Nurses as Leaders in Disaster Preparedness and Response-A Call to Action

Assessing the frontline competency gap: Emergency care perceptions among nurses in Yemen's conflict zone

BACKGROUND

Nursing competencies in armed conflict situations are critical for effective response and recovery. This study explores nurses' perceptions regarding their competencies in armed conflict zones to identify areas of proficiency and those requiring further emphasis in training.

METHODS

This cross-sectional descriptive study adhered to the STROBE reporting guidelines. It used a validated questionnaire examining 47 different competencies for nursing in armed conflict zones, which were subsequently ranked to identify those that were valued most and least.

RESULTS

In total, 102 questionnaires were returned (85% response rate). The highest-ranked competencies focused on immediate life-saving interventions and personal safety. In contrast, competencies involving broader disaster management, such as understanding organizational disaster plans, post-death care, and risk identification, ranked lower. This observation may indicate a tendency to prioritize direct clinical care over strategic planning and long-term recovery in disaster nursing education.

CONCLUSION AND IMPLICATIONS FOR NURSING AND HEALTH POLICY

This study highlights the critical need to strengthen emergency care competencies among nurses working in armed conflict zones in Yemen. Its findings underscore the importance of targeted training programs, particularly in complex trauma management and psychological first aid, to address nurses' self-identified competency gaps. Policy implications include prioritizing resource allocation for emergency care infrastructure, implementing competency-based deployment strategies, and ensuring access to mental health support for nurses in working conflict zones. These actions are essential for building a resilient nursing workforce capable of providing quality care amidst the unique challenges of armed conflict.

Expanding Opportunities in Emergency Preparedness Through Mutually Beneficial Community Partnerships

BACKGROUND

Already well known is the fact that disasters and emergencies in large scale will continue to grow in numbers, and nurses will have a role in almost all situations. Schools of nursing need to look for innovative ways to enhance these competencies.

METHOD

This project involved two activities: (1) to train lower-level nursing students to be active members in the local Medical Reserve Corporation and (2) to run a community-wide simulated event giving nursing students the opportunity to participate in emergency management.

RESULTS

Participant feedback was gained through a standardized evaluation form and postsurvey questionnaire, as well as a structured debriefing. Students verbalized an appreciation and excitement regarding future community involvement.

CONCLUSION

This project offered students the opportunity to connect what they learned in the classroom to a live situation and also strengthened the school of nursing's community partnerships. [J Nurs Educ. 2025;64(X):XXX-XXX.].

Ethical challenges nurses faced during the COVID-19 pandemic: Scoping review

Nurses encountered a myriad of ethical challenges during the height of the COVID-19 pandemic, such as allocation of scarce resources, the need to balance duty of care with safety of self as well as visitation restrictions. The impact of these challenges on the nursing workforce requires investigation. The aim of this review was to scope and describe the reported literature on ethical challenges faced by nurses during the COVID-19 pandemic, including contextual characteristics and strategies reported to address these challenges. The review was conducted in accordance with JBI methods for scoping reviews and reported using PRISMA-ScR guidance. A published protocol guided conduct of the review. The following databases were searched for eligible studies from November 2019 to January 2023: PubMed, CINAHL, Ovid, PsycINFO, the Cochrane Library, and Scopus. No language restrictions were applied. Studies were reviewed for inclusion by two independent reviewers, and a data extraction form was developed to extract data relevant to the review questions. Results were analyzed and presented according to the concepts of interest, using tables, figures, and supporting narrative synthesis. After searching the databases, 2150 citations were retrieved with 47 studies included in the review. Studies represented 23 countries across five continents. Most of the studies used qualitative designs. Ethical challenges were described in several ways, often without appealing to common ethics language or terms. Few studies reported on strategies to address the specific challenges, which may reflect the dynamic nature of the pandemic. The scoping review highlights the complex and, at times, overwhelming impact of ethical challenges faced by nurses across the globe during the COVID-19 pandemic. Findings from the review can be used as a basis for further research to explore, develop, and implement strategies to address ethical challenges faced by nurses during future public health crises.

Developing Disaster Nursing Competencies Through Academic Service-Learning

BACKGROUND

The American Association of Colleges of Nursing (AACN) and the Future of Nursing 2030 report emphasize the need for nursing students' competence in disaster care. Academic service-learning is a practical pedagogical approach for developing these skills that bolsters population health and leadership competencies.

METHOD

The Red Cross developed nine Academic Service-Learning (AS-L) modules that integrate training and hands-on experiences in disaster preparedness, response and recovery, well-being, diverse blood donation, case management, and immunizations and global health. Self-scored pre- and postquestions were developed to assess students' knowledge and confidence in skill application.

RESULTS

Ongoing evaluation shows promising preliminary results in student learning and community engagement. Active faculty participation significantly improved student learning outcomes.

CONCLUSION

The Red Cross AS-L initiative augments nursing students' disaster and community health competencies through practical training and immersive experiences that align with evolving health care needs and AACN competencies. [J Nurs Educ. 2025;64(4):265-268.].

Nursing students' knowledge, attitudes and awareness regarding shelter nursing in disaster preparedness

BACKGROUND

Shelter nursing plays a crucial role in disaster preparedness, yet its integration into nursing education remains limited. This study aims to evaluate nursing students' knowledge, attitudes, and awareness concerning shelter nursing and identify their educational needs in this critical area.

METHODS

A descriptive cross-sectional study was conducted among nursing students from Fırat University and Sakarya University Faculties of Health Sciences between August and November 2024. A total of 1,450 students were invited, and a sample size of 304 was determined using OpenEpi Version-3 software (power = 80%, confidence level = 95%). Data were collected through an online structured questionnaire, and statistical analyses included descriptive statistics, chi-square tests, means, and standard deviations.

RESULTS

The study sample included 304 participants with a mean age of 20.92 ± 2.66 years. The majority were female (83.2%) and single (98.7%). Only 5.9% had prior knowledge of shelter nursing, and 6.6% could correctly define the concept, highlighting significant educational gaps. Chi-square analysis revealed that gender significantly influenced awareness (p = 0.018), with female students demonstrating higher awareness levels. However, no significant differences were observed for other variables. A total of 76.6% of participants identified the need for additional training, while only 1% had received prior education on shelter nursing. Additionally, 91.1% of students reported inadequate knowledge of basic medical interventions in shelter nursing. Despite these gaps, 73.7% expressed a strong interest in crisis management training, with trauma and psychological issues being identified as the most critical health challenges in shelter environments.

CONCLUSIONS

There is a critical need to integrate shelter nursing education into nursing curricula to enhance disaster preparedness. Findings highlight the importance of incorporating gender-sensitive and subgroup-focused educational strategies. The inclusion of simulation-based training, field exercises, and disaster management modules is strongly recommended. Although knowledge deficits exist, students' high willingness to engage in shelter nursing education suggests a strong foundation for future curriculum development.

CLINICAL TRIAL NUMBER

Not applicable.

Work engagement among nurses in the context of the COVID-19 pandemic: A systematic review

BACKGROUND

Despite nurses receiving education on how to respond during crises, the stress and demands arising from unprecedented situations, such as the COVID-19 pandemic, may affect their work engagement.

AIM

To appraise and synthesize studies examining work engagement among nurses in the context of the COVID-19 pandemic.

METHODS

It is a systematic review in which three databases were searched. Critical appraisal tools and PRISMA guidelines were used. Content analysis was performed.

ETHICAL CONSIDERATIONS

Ethical approval was not required for this systematic review.

FINDINGS

A total of 21 studies were included. The results were classified into three categories: (1) levels and meanings of work engagement, (2) the relationship of work engagement with various factors, and (3) measures to enhance work engagement.

CONCLUSION

The review revealed that nurses' work engagement varied from moderate to high. Factors such as education level and work schedule flexibility influenced their engagement. Positive associations were found between work engagement and job satisfaction, intention to stay, and organizational support, while stress and workload showed negative relationships. The crucial role of health policymakers, hospital administrators, and nurse managers in acting ethically, creating favorable working conditions and fostering nurses' work engagement was emphasized.

