Evaluating the effectiveness of a multi-hazard operational framework for managing pharmaceutical supply during disasters: insights from a tabletop exercise

“Vital in today's time”: Evaluation of a disaster table-top exercise for pharmacists and pharmacy staff

Background Disasters are serious disruptions to a community's functioning that exceed its capacity to cope using its resources. Natural, man-made, technological hazards and other factors may cause disasters and influence a community's exposure and vulnerability. Objective To assess the knowledge, practice, and attitude of healthcare workers in Nepal regarding disaster preparedness and management for emergencies. Method A retrospective study was conducted among healthcare workers in Nepal registered for the 1st World Academic Council of Emergency Medicine- Table-top Exercise and Communication in Disaster Medicine conference as participants or faculty. Information was collected using total enumeration sampling and a questionnaire developed from a literature review and the questionnaire was adapted from the Emergency Preparedness Information Questionnaire (EPIQ). Percentages, means, and medians were calculated for socio-demographic data, knowledge, practices, and attitudes toward emergency preparedness. A chi-square test assessed associations between socio-demographic characteristics, emergency procedures, and familiarity scores on the preparedness questionnaire. Result A total of 118 participants took part in the study, most with over six months of emergency department experience. There was a significant association between work experience and emergency procedure status ((ꭓ2=6.982, p=0.008), and between education level and familiarity with disaster management (ꭓ2=5.507, p=0.019). However, there was a low correlation (r=0.140, p=0.129) between emergency procedure status and disaster management familiarity. Conclusion Emergency preparedness is crucial for life-saving in disasters. The availability of emergency services and skills related to emergency preparedness and disaster management are crucial for saving lives in emergency conditions. The hospital should provide emergency preparedness and disaster management training to all healthcare workers. In addition, the hospital authority should perform disaster exercises/tabletop simulation exercises or drills periodically.

The increasing frequency and severity of disasters worldwide needs effective disaster management training to enhance the preparedness and response capabilities of emergency responders. This study compares the outcomes of tabletop exercises (TTEs) and full-scale exercises (FSEs) in training senior paramedic students at Prince Sultan bin Abdul Aziz College for Emergency Medical Services, King Saud University, Riyadh, Saudi Arabia. A nonequivalent two-group quasi-experimental design was used. Forty-five senior paramedic students who had completed a disaster management course were randomly assigned to either TTE or FSE groups. Both groups participated in a simulated multi-vehicle accident scenario. Data were collected using an adapted CLUT Scale survey, which measured learning, trust, and usefulness immediately after the exercises. The Mann-Whitney U test was applied to compare outcomes between the 2 groups. Both TTE and FSE resulted in high levels of perceived learning, trust, and usefulness among participants, indicating a positive impact on disaster preparedness. While the TTE group scored slightly higher on average across all variables, these differences were not statistically significant, suggesting that both exercise types are similarly effective. The findings underscore the cost-effectiveness of TTEs and their potential to foster collaborative learning environments. Both TTE and FSE are effective in enhancing disaster preparedness among senior paramedic students. Given their adaptability and cost-effectiveness, TTEs may be particularly valuable for resource-constrained training settings. Further research with larger, more diverse samples and pre-/post-intervention assessments is recommended to validate these findings and improve disaster management training programs.

Background: To improve the knowledge and skills of hospital staff and better equip them to the handle unforeseen emergencies, hospitals in Indonesia need a participatory disaster preparedness training model. Media used is a simulation of the tabletop exercise model with the collaborative method using a disaster scenario. This study aims to determine whether current research adequately conceptualizes, describes, and interprets tabletop exercise related to hospital disaster preparedness to account for the effectiveness of the simulations. Method: This systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Six electronic databases were used as sources of information: google scholar, cambridge core, pubmed, proquest, scopus, and science direct. The search terms were "simulation" (tabletop exercise simulation or simulation-based disaster) and "hospital disaster preparedness". Results: Of the 470 research studies found during the search phase, six met the requirrements to be included in this review. The included six studies showed that tabletop exercise could improve the knowledge and skills of officers in disaster management in hospitals. Conclusion: Tabletop exercise can help hospital officials become more knowledgeable and competent in crisis management. This tabletop exercise is a creative and useful training tool for hospital disaster preparedness.

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

In mid-2020, the Centers for Research in Emerging Infectious Diseases (CREID) Network was established to address critical gaps in research expertise and capacity in emerging and re-emerging infectious diseases (EIDs). As the Network was established during the COVID-19 pandemic, most of the Network's research centers initially focused on SARS-CoV-2 research. By the end of 2021, the Network leadership realized that it had a blind spot with regards to research centers and their sites' overall capacities and stakeholder connections. To foster more meaningful and deeper levels of coordination and collaboration across research centers, as well as stress-test its capacity and readiness for rapid research during an EID outbreak. CREID conducted a tabletop exercise (TTX) during its Annual Partners Meeting in August 2022. Through the 2-day TTX, participants provided insight into their institutions' resources, stakeholder relationships, and research engagement before and after an EID outbreak; additionally, technical and operational challenges and solutions with regards to a successful outbreak research response were discussed. TTX participants' feedback was used to improve the Network's operational research response framework and processes. Given the limited existing resources on TTX for infectious disease outbreaks, the materials developed for the TTX and reported here can serve as a reference for determining and preparing for any research institution's role in pandemic preparedness and response research efforts.

