participants provided valuable input about specific contents to be considered in future nursing education programs. Implications for redesigning the nursing degree curriculum are analyzed in the discussion section.

Zika and Flint Water Public Health Emergencies: Disaster Training Tool Kits Relevant to Pregnant Women and Children

Pregnant women and children and individuals suffering from chronic illness are disproportionally impacted by public health emergencies. To meet the healthcare needs of these populations, the nursing workforce must be capable of responding in a timely and appropriate manner. The goal of this project was to create interactive and engaging evidence-based educational tool kits to advance healthcare provider readiness in the management of population health in response to the Zika and Flint Water crises. A multipronged, mixed-methods approach was used to identify essential education needs and required core competencies. Data were synthesized from discussion with key informants, review of relevant documents, and surveys of schools of nursing, public health, and medicine. The ADDIE model was used to integrate results into the development of the online learning tool kits using the ThingLink software program. An innovative online educational program to prepare healthcare providers to rapidly identify, mitigate, and manage the impact of the Zika and Flint Water crises upon pregnant women and children was implemented by the Society for the Advancement of Disaster Nursing. Innovative online learning tool kits can advance healthcare provider readiness by increasing knowledge and understanding of key components of specific public health emergencies.

Knowledge, Attitude and Performance Associated with Disaster Preparedness in Iranian Nurses: A Systematic Review and Meta-analysis

Context:

Nurses are the largest group of health service providers with a vital role in assisting victims during disasters. They must be therefore appropriately prepared to respond to health requirements in these situations.

Evidence acquisition:

Three articles were ultimately extracted from a comprehensive search conducted in the present systematic review and meta-analysis in Google Scholar, SID, Magiran, Scopus, PubMed and Web of Science using English keywords and their Persian equivalents. The I² index was used to evaluate the heterogeneity between the studies, and the analyses were performed in STATA 14.

Results:

This review was conducted on 586 nurses working in hospitals. The final meta-analysis included three articles. The matched mean scores of knowledge, attitude and performance concerning disaster preparedness were respectively found to be 43.49 (95% CI: 37.67–49.31, P=0.581, I²=0.0%), 68.81 (95% CI: 63.04–70.58, p=0.913, I²=0.0%) and 56.19 (95% CI: 53.95–58.42, P=0.001, I²=86.2%).

Conclusion:

The present findings suggested moderate levels of knowledge and performance and good attitudes associated with preparedness in disasters in the Iranian nurses. These parameters can be therefore improved to desirable levels and the overall preparedness for coping with disasters boosted in nurses by training nurses and performing hospital drills.

START versus SALT Triage: Which is Preferred by the 21st Century Health Care Student?

IntroductionWhile the art and science of disaster triage continue to evolve, the education of the US health care student in matters pertaining to disaster preparedness and response remains stifled. Unfortunately, these students will be assuming major decision-making responsibilities regarding catastrophes that will be complicated by climate change, nuclear threats, global terrorism, and pandemics. Meanwhile, Sort, Assess, Life-Saving Interventions, Treatment, and/or Transport (SALT) triage is being advocated over the globally popular Simple Triage and Rapid Treatment (START) algorithm for multiple reasons: (1) it's an all-hazard approach; (2) it has four medical interventions; and (3) it has an additional triage color for victims with non-survivable injuries.Hypothesis/ProblemAs present-day threats become more ominous and health care education emphasizes the needs of vulnerable populations and palliative care, the authors hypothesize that, when given a choice, health care students will prefer SALT triage.

METHODS

A convenience sample of 218 interprofessional, disaster-naïve health care students received just-in-time, unbiased education on both START and SALT triage systems. Students then completed a survey asking them to decide which triage system they believe would be most effective in their community.

RESULTS

A total of 123 health care students (56.4%) preferred SALT while 95 (43.6%) preferred START; however, only the physician assistant students showed a statistically significantly preference (28 versus six, respectively; P=.042). Interestingly, there was also a statistically significant difference in preference by gender (Chi-square=5.02; P=.025) of the observed distribution versus expected distribution in SALT and START. The females preferred SALT (61.0%) while the males preferred START (55.9%).Among those who preferred START, START being easier to learn was the most important reason cited. Among those who preferred SALT, the most important reason cited was that the number of patient triage categories seemed more logical, comprehensible, and consistent with traditional medical care.

