Emergency Preparedness Management Research Articles

Augmented reality simulation-based training for midwifery students and its impact on perceived knowledge, confidence and skills for managing critical incidents

ProblemEmergency obstetric management is essential in midwifery training to prevent fetal and maternal morbidity. Repeating this management in practice is often not possible. Sustainable confidence in these procedures is usually achieved in the first few years of practice. BackgroundSimulation training complements hands-on learning and improves practical skills, benefiting both students and patients. Research on obstetric emergency simulation training have demonstrated this, but the use of digital simulation approaches, such as augmented reality (AR), is under-researched. AimTo investigate whether AR simulation training influences midwifery students' subjective perceptions of knowledge, confidence and practical skills in emergency situations. MethodsA descriptive exploratory study was conducted using a pre-post design. AR scenarios were developed on the topics of 'preparing emergency tocolysis', 'preparing a pregnant woman for caesarean section' and ‘resuscitation of newborns'. The AR simulation was conducted in the fourth to fifth semester of the midwifery programme. A questionnaire was developed for students (N = 133) to self-assess their competence in the categories of knowledge, confidence and practical skills. ResultsStudents rated their competence significantly better in the post-survey than in the pre-survey (p=<0.05). Simulation has an impact on self-assessment of professional knowledge, confidence and practical skills in emergency situations. It enhances students' procedural knowledge and practical skills in complex contexts, complements subject knowledge and builds confidence. ConclusionThe results provide initial evidence that AR simulation is an effective learning strategy for emergency management preparedness. Future studies should validate the effect with control cohorts and measure competence through practical examinations.

A collaborative framework for cross-border disaster management in the Balkans

Disasters, marked by their sudden and profound impacts on human life, property, and the environment, necessitate a comprehensive management approach. This approach comprises mitigation, preparedness, response, and recovery phases, involving the engagement of various stakeholders (state/government, first responders' agencies, humanitarian organisations, emergency management research institutes). Preparedness, in particular, is essential to ensure an effective response to disasters. This research explored disaster management, with a specific focus on cross-border disasters within the Balkan region. Cross-border disasters, which extend beyond international borders and impact multiple countries and communities, present distinctive challenges due to the need for coordination and cooperation between diverse national governments and organisations. The research's exploration concentrated on the dimension of emergency preparedness management in the context of cross-border disasters in the Balkans, with a specific emphasis on the strategic preparedness phase of cross-border emergency management. This endeavor marked the pioneering attempt to provide a holistic and integrated approach to a joint cross-border preparedness disaster management framework for the Balkan region. The developed cross-border framework represents the final elements that needed to be present for all the Balkan countries when dealing together with cross-border disasters. It stems from the unanimous agreement, through the implemented Delphi study, of all the representative emergency management groups of experts from the participating countries. The outcomes serve as the foundation through the framework and hold the potential to lay the groundwork for the establishment of the first Balkan Civil Protection Observatory, providing support to the Balkan nations in civil protection and disaster management.

LARCalc, a tool to estimate sex- and age-specific lifetime attributable risk in populations after nuclear power plant fallout

A tool called LARCalc, for calculating the radiological consequences of accidental large scale nuclear power plant releases based on estimates of 137Cs ground deposition, is presented. LARCalc is based on a previously developed models that has been further developed and packaged into an easy-to-use decision support tool for training of decision makers. The software visualises the radiological impact of accidental nuclear power plant releases and the effects of various protective measures. It is thus intended as a rapid alternative for planning protective measures in emergency preparedness management. The tool predicts projected cumulative effective dose, projected lifetime attributable cancer risk, and residual dose for some default accidental release scenarios. Furthermore, it can predict the residual dose and avertable cumulative lifetime attributable risk (LAR) resulting from various protective measures such as evacuation and decontamination. It can also be used to predict the avertable collective dose and the increase in cancer incidence within the specified population. This study presents the theoretical models and updates to the previous models, and examples of different nuclear fallout scenarios and subsequent protective actions to illustrate the potential use of LARCalc.

