Disaster preparedness: A concept analysis and its application to the intensive care unit

Author(s):  
David Sellers ◽  
Julia Crilly ◽  
Jamie Ranse
Author(s):  
Catherine Larocque ◽  
Wendy E. Peterson ◽  
Janet E. Squires ◽  
Martha Mason-Ward ◽  
Kelli Mayhew ◽  
...  

2015 ◽  
Vol 71 (7) ◽  
pp. 1499-1517 ◽  
Author(s):  
Samantha Jakimowicz ◽  
Lin Perry

2020 ◽  
Vol 29 (2) ◽  
pp. 111-121 ◽  
Author(s):  
Elizabeth G. Broden ◽  
Janet Deatrick ◽  
Connie Ulrich ◽  
Martha A.Q. Curley

Background Societal attitudes about end-of-life events are at odds with how, where, and when children die. In addition, parents’ ideas about what constitutes a “good death” in a pediatric intensive care unit vary widely. Objective To synthesize parents’ perspectives on end-of-life care in the pediatric intensive care unit in order to define the characteristics of a good death in this setting from the perspectives of parents. Methods A concept analysis was conducted of parents’ views of a good death in the pediatric intensive care unit. Empirical studies of parents who had experienced their child’s death in the inpatient setting were identified through database searches. Results The concept analysis allowed the definition of antecedents, attributes, and consequences of a good death. Empirical referents and exemplar cases of care of a dying child in the pediatric intensive care unit serve to further operationalize the concept. Conclusions Conceptual knowledge of what constitutes a good death from a parent’s perspective may allow pediatric nurses to care for dying children in a way that promotes parents’ coping with bereavement and continued bonds and memories of the deceased child. The proposed conceptual model synthesizes characteristics of a good death into actionable attributes to guide bedside nursing care of the dying child.


Author(s):  
Ramon E. Gist ◽  
Pia Daniel ◽  
Nizar Tejani ◽  
Andrew Grock ◽  
Adam Aluisio ◽  
...  

Abstract Objective: The aim of this study was to implement pediatric vertical evacuation disaster training and evaluate its effectiveness by using a full-scale exercise to compare outcomes in trained and untrained participants. Methods: Various clinical and nonclinical staff in a tertiary care university hospital received pediatric vertical evacuation training sessions over a 6-wk period. The training consisted of disaster and evacuation didactics, hands-on training in use of evacuation equipment, and implementation of an evacuation toolkit. An unannounced full-scale simulated vertical evacuation of neonatal intensive care unit (NICU) and pediatric intensive care unit (PICU) patients was used to evaluate the effectiveness of the training. Drill participants completed a validated evaluation tool. Pearson chi-squared testing was used to analyze the data. Results: Eighty-four evaluations were received from drill participants. Forty-three (51%) of the drill participants received training and 41 (49%) did not. Staff who received pediatric evacuation training were more likely to feel prepared compared with staff who did not (odds ratio, 4.05; confidence interval: 1.05-15.62). Conclusions: There was a statistically significant increase in perceived preparedness among those who received training. Recently trained pediatric practitioners were able to achieve exercise objectives on par with the regularly trained emergency department staff. Pediatric disaster preparedness training may mitigate the risks associated with caring for children during disasters.


2020 ◽  
Author(s):  
Kobra Ghorbanzadeh ◽  
Abbas Ebadi ◽  
Mohammadali Hosseini ◽  
Sadat Madah ◽  
hamidreza Khankeh