CONCLUSION

While SALT's preference among females and physician assistant students was based on the addition of medical interventions and the provision of palliative care, START's preference was related to expediency. Based on this research, incorporating disaster concepts into US health care students' curricula encourages thoughtful consideration among the future health care leaders about the most effective approach to triage care. It is critical that further research be completed to determine, without reservation, which triage system will not only save the most lives but provide the most humane care to victims.Fink BN, Rega PP, Sexton ME, Wishner C. START versus SALT triage: which is preferred by the 21st century health care student? Prehosp Disaster Med. 2018;33(4):381-386.

Mass casualty education for undergraduate nursing students in Australia

With the increasing risk of mass casualty incidents from extreme climate events, global terrorism, pandemics and nuclear incidents, it's important to prepare nurses with skills and knowledge necessary to manage such incidents. There are very few documented accounts of the inclusion of mass casualty education within undergraduate nursing programs. This paper is the first to describe undergraduate mass casualty nursing education in Australia. A final year Bachelor of Nursing undergraduate subject was developed. The subject focused on initial treatment and stabilisation of casualties predominantly within pre-hospital environments, and included a capstone inter-professional mass casualty simulation. Students experience of the subject was evaluated using the Satisfaction with Simulation Experience Scale (Levett-Jones et al., 2011) and a subject evaluation survey. Student satisfaction and evaluations were extremely positive. As a tool for developing clinical skills, 93% (n = 43) agreed that the simulation developed their clinical reasoning and decision making skills. In particular, the simulation enabled students to apply what they had learned (77%, n = 35, strongly agree). Due to the frequency of mass casualty events worldwide, there is a need for educational exposure in undergraduate nursing curricula. We believe that this mass casualty education could be used as a template for development in nursing curricula.

Call to Action: The Case for Advancing Disaster Nursing Education in the United States

PURPOSE

Climate change, human conflict, and emerging infectious diseases are inexorable actors in our rapidly evolving healthcare landscape that are triggering an ever-increasing number of disaster events. A global nursing workforce is needed that possesses the knowledge, skills, and abilities to respond to any disaster or large-scale public health emergency in a timely and appropriate manner. The purpose of this article is to articulate a compelling mandate for the advancement of disaster nursing education within the United States with clear action steps in order to contribute to the achievement of this vision.

DESIGN AND METHODS

A national panel of invited disaster nursing experts was convened through a series of monthly semistructured conference calls to work collectively towards the achievement of a national agenda for the future of disaster nursing education.

FINDINGS

National nursing education experts have developed consensus recommendations for the advancement of disaster nursing education in the United States. This article proposes next steps and action items to achieve the desired vision of national nurse readiness.

CONCLUSIONS

Novel action steps for expanding disaster educational opportunities across the continuum of nursing are proposed in response to the current compelling need to prepare for, respond to, and mitigate the impact of disasters on human health. U.S. educational institutions and health and human service organizations that employ nurses must commit to increasing access to a variety of quality disaster-related educational programs for nurses and nurse leaders.

CLINICAL RELEVANCE

Opportunities exist to strengthen disaster readiness and enhance national health security by expanding educational programming and training for nurses.

A Strategy to Enhance Student Experiences in Public Health Emergency Preparedness and Response: Medical Reserve Corps Nursing Student Summer Externship

Development of the public health nursing workforce is crucial to advancing our nation's health. Many organizations, including the American Association of Colleges of Nursing, Centers for Disease Control and Prevention, and the US Department of Health and Human Services, have identified the need for strengthening academia's connection to public health and tailoring experiences to enhance workforce competency. The Oklahoma Medical Reserve Corps (OKMRC) Nursing Student Summer Externship was developed as a strategy to provide nursing students with strengthened knowledge and skills in disaster response through a structured summer volunteer experience with nurse educators within the OKMRC. The Medical Reserve Corps is a national organization with more than 200 000 volunteers dedicated to strengthening public health, improving emergency response capabilities, and building community resiliency. In the summer of 2015, the OKMRC offered a 10-week public health emergency preparedness and response externship pilot program to 8 nursing students. In the summer of 2016, the program expanded to include 3 Oklahoma baccalaureate nursing programs. Students completed trainings and participated in activities designed to provide a broad base of knowledge, an awareness of the local disaster plans, and leadership skills to assist their communities with preparedness and disaster response.

US Military Nurses: Serving Within the Chaos of Disaster

The purpose of this article is to share US military nurses' experiences of responding to disasters. Using phenomenology, 23 participants serving as US military nurses from different service branches and the US Public Health Service volunteered for a single face-to-face interview. Five polar themes plus one final theme emerged from the narratives. Nurses expressed a sense of loss, reshaping of thoughts regarding disasters, and new appreciation of how people's lives are totally disrupted. Findings showed a need for change in nursing education, practice, training, policy, and recommendations for higher education and how the military may better educate its personnel.