Ready.gov

Nearly 20 years ago, the U.S. Department of Homeland Security launched Ready.gov, a national public service advertising campaign designed to educate and empower Americans to prepare for and respond to emergencies such as natural and technological disasters. To date, little is known about the accessibility and adaptability of this information for vulnerable populations including persons with disabilities (PwDs) and those with limited English proficiency (LEP). This computer-automated analysis seeks (1) to determine the general web, mobile and language accessibility of state websites which extend and/or amplify the Ready.gov national campaign goals, (2) to evaluate the document accessibility of downloadable emergency preparedness information, and, based on findings, (3) reflect upon improvement opportunities for disaster and emergency management preparedness messaging processes to vulnerable populations. An exploratory, quantitative content analysis relying on computer-automated software is used to assess the web, language, mobile and document accessibility of Ready.gov state-affiliated websites dedicated to providing public information for emergency preparedness and disaster response. Additional factors such as the use of CAPTCHA, adherence to the Matterhorn Protocol, disclosure of accessibility policy statements, and the presence of tailored information are evaluated. No significant differences among FEMA regions were found. The most frequent errors were likely to impact the POUR dimensions of perceivability and operability. In all, 76% of the Ready.gov state-affiliated websites had WCAG Level AA detectable accessibility failures on the home pages. Furthermore, 62% of the sites offered translational language formats for LEP users, while only 6% ([Formula: see text]) explicitly provided PwDs an option to report accessibility-related user experiences to the agency. Document accessibility was deemed to be poor with 80% of the websites disseminating downloadable .pdfs such as emergency planning guides and preparedness kits in inaccessible digital formats. These findings identify opportunities for improvement specifically, in the web, mobile and document accessibility of information associated with the Ready.gov national campaign. We argue that improvement and compliance is expected to reduce the likelihood of litigation, increase the resilience of vulnerable populations, and improve user experiences.

Emergency Management Performance Grant (EMPG) funding allocations and relevance for US disaster policy

AbstractThe Emergency Management Performance Grant (EMPG) program has long been a cornerstone of state and local emergency management preparedness efforts. Through the EMPG program, the Federal Emergency Management Agency (FEMA) administers grants to state and local emergency management agencies to accomplish a wide range of tasks such as the development of response and recovery plans, the creation of emergency operation centers, and the hiring of staff, among other activities required to be effective. EMPG provides the predominant federal funding for this mission, and many agencies depend on these funds for their operations. Despite the importance of EMPG, there is a dearth of empirical research about the program. This study explores this gap by evaluating how EMPG funds were distributed across United States counties from 2014 to 2020. Using FEMA and US Census data, we conducted a county‐level analysis using robust regression statistical analysis to determine factors affecting funding awards. Findings indicate that high population, high diversity, a strong economy, and high risk (measured using both the National Risk Index score and the number of federal disaster declarations per county) increased the likelihood that a county would receive EMPG funds, with high‐risk urban counties rather than rural counties receiving more funding.

How Leadership Impacts FEMA’s Whole Community Approach during Emergency Management’s Preparedness

Disasters stipulate unfortunate remembrances of susceptibilities within society. Disasters often suddenly affect communities and result in the untimely loss of functions and social systems. Therefore, formulating preparedness policies and awareness of uncertainty is essential when addressing emergency management. The success of the emergency management approach within the community often relies on the leadership structure imposed. Leadership also helps to promote emergency management practices and provide new reserves to support emergency preparedness and funds for sustainability and resilience. This study concentrates on the whole community principle in handling disasters and emergencies. The whole community management strategy further maps preparedness-related capacities and community engagement in disaster control. Partnership with participants across the entire society program and efficient community management can result in significant disaster preparedness and response. The research will constitute a quantitative methodology, specifically, a survey on members of the Safeguard Iowa Partnership (SIP), an emergency management firm, on the organization’s whole community emergency leadership strategy. The Whole Community leadership model in emergency management proved its effectiveness through the survey conducted in SIP. Data will also be collected using the Organizational Leadership Evaluation Survey (OLA) from all the SIP members from various economic sectors. The OLA has six features that help gauge the organization’s leadership strength. The quantitative methodology suggested an association between the perceived essence of Whole Community management and the perceived efficiency of FEMA’s role in the emergency management preparedness process.