Evaluation of emergency nurses' knowledge of medical response in nuclear and radiological emergencies : a cross-sectional study

BACKGROUND

Evaluating emergency room nurses' knowledge of radiation protection, health effects, and decontamination procedures is crucial for preparedness in nuclear and radiological emergencies. This study aims to evaluate the level of knowledge among emergency nurses in Saudi Arabia regarding medical responses to nuclear and radiological emergencies.

METHODS

A multicenter cross-sectional study was conducted via a self-structured questionnaire with 15 true‒false questions divided into three domains, namely, radiation protection measures, radiation health effects, and decontamination procedures, each with five items and a possible score of 1 point per correct answer. The collected data were analyzed via descriptive and inferential statistics. The study followed the STROBE checklist for methodological rigor.

RESULTS

A total of 594 emergency nurses participated in this study, with the majority being young (64.50% aged ≤ 30), female (68.69%), bachelor's degree-holding (67.68%), single (63.64%), having ≤ 4 years of experience (56.06%), working in public health facilities (88.89%), and lacking training in medical response (85.35%). The mean knowledge scores for participants were highest for radiation exposure effects (3.27 ± 0.91), followed by radiation protective measures (2.32 ± 0.99), and lowest for decontamination procedures (1.46 ± 1.07). Overall knowledge was measured at a mean score of 7.06 ± 1.68, with 97.47% of the nurses categorized as having poor knowledge level. Nurses in private hospitals scored higher (7.77 ± 1.82) than those in public hospitals (6.97 ± 1.65) on overall mean knowledge (P = 0.034). Concerning findings include emergency nurses' misconceptions about the protection provided by dense materials, the effectiveness of increasing distance from a radiation source, and prioritizing decontamination of victims over life-saving measures. Additionally, they were unaware of the immediate symptoms following radiation exposure and misunderstood that the primary threat in a radioactive bomb event is the explosion rather than the radiation itself.

CONCLUSION

This study revealed poor knowledge among emergency nurses regarding medical responses to radiation emergencies and highlighted the critical need for enhanced and standardized training in radiation emergency preparedness among nurses. The gaps in knowledge identified in this study could significantly impact the effectiveness of healthcare responses in radiation emergency scenarios. Therefore, targeted educational interventions and policy changes are recommended to address these shortcomings.

Enhancing primary healthcare nurses' preparedness for climate-induced extreme weather events

BACKGROUND

Climate Change is causing frequent and sever extreme weather events globally, impacting human health and well-being. Primary healthcare (PHC) nurses' are at the forefront of addressing these challenges and must be prepared.

PURPOSE

This scoping revieww explored literature on the preparedness of the PHC nursing workforce for extreme weather events and identify gaps in knowledge and practice.

METHODS

Using Arksey and O'Malley's framework, a comprehensive search was conducted across PubMed, Scopus, CINHAL, Web of Sciences, and ProQuest, on studies from 2014-2024, addressing PHC nurses' preparedness.

DISCUSSION

Nine studies were identified and highlighted a need for preparedness training and facility-based preparedness plans. Key themes included prioritizing regional networks, clinical leadership, service delivery, health information, health workforce, medical products and technologies, and financing.

CONCLUSION

Strengthening PHC nurses' resilience against extreme weather requires targeted professional development, mental health support, comprehensive planning, and collaborative efforts. Future strategies should enhance PHC nurses' capacity through training, support, and policy development.

Core competencies of emergency nurses for the armed conflict context: Experiences from the field

BACKGROUND

Armed conflicts are usually associated with high mortality and morbidity rates, with unpredictable workload, injuries and illnesses. Identifying emergency nurses' views of the core competencies required to enable them to work effectively in hospitals in areas of armed conflict is critical. It is important to inform the requisite standards of care and facilitate the translation of knowledge into safe, quality care.

AIM

The aim of this study was to identify emergency nurses' perceptions of core competencies necessary to work in hospitals in the context of armed conflict.

METHOD

A descriptive qualitative phase of a mixed-method study using semi-structured interviews with participants was conducted from June to July 2019. The COREQ guideline for reporting qualitative research was followed.

FINDINGS

A sample of 15 participants was interviewed. The participant perceptions provided a different perspective of core competencies required for emergency nurses in the context of armed conflict, culminating in four main areas: (i) personal preparedness , (ii) leadership, (iii) communication and (iv) assessment and intervention.

CONCLUSION

This study identified emergency nurses' perceptions of their core competencies. Personal preparedness, leadership, communication, assessment and intervention were identified as contributing to calmness of character, confidence in care and cultural awareness for care in this setting and were essential for them to work effectively when managing victims of armed conflict in emergency departments.

IMPLICATIONS FOR NURSING PRACTICE AND HEALTH POLICY

The findings of this study are important and novel because the researchers sought the perspectives of emergency nurses who have experience in receiving patients from armed conflict firsthand. The findings will inform policymakers in those settings regarding standard of care, education and drills for hospital nurses in optimizing armed conflict care response outcomes.

Jordanian Nurses' Perceptions of Disaster Preparedness and Core Competencies

OBJECTIVE

This study aims to identify the Jordanian nurses' perception of their disaster preparedness and core competencies.

METHODS

A descriptive, cross-sectional research design was used. The data was collected via an online self-reported questionnaire using the disaster preparedness evaluation tool and the core disaster competencies tool.

RESULTS

A total of 126 nurses participated in the study. Jordanian nurses had moderate to high levels of core disaster competencies and moderate levels of disaster preparedness. Core disaster competencies and disaster preparedness levels differed based on previous training on disaster preparedness, and the availability of an established emergency plan in their hospitals. Lastly, a previous training on disaster preparedness and core disaster competencies were statistically significant predictors of disaster preparedness among Jordanian nurses.

CONCLUSIONS

Organizational factors and environmental contexts play a role in the development of such capabilities. Future research should focus on understanding the barriers and facilitators of developing core disaster competencies and disaster preparedness among nurses.

Do Experienced Nurses Benefit From Training on Bleeding Control in the Community Setting?

INTRODUCTION

Nurses' preparedness to provide hemorrhage control aid outside of the patient care setting has not been thoroughly evaluated. We evaluated nurses' preparedness to provide hemorrhage control in the prehospital setting after a proof-of-concept training event.

METHODS

We performed a secondary analysis of evaluations from a voluntary hemorrhage control training offered to a group of experienced nurses. Education was provided by a nurse certified in Stop the Bleed training and using the Basic Bleeding Control 2.0 materials. The training lasted approximately 1 hour and included a didactic portion followed by hands-on practice with task trainer legs. Participants were surveyed after training to assess their preparedness to provide hemorrhage control aid using a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree); comments and feedback were also requested. Mean (SD) was used to analyze Likert scale data. Content analysis was performed to identify common themes in qualitative data.

RESULTS

Forty-five experienced nurses participated in the voluntary training. Nursing experience included obstetrics, pediatrics, critical care, acute care, community health, and psychiatric/mental health. Only 39% of participants reported having previously completed a similar course. After training completion, participants reported an increase in their preparedness to provide hemorrhage control aid (mean 3.47 [SD = 1.40] vs mean 4.8 SD [.04], P < .01). Major themes identified included wanting to feel prepared to help others, refreshing skills, and knowing how to respond in an emergency.

DISCUSSION

Regardless of background and experience, nurses may benefit from more advanced hemorrhage control education to prepare them to provide aid in prehospital emergency settings.

Culture of Safety and Preparedness: Benefits of Applying a Daily Mitigation Mindset in the Hospital Setting

AIM

Utilizing the subjective experience of nurse executives who have supervised nurses during a major disaster in a hospital setting, this study aims to describe the subjective experience of nurse executives (NE) who have supervised nurses' responses to major disasters. This paper will focus on strategies to support nursing response to disasters, specifically to strengthen resiliency and the ability to maintain function despite the shock of a disaster, including those caused by climate change.

METHODS

Semi-structured interviews were conducted with 11 hospital-based nurse executives who supervised nurses during some of the worst natural and human-made disasters in different regions of the United States. A phenomenological approach was used to analyze and describe emerging themes from the qualitative data.

