Disaster Nursing Competencies Research Articles

Nurses’ Competencies in Disaster Nursing: Implications for Curriculum Development and Public Health

The purpose of this study was to explore Hong Kong nurses’ perceptions of competencies required for disaster nursing. Focus group interviews and written inquiry were adopted to solicit nurses’ perceived required competencies for disaster care. A total of 15 nurses were interviewed and 30 nurses completed the written inquiry on their perceived competencies related to disaster nursing. The International Council for Nurses’ (ICN) framework of disaster nursing competencies, consisting of four themes and ten domains, was used to tabulate the perceived competencies for disaster nursing reported by nurses. The most mentioned required competencies were related to disaster response; with the ethical and legal competencies for disaster nursing were mostly neglected by nurses in Hong Kong. With the complexity nature of disasters, special competencies are required if nurses are to deal with adverse happenings in their serving community. Nurses’ perceived disaster nursing competencies reported by nurses were grossly inadequate, demonstrating the needs to develop a comprehensive curriculum for public health. The establishment of a set of tailor-made disaster nursing core competencies for the community they served is the first step in preparing nurses to deal with disastrous situations for the health of the public.

Disaster training for nurses: a moral and humanitarian imperative

I am sure you do not need reminding of the large-scale disasters that have plagued our planet in recent years. Global warming has played a large part in this with historic temperature variations occurring in many parts of the world, like recent snow on the pyramids of Giza, and increases in adverse weather events, such as heavy rains, floods, and typhoons. For example, the huge Typhoon Haiyan (Yolanda) hit the Philippines on 8 November 2013, eventually continuing its destructive path into Vietnam. Typhoons seem to be growing in intensity in the Asia-Pacific region, and often hit areas where people are poor and local infrastructure is limited. This typhoon was the deadliest on record to affect the Philippines. As I write this editorial, bodies are still being found, and health systems are struggling to cope with the health needs of the population, especially as immediate international relief efforts wind down. Of course there are many other types of disasters and nurses like all other health professionals need to be better equipped to deal with their aftermath. While it is not in our power to stop such terrible events in the natural world, it is in our power to be better prepared to help communities deal with losses and ongoing effects. We also can be better prepared to help ourselves, for nurses are victims of disaster, too. Although the awareness of nurses regarding disaster preparation has grown around the world over the last decade, most nurses are not yet prepared, educationally or psychologically, to respond to disasters, despite scientists warning us that such disasters will continue with possibly greater catastrophic events in the 21st century. Little is known about the numbers of nurses who were gravely affected by the typhoon, and needing direct assistance (Philippine Nurses Association 2013). This was truly a catastrophic event and while our hearts might go out to our colleagues in the Philippines and Vietnam, such sentiments are not enough. We must help nurses in these troubled areas to cope and be prepared for future disasters. Unfortunately around the world we have only made very small inroads into providing nurses with appropriate disaster nursing education and training at undergraduate and graduate levels, and in courses offered within health systems. ‘Health systems and health care delivery in disaster situations are only successful when nurses have the fundamental disaster competencies or abilities to rapidly and effectively respond' (World Health Organization and International Council of Nurses 2009, p. 6). Capacity building in nursing and midwifery is needed to help limit injury and death, and provide for the ongoing health and well being of communities long after the disaster event. For example, the psychological effects of disasters often last for many years, and nurses need to be trained in psychological first aid, just as they are trained in physical first aid. Nurses have a major role to play in risk assessment and in helping communities be better prepared for disasters, large or small. I hope that everyone who reads this editorial will take steps to prepare nurses and midwives for disasters of the future, for these will pose serious and ongoing public health risks wherever they occur. We need to take urgent and critical action in all countries to ensure that nursing curricula contain some element of disaster nursing. The ICN Framework for Disaster Nursing Competencies (2009) will help in designing such courses. Specific courses for disaster nursing have been instigated in a number of countries, but often in more developed countries. Nurses need to make international efforts in this capacity building, and this involves advocating, policy-making, research, programme design and implementation. Since we are the largest group of health professionals globally, it is within our power to bring to the attention of politicians and policy-makers the urgent need to prepare nurses for disasters. After all if we don't do it, who will? The only certain thing about disasters is that they will happen in the future, so do your best to help nurses of the world be better prepared. I believe that this is one of our moral and humanitarian imperatives of the 21st Century.