Internal contamination cases: The REAC/TS experience

The Radiation Emergency Assistance Center/Training Site or REAC/TS is a United States Department of Energy (DOE) emergency response asset and part of the National Nuclear Security Administration's (NNSA) Nuclear Emergency Support Team (NEST). REAC/TS started in 1976 to provide support to the US DOE and is under the Oak Ridge Institute for Science and Education (ORISE) and operated for the US DOE by Oak Ridge Associated Universities, a consortium of 125+ universities to further science and developing future scientists. As part of the support for the US DOE, REAC/TS is on call 24 hours a day, seven days a week for any radiological/nuclear (R/N) injuries or illnesses in the US and throughout the world. REAC/TS was one of the initial eight World Health Organization (WHO) Collaborating Centers, throughout the world, established in 1980 for radiation emergency management and subsequent member of WHO's Radiation Emergency Management Preparedness and Assistance Network (REMPAN). This article will discuss the REAC/TS experience with more recent internal contamination cases and discuss the many gaps existing in assessing and managing cases of internal contamination.

The Impact of the Storm Prediction Center's Convective Outlooks and Watches on Emergency Management Operational Planning

For many emergency managers (EMs) and National Weather Service (NWS) forecasters, Convective Outlooks issued by the Storm Prediction Center (SPC) influence the preparation for near-term severe weather events. However, research into how and when EMs utilize that information, and how it influences their emergency operations plan, is limited. Therefore, to better understand how SPC Convective Outlooks are used for severe weather planning, a survey was conducted of NWS core partners in the emergency management sector. The results show EMs prefer to wait until an Enhanced Risk for severe thunderstorms is issued to prepare for severe weather. In addition, the Day 2 Convective Outlook serves as the threshold for higher, value-based decision making. The survey was also used to analyze how the issuance of different risk levels in SPC Convective Outlooks impact emergency management preparedness compared to preparations conducted when a Convective Watch is issued.

Disaster preparedness for charge nurses: A program evaluation.

Over the last 3 years at a large, -midwestern, pediatric hospital, there have been near -disaster events, a few of which required transfer or evacuation of patients. The responses from the inpatient units to these events have varied greatly and can be traced back to communication, knowledge, comfort level, and effectiveness of the charge nurses on the nursing units. A task force was formed to understand the variation in their disaster response procedures and to standardize disaster response procedures. Respondents included the bedside, clinical leader-ship, managers of patient services, emergency preparedness management, and senior leadership. This resulted in the creation of a tabletop simulation exercise for use by inpatient charge nurses within the institution. The results indicated that participants reported higher levels of self-reported knowledge, confidence, and effectiveness regarding the disaster preparedness on their units (p < 0.001). The program was effective, with feedback from participants indicating the need for more frequent and/or department -specific education.

Emergency management communication: The paradox of the positive in public communication for preparedness

Government emergency management agencies use public communication to inform and educate around risks such as floods, fires, storms, and earthquakes with the aim to help communities understand how to prepare for these emergency events. This study of government communication relating to emergency management preparedness examines an Australian context to understand the types of messages preparing community members for natural hazards. Findings suggest that agencies employ a two-track approach combining warranting and engagement messages. Yet a deeper look at the messages suggests a “paradox of the positive” that overemphasizes the capacity of local agencies to respond to crises and underemphasizes citizen shared responsibility. Implications for the paradox of the positive in other national contexts and public relations theory building are also discussed.

