Pediatric disaster preparedness and response and the nation's children's hospitals.

The increasing prevalence of disasters worldwide highlights the need for established and universal disaster preparedness plans. The devastating events of September 11 and Hurricane Katrina have spurred the development of some disaster response systems. These systems, however, are predominantly focused on medical needs and largely overlook mental health considerations. Negative outcomes of disasters include physical damage as well as psychological harm. Mental health needs should be considered throughout the entire disaster response process, especially when caring for children, adolescents, and their families. To provide an overview and recommendations for the integration of mental health considerations into pediatric disaster preparedness and response in the medical setting. Recommendations were developed by a panel of disaster preparedness and mental health experts during the Childrens Hospital Los Angeles Pediatric Disaster Resource and Training Center: Workshop on Family Reunification in Los Angeles, California, March 31-April 1, 2008. Experts discussed the inclusion of mental health-specific considerations and services at all stages of disaster preparedness and response. Recommendations involve the integration of mental health into triage and tracking, the adoption of a child ambassador model, environment, and developmentally appropriate interventions, education, communication, death notification, and family reunification. The inclusion of mental health concerns into pediatric disaster preparedness may help prevent further and unnecessary psychological harm to children and adolescent survivors following a disaster.

When Eligibility Is a Disadvantage: Changing Federal Guidelines Could Lead to Declining Investment in Pediatric Emergency Department Infrastructure

Disaster Management in the Era of Lean Healthcare

Disasters are major events that have significant effects on individuals, communities, and health care systems. Nurses are valuable resources that have a role in disaster response. However, barriers in disaster education in nursing programs negatively affect nurses' knowledge and skills in disaster preparedness and response. A literature review was conducted to better understand the disaster response educational needs of nurses and to explore gaps in nurses' preparedness for disaster response and nursing education and training. Findings indicated disaster response education is a vital component of nursing education. When provided with effective disaster education, nurses are better equipped for disaster management and disaster response. Challenges in educational needs continue, and nurses lack specific disaster knowledge and preparedness. Further research is needed to identify effective teaching strategies for disaster response and preparedness. Emphasis should be placed on integrating disaster education into nursing education programs at all levels. [J Nurs Educ. 2025;64(4):235-238.].

BackgroundNurses play an essential role in disaster response. All health care responders, including nurses, must have knowledge of the key principles of disaster medicine. The International Trauma and Disaster Institute (ITDI) at Massachusetts General Hospital has developed a core curriculum for Mass Casualty Incident (MCI) management. The curriculum provides all members of the multidisciplinary disaster team with the fundamentals of the MCI response. The proposed concurrent session will report on understanding of the fundamental knowledge in disaster medicine and preparedness for nurses in local and international disaster responses.Discussion and ObservationsDisasters follow no rules. Traditionally, medical providers have held the erroneous belief that all disasters are different, especially those involving terrorism. In reality, all disasters, regardless of etiology, have similar medical and public health consequences. A consistent medical approach to disasters, based on an understanding of their common features and the response they require, is becoming the accepted practice throughout the world. This strategy, called the MCI response, has the primary objective of reducing the mortality/morbidity caused by the disaster. The Advanced Disaster Medical Response (ADMR) Course, available in eight languages, including Chinese, is designed to train nurses in the ABC's of basic medical and public health disaster care. The delivery of optimal care in a disaster relies on a common understanding of each health professional's role and common mastery of defined essentials of disaster response such as the Incident Command System, field triage, decontamination, care of specific injuries, environmental considerations, psychological response to disasters, and care of the dead and their families. Understanding key principles and training in medical disaster response will guide nurses in disaster preparedness and response to future disasters.

This research demonstrates a resilience-based approach to integrating active transportation into disaster preparedness and response planning. It establishes a framework for analyzing current conditions to identify vulnerable active transportation assets that can support the movement of people and resources following a disaster event. The paper starts by reviewing past instances in which bicycles were used during disaster response and highlights various programs that integrated bicycles into disaster response planning. The second part of the paper demonstrates how the Vulnerability Assessment and Adaptation Framework can be expanded to directly focus on active transportation networks. This extension allows for the identification of vulnerable active transportation assets, while outlining critical assets for disaster response, as illustrated by a case study conducted in Tacoma, Washington. By further incorporating bicycles into emergency and transportation planning, communities can strengthen their resilience and establish a more efficient transportation system during disaster response.