A grounded theory study of 'turning into a strong nurse': Earthquake experiences and perspectives on disaster nursing education

BACKGROUND

While Asia has the dubious distinction of being the world's most natural disaster-prone area, disaster nursing education and training are sparse in many Asian countries, especially China where this study took place.

OBJECTIVE

To explore the earthquake disaster experiences of Chinese nurses and develop a substantive theory of earthquake disaster nursing that will help inform future development of disaster nursing education.

DESIGN

A qualitative study employing grounded theory, informed by symbolic interactionism.

PARTICIPANTS AND SETTING

Fifteen Chinese registered nurses from five hospitals in Jiangxi Province who undertook relief efforts after the 2008 Wenchuan Earthquake.

METHODS

Data were collected in 2012-2013 in digitally-recorded, semi-structured, in-depth interviews and reflective field notes, and analyzed using Glaser's grounded theory method.

RESULTS

Participants were unprepared educationally and psychologically for their disaster work. Supporting the emergent theory of "working in that terrible environment", was the core category of "turning into a strong nurse", a process of three stages: "going to the disaster"; "immersing in the disaster"; and "trying to let disaster experiences fade away". The participants found themselves thrust in "terrible" scenes of destruction, experienced personal dangers and ethical dilemmas, and tried the best they could to help survivors, communities and themselves, with limited resources and confronting professional work.

CONCLUSIONS

Our rich findings confirm those of other studies in China and elsewhere, that attention must be paid to disaster education and training for nurses, as well as the mental health of nurses who work in disaster areas. Emergent theory helps to inform nurse educators, researchers, leaders and policy makers in China, and elsewhere in developing strategies to better prepare nurses for future disasters, and assist communities to prepare for and recover after earthquake disasters.

Disaster nursing skills, knowledge and attitudes required in earthquake relief: Implications for nursing education

BACKGROUND

Globally, nurses becoming more aware of getting better prepared for disaster relief, but in China, disaster nursing knowledge, courses and research are still limited.

INTRODUCTION

China has long been prone to disasters, but disaster nursing education and training is in its infancy.

AIM

This study explored the skills, knowledge and attitudes required by registered nurses from across China who worked in the aftermath of three large earthquakes to try to determine future disaster nursing education requirements.

METHOD

The Questionnaire of Nurses' Disaster Nursing Skills at Earthquake Sites, assessing nursing skills, knowledge and attitudes, was distributed to 139 registered nurses in 38 hospitals in 13 provinces across China who had worked in one or more earthquake disaster zones. Descriptive statistics were used for quantitative data, and content analysis for qualitative data.

RESULTS

Eighty-nine questionnaires were returned, a response rate of 68.3%. No respondent had ever received specific disaster nursing training prior to their post-earthquake nursing. Skills most often used by respondents were haemostasis bandaging, fixation, manual handling, observation and monitoring, debridement and dressing, and mass casualty transportation. Respondents identified that the most important groups of skills required were cardiopulmonary resuscitation; haemostasis, bandaging, fixation, and manual handling; and emergency management. They emphasized the need for psychological care of victims as well as that of fellow health workers.

CONCLUSION

No respondent had ever received disaster nursing training prior to engagement at the earthquake disaster sites. All believed that there were important gaps in their knowledge and skills, and supported disaster nursing courses in the future.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

China urgently needs to develop disaster nursing courses, with the support of nurse leaders, educationalists and government, to implement training using an all hazards approach in accordance with international best practice and trainees' background clinical experience and knowledge.

Nursing Education for Disaster Preparedness and Response

Catastrophic mass casualty events (MCEs), such as pandemic influenza outbreaks, earthquakes, or large-scale terrorism-related events, quickly and suddenly yield thousands of victims whose needs overwhelm local and regional health care systems, personnel, and resources. Such conditions require deploying scarce resources in a manner that is different from the more common multiple casualty event. This article presents issues associated with providing nursing care under MCE circumstances of scarce resources and the educational needs of nurses to prepare them to effectively respond in these emergencies. J Contin Educ Nurs. 2015;46(x):xxx-xxx.

