Preparedness Competencies Research Articles

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.

Emergency Preparedness Nursing Education: Learner and Faculty Perspectives

Over the past decade, entry-to-practice emergency preparedness competencies have been identified as an essential component of nursing education. In this paper the author reports upon a small Canadian study which explores the perspective of undergraduate learners and faculty members who participated in and/or facilitated an Emergency Preparedness Simulation (EPS) module during a primary health care praxis course. The central purpose of this study was to explore the related experiences of learners and faculty who participated in or facilitated an Emergency Preparedness Simulation (EPS) module academic year and their perspectives on the effectiveness of the simulation in preparing learners to respond to emergencies in the future. The EPS module included a seminar followed by a mass-casualty simulation experience. The mass-casualty simulation experience included a “Teddy Bear” triage and an “Explosion” triage. The constructivist data analysis identified four related patterns for both the learner and faculty participants: Strengths (S), Objections (O), Suggestions (S), and Feelings (!) [SOS!]. Three themes were identified in each pattern: relevance, design, and engagement. In comparing the learner and faculty perspectives, there is a clear congruence between the strengths identified, the objections identified, and the power of feelings for both learners and faculty who participate in the emergency preparedness scenarios. Learners and faculty had different suggestions. Learners suggested more time on developing skills, particularly around first aid of individual clients, and recommended all students begin with the “Teddy Bear” triage. Faculty suggested a re-thinking of the “Explosion” triage simulation to emphasize community based emergency preparedness and responsiveness. Such re-focusing would support the integration of key primary health care principles and values including equity, social justice, and social determinants of health. Learners and faculty valued the EPS module and recommended it continue to be a learning component of the primary health care course.

재난관련 국내 간호연구 동향 분석

Purpose: This descriptive study was conducted in order to investigate the research trends of past nursing studies related to disasters in Korea, and to identify the direction of future research. Methods: Fifty studies conducted from July 1995 to June 2014 were analyzed according to general characteristics, disaster phase, disaster type, and research theme based on the four areas and 10 domains of the ICN Framework of Disaster Nursing Competencies. Results: The majority of studies were designed using quantitative methods (29). In disaster type, 12 studies explored natural disasters, and 14 explored manmade disasters. Disaster responders were the subject of 31 studies. In relation to research topics, the majority of studies were in the area of preparedness competencies of the ICN Framework (26). The studies were concentrated in the domain of education and preparedness (24). Conclusion: The total number of studies on disasters had increased over the years, while the topics failed to deal with all domains of the ICN Framework. The results indicate that the future direction of nursing research on disasters is to be vitalized through the flexibility of research design, systematic approach based on global perspectives, research on emergency responders and vulnerable people, and research relating to community-based disaster nursing.

Improving emergency preparedness system readiness through simulation and interprofessional education.

We applied emerging evidence in simulation science to create a curriculum in emergency response for health science students and professionals. Our research project was designed to (1) test the effectiveness of specific immersive simulations, (2) create reliable assessment tools for emergency response and team communication skills, and (3) assess participants' retention and transfer of skills over time. We collected both quantitative and qualitative data about individual and team knowledge, skills, and attitudes. Content experts designed and pilot-tested scaled quantitative tools. Qualitative evaluations administered immediately after simulations and longitudinal surveys administered 6-12 months later measured student participants' individual perceptions of their confidence, readiness for emergency response, and transfer of skills to their day-to-day experience. Results from 312 participants enrolled in nine workshops during a 24-month period indicated that the 10-hour curriculum is efficient (compared with larger-scale or longer training programs) and effective in improving skills. The curriculum may be useful for public health practitioners interested in addressing public health emergency preparedness competencies and Institute of Medicine research priority areas.

Preparedness and Emergency Response Learning Centers: supporting the workforce for national health security.