RESULTS

Three nurse executives demonstrated theme saturation for mitigation steps to augment traditional disaster readiness activities: (1) Assessment of human infrastructure: daily skills needed during disaster response; (2) Identification and study of failure points and metrics; (3) Strengthening human infrastructure: rectifying deficiencies; and (4) Monitoring metrics and making corrections during conventional periods.

CONCLUSION

Mitigation steps may improve outcomes in hospital function during conventional times; therefore, these steps may improve resiliency and the ability to maintain functions during major disasters, including climate change.

Post-quake call for action: developing core competencies matrix for Syrian health workers in emergency time

BACKGROUND

The recent earthquake in Syria has caused widespread devastation, leading to extensive damage and loss of life. Considering the diverse range of disasters and conflicts that have affected Syrian society, health workers must possess essential competencies to effectively manage various types of disasters, including earthquakes. Therefore, this study was undertaken to identify the specific competencies required by Syrian health workers to respond efficiently and effectively to earthquakes.

METHODS

An exploratory qualitative study was conducted at the Medical Education Program MEP of the Syrian Virtual University SVU. Nine members of the research team of the MEP, who represent various health specializations in medicine, dentistry, nursing, and pharmacy, accepted to take part in this study. Among these, three members have been actively involved in providing health care in hospitals and the field during the Syrian earthquake on 6 February 2023. The Delphi process was adopted to identify competencies. Health workers involved in earthquake response were categorized into nine groups including medical doctors, dentists, pharmacists, nurses, psychological support professionals, medical students, allied healthcare professionals, on-site disaster teams, and managers. The final list was accepted if it achieved more than 80% agreement among the participants in the first, second, and final rounds.

RESULTS

The study identified 74 competencies (12 knowledge items, 35 skills, and 27 attitudes) essential for health workers to respond effectively to earthquakes. They are categorized into five domains: "Preparing the team for the rescue process during and, after earthquakes, Implementation of the rescue process, Education and psychological support, Research, and development".

CONCLUSION

A list of earthquake competencies was identified for health workers. It is hoped that this list will enhance a country's resilience and will enable decision-makers to support health workers in acquiring these competencies within a very strained health system in Syria and other countries.

Theatre practitioners and organisational adaptive capacity in disaster response

Disasters are increasing globally, requiring flexible strategic approaches from healthcare organisations to manage the resultant influx of patients requiring care while also maintaining normal operational services. Theatre practitioners play a key role in disaster response and recovery; however, a lack of appropriate skill utilisation may be reducing overall organisational adaptive capacity and leading to poorer outcomes for organisations, staff and patients. Understanding what skills individual practitioners have, and how they can be deployed to the greatest effect, is a concern for managers to ensure optimal use of resources and to reduce negative impacts of disaster response upon healthcare personnel. This is especially pertinent in the post-COVID healthcare climate where a paucity of operating theatre practitioners and poor workforce planning has led to a lack of surgical capacity at a time when it is most needed.

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.].

Stress overload, influencing factors, and psychological experiences of nurse managers during early stages of the COVID-19 pandemic: a sequential explanatory mixed method study

Background

Healthcare systems had an exceptionally difficult time during the early COVID-19 pandemic. Nurse managers in particular made enormous contributions to ensuring the safety of patients and front-line nurses while being under excessive psychological stress. However, little is known about their experiences during this time.

Objective

The aim of this study was thus to assess the level of stress overload and psychological feelings of nurse managers during the early COVID-19 pandemic.

Methods

A mixed methods sequential explanatory design study with non-random convenience sampling was performed, following the STROBE and COREQ checklists. The study was conducted at the Affiliated Dongyang Hospital, Wenzhou Medical University, with data collected from six provinces in southern China (Zhejiang, Hubei, Shanghai, Jiangsu, Hunan and Jiangxi) during March 2020 and June 2020. A total of 966 nurse managers completed the Stress Overload Scale and Work-Family Support Scale. In addition, a nested sample of nurse managers participated in semi-structured face-to-face interviews. The data were then analyzed using qualitative content analysis, Pearson correlation, and multiple linear regression.

Results

The quantitative results showed that nurse managers experienced a moderate level of stress load. There was a significant negative correlation between work-family support and stress load (r = -0.551, p < 0.01). Concerns about protecting front-line nurses and work-family support were the main factors affecting the stress load, which accounted for 34.0% of the total variation. Qualitative analysis identified four main thematic analyses that explained stress load: (1) great responsibility and great stress, (2) unprecedented stress-induced stress response, (3) invisible stress: the unknown was even more frightening, and (4) stress relief from love and support. Taken together these findings indicate that concern about protecting front-line nurses and negative work-family support of nurse managers were the main factors causing stress overload.

Conclusion

Implementing measures focused on individual psychological adjustment combined with community and family support and belongingness is one potential strategy to reduce psychological stress among nurse managers.

Jordanian Nurses' Perceived Disaster Preparedness: Factors Influencing Successful Planning

Background

Current disaster knowledge, skills, and preparedness levels need to be evaluated to guide plans to strengthen disaster readiness.

Objective

This study aimed to explore the Jordanian staff nurses' perception regarding their familiarity, attitudes, and practices for disaster preparedness (DP) to reduce the negative impacts of disasters.

Methods

This is a cross-sectional, quantitative, descriptive study. The study was conducted on nurses working at governmental and private hospitals in Jordan. A convenience sample of 240 currently working nurses was recruited to participate in the study.

Results

The nurses were somewhat familiar with their role in DP (2.9 ± .84). The nurses' overall attitude towards DP was 2.2 ± 0.38, indicating that respondents had medium attitude levels. A low practice level for DP (1.59 ± 0.45) was also observed. Among the studied demographic variables, there was a significant relationship between experience and prior training with improved familiarity and practices. This indicates a need for strengthening nurses' practical skills as well as their theoretical knowledge. However, there is only a significant difference between attitude scale scores and disaster preparedness training (f = 10.120; p=0.002).

Conclusions

The study findings support the need for more training (academic and/or institutional) to increase and improve nursing disaster preparedness locally and globally.

Covid 19: A community based nursing disaster response

Nursing has been criticized for inconsistent and episodic attention to disaster response training in academic settings. The work described herein demonstrates that nursing was not only prepared for the COVID-19 pandemic but was able to mobilize and lead a large-scale response that benefited a university community and the larger surrounding communities and neighborhoods paying particular attention to marginalized populations. For healthcare providers outside of hospitals, it was clear that disaster response methods would need to be implemented. The authors demonstrate that nursing established an on-the-ground response in collaboration with other University officials and departments. Initially established for the University community, the response was moved into surrounding neighborhoods vaccinating the city's most vulnerable. The nurse led effort answered more than 25,000 Hotline telephone calls, collected more than 30,000 COVID-19 molecular tests, and administered more than 150,000 COVID-19 vaccines in an operation that served up to 2500 people a day for 5 months. Nurses saved thousands of lives at the height of the COVID-19 pandemic in hospitals and in community-based settings. The University of Texas Health Science Center San Antonio School of Nursing demonstrated the nimble nature of academic nursing and outlines a large-scale community response to an international pandemic in the seventh-largest United States city. The authors establish guidelines for nurses and others to follow for future events.

Challenges faced by nurse managers during the COVID-19 pandemic: an integrative review

Background

Nurses have crucial roles in caring for patients and preventing the spread of COVID-19. Therefore, nurse managers have a prominent role during the pandemic, being responsible for the support and training of the nursing team to ensure quality care. While performing their duties in this time of fear and uncertainty, nurse managers face several challenges.

Aim

To identify the challenges faced by nurse managers during the COVID-19 pandemic.

Methods

It is an integrative literature review whose search for articles was carried out in Medline, PubMed and Scopus. Qualitative content analysis was used.

Results

Twelve primary research studies were included. Four themes emerged: (1) Workplace demands, (2) Impacts on physical and psychological health, (3) Coping measures and resilience and (4) Recommendations to better support nurse managers in times of crisis. Nurse managers had their roles expanded or completely changed, and they experienced many pressures and stressors in the workplace. Nurse managers also faced physical and psychological health problems. Nurse managers drew on experience; management skills; social media applications; support from family, colleagues and hospital administrators; training, and continuing education to solve the problems that emerged due to the COVID-19 pandemic. Organisations should use collaborative, inclusive and participatory practices for better crisis management.

