Assessing Levels of Hospital Emergency Preparedness

2006 ◽  
Vol 21 (6) ◽  
pp. 451-457 ◽  
Author(s):  
Bruria Adini ◽  
Avishay Goldberg ◽  
Danny Laor ◽  
Robert Cohen ◽  
Roni Zadok ◽  
...  
Keyword(s):  
Emergency Preparedness ◽  
Acute Stress ◽  
Objective Assessment ◽  
Mass Casualty ◽  
Assessment Tools ◽  
Stress Reactions ◽  
Emergency Plan ◽  
Effective Response ◽  
Contingency Plans ◽  
High Level

AbstractIntroduction:Emergency preparedness can be defined by the preparedness pyramid, which identifies planning, infrastructure, knowledge and capabilities, and training as the major components of maintaining a high level of preparedness.The aim of this article is to review the characteristics of contingency plans for mass-casualty incidents (MCIs) and models for assessing the emergency preparedness of hospitals.Characteristics of Contingency Plans:Emergency preparedness should focus on community preparedness, a personnel augmentation plan, and communications and public policies for funding the emergency preparedness. The capability to cope with a MCI serves as a basis for preparedness for non-conventional events. Coping with chemical casualties necessitates decontamination of casualties, treating victims with acute stress reactions, expanding surge capacities of hospitals, and integrating knowledge through drills. Risk communication also is important.Assessment of Emergency Preparedness:An annual assessment of the emergency plan is required in order to assure emergency preparedness. Preparedness assessments should include: (1) elements of disaster planning; (2) emergency coordination; (3) communication; (4) training; (5) expansion of hospital surge capacity; (6) personnel; (7) availability of equipment; (8) stockpiles of medical supplies; and (9) expansion of laboratory capacities. The assessment program must be based on valid criteria that are measurable, reliable, and enable conclusions to be drawn. There are several assessment tools that can be used, including surveys, parameters, capabilities evaluation, and self-assessment tools.Summary:Healthcare systems are required to prepare an effective response model to cope with MCIs. Planning should be envisioned as a process rather than a production of a tangible product. Assuring emergency preparedness requires a structured methodology that will enable an objective assessment of the level of readiness.

scholarly journals (A284) Improving Hospital Mass Casualty Preparedness through Ongoing Readiness Evaluation

2011 ◽  
Vol 26 (S1) ◽  
pp. s79-s79
Author(s):  
B. Adini ◽  
D. Laor ◽  
T. Hornik-Luria ◽  
A. Goldberg ◽  
D. Schwartz ◽  
...  
Keyword(s):  
Acute Care ◽  
Emergency Preparedness ◽  
Life Experience ◽  
Real Life ◽  
High Standard ◽  
Acute Care Hospitals ◽  
Mass Casualty ◽  
Evaluation Tool ◽  
Effective Response ◽  
Mass Casualty Event

BackgroundIsraeli Hospitals are required to maintain a high level of emergency preparedness.ObjectivesTo investigate the effect of on-going use of an evaluation tool on acute-care hospitals' emergency preparedness for mass casualty events (MCE).MethodsEvaluation of emergency preparedness for MCE was carried out in all acute-care hospitals, based on an evaluation tool consisting of 306 objective and measurable parameters. Two cycles of evaluations were conducted in 2005 to 2009 and the scores were calculated to detect differences.ResultsA significant increase was found in the mean total scores of emergency preparedness between the two cycles of evaluations (from 77.1 to 88.5). An increase was found in scores for standard operating procedures, training and equipment, but the change was significant only in the training category. The relative increase was highest in hospitals that did not experience real MCE.DiscussionThis study offers a structured and practical approach for ongoing improvement of emergency preparedness, based on validated measurable benchmarks. An ongoing assessment of the level of emergency preparedness motivates hospitals' management and staff to improve their capabilities and thus results in a more effective response mechanism for emergency scenarios.ConclusionsUtilization of predetermined and measurable benchmarks allows the institutions being assessed to improve their level of performance in the evaluated areas. The expectation is that these benchmarks will allow for a better response to actual MCEs. The study further demonstrated that even hospitals without “real-life” experience can gear up using preset benchmarks and reach a high standard of mass casualty event preparedness.

scholarly journals Improving Monitoring and Evaluation Activities in High Education