The importance of a competent and prepared national public health workforce, ready to respond to threats to the public's health, has been acknowledged in numerous publications since the 1980s. The Preparedness and Emergency Response Learning Centers (PERLCs) were funded by the Centers for Disease Control and Prevention in 2010 to continue to build upon a decade of focused activities in public health workforce preparedness development initiated under the Centers for Public Health Preparedness program (http://www.cdc.gov/phpr/cphp/). All 14 PERLCs were located within Council on Education for Public Health (CEPH) accredited schools of public health. These centers aimed to improve workforce readiness and competence through the development, delivery, and evaluation of targeted learning programs designed to meet specific requirements of state, local, and tribal partners. The PERLCs supported organizational and community readiness locally, regionally, or nationally through the provision of technical consultation and dissemination of specific, practical tools aligned with national preparedness competency frameworks and public health preparedness capabilities. Public health agencies strive to address growing public needs and a continuous stream of current and emerging public health threats. The PERLC network represented a flexible, scalable, and experienced national learning system linking academia with practice. This system improved national health security by enhancing individual, organizational, and community performance through the application of public health science and learning technologies to frontline practice.

“Skip the infection, get the injection”: A case study in emergency preparedness education

The frequency of natural and manmade disasters along with increasing potential for public health emergencies emphasizes the need for emergency preparedness education. Because nurses are the largest group of health professionals to meet the needs of those affected by disasters and public health emergencies, schools of nursing need to prepare graduates who are knowledgeable about disaster and public health emergency management. The use of core competencies may be a means to ensure consistent application of best practices in disaster health care. The next step in competency development involves validation through evidence. Through documentation and dissemination of their experiences with emergency preparedness education, schools of nursing can provide supportive evidence to aid in competency development. The purpose of this paper is present a case study of an ongoing and evolving public health nursing education project consistent with disaster health care and emergency preparedness competencies.

Factors affecting emergency preparedness competency of public health inspectors: a cross-sectional study in northeastern China

ObjectivesTo determine the emergency preparedness competency specific to public health inspectors (PHIs), preparedness limitations and needs of the workforce, as well as to identify important factors that affect the preparedness...

MONEY DEMAND UNDER UNCERTAINTY: RECENT EVIDENCE FROM THE EURO AREA

In times of financial turmoil and heightened risk perception, money could serve as a safeguard from potential losses. Against this background, we theoretically and empirically examine possible effects of uncertainty on currency in circulation. The empirical analysis is founded on a money-in-the-utility approach. As a main finding, uncertainty seems to contribute to the explanation increase in overall money demand in the euro area in recent years. ABSTRACT Since the mid-1980s, the members of the accounting profession have called for academics to emphasize the importance of nontechnical skills in the education of accountants. In this study, we surveyed 375 business students and 50 business professionals. The respondents were surveyed to determine their perceptions of the importance of knowledge, skills, and abilities (KSAs) necessary for success in the accounting profession. The overall results of the study suggest that the business professionals perceive the value of nontechnical skills higher than the students' perception. However, the analysis by discipline shows that the accounting students' perceptions of nontechnical skills and technical skills are not significantly different from the accounting professionals' perceptions. The statistical analysis of the responses indicated some differences across business disciplines and gender. The results of the study suggest that non-accounting students and male students may benefit from increased academic attention to nontechnical skills. The results may be helpful to academics as they design courses and class activities to emphasize the importance of nontechnical skills to success in accounting and to help students acquire these essential skills. ABSTRACT This research examines the effect of valuable accounting information specialization on decision making advantage in the new model. Whereas, best accounting system, accountant competency readiness and modern knowledge integration to become the antecedents of valuable information accounting specialization. The key research question is how valuable accounting information specialization affects

Disaster Management in the Era of Lean Healthcare

Disaster Management in the Era of Lean Healthcare

Public health preparedness and response competency model methodology

The Pandemic and All-Hazards Preparedness Act calls for establishing a competency-based training program to train public health practitioners. To inform such training, the Centers for Disease Control and Prevention and the Association of Schools of Public Health managed groups of experts to produce a competency model which could function as a national standard of behaviorally based, observable skills for the public health workforce to prevent, protect against, respond to, and recover from all hazards. A systematic review of existing competency models generated a competency model of proposed domains and competencies. National stakeholders were engaged to obtain consensus through a three-stage Delphi-like process. The Delphi-like process achieved 84 percent, 82 percent, and 79 percent response rates in its three stages. Three hundred sixty six unique individuals responded to the three-round process, with 45 percent (n = 166) responding to all three rounds. The resulting competency model features 18 competencies within four core learning domains targeted at midlevel public health workers. Practitioners and academics have adopted the Public Health Preparedness and Response Core Competency Model, some of whom have formed workgroups to develop curricula based on the model. Efforts will be needed to develop evaluation materials for training and education programs to refine the model as well as for future training and education initiatives.