Competence for the Unforeseen: Social Support and Concurrent Learning as Basic Components of Interaction Under Risk

This study examines the importance of basic educational, organizational and operational structures of interaction under risk, and how these vary with competence level within an organization. The purpose of this study is to examine whether there are any basic components that can provide further insight into how competence for interaction under risk can be developed and implemented. The first aim was, therefore, to examine the relationship between components of the basic educational, organizational and operational structures and interaction. The second was to assess whether the perceived level of interaction varies due to competence level, controlling for gender, age, and professional experience. The third aim was to determine whether competence level group membership could be predicted by interaction, social support and the specified educational and organizational components. A questionnaire survey was carried out in the autumn of 2017. The respondents were male or female employees of the Norwegian Armed Forces (n =917). A purposive expert sample of 20 different units with different levels of competence were selected and included commissioned and non-commissioned officers, officer cadets, and conscripts. A total of 1050 personnel were employed by these units. All the employees were asked to participate. The response rate was 87%. The results showed that social support and concurrent learning were the most important predictors of interaction. Social support and concurrent learning combined with basic capabilities, organizational improvisation, training on decision-making, flexibility, general preparedness, and contingency plans accounted for a considerable proportion of the variance in interaction. Interaction, social support, and the specified educational, organizational and operational structure components were also significantly associated with competence level and competence group membership. The results showed that it could be possible to prepare for unforeseen events by implementing in particular social and educational measures that improve interaction. This study should be especially relevant to those involved in handling and stabilizing unforeseen events and emergency preparedness management.

Managing commercial actors in strategic networks in emergency preparedness

PurposeThe purpose of this paper is to analyse the management of commercial actors in strategic networks of emergency preparedness management (EPM) in developed countries and how these strategies connect to the emergency response efficiency. This study uses collaboration, strategy, and efficiency to evaluate the private governance of the food, healthcare, and transportation sectors and follows an analysis of these sectors’ management that finds an ambivalent impact on the efficiency of the worldwide supply chain network (SCN) system. This study discusses many strategic networks and nets of commercial standards with different management structures and emphasizes illustrating the EPM context, thereby offering directions for future research.Design/methodology/approachAn empirical research approach and triangulation methodology was adopted to design the selection, evaluation, and contribution of the observed data and the humanitarian and business literature. An overview of strategic networks’ role in EPM in Sweden comprises several network approaches and considers the strategic value of three SCNs for response efficiency.FindingsThe study finds that strategic networks are relevant for EPM and response efficiency and can be delimited and adapted to developing countries’ demands. However, growing interest in networks’ strategic value for EPM stresses public-private collaboration as a strategic choice to achieve response efficiency. To offer strategic planning that ties demand with supply, public-private actors must collaborate in SCNs.Originality/valueThe study contributes to the existing literature on strategic networks, for example, industrial networks, by illustrating their strategic value for developed countries’ SCNs. It also contributes to the business literature, for example, on strategic net management. The work is original because it adopts a practical perspective involving buyers and suppliers in planning, the delimitation of their capability in nets, and the strategic value of SCN collaboration.

Managing military involvement in emergency preparedness in developed countries

Purpose The purpose of this paper is to analyse supply chain network management (SCNM) in the context of emergency preparedness management (EPM). The results of this study revealed that civil-military relations are essential for EPM to function as a coordinated approach to safety and security, and are necessary to respond effectively to complex emergencies and mitigating threats to developed countries. Civil-military relations are still a concern in the context of communication, the exercise of authority, and the coordination of emergency supplies (ES) to emergency operations. Design/methodology/approach This qualitative study is based on field observations, with attention focused on the EPM of Sweden, Finland, and Poland. The analysis of a broader SCNM through EPM was supported by semi-structured interviews among civil-military actors in Sweden, information collected from informal conversations known as “hanging out”, and secondary materials. Empirically, the analysis included a variety of civil-military relationships and identified implications for management, policy, and planning that are applicable to developed countries. Findings The management of civil-military relations is a meaningful resource when used as an overall approach for safety and security. The integration of civil-military relations in EPM in the planning of ES is a long-standing and complex matter. The management of Swedish civil-military relations in EPM is recognising that implications for management are imbedded in continuous policy changes in, for example, the Swedish policy history. Civil-military relational complications that arise in the field of operations are impossible to anticipate during emergency planning, as those complications are grounded in policy changes. Originality/value Escalating threats to developed countries are highlighted. The study underlines the primary measures used in studying military involvement in EPM. An understanding of SCNM as a choice for management can be obtained in future research that focuses on a broader role of the military in EPM. Sweden has emphasised a clearer role for the military by reactivating total defence planning and by evolving common practices and processes with civil actors in civil defence. Meanwhile, Poland and Finland are increasing their focus on supporting the management of civil-military policies on safety and security regarding communication, authority, and developing coordination. Consistent with findings from previous reports on SCNM, civil-military relations are essential for EPM. This study confirmed the importance of civil-military coordination, the management and practice of authority, and shared forms of communication.