Nursing and complex humanitarian emergencies: Ebola is more than a disease

To effectively address the Ebola outbreak in West Africa, it must be viewed in terms of the connections between health, politics, security, the environment, and poverty. For the people in the countries involved and those responding, it is more than the viral illness. Although the medical management of the disease is far from simple, it is really only the proximal event of much greater social upheaval in the region, creating what is known as a complex humanitarian emergency (CHE). This article describes a course to introduce nursing students to CHEs and the role of nurses in the field of global response. CHEs are becoming more frequent with high death and disease rates. Nurses must become familiar with their complexity and multifaceted response. Although the planning for the course predated the current epidemic, the Ebola outbreak in West Africa served as an excellent exemplar for the health sector response in CHEs.

Undergraduate nursing students' perceptions about disaster preparedness and response in Istanbul, Turkey, and Miyazaki, Japan: a cross-sectional study

AIM

Although the awareness of disasters has increased among nurses, the concept of disaster preparedness and response has not been sufficiently explored with undergraduate nursing students. The aim of this study was to assess and compare the perceptions of students regarding disaster preparedness and response that live in different earthquake-prone cities; Istanbul, Turkey and Miyazaki, Japan.

METHODS

A cross-sectional study employing seven questions was conducted in a final group of 1053 nursing students from Istanbul, Turkey, and Miyazaki, Japan.

RESULTS

Most study respondents were female, aged 18-22 years, with a high proportion of second year students in both cities. Istanbul's students had more knowledge about disaster preparedness and response in relation to age and year of university, showing statistically significant differences. Istanbul's highest rated responses to disaster characteristics were on structural elements and injuries/deaths, while Miyazaki's was "unpredictable/sudden/disorganized". Respondents in Istanbul identified earthquakes as the disaster most likely to occur, while respondents in Miyazaki identified typhoon/hurricane. Study participants responded that they could provide caregiver roles during a disaster event rather than triage or managerial roles as disaster responders.

CONCLUSION

Disaster characteristics were not described by one third of the students. Of the two-thirds that were described, most were of events that were highly predictable because of their frequencies in the given areas. Universities need to target and then focus on high-risk factors in their areas and have disaster plans for students who can provide triage and managerial nursing roles as disaster responders.

What are the research needs for the field of disaster nursing? An international Delphi study

BACKGROUND

Internationally there is an increasing amount of peer-reviewed literature pertaining to disaster nursing. The literature includes personal anecdotes, reflections, and accounts of single case studies. Furthermore, issues such as the willingness of nurses to assist in disasters, the role of nurses in disasters, leadership, competencies, and educational preparedness for nurses have been the focus of the literature.

AIM

The aim of this research was to determine the international research priorities for disaster nursing.

METHOD

This research used a three-round Delphi technique. The first round used a face-to-face workshop to generate research statements with nursing members of the World Association for Disaster and Emergency Medicine (WADEM). The second and third rounds included the ranking of statements on a 5-point Likert scale with nursing members of WADEM and the World Society of Disaster Nursing (WSDN). Statements that achieved a mean of four or greater were considered a priority and progressed.

RESULTS

Participants were from multiple countries. Research statements were generated in the areas of: education, training, and curriculum; psychosocial; strategy, relationship, and networking; and clinical practice. Psychosocial aspects of disaster nursing ranked the highest, with five statements appearing in the top ten research areas, followed by statements relating to: education, training, and curriculum; clinical practice; and finally, strategy, relationship, and networking.

CONCLUSIONS

Future disaster nursing research should focus on the area of psychosocial aspects of disaster nursing, in particular, both the psychosocial needs of a disaster-affected community and the psychosocial wellbeing of nurses who assist in disaster health activities.

Nursing educators' perceptions about disaster preparedness and response in Istanbul and Miyazaki

AIM

As healthcare professionals, nursing educators need to be prepared to manage and deliver care in what are often dangerous conditions. This research aims to determine and compare nursing educators' perceptions of disaster preparedness and response (DP&R) in Istanbul and Miyazaki.

METHODS

An 18 question descriptive questionnaire was used.

RESULTS

One hundred and forty-four nursing educators representing two state university nursing schools in Istanbul, Turkey, and one state and two private universities in Miyazaki, Japan were enrolled. Educators had an average age of 40 years and had been educators for 1-15 years. Just over half of the participants had basic knowledge regarding DP&R with most of them considering taking special courses in the future. The majority considered "caregiver" as a role they could undertake in a disaster situation. The existence of major concerns and conflicts in disaster responses were low. The top ranked item was in the area of conflict between family and job responsibilities. Age and academic levels showed significant differences in basic knowledge on DP&R. Regardless of knowledge in this subject area, no statistical significance on personal preparedness or being a volunteer to disaster events was found.

