Disaster Training Program Research Articles

Paramedic Disaster Health Management Competencies: A Scoping Review.

Paramedics are tasked with providing 24/7 prehospital emergency care to the community. As part of this role, they are also responsible for providing emergency care in the event of a major incident or disaster. They play a major role in the response stage of such events, both domestic and international. Despite this, specific standardized training in disaster management appears to be variable and inconsistent throughout the profession. A suggested method of building disaster response capacities is through competency-based education (CBE). Core competencies can provide the fundamental basis of collective learning and help ensure consistent application and translation of knowledge into practice. These competencies are often organized into domains, or categories of learning outcomes, as defined by Blooms taxonomy of learning domains. It is these domains of competency, as they relate to paramedic disaster response, that are the subject of this review. The methodology for this paper to identify existing paramedic disaster response competency domains was adapted from the guidance for the development of systematic scoping reviews, using a methodology developed by members of the Joanna Briggs Institute (JBI; Adelaide, South Australia) and members of five Joanna Briggs Collaborating Centres. The literature search identified six articles for review that reported on paramedic disaster response competency domains. The results were divided into two groups: (1) General Core Competency Domains, which are suitable for all paramedics (both Advanced Life Support [ALS] and Basic Life Support [BLS]) who respond to any disaster or major incident; and (2) Specialist Core Competencies, which are deemed necessary competencies to enable a response to certain types of disaster. Further review then showed that three separate and discrete types of competency domains exits in the literature: (1) Core Competencies, (2) Technical/Clinical Competencies, and (3) Specialist Technical/Clinical Competencies. The most common domains of core competencies for paramedic first responders to manage major incidents and disasters described in the literature were identified. If it's accepted that training paramedics in disaster response is an essential part of preparedness within the disaster management cycle, then by including these competency domains into the curriculum development of localized disaster training programs, it will better prepare the paramedic workforce's competence and ability to effectively respond to disasters and major incidents.

Development and Effect of a Pandemic Disaster Training Program for Healthcare Providers from Designated Hospitals for Infectious Patient

Introduction:South Korea experienced Middle East Respiratory Syndrome (MERS) outbreak in 2015. To mitigate the threat posed by MERS, the Ministry of Health and Center for Disease Control designated hospitals to be responsible for managing any suspected or confirmed infectious patient. These hospitals receive mandatory training in managing infectious patients, but many of the trainings lack practical skills practice and pandemic preparedness exercise.Aim:To develop and evaluate a training course designed to train healthcare providers from designated hospitals to enhance their competencies in managing emerging infectious diseases and potential outbreaks.Methods:A two-day course was developed by the Center for Disaster Relief, Training, and Research in collaboration with the Korea Health Promotion Institute using Kern’s 6-step approach. The course consisted of didactic lectures, technical skills training, tabletop simulation, and scenario-based simulation. Table-top simulation exercises consisted of cases involving a single infectious patient detected in the outpatient clinic and outbreak in the emergency department. Scenario-based simulation exercises involved managing a critically ill infectious patient in an isolated ward. A post-survey questionnaire was used to evaluate the course and assess the perception changes of the participants. All pre-to-post differences within subjects were analyzed with paired t-tests.Results:A total of 121 healthcare providers participated in three separate courses. The competencies for pandemic preparedness knowledge, skills, and attitude improved from pre- to post-course. The differences were all statistically significant (p<0.05). Overall course satisfaction in average for expectation, time, delivery method, and contents were 9.5, 9.2, 9.4, and 9.2, respectively.Discussion:There needs to be tests and exercises to recognize gaps of systems in place for pandemic preparedness. Simulation exercises are ideal tools for this purpose. Although this was only a two-day intensive course, this increased familiarity with workflows, tested the coordination of workflows between different disciplines and allowed the identification of gaps.

Modelling the drivers for sustainable agri-food waste management

PurposeThe waste of invaluable agri-food produce is the concern of United Nations Organisation and all countries across the world. The purpose of this paper is to identify and model the drivers of agri-food waste management in India.Design/methodology/approachThe interpretive structural modelling method is used to model the drivers in this study. This method helps in understanding the driver-dependent relationships among various drivers/criteria which are selected for studying.FindingsThe findings of the study vividly shows that the drivers such as disaster management planning, information dissemination, and training and awareness programs for farmers are most vital for tackling the issue.Research limitations/implicationsThis work would help the policy makers in developing the effective policies regarding the management of agri-food waste in a sustainable manner.Practical implicationsThis work would be very helpful for deeply understanding the causes of occurring waste and carefully handling it scientifically with a managerial perspective. Hence, it has the potential to reduce the generation of waste and saving the food for society.Social implicationsWith the help of this study, the people, society, and underprivileged will be benefited directly. The savings in agri-food waste will not only help in controlling the prices of it but also its more availability would be beneficial for all in beating the hunger.Originality/valueThe identification of drivers for the sustainable management of agri-food is the novelty of this research.

