Analysis of Emergency Health Care Workforce and Service Readiness for a Mass Casualty Event in the Republic of Ireland

2018 ◽  
Vol 13 (02) ◽  
pp. 243-255 ◽  
Author(s):  
Tener Goodwin Veenema ◽  
Fiona Boland ◽  
Declan Patton ◽  
Tom O’Connor ◽  
Zena Moore ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Response ◽  
Large Scale ◽  
Mass Casualty ◽  
Republic Of Ireland ◽  
Emergency Responders ◽  
Mass Casualty Event ◽  
Service Readiness ◽  
The Republic ◽  
Professional Disciplines

ABSTRACTObjectiveUltimately, a country’s capacity for a large-scale major emergency response will be directly related to the competence of its health care provider (HCP) workforce and communication between emergency responders and hospitals. The purpose of this study was to assess HCP preparedness and service readiness for a major emergency involving mass casualties (mass casualty event or MCE) in Ireland.MethodsA cross-sectional study using a 53-item survey was administered to a purposive sample of emergency responders and HCPs in the Republic of Ireland. Data collection was achieved using the Qualtrics® Research Suite. Descriptive statistics and appropriate tests of comparison between professional disciplines were conducted using Stata 13.ResultsA total of 385 respondents, registered nurses (43.4%), paramedics (37.9%), medical doctors (10.1%), and administrators/managers (8.6%), participated in the study. In general, a level of knowledge of MCEs and knowledge of clinical response activities and self-assessed clinical competence varied drastically across many aspects of the survey. Knowledge and confidence also varied across professional disciplines (P<0.05) with nurses, in general, reporting the least knowledge and/or confidence.ConclusionsThe results demonstrate that serious deficits exist in HCP knowledge, skills, and self-perceived abilities to participate in a large-scale MCE. Results also suggest a poor knowledge base of existing major emergency response plans. (Disaster Med Public Health Preparedness. 2019;13:243–255)

Postexposure Interventions to Prevent Infection With HBV, HCV, or HIV, and Tetanus in People Wounded During Bombings and Other Mass Casualty Events—United States, 2008: Recommendations of the Centers for Disease Control and Prevention and Disaster Medicine and Public Health Preparedness

2008 ◽  
Vol 2 (3) ◽  
pp. 150-165 ◽  
Author(s):  
Louisa E. Chapman ◽  
Ernest E. Sullivent ◽  
Lisa A. Grohskopf ◽  
Elise M. Beltrami ◽  
Joseph F. Perz ◽  
...  
Keyword(s):  
Public Health ◽  
Disease Control ◽  
Emergency Response ◽  
Mass Casualty ◽  
Acute Injury ◽  
Mass Casualties ◽  
Public Health Preparedness ◽  
Mass Casualty Event ◽  
Public Health Officials ◽  
Centers For Disease Control

ABSTRACTPeople wounded during bombings or other events resulting in mass casualties or in conjunction with the resulting emergency response may be exposed to blood, body fluids, or tissue from other injured people and thus be at risk for bloodborne infections such as hepatitis B virus, hepatitis C virus, human immunodeficiency virus, or tetanus. This report adapts existing general recommendations on the use of immunization and postexposure prophylaxis for tetanus and for occupational and nonoccupational exposures to bloodborne pathogens to the specific situation of a mass casualty event. Decisions regarding the implementation of prophylaxis are complex, and drawing parallels from existing guidelines is difficult. For any prophylactic intervention to be implemented effectively, guidance must be simple, straightforward, and logistically undemanding. Critical review during development of this guidance was provided by representatives of the National Association of County and City Health Officials, the Council of State and Territorial Epidemiologists, and representatives of the acute injury care, trauma, and emergency response medical communities participating in the Centers for Disease Control and Prevention’s Terrorism Injuries: Information, Dissemination and Exchange project. The recommendations contained in this report represent the consensus of US federal public health officials and reflect the experience and input of public health officials at all levels of government and the acute injury response community. (Disaster Med Public Health Preparedness. 2008;2:150–165)

Knowledge, confidence, skills and practices among midwives in the republic of Ireland in relation to perinatal mental health care: The mind mothers study

Midwifery ◽  
2018 ◽  
Vol 64 ◽  
pp. 29-37 ◽  
Author(s):  
Margaret Carroll ◽  
Carmel Downes ◽  
Ailish Gill ◽  
Mark Monahan ◽  
Ursula Nagle ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Perinatal Mental Health ◽  
Republic Of Ireland ◽  
The Republic ◽  
The Mind

scholarly journals DairyWater: striving for sustainability within the dairy processing industry in the Republic of Ireland