Conclusions

Knowing the experiences of nurse managers during the pandemic period may help health institutions and policymakers better prepare for emergencies.

Prevalence of and risk factors associated with depression among nursing students acting on the frontline of COVID-19 pandemic: A cross-sectional study

Introduction

The widespread devastation caused by the ongoing waves of COVID-19 imposed a significant burden on the healthcare labor force. At the frontline in the battle against the deadly COVID-19 virus, nursing students in Vietnam were at a much-increased risk of developing mental health conditions. This study aims to identify the prevalence of depression and its related factors, along with coping strategies used by nursing students in the COVID-19 pandemic in Vietnam.

Materials and methods

The study was cross-sectional in nature, with convenient sampling at the epicenters of COVID-19 outbreaks in Vietnam (N = 191) from April to November 2021. After conducting a questionnaire pilot, the data was collected strictly using an internet-based approach. The Depression, Anxiety, and Stress Scale-21 items were used to identify the risk of depression among nursing students. The Chi-square test was used to assess the differences between coping strategies among nursing students. A multivariate logistic regression model was used to identify risk factors associated with depression.

Findings

The percentage of nursing students affected by depression was 21.5%, and almost half of the nursing students (49.2%) had no coping strategies for dealing with mental health concerns. Among the remaining nursing students, video-based mental consultation was the most popular method (25.7%). Being females (AOR: 2.7, 95% CI: 1.1-6.7), collecting bio-samples (AOR: 2.9, 95% CI: 1.4-6.2), providing support to vaccination spots (AOR: 2.3, 95% CI: 1.1-5.1), and not vaccinating against COVID-19 (AOR: 3.1, 95% CI: 1.1-9.1) were found as risk factors for depression among nursing students.

Conclusion

Our research revealed a significant number of nursing students suffering from depressive symptoms and underscoring the need for more effective methods of dealing with this condition. Depression management and coping skills focusing on female populations and those whose direct contacts with infectious sources should be implemented in the nursing curricula and continuous training credits. Those trainings, would support future nurses in handling crisis situations better.

Relationship between nursing students' attitudes toward nursing profession and online learning satisfaction during COVID-19 lockdown

Formal education is crucial for the development of nurses’ professional identity and can play a decisive role in attracting students to the nursing profession. This is even more important during a public health emergency such as the COVID-19 pandemic. This study aimed to investigate nursing students’ attitudes and feelings toward their future profession and academic studies during the first COVID-19 lockdown. A cross-sectional, descriptive study was conducted on 361 nursing students. The data were collected through the Students’ attitudes toward the nursing profession during the COVID-19 outbreak scale, and the Satisfaction with online learning scale. Nursing students expressed higher levels of commitment and dedication to their profession compared to perceived job security. They were generally satisfied with their distance learning experience in terms of accessibility of study materials, adaptation of lectures and quality of communication with academic staff. However, students perceived the ICT-supported distance learning as moderately effective. Students’ satisfaction with online learning was positively related to their perceived professional commitment. In times of health crisis, faculties should consider students’ perceived quality of nursing education and attitudes toward future profession to promote appropriate professional identity.

The relationship between disaster preparedness, psychological capital, and coping style among nurses: A cross-sectional study from China

PURPOSE

To find the relationship between psychological capital, coping style, and disaster preparedness in public hospital nurses.

DESIGN AND METHODS

A cross-sectional study of 515 registered nurses from a public hospital in northeast Sichuan Province, China who were enrolled to complete self-reported questionnaires sent through the WeChat app.

RESULTS

Disaster preparedness and psychology capital (r = 0.73, p < 0.01), disaster preparedness and coping style (r = 0.55, p < 0.01), and psychological capital and coping style (r = 0.56, p < 0.01) were positively correlated. Psychological capital (B = 1.81, p < 0.01) and coping style (B = 0.87, p < 0.01) accounted for 50% of disaster preparedness. Coping style partly mediated the effect of psychological capital on disaster preparedness (ab: 0.33, 95% confidence interval [CI]: 0.21-0.45).

PRACTICAL IMPLICATIONS

The level of psychological capital of nurses can provide an objective reference for administrators to establish intervention strategies and to promote positive psychological resources among nurses.

Factors and optimizations of healthcare workers' perception in alternative care facilities

Background

Diverse measures have been carried out worldwide to establish Alternative Care Facilities (ACFs) for different ends, such as receiving, curing or isolating patients, aiming to cope with tremendous shock in the urban medical system during the early passage of the COVID-19 epidemic. Healthcare workers always felt anxious and stressed during multiple major public health emergencies in medical facilities. Some active measures to improve healthcare workers' perceptions, such as temporary training, workflow improvement, and supplementary facilities, were proved insufficient in several past public health emergencies. Therefore, this study aims to analyze the contributing factors of the healthcare workers' perceptions of the ACFs in this pandemic, which can help find an innovative path to ensure their health, well-being and work efficiency.

Method

This paper conducted semi-structured in-depth interviews with the world's first batch of healthcare workers who have worked in ACFs through a qualitative study based on Grounded Theory. The healthcare workers interviewed from Heilongjiang, Shandong, Fujian, and Hubei provinces, have worked in one of the four different ACFs built in Wuhan. The results are obtained through the three-level codes and analyses of the interview recordings.

Results

The factors affecting the perception of healthcare workers in ACFs during the epidemic situation can be summarized into five major categories: individual characteristics, organization management, facilities and equipment, space design, and internal environment. The five major categories affecting the composition of perception can be further divided into endogenous and exogenous factors, which jointly affect the perception of healthcare workers in ACFs. Among them, individual characteristics belong to endogenous factors, which are the primary conditions, while other categories belong to exogenous factors, which are the decisive conditions.

Conclusion

This paper clarifies factors affecting the perception of healthcare workers in ACFs and analyzes the mechanism of each factor. It is posited that the passive strategies are a promising solution to protect healthcare workers' health, improve their work efficiency, and help reduce the operation stress of ACFs. We should train multidisciplinary professionals for future healthcare and enhance collaborations between healthcare workers and engineers. To sum up, this paper broadens new horizons for future research on the optimization of ACFs and finds new paths for alleviating healthcare workers' adverse perceptions of ACFs.

Global and Local Trends Affecting the Experience of US and UK Healthcare Professionals during COVID-19: Twitter Text Analysis

Background: Healthcare professionals (HCPs) are on the frontline of fighting the COVID-19 pandemic. Recent reports have indicated that, in addition to facing an increased risk of being infected by the virus, HCPs face an increased risk of suffering from emotional difficulties associated with the pandemic. Therefore, understanding HCPs’ experiences and emotional displays during emergencies is a critical aspect of increasing the surge capacity of communities and nations. Methods: In this study, we analyzed posts published by HCPs on Twitter to infer the content of discourse and emotions of the HCPs in the United States (US) and United Kingdom (UK), before and during the COVID-19 pandemic. The tweets of 25,207 users were analyzed using natural language processing (NLP). Results: Our results indicate that HCPs in the two countries experienced common health, social, and political issues related to the pandemic, reflected in their discussion topics, sentiments, and emotional display. However, the experiences of HCPs in the two countries are also subject to local socio-political trends, as well as cultural norms regarding emotional display. Conclusions: Our results support the potential of utilizing Twitter discourse to monitor and predict public health responses in emergencies.

Disaster Nursing Competency of Intensive Care Nurses in Jinan, China: A Multicenter Cross-Sectional Study

BACKGROUND

Patients in disaster areas require the most urgent assistance. In recent large-scale natural disasters, intensive care nurses have served as an important reserve component of disaster response teams. In disaster nursing, ability and attitude directly affect the quality and effectiveness of disaster rescues. However, few studies have examined the disaster nursing competency of intensive care nurses in China.

PURPOSE

This study was designed to describe the current status of disaster nursing competency among intensive care nurses, analyze the related factors affecting the disaster response effectiveness, and evaluate the values of disaster nursing continuing education and training in cultivating professional personnel with disaster emergency rescue competence.