CONCLUSION

Nursing educators were not thinking about what kinds of disasters occur in the areas where they currently teach and were underprepared to deal with disaster situations. To improve the perceptions of the nursing educators on DP&R, mass casualty care and disaster management skills need to be incorporated into formal education and training on disaster preparedness and workplace preparedness.

Wildfire disasters: implications for rural nurses

BACKGROUND

As natural disasters are increasing globally, nursing's role in responding to disasters is evolving. Disaster nursing has emerged as a specialty that focuses on the care of groups and communities during disaster response. The role of rural nurses in disasters is less well defined.

METHODS

A review of peer-reviewed literature combined with the International Council of Nurses framework of Disaster Nursing Competencies was conducted to understand the roles and functions of nurses in rural areas that experience disasters. The authors' findings from investigating the effects of four wildfires in rural Canadian communities are also discussed.

RESULTS

Six major themes derived from our wildfire studies were generated within the context of nursing practice and are useful in the preparation of rural nurses involved in disaster management and recovery. This adds to the current literature which by and large has not addressed nursing in rural catastrophes.

CONCLUSION

Well-prepared and educated rural nurses who combine theoretical knowledge with their understanding of a rural community potentially can reduce the impact of a disaster. Other nursing roles include mentoring nursing students in disaster preparation and assisting in initiatives to address community recovery in the aftermath of a disaster.

Educational competencies and technologies for disaster preparedness in undergraduate nursing education: an integrative review

OBJECTIVES

This integrative review of literature was conducted to determine (1) what are the suitable disaster preparedness competencies for undergraduate nursing curriculum? and (2) what are the suitable methods of instruction to deliver disaster preparedness content?

DATA SOURCES AND REVIEW METHOD

A literature search was conducted on three major electronic databases: Ovid MEDLINE, PubMed and the Cumulative Index of Nursing and Allied Health Literature (CINAHL) using the keywords; Disaster Preparedness, Disaster and nursing education; disaster response and nursing education. Limiters used were published within the last 10 years and in nursing field. Out of the 190 articles retrieved, eight were research articles that met the inclusion criteria. These articles were carefully reviewed and the results are summarized in two sections to answer the research questions.

RESULTS AND FINDINGS

There was no uniformity of intended competencies among the studies, though all studies used resources from reputed national and international organizations. All the studies reviewed adhered to a systematic approach in delivering content and used eclectic methods including multiple technologies to enhance the educational outcomes. Most of the studies had incorporated simulation in different ways involving low to high fidelity simulators, virtual simulation and live actors. Content and length of the programs were greatly varied but stayed focused on the general principles of disaster management and appropriate for the level of the students within the programs.

DISCUSSION AND CONCLUSION

More rigorous research is needed in this area since all published articles had deficiencies in the methodologies, especially in data collection and analysis. Disaster preparedness education was found to be a suitable activity for interprofessional education.

"Skip the infection, get the injection": a case study in emergency preparedness education

The frequency of natural and manmade disasters along with increasing potential for public health emergencies emphasizes the need for emergency preparedness education. Because nurses are the largest group of health professionals to meet the needs of those affected by disasters and public health emergencies, schools of nursing need to prepare graduates who are knowledgeable about disaster and public health emergency management. The use of core competencies may be a means to ensure consistent application of best practices in disaster health care. The next step in competency development involves validation through evidence. Through documentation and dissemination of their experiences with emergency preparedness education, schools of nursing can provide supportive evidence to aid in competency development. The purpose of this paper is present a case study of an ongoing and evolving public health nursing education project consistent with disaster health care and emergency preparedness competencies.

A Disaster Response and Management Competency Mapping of Community Nurses in China

BACKGROUND

It is widely accepted in many parts of the world thatcommunity nurses are of vital importance in various phases of disaster response and management. In China, however, it is not clear whether the Chinese community nurses are able to assume disaster-related duties due to the lack of a systematic assessment.

METHODS

A pre-designed and well-tested questionnaire was employed to evaluate the competency in disaster response and management among 205 valid registered Chinese community nurses between September and October 2009. Statistical analyses were performed with SPSS Version 13.0 using one way ANOVA, Least Significant Difference (LSD) and multiple stepwise regression analysis.