A pilot registry of trauma surgeons willing and ready to respond to disasters.

A well-defined means of organizing surgeons based on functional capabilities in disaster response has been lacking. We sought to create a pilot registry of surgeons, organized by functional capacities, available to respond to disasters in conjunction with the American College of Surgeons Operation Giving Back and to better understand their participation in disaster medicine training. The authors conducted a survey of the members of the American Association for the Surgery of Trauma and the Eastern Association for the Surgery of Trauma aimed at establishing a pilot registry of qualified trauma surgeons available to respond to disasters. Data from the surveys were analyzed retrospectively for surgical and subspecialty training, board certification, disaster response training, and military or civilian disaster experience to better understand the respondents' functional capacities and disaster training backgrounds. Of 211 respondents, 96% self-identified as trauma surgeons, whereas 87% and 89% reported active practice in acute care surgery and/or critical care. Nearly all had primary board certifications in general surgery (93%), and many had additional certifications in surgical critical care (65%). While many reported participation in American College of Surgeons-sponsored trauma courses, only 30% of those surveyed received disaster-specific training in Federal Emergency Management Agency courses, and even fewer received training in the Disaster Management and Emergency Preparedness course. Few had military (26%) or civilian (19%) experience in disaster response. This initiative complements efforts to organize a registry of trauma surgeons who are qualified and willing to respond in all aspects of disaster response. While trauma surgeons are optimally positioned to provide a wide range of surgical expertise in a disaster, this study further demonstrated the lack of a universally accepted disaster training program for surgeons willing to respond to mass casualty incidents. Standardized disaster response training for surgeons remains a challenge for the future. Care management, level IV.

大地震時を想定した病院非医療職対象図上訓練プログラム （Disaster Training Program for Hospitals（DT-H））の開発と検証

大地震時を想定した病院非医療職対象図上訓練プログラム （Disaster Training Program for Hospitals（DT-H））の開発と検証

Developing the Disaster Medical Assistant Team Education and Training Program (DMAT)

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Development and Effect of a Multi-Modality Disaster Training Program for Hospital Nurses

Development and Effect of a Multi-Modality Disaster Training Program for Hospital Nurses

Emergency nurses’ preparedness for disaster in the Kingdom of Saudi Arabia

Background and objective : The Kingdom of Saudi Arabia has recently faced many man-made and natural disasters. Since disaster victims are transferred to hospitals, nurses are among the first health care providers to respond to an emergency. Therefore, to improve disaster management it is essential to examine the current state of nurses’ preparedness. The aim of the study was attempts to determine the disaster preparedness of emergency nurses in Saudi Arabia. Methods : The study data were collected using two survey tools from the research literature, and 72 participants were recruited from two government hospitals in Riyadh. The response rate was 31.7%. Results : The study revealed that most nurses understood their roles after reading the disaster plan. Although half of the respondents had completed training in the previous 12 months, only 60% answered the item related to confidence after training. There was a significant difference between the confidence of those who had participated in a disaster or mass casualties training program and that of those who had not. Only 26% answered the item related to confidence after being involved in a real disaster, and no significant difference was found between the confidence of those who had attended a real disaster or mass casualties event and that of those who had not. Conclusions : The study found that respondents had minimal and limited disaster experience, as reflected in their low levels of confidence after being involved in real disaster events. This highlights the need for continued efforts to expand disaster training and ensure that nurses are appropriately prepared.

Education and Training of Emergency Medical Teams: Recommendations for a Global Operational Learning Framework.