The use of emergency operations centres in local government emergency management

This paper presents exploratory research into how local government emergency operations centres (EOCs) are used during emergency management preparedness activities, through a questionnaire survey of 48 organisations from New Zealand, Canada, and USA. Analysis was framed by defining effective emergency management as a person–environment fit process in which both person (competence, response management system) and environment (e.g., need for multi–agency response, decision making about complex, evolving emergencies) characteristics should be modelled in training. Each organisation was unique in their approach and the extent their EOC was active during training. Training tended to focus on implementing the structural model (e.g., CIMS) and less on developing the competencies necessary for people to operate effectively at a tactical or coordinating level of emergency management. There was recognition of a need to further develop approaches to training, with 63% of organisations stating that they would like more guidance and advice in emergency management training.

Intelligent Campus Emergency Preparedness Managing Platform System

Considering the feasibility of the application of GIS technology and multimedia technology in campus emergency preparedness managing platform system, this paper discusses the overall design for visual campus emergency preparedness management system, where the principles of prevention and treatment for campus public emergency and this emergency preparedness visualization management system works are proposed. Then, various multimedia animation preparedness is realized by using Flash soft. By the way of analyzing various data of GIS, using professional software tool of GIS-MapInfo, taking Scilab as platform, we realize the functions of the intelligent electronic map design for HEU campus. This platform can enable visualized query and data searching, such as Eagle eye location, target finding, the shortest path searching, network communication and preparedness videos playing.

(A324) Emergency Management Preparedness and Response Planning in the US: Aphis Foreign Animal Disease Preparedness and Response Plan (FAD PREP)

BackgroundPreparing for and responding to foreign animal diseases are critical missions to safeguard any nation's animal health and food supply. A specific challenge of foreign animal disease preparedness and response is the ability to rapidly incorporate and scale-up veterinary functions and countermeasures into emergency management operations during a disease outbreak. The United States Department of Agriculture, Animal and Plant Health Inspection Service, Veterinary Services has established a Foreign Animal Disease Preparedness and Response Plan (FAD PReP) which provides a framework for FAD preparedness and response. The FAD PReP goal is to integrate, synchronize, and de-conflict preparedness and response capabilities, as much as possible, before an outbreak by providing goals, guidelines, strategies, and procedures that are clear, comprehensive, easily readable, easily updated, and that comply with the National Incident Management System (NIMS). An overview of FAD PReP will be presented.BodyThe APHIS FAD PReP incorporates and synchronizes the principles of the National Response Framework (NRF), the National Incident Management System (NIMS), and the National Animal Health Emergency Management System (NAHEMS). The FAD PReP contains general plans and disease specific plans that include incident goals, guidelines, strategies, procedures and timelines for local, State, Tribal and Federal responders. The FAD PReP helps raise awareness of the required veterinary functions and countermeasures, helps identify gaps or shortcomings in current response preparedness and planning, and helps to provide a framework to the States, Tribes, and Industry sectors in developing their individual response plans for specific diseases such as HPAI and FMD. The FAD PReP will also identify resources and personnel for potential zoonotic disease outbreaks and large-scale outbreaks, define stakeholder expectations for successful and timely outcomes, identify and resolve issues that may become competing interests during an outbreak and provide a systems approach to preparedness issues that need additional time, attention and collaboration.