Abstract Background: Transition in the health system is associated with the movement of the patient between clinical units and between hospitals, This is a complex process with several potential challenges including medical errors, adverse events, increased costs and patient dissatisfaction. Evidence shows that there is a need for greater clarity regarding the concept of transition. Objectives: The present Study was conducted to clarify the core elements of transition in patients admitted to the ICU.Methods: Walker and Avant's eight-step model was used to guide this concept analysis to provid a comprehensive definition of transition. A Literature search was conducted on CINAHL, Scopus, Pubmed, and Google scholar using the following keywords: transition, intensive care unit, transition care, patient transfer and transition process. Thus, after an extensive review of resources published in the years 2000-2020, articles related to this concept were examined based on the inclusion criteria. Definitions, properties, applications, consequences and empirical references of the concept of transition were extracted.Results: Transition is a complex, multifaceted concept with defining attributes: Critical points and events, disturb normal life, passage of change, instability and un-anticipated changes, Multiple needs, Inadequate continuity of care, Poor coordination of care and communication among health care providers, patients and families, multiple factor, multiple professionals, Awareness, Engagement And Adaptation. The differences in the response to transition according to the patient's condition or position (beliefs, attitudes, socioeconomic status, willingness and knowledge) and environmental conditions (the status of communication and support from the community) lead to the development of confidence, adaptation, recovery from critical illness and return to normal life or disability and other complications.Conclusion: The transition is a process of progressive change and the adaptation requires training and environmental changes to improve and develop new skills for transition. Nurses play a supportive and complementary role in successful transition of patients. Therefore, studies need to focuse on the evaluation of nurses' perceptions of patient transition and the consequences and outcomes. The result of this study provide a definition of transition that is relevant and useful for clinical research and practice in healthcare setting.


Author(s):  
Nitin Kuppanda ◽  
Joelle Simpson ◽  
Lamia Soghier

Abstract Objective: To assess the level of neonatal intensive care unit (NICU) disaster preparedness among pediatric residents. Methods: A mixed-methods study including qualitative interviews and quantitative surveys was used. Interviews guided survey development. Surveys were distributed to residents who rotated through Children’s National NICU. Questions assessed residents’ background in disaster preparedness, disaster protocol knowledge, NICU preparedness, roles during surge and evacuation, and views on training and education. Results: Survey response was 62.5% (n = 80) with 51.3% of invited residents completing it. Pediatric residents (PGY-2 and PGY-3) (n = 41) had low levels of individual disaster preparedness, particularly evacuations (86%). None were aware of specific NICU disaster protocols. Patient acuity, role ambiguity, knowledge, and training deficits were major contributors to unpreparedness. Residents viewed their role as system facilitators (eg, performing duties assigned, recruiting other residents, and clerical work like documentation). Resident training requests included disaster preparedness training every NICU rotation (48%) using multidisciplinary simulations (66%), role definition (56%), and written protocols (50%). Despite their unpreparedness, residents (84%) were willing to respond. Conclusion: Pediatric residents lacked knowledge of NICU disaster response but were willing to respond to disasters. Training should include multi-disciplinary simulations that can be refined iteratively to clarify roles, and residents should be involved in planning and execution.


2013 ◽  
Vol 28 (5) ◽  
pp. 441-444 ◽  
Author(s):  
Walter Valesky ◽  
Patricia Roblin ◽  
Brijal Patel ◽  
John Adelaine ◽  
Shahriar Zehtabchi ◽  
...  

AbstractBackgroundMethods of defining hospital disaster preparedness are poorly defined in the literature, leaving wide discrepancies between a hospital's self-reported preparedness and that assessed by an objective reviewer.ObjectivesThis study compared self-reported surge capacity data from individual hospitals, obtained from a previously reported long-distance tabletop drill (LDTT) prior to the 2010 FIFA World Cup tournament in Cape Town, South Africa, with surge capacity data assessed by an on-site survey inspection team.MethodsIn this prospective, observational study, contact persons used in the prior LDTT assessing hospital disaster preparedness in the lead-up to the 2010 FIFA World Cup made surge capacity assessments (licensed bed capacity plus surge capacity beds) for the respiratory intensive care unit (RICU), neonatal intensive care unit (NICU), medical intensive care unit (MICU), and general medical/surgical beds in each hospital. Following the 2010 World Cup, this data was then re-evaluated by an on-site survey team consisting of two of the authors.ResultsThe contact persons for the individual hospitals from the LDTT underreported their individual hospital's surge capacity in 86% (95% CI, 46%-99%) of RICU beds; 100% (95% CI, 63%-100%) of MICU beds; 75% (95% CI, 40%-94%) of NICU beds; and 71% (95% CI, 35%-92%) of medical/surgical beds compared with the on-site inspection team.ConclusionsThe contact persons for the LDTT overwhelmingly underreported surge capacity beds compared with the surge capacity determined by the on-site inspection team.ValeskyW, RoblinP, PatelB, AdelaineJ, ZehtabchiS, ArquillaB. Assessing hospital preparedness: comparison of an on-site survey with a self-reported, Internet-based, long-distance tabletop drill. Prehosp Disaster Med. 2013;28(4):1-4.


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