An increasing number of international emergency medical teams are deployed to assist disaster-affected populations worldwide. Since Haiti earthquake those teams have been criticised for ill adapted care, lack of preparedness in addition to not coordinating with the affected country healthcare system. The Emergency Medical Teams (EMTs) initiative, as part of the Word Health Organization’s Global Health Emergency Workforce program, aims to address these shortcomings by improved EMT coordination, and mechanisms to ensure quality and accountability of national and international EMTs. An essential component to reach this goal is appropriate education and training. Multiple disaster education and training programs are available. However, most are centred on individuals’ professional development rather than on the EMTs operational performance. Moreover, no common overarching or standardised training frameworks exist. In this report, an expert panel review and discuss the current approaches to disaster education and training and propose a three-step operational learning framework that could be used for EMTs globally. The proposed framework includes the following steps: 1) ensure professional competence and license to practice, 2) support adaptation of technical and non-technical professional capacities into the low-resource and emergency context and 3) prepare for an effective team performance in the field. A combination of training methodologies is also recommended, including individual theory based education, immersive simulations and team training. Agreed curriculum and open access training materials for EMTs need to be further developed, ideally through collaborative efforts between WHO, operational EMT organizations, universities, professional bodies and training agencies. Keywords: disasters; education; emergencies; global health; learning

Learning Outcome Measurement in Nurse Participants After Disaster Training.

The National Disaster Health Consortium is an interprofessional disaster training program. Using the Hierarchical Learning Framework of Competency Sets in Disaster Medicine and Public Health, this program educates nurses and other professionals to provide competent care and leadership within the interprofessional team. This study examined outcomes of this training. Training consisted of a combination of online and on-site training. Learning outcomes were measured by using the Emergency Preparedness Information Questionnaire (EPIQ) pre/post training and participant performance during live functional exercises with the use of rubrics based on Homeland Security Exercise and Evaluation principles. A total of 64 participants completed the EPIQ before and after training. The mean EPIQ pre-training score of 154 and mean post-training score of 81 (reverse-scored) was found to be statistically significant by paired t-test (P<0.001). Performance was evaluated in the areas of triage, re-triage, surge response, and sheltering. Greater than 90% of the exercise criteria were either met or partially met. Participants successfully achieved overall objectives in all scenarios. Disaster response requires nurses and other providers to function in interprofessional teams. Educational projects, like the National Disaster Health Consortium program, offer the potential to address the need for a standardized, interprofessional disaster training curriculum to promote positive outcomes. (Disaster Med Public Health Preparedness. 2016;page 1 of 6).

Application and effects of a disaster nursing simulation training for Chinese undergraduates

Objective: Nurses, who are indispensable constituents of first responders, should be equipped to respond in a disaster. This study evaluated the effectiveness of a course to prepare undergraduate nursing students for disaster response. Methods: The course included three-hour overviews, one-hour case studies, and a three-hour disaster drill with six simulation skill stations among 120 junior nursing students. To measure education practice, simulation design, and outcomes embedded in the Jeffries’ framework, three Chinese-version self-evaluation scales designed by the National League for Nursing (NLN) were used. In addition, facilitators’ observation of student performance skills, two group interviews and one feedback questionnaire were utilized. Results: Of the three self-evaluation scales, the Simulation Design Scale and Educational Practices Questionnaire indicated that the simulation design was effective and promoted students’ learning practices. The Satisfaction and Self-Confidence Scale demonstrated satisfaction with current learning (4.39±0.46) and self-confidence in learning (4.27±0.53). Facilitator observation and group interviews revealed that most students need more time to prepare and practice for the disaster nursing drills. Conclusions: The study indicated that students were interested in the disaster nursing drill and satisfied with the diverse teaching methods and the motivating teaching materials used in the simulation. Simulation as a teaching strategy was an effective approach to improve team-work, active learning, problem-solving, satisfaction level and self-confidence during the disaster nursing drill. It is essential for nurse educators to provide disaster training programs for nursing students to prepare them for an active role in disaster response.

Competencies to Contend with Hazards and Disasters

This research study identified the competencies necessary to survive natural hazards and disasters. In addition, it held that these competencies are best identified by the (1) people involved in disaster risk reduction like planners, managers, and responders and the (2) survivors of major disasters like earthquake, landslide, volcanic eruption, and typhoon. The former have the training and experience in saving lives during critical times while the latter have directly experienced dangers and eventually triumphed over fatal conditions. Competencies gathered through focus group discussions and interviews were grouped into two: preparedness competencies and response competencies. The identified competencies include possession of disaster kit, ability to use disaster imagination, obedience to authority, trained in disaster preparedness or survival skills, application of science in decision-making, presence of mind, and possession of right attitude like optimism and being proactive. Finally, this research recommends that intensive disaster education and training in the schools and in the community be done, survivors' experiences in crafting disaster education and training programs be included and taught, non-skill competencies like behavior and attitude during disaster education and training.