A novel Health Disparities Index and acute asthma management

Disaster medicine and the emergency medicine resident

The Kidney Community Emergency Response (KCER) Coalition is a group of more than 150 volunteers across the United States who work collaboratively to develop and disseminate disaster preparedness and response information to the kidney community. It is vital for each member of the kidney community to develop and maintain all-hazards disaster plans. Would your practice or dialysis facility be able to run smoothly if your nurses were unable to come to work due to a disaster? What if half the staff was unable to come to work? Incorporating personal and workplace disaster plans can help address these issues. Disaster plans describe the actions to take in response to a natural or manmade disaster; additionally they describe the tasks to be performed—by whom, when, and where. The plans should be comprehensive and cover disaster mitigation, preparedness, response, and recovery. Plans should address potential impacts from all types of hazards, such as tornadoes, floods, earthquakes, hazardous material spills, terrorist attacks, hurricanes, blackouts, and fires. There are 4 steps in the emergency planning process: hazard analysis, plan development, testing the plan, and maintaining/revising the plan. Hazard analysis determines which hazards are likely to impact an area and ranks these hazards according to their likelihood of impact and their potential to impact normal functions. The first step is to identify each hazard and describe it. Next, determine how and why the organization (your family or business) is vulnerable to that hazard. Most emergency management agencies should have current and adequate hazard analyses you could use as a model. Contact your local emergency management agency for a copy of their plans. Disasters can strike anywhere, in any form. A well-prepared staff is pivotal to any workplace disaster plan—whether your office is a dialysis unit or transplant center. The Centers for Medicare & Medicaid Services (CMS) Guide Emergency Preparedness for Dialysis Facilities is an important tool that can help an organization build a disaster plan. The KCER Coalition worked with CMS to update this manual, which will be available in late 2009. Additionally, employees must have personal preparedness plans that include their family, pets, home, and any special needs so that their personal needs can be addressed quickly and in an organized fashion, as healthcare providers are often called on to quickly respond when disasters happen. Without adequate personal disaster plans, employees may be unable or unwilling to work after a disaster. It is important that employees communicate their personal plans to their supervisor or a designee. Business managers need to know if an employee would evacuate given a certain situation, and to where. Most importantly, managers need at least 2 ways to contact each employee. Options would include a mobile telephone number, e-mail address, or through a friend or relative who serves as an out-of-area contact person. Before a disaster, all employees should be trained on preparing adequate personal disaster plans, the facility's business plan, and the plan for patients. Managers should provide written disaster roles, responsibilities, and expectations for each staff position. What hours would employees be expected to work? What are the duties expected of each position? Will any exceptions be made for certain staff members or certain situations? After developing a plan, it should be tested through training and exercises, maintained, and revised. Testing and revising is a continuous cycle. It is vital to incorporate lessons learned from drills and exercises into updated disaster plans. Even the best written disaster plan is inadequate unless everyone is properly trained on the plan. The CMS Conditions for Coverage for End-Stage Renal Disease facilities, effective October 14, 2008 require that staff be able to demonstrate the ability to manage emergencies that are likely to occur in the facility's geographic area. IS-100.HC: Introduction to the Incident Command System (ICS) for Health Care/Hospitals IS-200.HC: Applying ICS to Health Care Organizations IS-700: National Incident Management System (NIMS), An Introduction IS-808: Emergency Support Function (ESF) #8—Public Health and Medical Services Additional courses target hazard preparedness and planning, the National Disaster Medical System (NDMS), personal preparedness, disaster assistance, disaster exercise, and general emergency management principles. Course length varies from 30 minutes to 3 hours. These courses can be accessed at www.training.fema.gov/is. In addition to a cohesive training program, familiarity with the FEMA principles and language of the Incident Command System (ICS), the National Incident Management System (NIMS), and the National Response Framework will better equip dialysis facilities in contacting their local disaster management officials. Ongoing communications with local disaster management, at least annually, is another CMS Conditions for Coverage requirement. Disaster plans should be practiced and revised at least annually. They should also be updated and staff should be trained each time there is a supervisory or leadership change. The disaster plan should be practiced if there is a change in procedure, contact information, or staff turnover. Other goals of disaster drills and exercises are to clarify roles and responsibilities, improve coordination, identify gaps, train staff, and improve the plan. There are many types of exercises that can achieve these goals. Choose a variety of exercises throughout the year to build a solid exercise program, drill schedule, and/or evaluation program. Discussion-based exercises can be seminars, workshops, tabletop exercises, and games. These exercises are generally less complicated because they do not require actual response activities such as gathering supplies or evacuating. Operations-based exercises focus on activities. Drills (which physically test one specific function), functional exercises, and full-scale exercises simulate the execution of actual response activities. The first step in all exercises is to set objectives that outline goals, the scenario, and how the exercise will be evaluated. A scenario is the story that guides the exercise. The story can be hazard-specific, such as a tornado impact, and serves to apply “what if” scenarios to the implementation of the disaster plan. Disaster plans should be practiced and revised at least annually, and updated each time there is a leadership change. They should be practiced if there is any change in procedure. The KCER Coalition performs annual disaster exercises and quarterly or monthly tests of response mechanisms such as telephone hotlines and reporting systems. Coalition members test the capability to establish communications via e-mail and telephone, collaborate in groups, and solve problems brought on by a disaster scenario. Often these hands-on scenarios reveal the need for additional policies and activities to solidify existing disaster plans. Do not assume your employees can handle the stress of a disaster, whether they are nephrologists, nurses, technicians, or other trained healthcare professionals. Staff may not be able to contact their families, their pets may have been lost, or their homes may have been destroyed. Talking about these potential losses may help mentally prepare staff for a disaster, as well as set the stage to address employee mental-health concerns after a disaster impact. It is important to understand, and convey to all staff members, that working in a disaster response may require irregular and extended working hours and working at a location other than the normal office location. A disaster may also demand that employees perform duties that are not a part of their normal job description. Additionally, disasters can cause intense physical and mental stress. Because the emotional damage of disasters often overshadows the financial and physical damage, it is important to incorporate a mental-health component into disaster plans. Supervisors and other employees should be able to recognize the signs and symptoms of disaster-related stress, know how to identify employees and patients who may need assistance or crisis counseling, and how to provide that assistance. When planning for a disaster, include ways to help employees identify and ease stress in themselves as well as their patients. The KCER Coalition is an active group of individuals working toward establishing and facilitating partnerships that provide a framework for disaster readiness and continuity of care for the kidney community. The Coalition is comprised of healthcare professionals and partners in the community including utility companies, emergency operations personnel, regulatory agencies, and corporations. By uniting, the Coalition is forming working relationships to help provide uninterrupted dialysis and transplant care in the event of disasters. There are 8 Response Teams focusing on different areas of preparedness and response. These teams hold bi-monthly teleconferences and communicate via e-mail distribution lists to develop educational materials, outreach, and response mechanisms for the kidney community. The Coalition has created valuable educational tools for patients and providers, as well as fostered relationships, both on the state and federal level, which will help to ensure continuity of care for kidney patients in times of emergencies. The KCER Coalition is dedicated to the purpose of providing public education and promoting public awareness regarding the needs of kidney patients during emergencies. Community participation is essential to the ongoing success of this Coalition. The analyses upon which this publication is based were performed under Contract Number 500-2006-0076-NW07 entitled End Stage Renal Disease Networks Organization for the State of Florida, sponsored by the Centers for Medicare & Medicaid Services, Department of Health and Human Services. The content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government. The author assumes full responsibility for the accuracy and completeness of the ideas presented. This article is a direct result of the HealthCare Quality Improvement Program initiated by the Centers for Medicare & Medicaid Services, which has encouraged identification of quality improvement projects derived from analysis of patterns of care, and therefore required no special funding on the part of this contractor.