2018 ◽  
Vol 85 (3) ◽  
pp. 366-374 ◽  
Author(s):  
William Finnegan ◽  
Eoghan Clifford ◽  
Jamie Goggins ◽  
Niall O'Leary ◽  
Alan Dobson ◽  
...  
Keyword(s):  
Wastewater Treatment ◽  
Large Scale ◽  
Energy Use ◽  
Rainwater Harvesting ◽  
Batch Reactor ◽  
Dairy Wastewater ◽  
Processing Industry ◽  
Republic Of Ireland ◽  
Dairy Processing ◽  
The Republic

This Review describes the objectives and methodology of the DairyWater project as it aims to aid the Irish dairy processing industry in achieving sustainability as it expands. With the abolition of European milk quotas in March 2015, the Republic of Ireland saw a surge in milk production. The DairyWater project was established in anticipation of this expansion of the Irish dairy sector in order to develop innovative solutions for the efficient management of water consumption, wastewater treatment and the resulting energy use within the country's dairy processing industry. Therefore, the project can be divided into three main thematic areas: dairy wastewater treatment technologies and microbial analysis, water re-use and rainwater harvesting and environmental assessment. In order to ensure the project remains as relevant as possible to the industry, a project advisory board containing key industry stakeholders has been established. To date, a number of large scale studies, using data obtained directly from the Irish dairy industry, have been performed. Additionally, pilot-scale wastewater treatment (intermittently aerated sequencing batch reactor) and tertiary treatment (flow-through pulsed ultraviolet system) technologies have been demonstrated within the project. Further details on selected aspects of the project are discussed in greater detail in the subsequent cluster of research communications.

Challenge of Hospital Emergency Preparedness: Analysis and Recommendations

2009 ◽  
Vol 3 (S1) ◽  
pp. S74-S82 ◽  
Author(s):  
Joseph A. Barbera ◽  
Dale J. Yeatts ◽  
Anthony G. Macintyre
Keyword(s):  
Public Health ◽  
United States ◽  
Health Care ◽  
Natural Disasters ◽  
Emergency Response ◽  
Emergency Preparedness ◽  
Large Scale ◽  
The United States ◽  
Public Health Care ◽  
Medical Emergency

ABSTRACTIn the United States, recent large-scale emergencies and disasters display some element of organized medical emergency response, and hospitals have played prominent roles in many of these incidents. These and other well-publicized incidents have captured the attention of government authorities, regulators, and the public. Health care has assumed a more prominent role as an integral component of any community emergency response. This has resulted in increased funding for hospital preparedness, along with a plethora of new preparedness guidance.Methods to objectively measure the results of these initiatives are only now being developed. It is clear that hospital readiness remains uneven across the United States. Without significant disaster experience, many hospitals remain unprepared for natural disasters. They may be even less ready to accept and care for patient surge from chemical or biological attacks, conventional or nuclear explosive detonations, unusual natural disasters, or novel infectious disease outbreaks.This article explores potential reasons for inconsistent emergency preparedness across the hospital industry. It identifies and discusses potential motivational factors that encourage effective emergency management and the obstacles that may impede it. Strategies are proposed to promote consistent, reproducible, and objectively measured preparedness across the US health care industry. The article also identifies issues requiring research. (Disaster Med Public Health Preparedness. 2009;3(Suppl 1):S74–S82)

scholarly journals The cost associated with disease-related malnutrition in Ireland

2012 ◽  
Vol 15 (10) ◽  
pp. 1966-1972 ◽  
Author(s):  
Niamh Rice ◽  
Charles Normand
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Large Scale ◽  
Social Care ◽  
Health Care Utilisation ◽  
Increased Risk ◽  
Health And Social Care ◽  
The Republic ◽  
The Uk ◽  
The Cost

AbstractObjectiveThe present study aimed to establish the annual public expenditure arising from the health and social care of patients with diet-related malnutrition (DRM) in the Republic of Ireland.DesignCosts were calculated by (i) estimating the prevalence of DRM in health-care settings derived from age-standardised comparisons between available Irish data and large-scale UK surveys and (ii) applying relevant costs from official sources to estimates of health-care utilisation by adults with DRM. No attempt has been made to estimate separately the costs of DRM and any associated disease, since each can be a cause or consequence of the other. The methods used are adapted from an evaluation of the cost of malnutrition in the UK by the British Association for Parenteral and Enteral Nutrition (2009).SettingsHospitals, nursing homes, out-patient clinics, primary-care clinics and home care.SubjectsAll adult patients receiving hospital in-patient, out-patient or specified community health-care services.ResultsThe annual public health and social care cost associated with adult malnourished patients in Ireland is estimated at over €1·4 billion, representing 10 % of the health-care budget. Most of this cost arises in acute hospital or residential care settings (i.e. 70 %), with nutritional support estimated to account for <3 % of spend.ConclusionsThe cost associated with the care of patients with DRM is substantial and may rise as the proportion of older people within the population increases, a group at increased risk of DRM. Despite growing pressure on health-care budgets, little attention has been focused on the economic burden associated with DRM in Ireland or the potential for savings arising from improved detection and treatment of those at risk.