METHODS

This cross-sectional study was conducted at six tertiary general government hospitals in Jinan, Shandong Province, China. A convenience sampling method was adopted, and the Wenjuanxing website was used to compile the network questionnaire, which participants completed via a WeChat group. Descriptive, correlation, and regression analyses were performed using SPSS software.

RESULTS

The participants in this study included 285 registered intensive care nurses employed at six hospitals in Jinan. Most were female (77.9%), and the mean age was 29.9 years. The mean total disaster nursing ability score was 122.98 (SD = 31.70), and the average scores for each item ranged from 2.78 to 3.70. The incident command system item earned the highest mean score (3.70, SD = 1.22), followed by triage (3.24, SD = 0.93). The biological preparedness item earned the lowest mean score (2.78, SD = 1.04). Being male, being < 30 years old, having an understanding of disaster nursing, having previously participated in disaster emergency simulation drills or training, and having a higher self-evaluation of rescue competence were all associated with higher disaster-nursing knowledge scores. Multiple linear regression analyses indicated that understanding of disaster nursing and experience participating in disaster emergency rescue drills or training had the most significant influence on the disaster nursing emergency knowledge score, followed by positive self-evaluation of disaster nursing ability and demand for training.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

The findings of this study indicate that the participants had a moderate disaster-nursing competency and that this competency may be improved through disaster-related continuing education and training. The cognitive attitude of disaster nursing was found to correlate positively with self-efficacy. Simulated emergency drills may effectively improve the disaster nursing competency of critical care nurses. The findings emphasize that experiences other than direct clinical practice such as specialized simulated emergency drills and training as well as willingness for such training are stronger factors for identifying and developing overall disaster nursing competency.

Disaster Relief Nurses: Exploring the Impetus to Respond to Multiple Efforts

Little is known about the impact that disaster volunteerism has on nurses. It is important to hear the experiences of those who return again to better understand the reasons that call them back. Using grounded theory methodology, 20 nurses who responded to more than one disaster event participated in semistructured interviews. Capacity for the art of nursing, confidence in performing the role, fostering the team among the chaos, and humanistic symbiosis emerged, leading to a core category, facilitating self-transcendence, guided by Reed's middle-range theory. With repeat deployments come enhanced personal rewards that provide meaningful opportunities for self-transcendence.

Impact of the COVID-19 Pandemic on the Future of Nursing Education

Nursing is the largest health profession, with nearly 4 million providers practicing across acute, primary, and public health care settings. In response to the pandemic, nursing schools halted on-site course delivery and redesigned programs to attenuate risks to students and faculty. Key challenges faced by schools included financial cutbacks, rapid increases in online learning technology, maintaining student academic progression, disruption to clinical learning opportunities, and meeting accreditation standards, while addressing the stress and loss experienced by faculty, staff, and students. Despite challenges, nursing organizations provided guidance for decision making, new learning resources, and faculty development opportunities. Schools of nursing leveraged their resources to redesign nursing curricula, strengthen partnerships for student clinical experiences, and address needs of the community. Nursing education will look different from its prepandemic profile in the future. Lessons learned during the pandemic point to gaps in nursing education, particularly related to disaster and public health preparedness, health equity, and technology. The American Association of Colleges of Nursing's new Essentials-standards for professional nursing education-were finalized during the pandemic and reflect these lessons. The need for nurse scientists to conduct emergency response research was made evident. The importance of strong academic-practice partnerships was highlighted for rapid communication, flexibility, and responses to dynamic environments. For the future, nursing education and practice must collaborate to ensure that students and practicing nurses are prepared to address emergencies and pandemics, as well as the needs of vulnerable populations.

Self-Efficacy and Emergency Preparedness in Indonesia

Purpose: Indonesia had the highest death toll in the world due to earthquakes and tsunami. In recent years, Indonesia has changed its disaster management strategy, from emergency response and preparedness to disaster management preparedness. This study aims to analyze the relationship of self-efficacy with the preparedness of nurses, IEDNA members, in dealing with natural disasters in Indonesia. Methods: This study is an analytical observational study with a cross-sectional approach. The study population is a member of the Indonesian Emergency and Disaster Nurses Association (IEDNA). The sample was 107 nurses that sampled using random cluster sampling. The data were analyzed using Fisher's test with a significance level of 95%. Results: Out of 510, 107 nurses became respondents in the study. The gender of the majority of respondents was male (56.1%). As many as 46.7% of respondents were dominated by respondents aged 31-40 years, 34.6% of respondents worked in the Emergency Department. Most respondents (41.1%) had less than one year of experience as emergency nurses. The result of self-efficacy test was p-value = 0.001 (p < 0.05). The majority of emergency nurses (94%) in Indonesia have good self-efficacy in dealing with disasters, although some do not have experience in disaster management. This is because the emergency nurses in Indonesia are often attended disaster management training. Conclusion: This study concludes that the preparedness phase was good and there was a significant relationship between self-efficacy and nurse preparedness in facing the disasters.

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.].

Disaster preparedness and core competencies among emergency nurses: A cross-sectional study

Aim

With the rise in frequency and severity of disasters in recent decades, it is essentially important that nurses must be adequately prepared to handle them. This study was aimed to evaluate the levels of disaster core competencies and preparedness of nurses in the emergency department.

Design

A cross‐sectional survey design was used.

Methods

This cross‐sectional research was conducted from August 2020 to December 2020 among 271 nurses in the emergency departments of six hospitals in Qazvin, Iran. The participants completed the “Nurses Perceptions of Disaster Core Competencies Scale” (NPDCC) (45 items) and the disaster preparedness (a single‐item visual scale). Data were analysed by one‐way analysis of variance, independent t‐tests and multiple linear regression analysis.

Results

The mean scores of disaster preparedness and core competencies of nurses were 6.75 out of 10 (SD = 1.63) and 2.88 out of 5 (SD = 0.80), respectively. "Technical skills" (mean = 3.24, SD = 0.91) were the highest and "communication skills" (mean = 2.57, SD = 0.95) were the lowest across the subscales of the scale. A significant association was found between disaster core competencies and preparedness of nurses (p < .001). Regression analysis results indicated that nursing disaster core competencies were perceived betted by older nurses (B = −0.405) who had experience in the disaster stage (B = 0.228) and nurses with disaster response experience (B = 0.223) and lower professional experience (B = 0.309). Nurses with a postdiploma degree (B = −0.480) and bachelor's degree (B = −0.416) were perceived to have lower disaster core competency than nurses with a master's or PhD degree.

Conclusion

There are still gaps in disaster preparedness and core competencies for emergency nurses that need to be addressed. Nursing managers must support an improvement in nursing disaster core competencies. This may be done by conducting sessions for routine disaster scenarios and providing formal disaster preparedness training.

Factors affecting nurses' ability to provide effective care in a disaster response: a review

Disasters cause death, trauma, and psychological distress. Comprising the largest number of healthcare workers, nurses play a crucial role in reducing the impact of a disaster. The objective of this review is to identify the factors that influence nurses’ ability during a disaster emergency response to provide adequate care. This research was conducted by doing a literature search from the Pro-Quest and Science-Direct databases using the PRISMA-ScR to screen the articles. The final results included 13 articles. An analysis was performed to identify themes in line with the purpose of the review. All factors affecting nurses’ ability to respond to a disaster situation were classified into three themes: 1) factors increasing nurses’ ability, 2) barriers to delivering effective nursing care, and 3) support needed to maintain the nurses’ ability. During an emergency situation due to a disaster, adequate knowledge and skill to save lives, treat injuries, manage stress and coordinate between teams are the basic competencies needed for optimal care. Nurses’ clinical experience or previous disaster experience and training could increase nurses’ adaptability in disaster conditions. Support from nurses’ workplace and proper implementation of disaster management policy enhance nurses’ services and prevent barrier under disaster condition. The results emphasize that future training should aim for improving nurses’ knowledge and skills, including the knowledge of nurses’ family to protect themselves and deal with disasters. Such knowledge increased family preparedness, which is an important factor to enhance nurses’ willingness to work following a disaster.