2019 ◽  
Vol 8 (9) ◽  
pp. 2061-2067
Keyword(s):  
High Education ◽  
Objective Assessment ◽  
Monitoring And Evaluation ◽  
Assessment Tools ◽  
Educational Institutions ◽  
Global Changes ◽  
Pedagogical Competence ◽  
Assessment Activity ◽  
High Level ◽  
High Educational

At present, global changes are taking place in the system of high education. They are the result of, firstly, serious socio-economic transformations in society, and secondly, integration processes that have occurred in the European educational space. Under these conditions, the issue of the quality of education did not lose its relevance, but also acquired new facets. The level of students’ training in high educational institutions requires an objective assessment at high level. Since modernization of educational space is a difficult and long process, high education institutions must constantly look for new tools, methods and technologies for evaluating the results of educational activities. Professional and pedagogical competence of teachers in the framework of modern system of high education requires constant improvement. The argument for using new methods is that they comprehensively assess emerging competencies. In turn, for the most efficient use of the methods traditionally used, it is necessary to carry out a phased improvement of traditional means of control. To this end, the authors investigated the issue of improving control and appraisal activities in Nizhny Novgorod State Pedagogical University named after Kozma Minin. The aim of the work is to develop a model of teacher’s control and assessment activity in the context of competence approach implementation. The verification of the model was carried out with the help of the research of completion level of qualifying work done by students. The verification was carried out in two stages: before the introduction of the model in 2017 and after the introduction of the model in 2018. The main results and conclusions of the work can be used in development of control and assessment tools for mastering competencies of students of high educational institutions.

Assessing Acute Traumatic Stress Symptoms

2012 ◽  
pp. 249-261
Author(s):  
Richard A. Bryant
Keyword(s):  
Posttraumatic Stress ◽  
Acute Phase ◽  
Acute Stress ◽  
Traumatic Event ◽  
Assessment Tools ◽  
Self Report ◽  
Current Evidence ◽  
Stress Reactions ◽  
Psychological States ◽  
Acute Period

There is significant change in acute stress reactions in the weeks after exposure to a traumatic event, which raises challenges for assessing the responses in the acute posttraumatic period. This chapter reviews the assessment tools and strategies that are appropriate in the acute period. It focuses initially on acute stress disorder (ASD) as a description of acute posttraumatic stress and as a predictor of subsequent PTSD. Psychometrically-validated scales are reviewed for both diagnostic and symptom responses in the acute period, with a critique of the limited ability of these measures to identify most people who are at high risk for subsequent PTSD. Finally, this chapter identifies mechanisms that may enhance our ability to identify maladaptive responses in the acute phase, and specific populations that need particular attention in the immediate period following trauma exposure. The weeks following exposure to a traumatic event are often characterized by considerable distress, fluctuating emotions, and changing environmental factors. This lack of emotional and contextual stability raises significant challenges for assessment of psychological states shortly after trauma. This chapter aims to provide an overview of assessment of psychological responses in the weeks after trauma. It commences with a review of the current evidence about the nature of acute posttraumatic stress reactions and discusses the different goals of assessment at this stage. Established psychometric instruments are then reviewed, including structured clinical interviews, self-report measures, and other tools relevant to acute reactions. The review then turns to other factors that can be assessed, including cognitive and biological factors, occurring in the acute posttraumatic period. Finally, the chapter outlines other procedural issues that need to be considered when assessing trauma survivors in the acute phase.

scholarly journals A Case of Acute Stress in Post-hypnotized Patient

2021 ◽  
Vol 9 (T3) ◽  
pp. 13-15
Author(s):  
Cut Rika Pratiwi ◽  
Elmeida Effendy ◽  
Muhammad Surya Husada
Keyword(s):  
Traumatic Stress ◽  
Stress Disorder ◽  
Acute Stress ◽  
Psychological Symptoms ◽  
Traumatic Event ◽  
Brain Regions ◽  
Human Mind ◽  
Stress Reactions ◽  
Post Traumatic Stress ◽  
High Level

Background: Mental health conditions that can occur immediately after a traumatic event is called acute stress reaction; in this case, happens after hypnosis. This can cause a variety of psychological symptoms without attention or treatment, causesost-traumatic stress disorder. The psychological symptoms can negatively affect the quality of life, especially the reactions arise after a traumatic event that after being hypnotized. Hypnosis works by changing the activity in brain regions associated with attention or alertness. At the time hypnotised, we saw a very high level of concentration, so that suggestions given to him will be more easily accepted. Case Report: The case presented is the hypnotic impact of acute stress reactions. A woman named Mrs. J 63 years old. The Karo tribe who experienced anxiety, fear, and difficulty sleeping after experiencing hypnosis four days ago. This experienced it after being hypnotized at home. Conclusion: Hypnosis plays a role in all parts of life involving human mind. Hypnosis is a science that exploits the potential mental and hidden in humans, known as the subconscious. in medical health, hypnosis therapy is very important, what we need to realize is that hypnosis with bad intentions can harm humans. Hypnosis incident was reported in patients who suffer from post traumatic stress disorder. found in many women. older women are more vulnerable to acute stress. Previous research has shown that hypnotic susceptibility correlated with personality traits.