Persistent stigma despite social change: experiences of stigma among single women who were pregnant or mothers in the Republic of Ireland 1996–2010

2020 ◽  
Author(s):  
Ciara Bradley ◽  
Michelle Millar
Keyword(s):  
Social Change ◽  
Lived Experience ◽  
Large Scale ◽  
Single Women ◽  
Republic Of Ireland ◽  
Social Lives ◽  
Symbolic Resources ◽  
The Social ◽  
The Republic ◽  
Interpretive Method

‘Single’ women continue to experience stigma during pregnancy and mothering in the Republic of Ireland. This article explores the experiences of stigma of single women who were pregnant and mothering in Ireland between 1996 and 2010. The biographic narrative interpretive method (BNIM) was used to elicit biographical narratives. Analysis on both the lived experience of the women and the social context of the time created a ‘situated subjectivity’ in a sociocultural context. This article argues that despite large-scale positive social change before and during this period, single women’s pregnancy and motherhood continued to be to be stigmatised in Ireland. Women experienced this stigma in their everyday interactions. They negotiated stigma in their personal and social lives, employing strategies that drew on material and symbolic resources available to them. Social class, ethnicity and time were among factors that mediate the experience, but can also intersected in particular social locations to create a more stigmatised identity.

Factors Influencing the Prioritization of Injured Patients for Transfer to a Burn or Trauma Center Following a Mass Casualty Event

2020 ◽  
pp. 1-8
Author(s):  
Elizabeth A. Lancet ◽  
Wei Wei Zhang ◽  
Patricia Roblin ◽  
Bonnie Arquilla ◽  
Rachel Zeig-Owens ◽  
...  
Keyword(s):  
New York ◽  
Large Scale ◽  
Local Community ◽  
Injury Severity ◽  
Community Hospital ◽  
Clinical Information ◽  
Mass Casualty ◽  
Patient Profile ◽  
Mass Casualty Event ◽  
Consultation Team

ABSTRACT Objectives: In New York City, a multi-disciplinary Mass Casualty Consultation team is proposed to support prioritization of patients for coordinated inter-facility transfer after a large-scale mass casualty event. This study examines factors that influence consultation team prioritization decisions. Methods: As part of a multi-hospital functional exercise, 2 teams prioritized the same set of 69 patient profiles. Prioritization decisions were compared between teams. Agreement between teams was assessed based on patient profile demographics and injury severity. An investigator interviewed team leaders to determine reasons for discordant transfer decisions. Results: The 2 teams differed significantly in the total number of transfers recommended (49 vs 36; P = 0.003). However, there was substantial agreement when recommending transfer to burn centers, with 85.5% agreement and inter-rater reliability of 0.67 (confidence interval: 0.49–0.85). There was better agreement for patients with a higher acuity of injuries. Based on interviews, the most common reason for discordance was insider knowledge of the local community hospital and its capabilities. Conclusions: A multi-disciplinary Mass Casualty Consultation team was able to rapidly prioritize patients for coordinated secondary transfer using limited clinical information. Training for consultation teams should emphasize guidelines for transfer based on existing services at sending and receiving hospitals, as knowledge of local community hospital capabilities influence physician decision-making.

Health Care Emergency Management: Establishing the Science of Managing Mass Casualty and Mass Effect Incidents

2009 ◽  
Vol 3 (S1) ◽  
pp. S52-S58 ◽  
Author(s):  
Anthony G. Macintyre ◽  
Joseph A. Barbera ◽  
Peter Brewster
Keyword(s):  
Health Care ◽  
Emergency Management ◽  
Emergency Response ◽  
Mass Effect ◽  
Mass Casualty ◽  
Conceptual Approach ◽  
Health Care Administrators ◽  
Emergency Response System ◽  
Care Integration ◽  
Security Personnel