Predictors of nurses' reporting for work at the time of epidemics and natural disasters; solutions for hospital surge capacity

PURPOSE

To identify the predictors of nurses' presence at hospitals at the time of three types of disasters.

DESIGN

This cross-sectional study was performed using a researcher-generated questionnaire.

METHODS

This study was performed on 350 nurses of five public hospitals. Data was collected using a questionnaire in which the respondents were asked about their decisions on reporting for work in the event of three scenarios: epidemic of an unknown contagious respiratory disease, earthquake, and flood. Multiple logistic regression was used to analyze the data.

FINDINGS

The four predictors of nurses reporting for work include receiving trainings on disasters, and concerns on the non-compensation for providing services following the disaster, concerns about family safety and workplace safety.

CONCLUSION

Although slightly different factors affect the willingness of participants to report for work in each scenario, they can be put in two main categories; namely as personal and impersonal. Devising a family disaster plan and providing educational programs on self-care are two main strategies to increase the chances of presence at work following disasters.

CLINICAL RELEVANCE

The presence of more nurses in the hospital at the time of disasters can significantly improve the quality of care, and clinical outcomes of patients and disaster victims.

Mapping a postgraduate curriculum in disaster nursing with the International Council of Nursing's Core Competencies in Disaster Nursing V2.0: The extent of the program in addressing the core competencies

BACKGROUND

The increasing frequency and magnitude of disasters call for enhancing the preparation of nurses with advanced knowledge and skills in disaster management.

OBJECTIVES

With the release in December 2019 of the updated version 2.0 of the ICN's Core Competencies in Disaster Nursing (ICN CCDN V2.0), the aims of this study were to examine the extent to which the selected disaster nursing postgraduate program curriculum and the dissertation projects address the updated core competencies and to determine whether the syllabus requires revision.

METHODS

A data mapping analysis approach was used to review the syllabus of the studied program for coverage of the ICN V2.0 core competencies for general professional (Level I) and advanced/specialized nurses (Level II). The dissertation projects of the students were also included in the mapping analysis.

RESULTS

It found that 83% of the core competencies were addressed at Level I for general professional nurses and 69% at Level II for advanced/specialized nurses in the curriculum. Out of the 35 core competencies at Level I under the eight domains, six items (17.1%) were not covered under the domains of Intervention and Recovery. Out of the 32 core competencies at Level II, ten items (31.3%) were not covered under the domains of Communication, Incident Management, Safety and Security, Assessment, Intervention, and Law and Ethics. Students' dissertations could complement some of the competencies not covered in the syllabus.

CONCLUSIONS

The studied curriculum covered the majority of the core competencies proposed by ICN CCDN V2.0, but subjects were required to be revised to address the competencies missing from the syllabus. Moreover, it is critically important for educators to review their curriculum to prepare nurses for disasters, to ensure that they are equipped with the competencies required to meet the demands arising from the increasingly frequent occurrences of global disaster.

The State of Mind of Health Care Professionals in Light of the COVID-19 Pandemic: Text Analysis Study of Twitter Discourses

BACKGROUND

The COVID-19 pandemic has affected populations worldwide, with extreme health, economic, social, and political implications. Health care professionals (HCPs) are at the core of pandemic response and are among the most crucial factors in maintaining coping capacities. Yet, they are also vulnerable to mental health effects caused by managing a long-lasting emergency with a lack of resources and under complicated personal concerns. However, there are a lack of longitudinal studies that investigate the HCP population.

OBJECTIVE

The aim of this study was to analyze the state of mind of HCPs as expressed in online discussions published on Twitter in light of the COVID-19 pandemic, from the onset of the pandemic until the end of 2020.

METHODS

The population for this study was selected from followers of a few hundred Twitter accounts of health care organizations and common HCP points of interest. We used active learning, a process that iteratively uses machine learning and manual data labeling, to select the large-scale population of Twitter accounts maintained by English-speaking HCPs, focusing on individuals rather than official organizations. We analyzed the topics and emotions in their discourses during 2020. The topic distributions were obtained using the latent Dirichlet allocation algorithm. We defined a measure of topic cohesion and described the most cohesive topics. The emotions expressed in tweets during 2020 were compared to those in 2019. Finally, the emotion intensities were cross-correlated with the pandemic waves to explore possible associations between the pandemic development and emotional response.

RESULTS

We analyzed the timelines of 53,063 Twitter profiles, 90% of which were maintained by individual HCPs. Professional topics accounted for 44.5% of tweets by HCPs from January 1, 2019, to December 6, 2020. Events such as the pandemic waves, US elections, or the George Floyd case affected the HCPs' discourse. The levels of joy and sadness exceeded their minimal and maximal values from 2019, respectively, 80% of the time (P=.001). Most interestingly, fear preceded the pandemic waves, in terms of the differences in confirmed cases, by 2 weeks with a Spearman correlation coefficient of ρ(47 pairs)=0.340 (P=.03).

CONCLUSIONS

Analyses of longitudinal data over the year 2020 revealed that a large fraction of HCP discourse is directly related to professional content, including the increase in the volume of discussions following the pandemic waves. The changes in emotional patterns (ie, decrease in joy and increase in sadness, fear, and disgust) during the year 2020 may indicate the utmost importance in providing emotional support for HCPs to prevent fatigue, burnout, and mental health disorders during the postpandemic period. The increase in fear 2 weeks in advance of pandemic waves indicates that HCPs are in a position, and with adequate qualifications, to anticipate pandemic development, and could serve as a bottom-up pathway for expressing morbidity and clinical situations to health agencies.

Doubling Intensive Care Unit Capacity by Surging Onto Medical-Surgical Units During the COVID-19 Pandemic

INTRODUCTION

The ability of an organization to accommodate a large influx of patients during a prolonged period is dependent on surge capacity. The aim of this article is to describe the surge experience with space, supplies, and staff training in response to COVID-19 and provide guidance to other organizations.

BACKGROUND

A hospital's response to a large-scale event is greatly impacted by the ability to surge and, depending on the type of threat, to maintain a sustained response. To identify surge capacity, an organization must first consider the type of event to appropriately plan resources.

PREPARATION PROCESS

An epidemic surge drill, conducted in 2012, served as a guide in planning for the COVID-19 pandemic. The principles of crisis standards of care and a hospital incident command structure were used to clearly define roles, open lines of communication, and inform our surge plan. Preparation began by collaborating with multidisciplinary groups to acquire the most appropriate space, as well as adequate supplies, and identify and train staff.

IMPLEMENTATION

Teams were formed to identify the necessary resources to expand the intensive care unit (ICU) environment quickly and efficiently. Educational training was developed for redeployed staff.

OUTCOMES

Beth Israel Deaconess Medical Center experienced the largest surge of ICU patients within a hospital system in the state of Massachusetts. The ICU capacity was expanded by 93% from 77 to 149 beds, and the surge was maintained for approximately 9 weeks. Shadowing experiences before the actual surge were extremely valuable.

CONCLUSIONS

Planning for the surge of critically ill patients required a thoughtful, collaborative approach. Ongoing staff support and communication from nursing leadership were necessary to ensure safe, effective care for critically ill patients in a new and dynamic environment.

The Virtual Hospital: An Innovative Solution for Disaster Response

Like any disaster, the COVID-19 pandemic has presented significant challenges to healthcare systems, especially the threat of insufficient bed capacity and resources. Hospitals have been required to plan for and implement innovative approaches to expand hospital inpatient and intensive care capacity. This article presents how one of the largest healthcare systems in the United States leveraged existing technology infrastructure to create a virtual hospital that extended care beyond the walls of the "brick and mortar" hospital.

Educating nursing students for cultural competence in emergencies: a randomized controlled trial

BACKGROUND

Racial and ethnic minorities suffer significantly more than others in the wake of disasters. Despite the growing recognition of the importance of culturally competent health services, systematic cultural competence training in the medical education system is still scarce, especially in the field of emergency. The current study aimed to examine the effectiveness of an online culturally informed intervention for increasing cultural competence in emergencies among nursing students.