Disaster risk management is a critical area of study, as effective preparedness and response strategies can significantly reduce the impact of hazardous events. This research evaluates key disaster response parameters, including Risk Score, Preparedness Level, Response Time, Economic Impact, and Casualty Risk, using statistical analysis. By identifying correlations and patterns among promoting improvements disaster resilience and mitigation efforts. Research Significance: This study is significant as it provides an evidence-based method to disaster preparedness and response evaluation. By analyzing key risk factors and preparedness indicators, the findings help policymakers, emergency responders, and infrastructure planners develop more effective risk reduction strategies. The research also highlights how different environmental and infrastructural conditions influence response efficiency. Methodology: The research employs SPSS statistical analysis, utilizing methods such as, regression analysis, and ANOVA—these methods help determine the relationships between evaluation parameters and assess their collective impact on disaster response effectiveness. Alternative Influencing Factors: In addition to the primary evaluation parameters, the study considers several alternative influencing factors that may impact disaster preparedness and response, including: Disaster Type (e.g., natural vs. man-made disasters) Location Type (urban vs. rural areas) Weather Conditions (floods, storms, droughts, etc.) Ground Stability (earthquake-prone areas, landslide risks) Warning System Availability (early warning mechanisms, public alert systems) Infrastructure Readiness (emergency shelters, transportation networks, healthcare facilities) Evaluation Parameters: The key parameters assessed in this study include: Risk Score: Measures the overall level of risk associated with a disaster event. Preparedness Level: Evaluates the extent of readiness before a disaster occurs. Response Time: Assesses the efficiency of emergency response efforts. Economic Impact: Estimates the financial and infrastructural losses caused by disasters. Casualty Risk: Analyzes the potential for injuries or fatalities due to a disaster. Results: The analysis reveals a strong correlation among preparedness indicators, with Principal Component Analysis (PCA) showing that over 91% of the total variance is explained by a single component. This suggests that disaster response factors are highly interdependent. Regression and ANOVA results further confirm the statistical significance of these parameters in predicting disaster outcomes. The study emphasizes the need for enhanced early warning systems, robust infrastructure, and efficient response mechanisms to mitigate disaster risks.