(A32) Emergency Preparedness in Louisiana Nursing Programs – Response Roles, Impacts, and Competencies

IntroductionNurses are leaders and primary health responder/providers in natural, anthropic and technological disasters. Preparation and education for nursing emergency and disaster response should begin before nursing program graduation and before disaster events occur. In Louisiana, 17 federally-declared disaster declarations were experienced from 2000 – 2009, ranging from the Space Shuttle “Columbia” to Hurricane “Katrina”. This presentation overviews Louisiana nursing programs' disaster preparedness and operational planning as demonstrated to Louisiana's Schools of Nursing Aligned for Emergency Responsiveness (SAFER) Conference, New Orleans, 2010. Co-sponsored by Dillard University, Division of Nursing, New Orleans, and Northwestern State University, College of Nursing, Shreveport, the invitational conference brought expert nurse and physician preparedness speakers from federal, state and local venues to review disaster planning, experiences, needs, and nurse preparedness competencies with nurse faculty leadership.MethodsA multiple choice survey was developed, trialed and emailed to 42 Louisiana Nursing Programs. Programs surveyed included Associate degree, Bachelors and Graduate-level providers for Registered Nurses as well as Vocational Technical programs for the Licensed Practical Nurse. National Planning Scenario threat priorities; impacts of federally declared disasters on Louisiana nursing programs; nursing program roles in disaster; and awareness of nurse emergency preparedness competencies were queried.Results34 of 42 surveys were returned. 20 were complete. Nursing programs were located state-wide and found in 7 of 9 Louisiana regions. Surveyed programs offered a Bachelors degree (45%); Graduate degree (35%); Associate degree (35%) and vocational or Licensed Practical Nursing (35%).ConclusionsThe majority of Louisiana nursing programs and their health communities have been impacted by federally declared disasters. Coordinated efforts to improve nursing program preparedness education, roles and responsibility are warranted as vulnerability increases.

Emergency Preparedness Training of Tribal Community Health Representatives

This study describes the development and evaluation of online Public Health Emergency Preparedness (PHEP) training adapted to the learning styles and needs of tribal Community Health Representatives (CHRs). Working through a university-tribal community college partnership, the Arizona Center for Public Health Preparedness at the University of Arizona and Diné College of the Navajo Nation delivered a blended online and face-to-face public health preparedness certificate program based on core public health emergency preparedness competencies. This program was carefully adapted to meet the environmental and learning needs of the tribal CHRs. The certificate program was subsequently evaluated via a scenario-based decision-making methodology. Significant improvements in five of six competency areas were documented by comparison of pre- and post-certificate training testing. Based on statistical support for this pedagogical approach the cultural adaptations utilized in delivery of the certificate program appear to be effective for PHEP American Indian education.

일 병원 프리셉터의 학생 프리셉터쉽에 대한 인식 및 임상수행능력 준비도에 대한 간호학생과의 지각비교

Purpose: The purpose of this study was to investigate the perception of nursing student`s preceptorship and to compare the perception on the readiness of clinical competence between nurse preceptors and senior-level nursing students. Method: Data was collected with self-administered questionnaires and analyzed by descriptive statistics and t-test. Study participants were 65 preceptors in one university hospital and 59 nursing students in the same university. Result: The knowledge and satisfaction about preceptorship in the nurse preceptor was 2.66 and 2.70 out of 5. Most of the preceptors (70%) agreed to the students preceptorship program even though the intention to be a preceptor was very low (14.1%). They responded that the merits of student preceptorship were self-development (29.7%) and knowledge acquisition (29.7%), whereas the disadvantages were increased workload (67.2%) and increased stress (23.4%). Requested rewards were monetary reward (44.4%) and promotion (33.3%). In all areas of clinical competence readiness, students` perception score was higher than preceptors`. Conclusion: Nursing education must reexamine current approaches to clinical teaching and seek methods to better prepare future nurses. These findings may serve as a guide to create an ideal students preceptorship program to place a greater emphasis on the competencies desired for providing high quality nursing services.