Impacto de un programa de formación de catástrofes en el personal sanitario

ObjectivesThe aim of this study is to evaluate the effectiveness of a disaster preparedness training program in a Paediatric Emergency Department (PED). MethodsA quasi-experimental study was conducted using an anonymous questionnaire that was distributed to health care providers of a PED in a tertiary paediatric hospital. The questions concerned the disaster plan (DP), including theoretical and practical aspects. Questionnaires were distributed and completed in January 2014 (period 1) and November 2014 (period 2). The disaster training program includes theoretical and practical sessions. ResultsA total of 110 questionnaires were collected in period 1, and 80 in period 2. Almost three-quarters (71.3%) of PED staff attended the theoretical sessions, and 43.8% attended the practical sessions. The application of this training program significantly improved knowledge about the DP, but no improvement was observed in the practical questions. PED staff felt more prepared to face a disaster after the training program (15.5% vs. 41.8%, P<.001). ConclusionsThe training program improved some knowledge about the disaster plan, but it has not improved responses in practical situations, which may be due to the low attendance at practical sessions and the time between the training program and the questionnaires.

Development of a self-administered questionnaire to assess the psychological competencies for surviving a disaster.

To find the psychological competencies for surviving a disaster and develop a self-report questionnaire to assess them. Interviews with 16 earthquake survivors and 16 fire fighters followed by qualitative analysis were used to find psychological competencies. Formation of the item pool, a pilot study among 20 college teachers and students, a series of principal component analyses for the data from 345 college students, and a confirmatory factor analysis for the data from 307 participants with various occupations were used to develop the Psychological Competencies for Surviving a Disaster Questionnaire (PCSDQ). We found 4 psychological competencies: risk perception of a disaster, disaster knowledge and self-relief skills, low fear in a disaster, and sense of control over a disaster. The 24-item PCSDQ assessed these psychological competencies. The Cronbach alpha of PCSDQ subscales ranged from .75 to .87. The psychological competencies for surviving a disaster were found to be risk perception of a disaster, disaster knowledge and self-relief skills, low fear in a disaster, and sense of control over a disaster. Using the PCSDQ to assess a person's psychological competencies for disaster survival will make it possible to provide that person with an individualized and targeted disaster self-relief education and/or training program.

Diabetes, disasters and decisions

SUMMARY Man-made and natural disasters pose special challenges for people with diabetes. The disruption of healthcare delivery systems can have both short- and long-term health impacts. Disaster training programs should educate people with diabetes and their caregivers, emergency personnel, and other healthcare professionals about disaster prevention, mitigation and recovery. Early planning can prevent later disaster-related exacerbations of diabetes.

Emergency nurses and disaster response: An exploration of South Australian emergency nurses’ knowledge and perceptions of their roles in disaster response

Summary The word ‘disaster' for many people conjures up images of well publicized events such as 9/11 (2001), the London bombings (2005), Hurricane Katrina (2005) and more recently the Haiti earthquake (2010). For Australians, the impact of disasters closer to our shores has been felt through such incidents as the Bali bombings (2002 and 2005) and the Boxing Day Tsunami (2004). Significant events that have occurred on Australian soil include Cyclone Tracey (1974), the Granville Rail disaster (1977) and Ash Wednesday bushfires (1983). Natural disasters such as flooding, cyclones and bushfires continue to impact Australian communities. However, to date Australia has avoided a large scale disaster event that has overwhelmed the health care system. A mixed method approach underpins this study. Both quantitative and qualitative data was collected through a self report questionnaire. Quantitative data has provided statistic evidence to support the findings, while the qualitative data has allowed for a richer understanding of nurses' perceptions. The population for this study is South Australian emergency nurses working in public hospital emergency departments in metropolitan Adelaide. Three key themes emerged from the data. Firstly, South Australian emergency nurses have had minimal previous disaster experience (either through a real event or simulated exercises). Second, although a large number of nurses have completed what they perceive to be disaster education and training, questions were raised regarding the appropriateness, relevance and availability of such education. Third, South Australian emergency nurses have a low level of disaster knowledge. The findings from this study are relevant not only for emergency nurses, but for all health professionals involved in disaster response. In particular for those who have had minimal disaster response experience and limited exposure to disaster education and training opportunities. This study suggests a disaster training program for South Australian emergency nurses would be beneficial. The need for future research into appropriate disaster education and training for health professionals is highlighted by the study.

