Identification and Analysis of Parameters and Global Experiences of Hospital Preparedness Against Chemical, Biological, Radiological and Nuclear Disasters: A Scoping Review

Abstract

Context: Chemical, biological, radiological and nuclear (CBRNs) disasters represent a disconcerting event for governments, health care providers, the public, and hospitals need to be prepared to cope with such disasters. Therefore, the present scoping review was conducted to identify and analyze the parameters and global experiences of hospital preparedness against CBRN disasters. Methods: The study is a scoping review that examines English and Persian databases including PubMed, Scopus, Web of Science, Science Direct, Google Scholar, and Jihad Daneshgahi Scientific Information Database (SID), Iranian Research Institute for Information Science and Technology, Magiran, and Iranmedex. Reviewing the studies found on the search bases was carried out in three stages; title, abstract and full text. According to refined studies, the data were extracted in order to meet the objectives and respond to the research questions. Results: In the initial search, 1104 articles were identified. First, the articles were reviewed in terms of duplication, year of publication, title, abstract, and relevance to the topic, and finally, 17 articles that met the inclusion criteria were incorporated in the systematic review process. Finally, 8 primary issues addressed in the articles, including (1) staff training, (2) planning to deal with disasters, (3) personal protection equipment, (4) risk perception, (5) decontamination of medical centers and wards, (6) detection of CBRN infection, (7) availability of drugs and antidotes, and (8) the presence of health professionals and staff were discussed. The review of findings reported by various studies revealed shortcomings in the above eight areas. Conclusions: Most hospitals have begun to undertake activities to deal with CBRN and follow a special program for this purpose. However, due to the industrialization of human societies and the surge in CBRN events and other threatening activities, this level of preparedness is not satisfactory and further planning is warranted. However, the present study offers valuable insights and recommendations for policymakers and hospital managers to improve their hospital preparedness for the risks of CBRN disasters.