METHODS

A randomized controlled trial was used to test the intervention effectiveness in increasing nursing students' cultural competence in four domains: attitudes, knowledge, skills, and encounters. The study included 72 undergraduate nursing students recruited from two academic institutes. Participants were randomized (1:1 ratio) to an intervention (n = 34) and control group (n = 38). The study adheres to the Consolidated Standards of Reporting Trials (CONSORT). Data analysis was based on multivariate analysis of variance with repeated measures, followed by post hoc analyses with Bonferroni correction for multiple comparisons.

RESULTS

Results showed that the intervention was effective in increasing the participants' culturally competent knowledge. The effect of the intervention on the skills domain approached significance. No group differences were identified in the attitudes and the encounters domains.

CONCLUSIONS

An online culturally informed intervention, incorporated in the curriculum, was effective in enhancing the cognitive aspect of cultural competence (especially at the basic knowledge and understanding levels), but not other domains. Our results encourage the development of future intervention programs that are based on a deep understanding of local values, needs, and preferences.

Occupational Disruptions during the COVID-19 Pandemic and Their Association with Healthcare Workers' Mental Health

Background: The COVID-19 crisis has caused prolonged and extreme demands on healthcare services. This study investigates the types and prevalence of occupational disruptions, and associated symptoms of mental illness, among Australian frontline healthcare workers during the COVID-19 pandemic. Methods: A national cross-sectional online survey was conducted between 27 August and 23 October 2020. Frontline healthcare workers were invited to participate via dissemination from major health organisations, professional associations or colleges, universities, government contacts, and national media. Data were collected on demographics, home and work situations, and validated scales of anxiety, depression, PTSD, and burnout. Results: Complete responses were received from 7846 healthcare workers (82.4%). Most respondents were female (80.9%) and resided in the Australian state of Victoria (85.2%). Changes to working conditions were common, with 48.5% reporting altered paid or unpaid hours, and many redeployed (16.8%) or changing work roles (27.3%). Nearly a third (30.8%) had experienced a reduction in household income during the pandemic. Symptoms of mental illness were common, being present in 62.1% of participants. Many respondents felt well supported by their workplaces (68.3%) and believed that workplace communication was timely and useful (74.4%). Participants who felt well supported by their organisation had approximately half the risk of experiencing moderate to severe anxiety, depression, burnout, and PTSD. Half (50.4%) of respondents indicated a need for additional training in using personal protective equipment and/or caring for patients with COVID-19. Conclusions: Occupational disruptions during the COVID-19 pandemic occurred commonly in health organisations and were associated with worse mental health outcomes in the Australian health workforce. Feeling well supported was associated with significantly fewer adverse mental health outcomes. Crisis preparedness focusing on the provision of timely and useful communication and support is essential in current and future crises.

Nurse Leader Expertise for Pandemic Management: Highlighting the Essentials

The COVID-19 pandemic requires military nurse leaders in various patient care settings to engage in disaster response. Evidence supports essential leadership attributes for nurses that include skilled communication, organizational influence, and personnel management. Yet, nursing expertise that shapes nurse leader responsibilities during disaster management remains unclear. A description of how military nurse leaders contributed their nursing expertise during the COVID-19 pandemic response at one U.S. Military health care facility is provided to begin to delineate disaster management responsibilities.

Hospice Emergency Planning and COVID-19

Objectives: Centers for Medicare and Medicaid Services requirements for Emergency Preparedness Planning (EPP) by hospice organizations significantly increased in 2017. This study seeks to assess the involvement of various hospice personnel in EPP before and since the onset of the novel coronavirus disease COVID-19 pandemic. Methods: A link to an anonymous online survey was sent to members of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association, targeting members involved in hospice care in the United States. A descriptive analysis of the data was performed. Results: Prior to the pandemic, 39.8% of respondents were "moderately" or "very" involved with the development and revisions of the Emergency Preparedness Plan. Since the beginning of the pandemic, this increased to 59%, which largely occurred among physicians. Clinical Nurse and Nurse Practitioner involvement in development/revisions remained low. Approximately 30% of respondents desired more involvement across the areas of EPP. Conclusion: The involvement of personnel of various disciplines is varied and the involvement of physicians appears to have increased with the onset of the COVID-19 pandemic. A notable portion of personnel desired more involvement across all aspects of EPP. More research is needed in this important but little-understood area.

Development, Psychometric Testing, and Use of a Disaster Nursing Competency Scale in Iran: A Mixed Methods Study

Nurses play an important role during disaster response and recovery. Few tools are available to assess the relative competence of nurses in disaster. This study aimed to develop, test, and evaluate a disaster nursing competency scale. This was an exploratory mixed methods study. In the qualitative phase, 35 Iranian nurses and managers with experience in disaster relief were asked about the skills they need to respond effectively to a disaster event. From the qualitative data, a 50-item questionnaire was developed. In the quantitative phase, exploratory factor analysis was conducted with 400 samples followed by a test-retest reliability assessment with 30 nurses. The developed and validated instrument was applied to 200 nurses in Iran to assess their competency. From content analysis of the qualitative data, 5 main themes emerged. In the quantitative phase, exploratory factor analysis loaded 50 items into 4 domains named management, legal and ethical, specific personal, and technical competence. Use of the tool showed that nurses estimated their competence overall at 70.28%. Findings demonstrate the necessity for new domains in disaster nursing competencies; which may be applicable as a useful tool and guideline to improve nursing education and practice.

Spiritual Support During COVID-19 in England: A Scoping Study of Online Sources

Spiritual support is a key element of holistic care, and better healthcare professionals training and stronger strategic guidelines become urgent in light of health disasters and emergencies, such as the COVID-19 pandemic. To this end, the aim of this study was to explore spiritual support provision within mass and social media and the websites of spiritual leaders, institutions and NHS chaplaincy units during COVID-19 in England, between March and May 2020. A scoping review design informed by Levac and colleagues' five-staged framework was adopted, and adapted with a multi-strategy search to scope the different domains of online sources. Results revealed that spiritual support for dying patients, their families, health care staff, spiritual leaders and chaplains, had to be drastically reduced, both in quality and quantity, as well as being provided via different technological devices or domestic symbolic actions. No mention was found of a central strategy for the provision of spiritual support. This study points to the importance of developing centralized strategies to prepare healthcare systems and professionals in relation to spiritual support provision, both routinely and during health disasters and emergencies. Further research will have to explore innovative practices, in particular the role of digital technologies, in spiritual support provision.

Emergency department registered nurses overestimate their disaster competency: A cross-sectional study

BACKGROUND

Major incidents continue to pose a threat to health care systems by overwhelming them with a sudden surge of patients. A major factor impacting a hospital's surge capacity is the skills, abilities, and knowledge of emergency department (ED) registered nurses (RN). The level of disaster nursing competency they possess affects patient safety and outcome. ED RNs' ability to accurately assess their competency and knowledge is imperative for mitigating the effect of major incidents. ED RN's perception of overall disaster preparedness has not been thoroughly addressed. The aim of this study was to assess emergency department registered nurses' self-perceived disaster preparedness.

METHOD

The study was a cross-sectional study per the STROBE checklist. A self-assessment questionnaire based on the results of a study identifying specific disaster nursing competencies for ED RNs was distributed to all ED RNs at six participating hospitals between January 10th to February 19th of 2019. A five-point Likert-type scale was used to assess competency.

RESULTS

ED RNs' disaster preparedness according to the Total Disaster Competency mean was low. Furthermore, the results indicate that ED RNs' significantly overestimate their disaster nursing competency when compared to the Total Disaster Competency mean. Additionally, this study identified factors such as experience and education were positively associated with disaster preparedness and self-assessment ability.

CONCLUSION

ED RNs' overestimate their disaster preparedness. However, ED RNs with experience and education may be better prepared. ED RNs with formal disaster education appeared to have better insight concerning their preparedness. Clinical experience, advanced levels of education, and training were positively associated with preparedness. Overestimating disaster competencies may negatively impact patient outcomes during a major incident.

Filling the Knowledge Gap for Nurse Leaders: Next Steps Following COVID-19

The purpose of this article is to share gaps in knowledge and research related to pandemic management identified by nurse leaders during the COVID-19 pandemic. As part of a larger Delphi study, nurse leaders responded to an open-ended question about gaps in research they saw as important following the pandemic. Responses were analyzed using directed content analysis. Results are presented as 4 supercategories: Organizational leadership preparedness, adaptive leadership in crisis, innovations in care delivery, and health, well-being, and resilience.