Background: Disasters pose significant challenges to public health by disrupting essential services, especially during mass gatherings such as the Hajj pilgrimage. These complex events demand swifts coordinated action from healthcare professionals. However, many remain insufficiently equipped for large-scale emergencies due to gaps in triage training, disaster knowledge, and established response protocols-issues that are particularly critical in high-risk settings. Aim: This systematic literature review aims to explore the clinical insights of registered nurses and other healthcare professionals in disaster preparedness and response during the Hajj pilgrimage in Saudi Arabia. Methods: A systematic literature review was conducted following PRISMA guidelines. A comprehensive database search was performed across CINAHL, Scopus, Medline, Embase, and APA PsycINFO, focusing on studies published between 2012 and 2025. Eligible studies addressed disaster nursing education, preparedness, and response. The Mixed Methods Appraisal Tool (MMAT) was used for quality assessment. Results: Twenty-three studies met the inclusion criteria. Three main themes emerged: disaster preparedness, experiences and challenges in disaster response, and education and training. The review revealed lack in nurses' readiness, policy awareness, and real-world disaster experience. Training and curriculum improvements are essential to enhance disaster response capabilities. Conclusions: This review highlights the urgent need for standardized disaster nursing curricula to enhance preparedness and response competencies. Incorporating structured disaster training into nursing education will strengthen healthcare system resilience. Future research should adopt qualitative methods to capture healthcare professionals lived experiences during the Hajj. Including diverse participants and focusing on the unique cultural context can enhance disaster preparedness and response strategies.

Nursing leadership is integral to effective disaster preparedness and response, demanding agility, strategic planning, and robust resource management. Disasters, both natural and man-made, present unique challenges that require nursing leaders to be adept in rapid decision-making and efficient coordination. The unpredictability of disasters necessitates comprehensive and regularly updated preparedness plans, ensuring nursing teams are well-versed in their roles through continuous training and simulations. Interprofessional collaboration and strong community partnerships are essential, fostering a unified response and efficient resource distribution. Communication remains a cornerstone of disaster management, with clear, timely information dissemination being crucial for coordinating efforts and maintaining public trust. Resource scarcity during disasters, such as shortages of medications and personal protective equipment (PPE), poses significant challenges. Effective resource management strategies are essential to maintain patient care standards and protect healthcare workers. The psychological toll on healthcare providers is another critical issue, with nursing leaders needing to implement support systems that address mental health and promote resilience. Integrating advanced technologies like telehealth and data analytics can enhance disaster response, providing remote care options and enabling predictive modeling for better resource allocation. Innovative approaches in nursing leadership include the use of telehealth for remote consultations and monitoring, data analytics for predictive modeling, and interprofessional education to improve teamwork and coordination. Strengthening community partnerships enhances overall disaster response capacity, ensuring that community-specific needs are addressed. Mental health support for healthcare providers, both immediate and long-term, is vital for maintaining a resilient workforce. Policy advocacy by nursing leaders is crucial to developing robust disaster preparedness frameworks and securing adequate funding. In summary, nursing leadership is pivotal in disaster preparedness and response, with a focus on strategic planning, interprofessional collaboration, effective communication, resource management, mental health support, and the integration of advanced technologies. Emphasizing these areas will enhance the resilience and responsiveness of healthcare systems, ultimately improving outcomes for patients and healthcare providers during disasters.