Mental disturbances in patients with acute medical condition

2016 ◽  
Vol 33 (S1) ◽  
pp. S381-S381
Author(s):  
B. Fedak
Keyword(s):  
Acute Stress ◽  
Medical Condition ◽  
Integrative Model ◽  
Stress Reactions ◽  
Main Research ◽  
Mental Disturbances ◽  
Structured Analysis ◽  
Competing Interest ◽  
Ischemic Attack ◽  
High Level

Contemporary remains understudied health issue - the psychological aspect of the acute therapeutic diseases problem. Among the most common diseases - coronary heart disease (CHD), myocardial infarction (MI), crisis states in patients with arterial hypertension (AH), transient ischemic attack (TIA) and acute stroke (AS), gastric ulcer and duodenal ulcer (GU&DU). Clinical features of the structure, dynamics, current and immediate link with the medical conditions is not fully understood. The basis of our research, the purpose of which, was to identify mental disturbances in patients with acute therapeutic diseases. One hundred and eighty-seven patients were examined, 34 CHD patients, 37–MI, 38 - TIA, 39–AH, 39 - GU&DU, 65% male and 35% female aged 20 to 60 years. The main research method was clinical and psychopathological. A high-level affective and neurotic disorders in these patients was observed. Structured analysis allowed identifying four main options disturbances: nosogenic neurotic reaction–68 patients; somatogenic asthenic syndrome–46 patients; reaction psychological maladjustment–34 patients; acute stress reactions–39 patients. Stratification of structure psychopathological syndroms allowed systematizing them in 4 different groups: asthenic–24%; anxiety - 46%; subdepressive - 11%; somatoform - 19%. That was the basis for the determination early psychotherapeutic correction program, formed by integrative model. The high efficacy was shown in 74% patients, middle range–in 15%, low–in 11% patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals (A22) Promoting Emergency Preparedness of Local Municipalities for Disasters – Lessons Learned

2011 ◽  
Vol 26 (S1) ◽  
pp. s8-s8
Author(s):  
R. Ringel ◽  
D. Laor ◽  
A. Ohana ◽  
B. Adini
Keyword(s):  
Training Program ◽  
Emergency Preparedness ◽  
Acute Stress ◽  
Chemical Warfare ◽  
Lessons Learned ◽  
Community Treatment ◽  
Stress Reactions ◽  
Multiple Choice Questions ◽  
Local Municipalities ◽  
Emergency Scenarios

BackgroundInvolvement of local municipalities in promoting emergency preparedness has been recognized as a key factor to build a resilient community. As part of the efforts to build and maintain knowledge and capabilities, the Israeli Ministry of Health initiated a series of conferences aimed at capacity building of city councils to provide services to the population following disasters.Methods6 conferences have been planned for the years 2010-2011 in which 250 senior administrative employees from all municipalities, responsible for the health status in their communities are expected to participate. Each conference covers a variety of emergency scenarios, including biological events, regional hostilities and management of massive Acute Stress Reactions among the civilian population. Pre-post tests based on Multiple Choice Questions are conducted before and following each conference to identify impact of the training program.ResultsFindings from the pre-post tests conducted up to date showed a significant increase in all elements included in the training program. The average knowledge scores of the pre-post tests were 33% and 79% respectively. The highest increases in level of knowledge were found in regard to deployment of community centers for light casualties in chemical warfare scenarios (48% and 100% respectively) and concerning population that requires evacuation during emergencies (68% to 100% respectively). Overall levels of knowledge regarding community treatment centers in biological events were relatively low both before and after the training (16% and 44% respectively).DiscussionTraining local municipalities' personnel is crucial in order to promote emergency preparedness. Raising knowledge regarding response to newly emerging threats (such as deployment of exposure centers in biological events) was found to be more complex in comparison to well-recognized hazards (such as deployment of community treatment centers in chemical warfare). There is a need to conduct follow-up studies to determine the retention of knowledge over time.