Are We Ready and How Do We Know? The Urgent Need for Performance Metrics in Hospital Emergency Management

An extraordinary number of health care quality and patient safety indicators have been developed for hospitals and other health care institutions; however, few meaningful indicators exist for comprehensive assessment of hospital emergency management. Although health care institutions have invested considerable resources in emergency management preparedness, the need for universally accepted, evidence-based performance metrics to measure these efforts remains largely unfulfilled. We suggest that this can be remediated through the application of traditional health care quality paradigms, coupled with novel analytic approaches to develop meaningful performance data in hospital emergency management.

Integrating authorities and disciplines into the preparedness-planning process: A study of mental health, public health, and emergency management

The process of integrating all necessary authorities and disciplines into an organized preparedness plan is complex, and the inclusion of disaster mental health poses specific challenges. The goals of this project were (1) to identify whether state mental health preparedness was included in state public health and emergency management preparedness plans, (2) to document barriers to entry and strategies reportedly used by state authorities in efforts to incorporate reasonable mental health preparedness into existing public health and emergency management preparedness planning, (3) to employ a theory for organizational change to organize and synthesize this information, and (4) to stimulate further discussion and research supporting coordinated preparedness efforts at the state level, particularly those inclusive of mental health. To accomplish these goals we (1) counted the number of state public health preparedness and emergency management plans that either included, mentioned, or omitted a mental health preparedness plan; (2) interviewed key officials from nine representative states for their reports on strategies used in seeking greater inclusion of mental health preparedness in public health and emergency management preparedness planning; and (3) synthesized these results to contribute to the national dialogue on coordinating disaster preparedness, particularly with respect to mental health preparedness. We found that 15 out of 29 publicly available public health preparedness plans (52 percent) included mental health preparedness, and eight of 43 publicly available emergency management plans (18 percent) incorporated mental health. Interviewees reported numerous barriers and strategies, which we cataloged according to a well-accepted eight-step plan for transforming organizations.

Prevalence of medical emergencies in dental practices and emergency management preparedness of Thai dentists

Prevalence of medical emergencies in dental practices and emergency management preparedness of Thai dentists

Tularemia in New York City: When do we need to suspect bioterrorism?

ISSUE: Tularemia (Tu), known as rabbit fever, is a Category A agent of bioterrorism (BT). It was last seen in New York City (NYC) in 1998. This NYC medical center has been preparing for a BT event, and its emergency management preparedness program proved to be successful when a patient was admitted with Tu around the time of the Republican National Convention (RNC) being held in NYC. PROJECT: The medical center has been conducting nuclear, biologic and chemical (NBC) preparedness training since 2002 for all its healthcare workers (HCWs). The hospital emergency incident command system (HEIC) is used in the event of an emergency. NBC training provides education, communication, guidelines, and response plans to ensure safety and cooperation in the event of an attack. Our plan was tested when the diagnosis of Tu was made after the patient was discharged. RESULTS: A 20-year-old woman from Staten Island presented to the emergency department in August 2004 with an enlarged submandibular lymph node, pneumonia, and a pleural effusion. Pleural fluid and blood cultures grew gram-negative bacilli that were difficult to identify. Close cooperation with the NYC Department of Health identified the bacilli as Francisella tularensis . Because the case occurred around the time of the RNC and Tu is rare in NYC, there was concern as to whether this was a BT sentinel event. A thorough investigation revealed that the infection was naturally acquired. The patient's dog had captured a wild rabbit and then licked the woman's face. The woman survived, and no other cases were reported. Laboratory HCWs who handled the culture plates were contacted and evaluated for risk exposure. Antibiotic prophylaxis was deemed not necessary since specimens had not been handled by any HCW for almost 2 weeks. A fever watch was instituted and the laboratory HCWs were followed by employee health services. None developed any symptoms. LESSONS LEARNED: It is imperative to have an emergency plan in place. Our NBC training program allowed us to facilitate identification, apply precautions, alleviate fears, and communicate with all appropriate agencies in a timely and successful manner. NBC training also ensured that the laboratory had an employee roster with names and phone numbers readily available so that lab HCWs could be notified quickly—this was especially important since notification occurred on a Friday night.