Building capacity in times of crisis: Increasing cultural competence of healthcare professionals in the context of the COVID-19

BACKGROUND

Nurses are the frontline healthcare professionals fighting the medical and social effects of the current COVID-19 pandemic. Although they work with diverse populations, there is a lack of literature on culturally competent education during an emergency such as a pandemic.

AIMS AND OBJECTIVES

To examine the effectiveness of an online education programme aimed at increasing cultural competence among rescue teams and healthcare professionals facing the challenges of the COVID-19 pandemic.

DESIGN

Pre-post-web-based intervention study.

METHODS

Pre-post-intervention surveys were administered to a matched sample of Israeli healthcare and rescue organisation professionals. The initial sample included 303 participants (52% women) who completed the pre-intervention survey. More than half of the sample (56%, n = 170) were paid workers or volunteers in health organisations. Of the initial sample, 154 participants completed the post-intervention survey following the online cultural competence education programme. Descriptive statistics and multivariate analysis were used to evaluate participants' gains in culturally competent attitudes, knowledge, skills and encounters. This study followed the STROBE guidelines.

RESULTS

Participants found the online programme useful in improving their cultural competence during the COVID-19 pandemic. The highest gains were found in the attitudes domains, whereas the lowest in the knowledge domain. Pre-intervention cultural competence scores and incorporating the programme in the educational curricula predicted increased gains in cultural competence.

CONCLUSIONS

Online educational interventions showed potential for increasing professionals' awareness of cultural biases, differences and attitudes, leading to more open and accepting attitudes towards patients of different backgrounds.

RELEVANCE TO CLINICAL PRACTICE

Recognising the need for real-time, low-cost and available training, the World Health Organization recommended using online courses for healthcare professionals struggling in the pandemic frontline. Online education programmes provide a useful platform for training health professionals in times of emergency.

Identify the Disaster Nursing Training and Education Needs for Nurses in Taif City, Saudi Arabia

Introduction

Nursing is considered the healthcare profession with the most members. Emergency nurses constitute the first line of treatment in healthcare facilities when catastrophic events bring disaster victims in need of medical attention. Therefore, these nurses must be well educated and trained efficiently to be able to deal with disastrous situations properly. This study aimed to distinguish the most important elements of education and training for preparing emergency nurses to face disasters in the Kingdom of Saudi Arabia (KSA), specifically, the city of Taif.

Methods

This study employed a tool to measure nurses’ most important training and education needs that was created by the authors based on a literature review and was approved by an expert panel in disaster nursing. Questionnaires were distributed to emergency nurses in four hospitals run by the Ministry of Health in Taif city. Survey responses were received from 210 participants, and the data were analyzed using a principal component analysis (PCA). A one-way ANOVA was used to determine the differences between groups according to their experiences.

Results

The following three factors were extracted from the data after redundant items were loaded and excluded: incident management systems (IMSs), disaster triage, and disaster drills. Nurses with less than three years of experience have a significant need to learn about these elements in order to be able to cope with disasters.

Conclusion

Understanding different types of disasters and how to deal with these catastrophic events is crucial. Significant differences existed between ED nurses in their understanding of the basic elements of disaster management based on their level of experience in an ED. Therefore, disaster education must be included in nursing curricula, and more training courses, mock drills, and simulations must be conducted in hospitals for nurses, especially nurses with less experience, so they can learn to manage their responsibilities during disasters.

Exploring National Nursing Readiness for a Radiological or Nuclear Incident: A Cross-Sectional Study

INTRODUCTION

As the largest component of the United States health care workforce, nurses will play a critical role in radiological or nuclear disaster medical response. Despite this, the United States' schools of nursing are not currently providing radiation content (75% teach zero or <1 hour), and much of the current nursing workforce may not have received adequate response education and training. Nurses working in emergency departments and those who work at hospitals within the Radiation Injury Treatment Network will be relied on heavily, but little is known about whether these nurses possess the knowledge and skills needed to care for and protect patients after a radiation emergency. Current federal and state radiological/nuclear preparedness plans may be built on false assumptions of readiness, which would have serious implications for national preparedness and the National Health Security Strategy. The purpose of this study was to assess nurses' knowledge and skill in emergency radiological or nuclear response and determine their willingness to use mobile technology for education and training in response to a large-scale radiation event.

METHODS

Descriptive cross-sectional survey of registered nurse members of the Emergency Nurses Association and/or those employed at Radiation Injury Treatment Network centers.

RESULTS

Knowledge scores were low for all respondents. Prior attendance at a Radiation Emergency Medical Management course, use of online resources, and having a preparedness plan were associated with higher scores. Experience with a radiation emergency was associated with the highest score. Nurses are willing to use mobile technology during a radiological or nuclear disaster response.

DISCUSSION

Key nurses may not possess adequate knowledge or clinical competence to participate in radiation response activities. The results of this assessment identified educational gaps and areas to strengthen nursing education and clinical skills.

A qualitative exploration of the norms and intentions of nurses toward the clinical use of herbal medicine in Ghana

PURPOSE

The purpose of the study was to determine the norms and intentions of nurses towards the clinical use of herbal medicine.

METHOD

Information on nurses' demographics, norms and intentions was gathered through individual face-to-face interviews. Interviews were analysed using the process of content analysis.

RESULTS

Beliefs of the nurses and motivational factors formed their norms. The nurses believed herbal medicine was God-given and was used by their ancestors with good outcomes. Some were self-motivated to serve herbal medicine while others counted on patient's recovery upon the use of herbal medicine to motivate them. Positive and negative intentions were discovered; thus, preparedness and unpreparedness to serve herbal medicine in the future.

CONCLUSIONS

Though some nurses believe herbal medicine is God-given, used by their ancestors and motivated to serve, others were unwilling because of inadequate training. Training of professional nurses on herbal medicine may improve their negative intentions.

Unique factors to the implementation of a disaster preparedness plan at Georgetown Public Hospital in Guyana

ABSTRACT

Disaster planning in developing countries is largely ineffective despite these countries being more likely to suffer from catastrophic events. This article aims to identify strengths, educational needs, practice improvement opportunities, and local factors that may contribute to the development/implementation of a disaster preparedness plan at Georgetown Public Hospital in Guyana.

Development of disaster nursing education and training programs in the past 20 years (2000-2019): A systematic review

BACKGROUND

Nurses play a pivotal role in disaster management across the globe. With the call for all nurses to be prepared for disasters, disaster nursing education and training programs have expanded globally. However, a clear picture of the development and coverage of disaster nursing education and training programs is lacking.

OBJECTIVES

This study aimed to establish an overall picture of the development of disaster nursing education and training programs in the last 20 years, outline the contents included, approaches adopted and outcomes reported.

METHODS

A systematic search for relevant literature published between January 2000 to December 2019 was conducted using electronic databases including the CINAHL, MEDLINE, PubMed, Web of Science, and Scopus with the keywords on disaster nursing education and training.

FINDINGS

A total of 75 eligible studies were identified from 3395 potentially relevant articles. The numbers of disaster nursing education and training programs increased gradually over the past 20 years. They were offered in various countries with an unbalanced geographical distribution. Most of the existing programs focused on disaster preparedness and response, especially on the skills of triage during disaster response, instead of addressing the full spectrum of disaster management that included mitigation, preparedness, response, and recovery phases. Multiple approaches and technologies were adopted, including competency-based, all-hazard, inter-professional, flipped classroom, simulation, tabletop exercises, and virtual reality ones. Nearly half of the included programs adopted a pre- and post-test evaluation to examine the outcomes of learning and all of the programs reported significant increases in nursing professionals' knowledge and skills of related content on disaster management covered in the training programs.

CONCLUSIONS

This review provides nurse leaders, educators and researchers in nursing with an understanding of the state-of-art of the existing disaster nursing education and training programs. More disaster nursing research are necessary to enhance the knowledge, skills and readiness of the nursing professionals for disaster management in meeting global disaster challenges.