scholarly journals Ensuring Emergency Preparedness through Systematic Evaluations

2019 ◽  
Vol 34 (s1) ◽  
pp. s76-s76
Author(s):  
Gila Margalit ◽  
Orna Rachaminov ◽  
Yuval Levy ◽  
Bruria Adini ◽  
Amir Grinberg
Keyword(s):  
Emergency Preparedness ◽  
Trauma Center ◽  
Mass Casualty ◽  
Home Front ◽  
Administrative Professionals ◽  
Emergency Scenarios ◽  
High Level ◽  
Relative Change ◽  
Chemical Incidents ◽  
The Impact

Introduction:Hospitals are required to maintain emergency preparedness 24/7. In order to maintain readiness, Israeli hospitals operate Emergency Committees comprised of medical, nursing, and administrative professionals who are responsible for capacity building including the development of plans, infrastructure, equipment, training, crisis management, and learning lessons. The Ministry of Health (MOH) and Home Front Command (HFC) conduct a comprehensive, structured evaluation of emergency preparedness in every hospital every two to three years.Aim:To assess the impact of a periodical evaluation on levels of emergency preparedness over time in a level one trauma center.Methods:Evaluation of emergency preparedness is conducted by approximately 12 evaluators from the MOH and HFC, encompassing mass casualty incidents (MCIs), mass toxicological/chemical incidents (MTEs), radiological and biological events, earthquakes and conflicts. Evaluations are based on objective parameters, relayed to hospitals prior to the evaluation. The hospital’s level of emergency preparedness is graded and improvements that must be implemented are delineated. The grades of four evaluations conducted from 2011 to 2018 were compared to identify trends in preparedness.Results:Mean levels of emergency preparedness in the 2018 versus 2011 evaluations presented an increase concerning all threats, including MCIs (92 vs. 90), MTEs (99 vs. 77, respectively), biological events (96 vs. 73, respectively), radiological events (91 vs. 79), earthquakes (87 vs. 60, respectively), and conflicts (95 vs. 74). The relative change in levels of preparedness was more noted concerning biological events and earthquakes.Discussion:A periodical evaluation by governing authorities seems to motivate the hospital’s administrations to invest efforts in building and maintain a high level of emergency preparedness. Systematic evaluations conducted bi-annually contributed to improved readiness for diverse emergency scenarios, including for threats that less frequently materialize.

Comparison of Frenotomy Techniques for the Treatment of Ankyloglossia in Children: A Systematic Review

2020 ◽  
Vol 163 (3) ◽  
pp. 428-443
Author(s):  
Usman Khan ◽  
Jake MacPherson ◽  
Michael Bezuhly ◽  
Paul Hong
Keyword(s):  
Rating Scale ◽  
Pediatric Population ◽  
Meta Analysis ◽  
Numeric Rating Scale ◽  
Assessment Tools ◽  
Future Research ◽  
Randomized Controlled ◽  
Comprehensive Search ◽  
High Level ◽  
Numeric Rating

Objective To compare the effectiveness of conventional (CF), laser (LF), and Z-plasty (ZF) frenotomies for the treatment of ankyloglossia in the pediatric population. Data Sources A comprehensive search of PUBMED, EMBASE, and COCHRANE databases was performed. Review Methods Relevant articles were independently assessed by 2 reviewers according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Results Thirty-five articles assessing CF (27 articles), LF (4 articles), ZF (3 articles), and/or rhomboid plasty frenotomy (1 article) were included. A high level of outcome heterogeneity prevented pooling of data. All 7 randomized controlled trials (RCTs) were of low quality. Both CF (5 articles with 589 patients) and LF (2 articles with 78 patients) were independently shown to reduce maternal nipple pain on a visual analog or numeric rating scale. There were reports of improvement with breastfeeding outcomes as assessed on validated assessment tools for 88% (7/8) of CF articles (588 patients) and 2 LF articles (78 patients). ZF improved breastfeeding outcomes on subjective maternal reports (1 article with 18 infants) only. One RCT with a high risk of bias concluded greater speech articulation improvements with ZF compared to CF. Only minor adverse events were reported for all frenotomy techniques. Conclusions Current literature does not demonstrate a clear advantage for one frenotomy technique when managing children with ankyloglossia. Recommendations for future research are provided to overcome the methodological shortcomings in the literature. We conclude that all frenotomy techniques are safe and effective for treating symptomatic ankyloglossia.

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