Disaster Experience, Perception and Core Competencies on Disaster Nursing of Nursing Students

Abstract Disaster Experience, Perception and Core Competencies on Disaster Nursing of Nursing Students. This paper was aimed to investigate disaster experience, perception and core competencies on disaster nursing of nursing students and to provide basic data needed for development of disaster nursing program. 172 nursing students enrolled in a department of nursing completed questionnaires. The data were collected from December 1, 2012 to December 23, 2012. The result were as follows; The average level of perception about disaster nursing was 18.16 out of 25 points, suggesting that they generally perceived disaster nursing as an important matter. Core competencies of the subjects on disaster nursing was 41.56 out of 75 points, which was moderate for the core competencies on disaster nursing. There was statistically significant positive correlation between the perception about disaster nursing and core competencies on disaster nursing. It is necessary to develop disaster nursing program to reflect the needs of the field in Korea. Further research is needed to adequately address this issue.

A literature review of disaster nursing competencies in Japanese nursing journals

Competencies is an important concept used for assessing health professionals' capability to perform their role. By means of a literature review of Japanese professional journals this paper will investigate the competencies concept, particularly with relation to disaster nursing. The literature research was conducted using the database ichu-shi (ver. 4). All literature is written and published in Japanese and was published between 2001 and 2008. Due to an unfamiliarity of the term 'competencies' in Japanese, the key words were sought while deconstructing the meaning and concepts of 'competencies' into terms more recognisable in the Japanese context. Twelve key words: disaster, capability, education, practice, licensure, ability, function, prevention, response, planning, emergency, and disaster nursing were chosen as being most likely to find literature relevant to the English Language concept of competencies. The searched articles were then written into the disaster nursing competencies review worksheet for analysis. One hundred and twenty articles were found by searching a combination of these key words. Of these articles, those that were not in the context of disaster nursing were eliminated. As a result, 43 articles were chosen as being suitable for analysis of the context. These articles are classified into four themes. These theme groups indicated a foundation for competencies in disaster nursing. The definition of competencies in Japanese nursing journals was quite varied and cannot be easily defined as common disaster nursing competencies. Given the variety of areas and the distinct phases in disaster nursing, as well as the 'what for' and 'who governs', disaster nursing competencies will need its own discussion in order to establish the common competencies internationally.

Development and Evaluation of an Undergraduate Training Course for Developing International Council of Nurses Disaster Nursing Competencies in China

Nurses are often called upon to play the role of first responder when disaster occurs. Yet the lack of accepted competencies and gaps in education make it difficult to recruit nurses prepared to respond to a disaster and provide assistance in an effective manner. Based on the International Council of Nurses (ICN) Framework of Disaster Nursing Competencies and Global Standards for the Initial Education of Professional Nurses and Midwives, a training course titled "Introduction to Disaster Nursing" was designed and implemented with 150 students. A pre-post survey design was used to assess changes in participants' self-rated disaster nursing competencies. The impact of the training course on participants' attitudes toward disaster nursing and their learning experience were also assessed. All participants passed the assessments and examination with an average score of 70%. Pre- and posttraining self-ratings of the disaster nursing competencies increased from 2.09 to 3.71 (p < .001) on a Likert scale of 1 to 5, and the effect size was large, with Cohen's d higher than 0.8. No significant difference in both examination results (60% group assignments; 40% written examination) and self-rated competencies was noted between the senior year students and graduate nurse participants by Mann-Whitney U test (p value = .90). The majority of participants indicated their willingness to participate as a helper in disaster relief and saw themselves competent to work under supervision. The ICN Framework of Disaster Nursing Competencies was instrumental to guide the training curriculum development. This introductory training course could be incorporated into undergraduate nursing education programs as well as serve as a continuing education program for graduate nurses. The training program can be used for preparing generalist nurses of their nursing competencies in disaster preparedness, response and post-disaster recovery and rehabilitation.