A comprehensive disaster training program to improve emergency physicians’ preparedness: A 1-year pilot study

The main objective of this pilot study was to measure the effectiveness of a 1-year comprehensive training program on the long-term cognitive competence in disaster preparedness among attending emergency physicians (EPs). Ten attending EPs participated in a year-long training program in disaster preparedness and management. A baseline pretraining test and self-evaluation questionnaire were administered to the participants. Post-training written test and self-evaluation questionnaire were repeated at 12 months after the completion of the program. The study took place at an urban tertiary care medical center from July 2007 to June 2008. The training program was divided into three main categories: didactic core topics, formally recognized courses, and a practicum (drill). Pretraining and posttraining test scores in addition to pretraining and posttraining self-assessments were compared for disaster preparedness in various areas. There was a statistically significant increase in the overall post-test versus pretest scores on the written examination for the entire group (44.4 vs. 29.8, p < 0.005). In addition, statistically significant increases in each area of disaster preparedness were noted for the self-assessments (2.7 +/- 0.82 vs. 3.9 +/- 0.56, p = 0.01), where 1 means not prepared at all and 5 means extremely well prepared. Disaster preparedness is an essential area of clinical competence for EPs. Participation in a yearlong pilot training program demonstrated a statistically significant increase in cognitive competence among a pilot sample of EPs. More research is needed to validate the content of the training program and its instruments of evaluation.

National Emergency Response Programs for Dental Health Care Professionals

Members of the established public health systems and medical community must understand that, in medical surge events, members of the dental profession and other non-traditional disaster health care personnel are an additional source of assistance in response activities. The authors relied on hands-on experience, expert consultations, literature reviews and Web searches to identify disaster response training programs appropriate for members of the dental profession and other health care personnel. The authors identified multiple governmental and professional disaster training programs. Five key national-level programs address the training and organization of health care professionals to support a large-scale disaster program. Because of their training and skills, dental professionals would be valuable additions to these programs and could make significant contributions if natural disasters and/or terrorist events were to occur.

IMPACT OF A COMMUNITY DISASTER AWARENESS TRAINING PROGRAM IN TURKEY: DOES IT INFLUENCE HAZARD-RELATED COGNITIONS AND PREPAREDNESS BEHAVIORS

A community disaster training program focusing on earthquakes, floods and landslides was implemented in Çankiri, Turkey, in 2002. It covered mitigation, preparedness and response aspects of natural disaster management. Four thousand community members participated in the training program delivered by 95 local trainers. This study evaluated the impact of participation in this program. One year later, 400 randomly selected participants in the training program and a comparable sample of 400 community members who did not participate in any disaster training program (nonparticipants) were surveyed. Disaster-related cognitions (i.e., disaster expectation, worry about future disasters, loss estimations if a disaster occurs, beliefs in the possibility of mitigation and preparedness) and reported preparedness behaviors were assessed. The relationship of sociodemographic, previous disaster experience, anxiety and locus of control variables with disaster-related cognitions and behaviors was examined. Results showed that participants in the training program had more disaster expectation, worry and loss estimation and more preparedness behaviors. Results of regression analyses, examining the relationship of the variables of the study with disaster cognitions, affect and actual preparedness behaviors showed that gender, education, being a participant in the training program, anxiety and locus of control are important variables related to different kinds of disaster-related cognitions. However, reported preparedness behaviors were quite low and this result needs to be viewed with caution. These results have important implications for the modification of programs for targeting sustainable behavioral change, which is likely to reduce the impact of future disasters.

DVATEX: Navy medicine’s pioneering approach to improving hospital emergency preparedness

The level of emergency preparedness considered adequate for hospitals prior to the events of 9/11 is no longer sufficient. To analyze and improve emergency preparedness in Navy healthcare facilities, the US Navy Medical Department has established the Disaster Preparedness, Vulnerability Analysis, Training and Exercise (DVATEX, pronounced ‘dee-va-tex’) program. The four-stage program includes a hospital or clinic self-assessment, a site visit to each Navy hospital and clinic (during which a team of emergency preparedness experts trains staff, performs a vulnerability analysis, and conducts an exercise of the facility’s emergency management plan), development of an after-action report, and ongoing support to improve preparedness (Figure 1). In its first year, the DVATEX program has been successful in identifying hospital vulnerabilities, applying remedies, and developing long-term plans to improve preparedness.