RESULTS

This group of Chinese community nurses scored at an intermediate level of competency (a score of 3.68 (SD 0.48) out of a perfect score of 5) in disaster response and management, suggesting that they have the basic ability to participate in disaster-related nursing. Four factors, namely, Experiences in Disaster Relief, Participation in Disaster Training, the Age and Duration in Job, were identified to be the predominant factors contributing significantly to the integrated competency in disaster response and management of an individual.

CONCLUSION

Most of the Chinese community nurses have basic qualifications and competencies to undertake the responsibilities of disaster response and management. However, more targeted disaster training including virtual-reality based drills should be provided in order to improve their competency.

Willingness to respond in a disaster: a pediatric nurse practitioner national survey

OBJECTIVE

The objective of this study was to examine factors associated with pediatric nurse practitioners (PNPs) reporting to work in the event of a disaster.

METHODS

An anonymous national survey of PNPs was conducted. Several domains were explored, including demographics, personal preparedness plans, disaster training, prior disaster experience, and likelihood of responding in the event of a disaster. A logistic regression analysis was conducted to determine which factors were associated with the respondent's likelihood of responding in the event of a disaster.

RESULTS

Factors associated with increased likelihood of responding included gender (being a male PNP), military experience, and disaster training. The most significant factor associated with an increased likelihood of responding to work during a disaster was having a specified role in the workplace disaster plan. PNPs with a specified role were three times more likely to respond than were those without a specified role.

CONCLUSIONS

PNPs are health care workers with advanced skill sets. This untapped resource is available to provide care for a vulnerable population: our children. Disaster planners should explore the possibility of utilizing these highly skilled health care workers in their disaster plans.

An assessment of nurses' knowledge of botulism

OBJECTIVE

To assess nurses' knowledge of botulism, a Centers for Disease Control Category A bioterrorism agent, one case of which constitutes an emergency.

DESIGN

The study utilized survey research.

SAMPLE

The cluster sample included 1,414 registered nurses.

MEASURE

The survey gathered demographic data and nurses' knowledge of the background, manifestation and management of botulism.

RESULTS

The mean percentage of correct answers for the sample was 25.95%, with a standard deviation (SD) of ±19.89%. Only 90 (6.3%) achieved 60% or more correct. Educational preparation, experience, specialty/area of practice and whether nurses had a class in disaster medicine were also examined and although differences were noted, none of these factors accounted for a score of 60% or above.

CONCLUSIONS

The results of this study indicate the need for an assessment of the current education nurses receive about botulism.

Using disaster exercises to determine staff educational needs and improve disaster outcomes in rural hospitals: the role of the nursing professional development educator

Using human potential in rural hospitals is vital to successful outcomes when handling disasters. Nursing professional development educators provide leadership and guiding vision during a time when few educational research studies demonstrate how to do so. This article explains the role of the rural nursing professional development educator as a disaster preparedness educator, facilitator, collaborator, researcher, and leader, using the American Nurses Association's Nursing Professional Development: Scope and Standards of Practice.

A survey of the practice of nurses' skills in Wenchuan earthquake disaster sites: implications for disaster training

AIMS

To determine nursing skills most relevant for nurses participating in disaster response medical teams; make recommendations to enhance training of nurses who will be first responders to a disaster site; to improve the capacity of nurses to prepare and respond to severe natural disasters.

BACKGROUND

Worldwide, nurses play a key role in disaster response teams at disaster sites. They are often not prepared for the challenges of dealing with mass casualties; little research exists into what basic nursing skills are required by nurses who are first responders to a disaster situation. This study assessed the most relevant disaster nursing skills of first responder nurses at the 2008 Wenchuan earthquake disaster site.

METHOD

Data were collected in China in 2008 using a self-designed questionnaire, with 24 participants who had been part of the medical teams that were dispatched to the disaster sites.

FINDINGS

The top three skills essential for nurses were: intravenous insertion; observation and monitoring; mass casualty triage. The three most frequently used skills were: debridement and dressing; observation and monitoring; intravenous insertion. The three skills performed most proficiently were: intravenous insertion; observation and monitoring; urethral catheterization. The top three ranking skills most important for training were: mass casualty transportation; emergency management; haemostasis, bandaging, fixation, manual handling.

CONCLUSION

The core nursing skills for disaster response training are: mass casualty transportation; emergency management; haemostasis, bandaging, fixation, manual handling; observation and monitoring; mass casualty triage; controlling specific infection; psychological crisis intervention; cardiopulmonary resuscitation; debridement and dressing; central venous catheter insertion; patient care recording.