Government-communities Collaboration in Disaster Management Activity: Investigation in the Current Flood Disaster Management Policy in Thailand

Purpose: The purpose of this study is to analyze the contents of disaster nursing education at universities in Korea and Japan, with focus on textbooks. Methods: Disaster nursing contents from 11 Korean community health nursing textbooks and 3 Japanese disaster nursing textbooks were analysed. Results: Three themes and 8 categories of disaster nursing content in the selected textbooks were analyzed. The themes classified include ‘understanding of disaster’, ‘disaster management’ and ‘disaster management system’. The theme of ‘understanding of disaster’ consists of such categories as ‘disaster concept/outline’, ‘classification of disaster’, ‘disaster management step’ and ‘disaster impact’. The theme of ‘disaster management activities’ consists of categories such as ‘disaster management activities’ and ‘disaster nursing’. The theme of ‘national disaster management system’ consists of categories like ‘national disaster management system’ and ‘international disaster relief’. From the comparison of disaster nursing education in the two countries, we found that themes were similar but there were differences between the two countries in content configuration. Korea and Japan have adopted the framework of International Council of Nurses for disaster nursing education. Korea stressed legal and ethical capabilities, while Japan included psychological support for disaster management service providers. Conclusion: Disaster education is an important factor in a nurse’s ability for a disaster management. Development of a comprehensive disaster education program is necessary to enhance disaster care capacities.

One of the principles of disaster management in Law Number 24 of 2007 concerning Disaster Management is non-discrimination, towards gender, ethnicity, religion, race and any political sect. This principle applies at every stage of disaster management, both pre-, emergency and post-disaster. In its development, the role of disaster management cannot be generalized to just one group. Gender mainstreaming is one of the strategies adopted so that the principle of non-discrimination can work well. Efforts to apply these principles are carried out in Tabletop Exercise (TTX) preparedness training activities which are carried out for socialization, to provide an understanding of policies, procedures, plans that have been prepared, will be prepared or need to be prepared. It is hoped that the role of women in TTX can provide a more specific perspective regarding the needs and roles that can be filled by women in disaster management. Although the number of female personnel involved in TTX is limited, if they hold key positions they can provide significant results in the implementation of TTX.

The purpose of this study was to analyze disaster communication management activities carried out by the Sleman Emergency Operation Center in coordinating disaster information and identifying information coordination that occurred between Kab. Sleman, community, and non-governmental organizations @merapi_news. This study used descriptive qualitative method. Data search is done by in-depth interviews with parties involved in the disaster management process, namely Supervisors, Operators of PB Emergency Operations District. Sleman, the private organization @Merapi_news, and the Sleman community. The results of the study showed that the Sleman Emergency Operation Center was still not maximal in the implementation of the disaster communication management process. The lack of coordination of information that causes miss communication and distribution of disaster information to the community is often too late, the use of Instagram social media is not optimal by the Sleman Emergency Operation Center, and mitigation needs to be done simultaneously both BPBD and Pusdalops to shape the attitudes and knowledge of the community and implementing officers in disaster management.

Training exercises are now frequently used in health disaster and emergency medicine to train first responders,1 including the use of tabletops’ exercises.2–4 However, these kinds of drill are barely described in occupational and industrial safety and health. They represent an interesting alternative to real life disaster plans, considering the enormous human and technical resources that are required, and the disruptance of company’s daily business. We aimed at developing a special training for professionals of health and safety (occupational physicians, hygienists…) in case of health disaster in industrial settings, using a tabletop exercise. We organized a one day-session about disaster fundamentals for 28 occupational physicians included in a Master degree in emergency medicine training. A tabletop exercise was made based on a scenario of a fire in a plant with risk of chemical explosion - 22 victims and one dead (person). Three groups of 9/10 participants had 1h15 to discuss and « play » rescue operations from the initial accident to the discharge of the last victims from the triage centre. They were supervised by a physician and a nurse who are specialized in disaster training. We used a large tabletop representing the industrial plant and the figurines/vehicles (patients, industrial and emergency responders, firemen and police officers, journalist…). Satisfaction and cost were evaluated such as repeatability. The participants were largely satisfied by the training and believe, such as the teachers, that the exercise well illustrates the roles of occupational physicians, the triage centre, and intricate logistics during a health disaster. The direct cost was $1,285 (975 euros), namely $646 for the figurines and $639 for the supervisors for the first year ($46 per participant). At the opposite of a real life exercise, we didn’t notice any impact on daily activities of the company/plant. One year later, the tabletop was performed again with other 28 participants with similar satisfaction and reduced cost (only $639 for the supervisors, $23 per participants). Tabletop exercises simulating industrial disasters appear to be a cost-effective way to train professionals of health and safety. Similar experiences are reported in other contexts: airport disasters,2 biological threats in a public health preparedness,5;6 training of medical technicians for emergency.3 Tabletop exercises could also be used to train different categories of participants in similar drill. Considering the purpose of training participants to organise the prevention and the management of industrial disasters in their own company, it was seen as easier and as cheaper than real life disaster plans. To conclude, although real life exercise remains essential (especially in order to challenge emergency responders) effectiveness should be studied in depth. We think these kinds of exercises should be developed in the industrial settings.