Nursing and disaster preparedness

Disaster Preparedness is one of several Position Statements that ICN has announced it will be reviewing during 2010, to be carried out with National Nursing Associations and the ICN Bank of Experts. ICN's proposed review could not be more timely in the light of the Haiti earthquake on 12 January that resulted in such devastating loss of life and infrastructure, followed on 27 February by yet another earthquake and tsunami in Chile. Hard evidence supports an impression that disasters are becoming much more frequent. A 60% increase in disasters was reported between 1997–2006 compared with the decade1987–1996; the number of reported deaths for the same periods grew from 600,000 to over 1.2 million; and the numbers of people affected rose from 230 to 270 million, a 17% increase (Klyman et al. 2007). ICN is already very active in this area (see International Perspectives in this issue on assistance in Haiti). In March 2007 (then) President Hiroko Minami wrote about her personal experiences of nursing in a disaster area, and urged nurses in every nation to assume a leadership role in their efforts to prepare their countries and regions in the event that disaster strikes (Minami 2007). Then, last year, ICN published in conjunction with the World Health Organization in the Western Pacific Region, an invaluable booklet on the ICN Framework of Disaster Nursing Competencies (ICN & WHO Western Pacific Region 2009). With a wealth of background information, definitions and statistics, this framework of disaster nursing competencies for the generalist nurse should be compulsory reading for nurses everywhere. Disasters come in many forms, natural and man made, and no one knows when they will strike and who will be called upon to assist. Experience in many disasters suggests that although teams of experts may later fly in to help, it is the available services from local hospitals and clinics that are called upon to provide immediate assistance. Too often these personnel are confused, disoriented and left to work without prior guidelines (Nasrabadi 2007). An article on Chinese nurses' experience in the Wenchuan earthquake relief in this issue (pp. 217–223) reinforces the need to ensure that all nurses are well prepared for such eventualities. Destruction of the infrastructure with thousands of deaths and many more injuries over wide areas of Wenchuan and Li counties, resulted in an overwhelming situation for the ten nurses who were later interviewed about their experiences. Voluntarily joining rescue teams from tertiary hospitals affiliated with Chongquing University, all participants had emergency and peri-operative care backgrounds, but none had any formal disaster nursing training. They found that previous experience did not guarantee productive work in disaster conditions, and they questioned their abilities to undertake this relief work. The authors point out that while health professionals working in rural hospitals and community care areas are expected to play a key role in disaster relief, generally they are not well prepared and that is only military hospitals that provide appropriate training. Although these comments are made in the context of developing countries, similar reactions have been identified in developed world disasters (Arbon et al. 2006; Bless 2005). The ICN Framework described will not only ensure better responsiveness to disasters when they occur, but also encourage the development of competencies for nurses in the areas of prevention, preparedness and recovery. These must surely be a priority for nursing in the 21st Century.

Pilot training program for developing disaster nursing competencies among undergraduate students in China

As nurses constitute the largest group of health-care providers, their readiness to respond to disasters and to participate in preparedness and disaster recovery activities will be significant for making a community more resilient against disaster. Concern is raised regarding how to build the capacity of all nurses with a knowledge base and a minimum set of skills in responding to various disasters. Drawing on the ICN Framework of Disaster Nursing Competencies and Global Standards for the Initial Education of Professional Nurses and Midwives, a training program entitled "Introduction to Disaster Nursing" was developed. Four teaching methods including action learning, problem-based learning, skill training, and lecture were used to orchestrate a series of planned activities for helping students develop the required disaster nursing competencies in a 2-week intensive training program held in Sichuan China in July 2009. The pre- and post-tests which were given to assess the students' perceived level of competencies demonstrated a significant gain in relevant knowledge and skills constituting the required competencies upon completion of the program. In the program evaluation, most students indicated their willingness and capability in disaster relief work under supervision, and they were keen to advance their competencies in the field of disaster nursing.

Disaster Management and Response

1. The Changing Face of Nursing Practice: Homeland Security Challenges to Health Care Delivery (Boatright, McGlown) 2. Disaster Nursing Competencies (Bond, Beaton) 3. Care of the Victim of Bioterrorism During Aeromedical Evaluation (Cieslak, Herrold) 4. Historical Lessons Learned from Third World Disasters (Davies) 5. The Impact of the Disaster Experience on Culture, Self and Identity: A Need for Increased Awareness Among Healthcare Professionals (Deeny, McFetridge) 6. Mass Casualty Triage: Field Considerations in WMD Events (Hembree) 7. Antidote Therapy for Hazardous Materials (Lehmann, Weber) 8. Care of the Patient Exposed to Biological Agents (Ricciardi) 9. Role of Public Health Nurses in Emergency Preparedness and Response (Rowney) 10. Competency Development and How Competencies can be Integrated into the Basic Nursing Curriculum (Stanley) 11. Preparing Hospital-Based Nurses for Radiation Emergencies: Clinical Response and Systems Preparedness (Veenema) 12. A National Curriculum in Emergency Preparedness for Nurses (Weiner) 13. Pediatrics in Disasters (Hohenhaus)