A Review of Competencies Developed for Disaster Healthcare Providers: Limitations of Current Processes and Applicability

In order to prepare the healthcare system and healthcare personnel to meet the health needs of populations affected by disasters, educational programs have been developed by numerous academic institutions, hospitals, professional organizations, governments, and non-government organizations. Lacking standards for best practices as a foundation, many organizations and institutions have developed "core competencies" that they consider essential knowledge and skills for disaster healthcare personnel. The Nursing Section of the World Association for Disaster and Emergency Medicine (WADEM) considered the possibility of endorsing an existing set of competencies that could be used to prepare nurses universally to participate in disaster health activities. This study was undertaken for the purpose of reviewing published disaster health competencies to determine commonalities and universal applicability for disaster preparedness. In 2007, a review of the electronic literature databases was conducted using the major keywords: disaster response competencies; disaster preparedness competencies; emergency response competencies; disaster planning competencies; emergency planning competencies; public health emergency preparedness competencies; disaster nursing competencies; and disaster nursing education competencies. A manual search of references and selected literature from public and private sources also was conducted. Inclusion criteria included: English language; competencies listed or specifically referred to; competencies relevant to disaster, mass-casualty incident (MCI), or public health emergency; and competencies relevant to healthcare. Eighty-six articles were identified; 20 articles failed to meet the initial inclusion criteria; 27 articles did not meet the additional criteria, leaving 39 articles for analysis. Twenty-eight articles described competencies targeted to a specific profession/discipline, while 10 articles described competencies targeted to a defined role or function during a disaster. Four of the articles described specific competencies according to skill level, rather than to a specific role or function. One article defined competencies according to specific roles as well as proficiency levels. Two articles categorized disaster nursing competencies according to the phases of the disaster management continuum. Fourteen articles described specified competencies as "core" competencies for various target groups, while one article described "cross-cutting" competencies applicable to all healthcare workers. Hundreds of competencies for disaster healthcare personnel have been developed and endorsed by governmental and professional organizations and societies. Imprecise and inconsistent terminology and structure are evident throughout the reviewed competency sets. Universal acceptance and application of these competencies are lacking and none have been validated. Further efforts must be directed to developing a framework and standardized terminology for the articulation of competency sets for disaster health professionals that can by accepted and adapted universally.

Lessons learned from a pandemic influenza triage exercise in a 3D interactive multiuser virtual learning environment—Play2Train

Practicing drills and exercises to improve individual and team performance in real physical hospital settings often requires lockdown of the healthcare center, and effects on real patients are unpredictable. A virtual triage exercise was developed around a pandemic influenza scenario and was carried out in a 3D interactive virtual environment. Without putting real patients or participants at risk, the environment allowed geographically dispersed first responders and hospital staff to practice their roles in a common setting. The results showed that the exercise produced perceived improvements in preparedness competencies and team interactions.

Willingness of University Nursing Students to Volunteer During a Pandemic

The global threat of an influenza pandemic continues to grow and thus universities have begun emergency preparedness planning. This study examined stakeholder's knowledge, risk-perception, and willingness to volunteer. The design of this study is a cross-sectional survey. Questionnaires were sent to 1,512 nursing students and were returned by 484, yielding a response rate of 32% for this subgroup. Nursing students may be a much-needed human resource in the event of an influenza pandemic. The measurement tool was a Web-based questionnaire regarding pandemic influenza designed by a subgroup of researchers on the Public Health Response Committee. Most nursing students (67.9%) said they were likely to volunteer in the event of a pandemic if they were able to do so. An even higher number (77.4%) said they would volunteer if provided protective garments. Overall, 70.7% of students supported the proposition that nursing students have a professional obligation to volunteer during a pandemic. Nursing students indicated that they have had a wealth of volunteer experience in the past and they would apply this service ethic to a pandemic situation. Emergency preparedness competencies should be integrated into existing nursing curricula and other health science programs. University administrations need to engage in planning to create protocol for recruitment, practice, and protection of volunteers.