There is a crucial need for teamwork in disaster management. Gaps in collaborative efforts resulted in significant loss of life and property during recent disasters. Such losses could have been minimized with enhanced teamwork. Unfortunately, the current US healthcare system fosters a fractured structure where health professions work in isolated silos. While coordinated disaster management has done much to overcome this, the silo mentality still inhibits maximal achievement toward the four phases of emergency and disaster preparedness and response. Since 2007, Western University of Health Sciences (Western U) has embarked upon an initiative focusing upon the concept of patient-centered, collaborative care in students from the beginning of the clinical education process. The intent of the program is to instill in all students non-technical competencies that promote teamwork such as communication, collaboration, and understanding scope of practice. The long term vision is to develop a three phase program (case based, team training and clinical experience) that will take the student through an awareness level to an application level of the competencies. The second phase of the program utilizes the TeamSTEPPS® training to instill these competencies in students. The application and assessment of the teaching points will be through community and patient safety exercises that include topics such as disaster preparedness and response. In conjunction with the TeamSTEPPS® training, the students from the nine professional programs (DO, PA, PT, PharmD, Graduate Nursing, Vet Med, Dental, Podiatry, and Optometry) will also be exposed to principles and practices of disaster response. By intensifying teamwork principles as the basis of disaster preparedness, the response pool for disaster response will be amplified, and future healthcare practitioners will be more aware of teamwork strategies necessary in a disaster setting. The intent of this presentation is to introduce this academic model including early outcome data.

Purpose Despite the increasing number of literature that identifies the roles of various rehabilitation professionals in disaster-related work, there is still limited evidence that examines how these professionals prepare for and function in the various phases of disasters. This study describes the roles and responsibilities practiced by Filipino occupational therapists in disaster preparedness, response, and recovery. The study also describes the preparations undertaken for the therapists to assume these roles. Materials and methods A survey was conducted among licensed occupational therapists with prior experiences in disaster response. The survey consisted of 23 items - seven were related to preparedness, ten to disaster response, and six to the recovery phase. The participants were asked to indicate their degree of involvement in specific roles and responsibilities using a 5-point Likert scale. The questionnaire also explored their personal preparation for disaster-related work. Results The participants were mostly engaged in roles related to the recovery phase, followed by the response phase, and were least engaged in the preparedness phase. The roles most frequently performed include: encourage connectedness and social interactions among survivors (recovery); provide supportive mental health services to survivors and their families (response); and attend trainings in disaster response to be part of a response team (preparedness). The majority of the participants received training in mental health responses and orientation prior to deployment. They identified the need to gain additional knowledge on emergency response and the effects of human displacement in disaster situations. Conclusions Given additional training and orientation, occupational therapists are able to perform various roles and responsibilities in the different phases of disasters. They can serve as additional resources for government and non-government organizations to address the needs of vulnerable populations in disasters. The study results could inform professional organizations on how rehabilitation professionals could be further trained to address disaster-related concerns. IMPLICATIONS FOR REHABILITATION With additional orientation and training, occupational therapists could serve as an important health human resource especially in providing mental health services to people with special needs in disasters. There is a need to intentionally integrate disaster preparedness in the scope of practice of rehabilitation professionals to prepare people with special needs for disasters. Additional knowledge and skills in humanitarian action need to be integrated with clinical expertise to benefit government and non-government disaster management activities.

PurposeThis paper aims to assess the effectiveness of the city disaster prevention, mitigation, response, recovery, and rehabilitation practices of the local governments in Metro Manila, Philippines.Design/methodology/approachBased on purposive sampling technique, descriptive-evaluative and comparative research designs were adopted to assess the effectiveness of local governments in implementing the four thematic areas: (1) disaster preparedness, (2) disaster prevention and mitigation, (3) disaster response, and (4) disaster recovery and rehabilitation.FindingsThe findings showed that disaster preparedness had the highest grand mean of 3.47, interpreted as effective, in the effectiveness of the City Disaster Risk Reduction Management in Metro Manila. This was followed by disaster response, and disaster recovery and rehabilitation, both with a grand mean of 3.42. Disaster prevention and mitigation received the lowest grand mean of 3.40. The overall grand mean across the four thematic areas was 3.42, also interpreted as effective.Originality/valueThe paper will be valuable to policymakers, legislators, and scholars in effectively implementing their policies and guidelines in disaster management, risk reduction, rehabilitation, and recovery.