ABSTRACTParticularly since 2001, the health care industry has witnessed many independent and often competing efforts to address mitigation and preparedness for emergencies. Clinicians, health care administrators, engineers, safety and security personnel, and others have each developed relatively independent efforts to improve emergency response. A broader conceptual approach through the development of a health care emergency management profession should be considered to integrate these various critical initiatives. When based on long-standing emergency management principles and practices, health care emergency management provides standardized, widely accepted management principles, application concepts, and terminology. This approach could also promote health care integration into the larger community emergency response system. The case for a formally defined health care emergency management profession is presented with discussion points outlining the advantages of this approach. (Disaster Med Public Health Preparedness. 2009;3(Suppl 1):S52–S58)

A multi-objective location-allocation model in mass casualty events response

2018 ◽  
Vol 13 (1) ◽  
pp. 236-274 ◽  
Author(s):  
Mahsa Pouraliakbarimamaghani ◽  
Mohammad Mohammadi ◽  
Abolfazl Mirzazadeh
Keyword(s):  
Genetic Algorithm ◽  
Health Care ◽  
Emergency Operation ◽  
Mass Casualty ◽  
Nsga Ii ◽  
Content Type ◽  
Multi Objective ◽  
Mass Casualty Event ◽  
Personnel Shortages ◽  
Injured Patients

Purpose When designing an optimization model for use in a mass casualty event response, it is common to encounter the heavy and considerable demand of injured patients and inadequate resources and personnel to provide patients with care. The purpose of this study is to create a model that is more practical in the real world. So the concept of “predicting the resource and personnel shortages” has been used in this research. Their model helps to predict the resource and personnel shortages during a mass casualty event. In this paper, to deal with the shortages, some temporary emergency operation centers near the hospitals have been created, and extra patients have been allocated to the operation center nearest to the hospitals with the purpose of improving the performance of the hospitals, reducing congestion in the hospitals and considering the welfare of the applicants. Design/methodology/approach The authors research will focus on where to locate health-care facilities and how to allocate the patients to multiple hospitals to take into view that in some cases of emergency situations, the patients may exceed the resource and personnel capacity of hospitals to provide conventional standards of care. Findings In view of the fact that the problem is high degree of complexity, two multi-objective meta-heuristic algorithms, including non-dominated sorting genetic algorithm (NSGA-II) and non-dominated ranking genetic algorithm (NRGA), were proposed to solve the model where their performances were compared in terms of four multi-objective metrics including maximum spread index (MSI), spacing (S), number of Pareto solution (NPS) and CPU run-time values. For comparison purpose, paired t-test was used. The results of 15 numerical examples showed that there is no significant difference based on MSI, S and NPS metrics, and NRGA significantly works better than NSGA-II in terms of CPU time, and the technique for the order of preference by similarity to ideal solution results showed that NRGA is a better procedure than NSGA-II. Research limitations/implications The planning horizon and time variable have not been considered in the model, for example, the length of patients’ hospitalization at hospitals. Practical implications Presenting an effective strategy to respond to a mass casualty event (natural and man-made) is the main goal of the authors’ research. Social implications This paper strategy is used in all of the health-care centers, such as hospitals, clinics and emergency centers when dealing with disasters and encountering with the heavy and considerable demands of injured patients and inadequate resources and personnel to provide patients with care. Originality/value This paper attempts to shed light onto the formulation and the solution of a three-objective optimization model. The first part of the objective function attempts to maximize the covered population of injured patients, the second objective minimizes the distance between hospitals and temporary emergency operation centers and the third objective minimizes the distance between the warehouses and temporary centers.

scholarly journals The Psychosocial Impact of Compounding Humanitarian Crises Caused by War and COVID-19 Informing Future Disaster Response

2021 ◽  
pp. 1-5
Author(s):  
Hakob Harutyunyan ◽  
Artak Mukhaelyan ◽  
Attila J. Hertelendy ◽  
Amalia Voskanyan ◽  
Todd Benham ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Disaster Response ◽  
Large Scale ◽  
Health Care Systems ◽  
Influenza Pandemic ◽  
Care Workers ◽  
Care Systems ◽  
The Republic ◽  
1918 Influenza

Abstract The coronavirus disease 2019 (COVID-19) pandemic has caused the greatest global loss of life and economic impact due to a respiratory virus since the 1918 influenza pandemic. While health care systems around the world faced the enormous challenges of managing COVID-19 patients, health care workers in the Republic of Armenia were further tasked with caring for the surge of casualties from a concurrent, large-scale war. These compounding events put a much greater strain on the health care system, creating a complex humanitarian crisis that resulted in significant psychosocial consequences for health care workers in Armenia.

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