The Indonesian government, through the Disaster Management Law, has delegated the National Disaster Management Agency (BNPB) at the central level and Local Disaster Management Agencies (BPBD) at the regional level to organize inclusive disaster management. However, the role of BPBD in realizing this has not yet been optimally executed. This can be seen from the low of score Indonesian inclusiveness index and the assistance interventions provided to vulnerable groups that do not match their needs. This research aims to understand the complex issues experienced by vulnerable groups in Indonesia and identify various challenges faced by BPBD in achieving inclusive disaster management. This research uses a qualitative method that Research data was obtained through in-depth interviews, with research informants coming from three regions, namely BPBD Sleman Regency, BPBD South Lampung Regency, and BPBD Sigi Regency. To strengthen the analysis, data triangulation was conducted by analysing secondary data from various sources, including academic publications, policy papers, legislation, and mass media. The research results show that the number of vulnerable groups in Indonesia is huge, 37% of the population. This significant number requires attention and specific treatment that aligns with their characteristics and needs. At the implementation level, BPBD faces various challenges, including the lack of data categorization for vulnerable groups at the regional level, insufficient budget allocation for institutional strengthening, a shortage of human resources capacity, suboptimal coordination among government agencies, and limited participation of vulnerable groups in disaster management activities.

The West African Disaster Preparedness Initiative held a disaster preparedness tabletop exercise with representatives from the Economic Community of West African States (ECOWAS) in November 2015. The tabletop exercise was hosted by the Republic of Ghana's National Disaster Management Organization and partners in Accra, Ghana. ECOWAS Commission delegates and representatives from 10 member states were confronted with a series of simulated crises. Participants utilized existing national preparedness plans and web-based information technologies to research and communicate about internal disaster threats and those from neighboring countries. After each of the exercise's three phases, facilitators distributed participant surveys. A total of 106 individuals participated in the tabletop exercise. During the exercise, national teams utilizing well-developed disaster contingency plans and emergency operations center (EOC) standard operating procedures (SOPs) reached out to help less-prepared national teams. Key issues identified in the survey were language and cultural issues as barriers, effectiveness of disaster management agencies linked to heads of state, and the need for data sharing and real-time communication for situational awareness and multisector coordination. This tabletop exercise helped improve and refine the ECOWAS regional and member states' national SOPs that teams will employ to prepare for, respond to, and recover from future disasters. (Disaster Med Public Health Preparedness. 2019;13:400-404).

Background: Augmented reality/virtual reality (AR/VR) has been recognised as an excellent technology for many fields, especially emergency and disaster management. This technology can also be applied to one of the disaster exercises, a tabletop exercise (TTX). In TTX, a group discusses a simulation of an emergency led by a facilitator. This study aimed to determine the knowledge and attitude of nursing and medical students towards using AR/VR as an approach to TTX in emergency and disaster preparedness and its association with sociodemographic data. Methods: A quantitative cross-sectional study with convenience sampling was conducted among 211 International Islamic University Malaysia (IIUM) Kuantan Campus nursing and medical students from April to June 2022. Data were collected using questionnaires through Google Forms, available in English. The questionnaire for students' knowledge and attitude on AR/VR was self-developed, and a reliability test was conducted with reliability of 0.720 and 0.865 for knowledge and attitude, respectively. Results: Most respondents have high knowledge and positive attitudes towards using AR/VR to approach TTX in emergency and disaster preparedness. It was found that the frequency of playing on a computer or mobile games is statistically significant regarding attitudes toward AR/VR. In comparison, no significant difference was identified between gender, ownership of computer/mobile devices, and period of daily internet use regarding attitudes towards AR/VR. Conclusion: AR/VR can be beneficial in emergencies and disasters. The relevant authorities, predominantly in healthcare education institutions, can implement this advanced technology to prepare students for the future.

Background: Society is an important element in a nation, especially in disaster management. Based on the law, one of the obligations of the community in disaster management is to carry out disaster management activities so that this requires every Indonesian citizen to play an active role in disaster management activities. The purpose of this study was to determine the activities carried out by the Kelud slope community in disaster management that had been carried out. Methods : design of this research is a qualitative phenomenological study, data collection is carried out using online Focus Group Discussion. The participants in this study were good community leaders consisting of government elements, disaster preparedness teams, and the general public. Data analysis was carried out based on a qualitative research design. Results: The results of this study show that community activities in disaster management are following the experiences that have been carried out in the pre-disaster, during, and post-disaster phases. Conclusion : Communities in the Kelud slope area are active in volcanic eruption disaster management activities that are resilient in dealing with volcanic eruptions.