Building a System for Preparedness

The New York Consortium for Emergency Preparedness Continuing Education grew from clinician-oriented, Web-based continuing education developed with and primarily for clinicians associated with the New York Presbyterian Healthcare System. As the consortium expanded to reach all of New York State (and beyond, via the Web), courses originally developed at Columbia were transferred to a widely advertised Web site, and the content expanded. The National Education Strategy Team supplemental funds allowed New York Consortium for Emergency Preparedness Continuing Education to consider how to overcome one of the major challenges in emergency preparation, connectivity across all sectors, and levels of the public health community. We chose to use community health centers as paradigmatic of the challenge: the clinician needs emergency preparedness competencies, but if the site at which practice takes place has no plan, those skills will not be best used; if the practice site is not connected to the community-wide plan, capacity may be duplicated or unused. If clinician, practice and community all plan, train, and practice in a common framework, the community should be much more resilient in the face of emergencies of any dimension.

The Role of Public Health Nurses in Emergency Preparedness and Response: A Position Paper of the Association of State and Territorial Directors of Nursing

The Association of State and Territorial Directors of Nursing vision for emergency preparedness is that every community, family, and individual will have a comprehensive emergency preparedness plan that minimizes the consequences of disasters and emergencies, and enables communities, families, and individuals to respond and recover. This position paper provides national and state policy guidance during emergencies to all public health nurses in the United States and its Territories. Public health nurses bring critical experience to each phase of a disaster: mitigation, preparedness, response, and recovery. Public health nurses strive to achieve individual competencies so that they may better collaborate with others and contribute to emergency preparedness and response. Twelve Emergency Preparedness Competencies are listed in this position paper that will assist public health nurses with disaster prevention, planning, response, recovery, drills, exercises, and training. This position paper will be useful in clarifying the expertise that public health nurses can contribute to teams that serve to protect the health and safety of communities against disaster threats and realities.

State of emergency preparedness of Kentucky's rural public health workforce: assessing its ability to identify community health problems.

The author examined the emergency preparedness readiness of all workgroups within Kentucky's rural public health departments as it related to the 10 Essential Public Health Services. This article describes the results related to the three emergency preparedness competencies for the first Essential Public Health Service: the ability to monitor health status to identify community health problems. Onsite surveys were conducted in one urban and 93 rural Kentucky public health agencies during 2005 and 2006. Categorical data were analyzed using univariate and multivariate analysis techniques. The author compared responses to the level of confidence (LOC) and need for training (NFT) among the seven workgroup classifications. One thousand nine hundred ninety-four public health workers completed the surveys. Of these, 1,813 workers represented 55% of the state's rural local public health workforce. Kentucky's rural public health workforce can be described as predominantly Caucasian, female, and not planning to retire within the next five years. There were significant differences among workgroups for LOC and NFT for each competency examined. Across all workgroups, there was a mean LOC (58%) in the ability to describe the actions to take and procedures to follow in an emergency. There was a correspondingly higher mean perceived NFT (73%) for this competency. This study raises the question of whether we are adequately prepared to monitor our communities' health status. Further research that minimizes the limitations of self-reports and, instead, requires the worker to demonstrate the competency may provide a more accurate assessment of emergency preparedness.

An assessment of bioterrorism competencies among health practitioners in Australia

Public health and medical professionals are expected to be well prepared for emergencies, as they assume an integral role in any response. They need to be aware of planning issues, be able to identify their roles in emergency situations, and show functional competence. However, media perceptions and non-empirical publications often lack an evidence base when addressing this topic. This study attempted to assess the competencies of various health professionals by obtaining quantitative data on the state of bioterrorism preparedness and response competencies in Australia using an extensive set of competencies developed by Kristine Gebbie from the Columbia University School of Nursing Center for Health Policy with funding from the US Centres for Disease Control and Prevention. These competencies reflect the knowledge, capabilities, and skills that are necessary for best practice in public health. Sufficient data were collected to enable comparison between public health leaders, communicable disease specialists, clinicians (with and without medical degrees), and environmental health professionals. All health professionals performed well. However, the primary finding of this study was that clinicians consistently self-assessed themselves as lower in competence, and clinicians with medical degrees self-assessed themselves as the lowest in bioterrorism competence. This has important implications for health professional training, national benchmarks, standards, and competencies for the public health workforce.