scholarly journals (P1-63) Post-Tsunami Hospital Evacuation Preparedness Improved by Development of Portable Medical Supply Caches

2011 ◽  
Vol 26 (S1) ◽  
pp. s119-s119
Author(s):  
D.B. Bouslough ◽  
E. Peters ◽  
C. Peters ◽  
S. Tuato'o
Keyword(s):  
Emergency Preparedness ◽  
Hospital Setting ◽  
American Samoa ◽  
Lessons Learned ◽  
Field Hospital ◽  
Medical Supply ◽  
Preparedness Planning ◽  
Hospital Units ◽  
Hospital Leadership ◽  
Medical Supplies

BackgroundOn September 29, 2009, an earthquake-caused tsunami struck American Samoa with only 20 minutes warning. Personnel successfully evacuated patients from the hospital within 20 minutes. The organization and transportation of medical supplies required for patient care took 90 minutes.ObjectiveTo describe a hospital evacuation exercise designed to identify critical medical supplies, and test their transport, and use in a field-hospital setting.MethodsA retrospective review of hospital emergency preparedness and Boy Scout Eagle Project minutes, participant surveys, and key-informant interviews was performed. Descriptive statistics were used to evaluate data.ResultsUnit supervisors hospital-wide were tasked with designing portable supply caches for the care of typical unit patients for 72 hours. Nine hospital units participated (ED, Surgery, Medicine, Pediatrics, Labor & Delivery, Maternity, Nursery/NICU, ICU, Hemodialysis) in the exercise. Unit evacuation teams (1 physician & 2 nurses) carried caches by foot to a nearby field clinic site (1/4 mile). Cache transport times ranged from 3 minutes (maternity ward) to 15.5 minutes (hemodialysis), averaging 11.2 minutes. Hospital leadership arrived in 4 minutes, and maintenance staff with portable power and oxygen in 23 minutes. Fifty-seven community volunteers (age 9 months – 60 years) under Eagle Scout candidate leadership were prepared as moulaged mock patients. Unit teams used evacuated supplies to provide medical care for 6 mock patients each, listing missing or insufficient supplies at exercise end. Cache supply deficits noted by participating teams included: portable oxygen (66%), blood pressure cuffs (44%), thermometers (44%), select pharmaceuticals (44%), and others. Reported cache deficits and exercise lessons learned were reported hospital-wide for incorporation into preparedness planning.ConclusionThe hospital unit medical supply cache exercise was effective in addressing prior evacuation deficits. Hospital collaboration with community service volunteers provides exercise realism for participants and increases community awareness for emergency preparedness.

scholarly journals (P2-43) Utilizing a Unified Health Command Structure for Mass Gathering Preparedness and Response: Lessons Learned from the 2008 Pacific Arts Festival

2011 ◽  
Vol 26 (S1) ◽  
pp. s149-s150
Author(s):  
D.B. Bouslough ◽  
S. Lemusu ◽  
F. Avegalio
Keyword(s):  
Public Health ◽  
Interpersonal Violence ◽  
Hospital Setting ◽  
Respiratory Illness ◽  
American Samoa ◽  
Lessons Learned ◽  
Surveillance Data ◽  
Population Increase ◽  
Mass Gathering ◽  
Arts Festival

BackgroundThe Pacific Arts Festival is a mass-gathering event occurring every four years in Oceania. The 10th festival in American Samoa, July 20 to August 2, 2008, brought 2200 performers and 2500 tourists (a 15% population increase) from 27 Pacific nations to the island. Anticipated healthcare concerns included hospital surge (175% in 2004), HIV/STI transmission, imported/communicable diseases, food/water/sanitation-borne illness, interpersonal violence, and healthcare resource utilization.ObjectiveTo describe the preparedness and response efforts for this mass gathering event by emergency medical services, the hospital, and the department of health.MethodsA retrospective review of after-action reports, public health and emergency department surveillance records, and key-informant interviews was conducted. Descriptive statistics were used to evaluate data.ResultsA Unified Command structure was utilized for pre-/post-event response. Patient surveillance data was collected daily. During the festival 217 participants (42% female, 58% male, Average age 36) sought medical care. Acute illness (n = 166), injury (n = 39), other (n = 15), routine follow up (n = 9), chronic conditions (n = 6), mental health (n = 1), OB/GYN (n = 1) were complaints addressed. Predominant acute illnesses included headache (n = 49, 23%), respiratory illness (n = 30, 14%), musculoskeletal pain (n = 26, 12%), and gastroenteritis (n = 17, 8%). One fatality occurred among delegates. No public health outbreaks were reported. Visits per healthcare venue demonstrated a decentralization of patient surge from the hospital setting (37.4% venue aid stations, 28.1% delegation medical staff, 24% DOH clinic, 10.6% hospital).ConclusionA unified health command structure was effective in responding to this mass gathering event. Surveillance data was rapidly gathered and utilized to direct healthcare resources. Efforts to decentralize healthcare from the hospital were successful. Public health emergencies were avoided.

scholarly journals Towards defining core principles of public health emergency preparedness: scoping review and Delphi consultation among European Union country experts

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Evelien Belfroid ◽  
Dorothee Roβkamp ◽  
Graham Fraser ◽  
Corien Swaan ◽  
Aura Timen
Keyword(s):  
Public Health ◽  
Emergency Preparedness ◽  
National Level ◽  
European Union Country ◽  
Public Health Emergency ◽  
Lessons Learned ◽  
Face To Face ◽  
Preparedness Planning ◽  
Consensus Procedure ◽  
Public Health Emergency Preparedness

Abstract Background European Member States, the European Commission and its agencies work together to enhance preparedness and response for serious cross-border threats to health such as Ebola. Yet, common understanding of public health emergency preparedness across EU/EEA countries is challenging, because preparedness is a relatively new field of activity and is inherently fraught with uncertainty. A set of practical, widely accepted and easy to use recommendations for generic preparedness that bundles the activities described in separate guidance documents supports countries in preparing for any possible health threat. The aim of this consensus procedure was to identify and seek consensus from national-level preparedness experts from EU/EEA countries on key recommendations of public health emergency preparedness. Methods To identify key recommendations and to prioritize the recommendations we started with a literature consensus procedure, followed by a modified Delphi method for consultation of public health emergency preparedness leaders of EU/EEA countries. This consisted of six consecutive steps: a questionnaire to achieve consensus on a core set of recommendations, a face-to-face consultation, preselection of prioritized recommendations, a questionnaire to achieve consensus on the prioritized set and a face-to-face consensus meeting to further prioritize recommendations. Results As a result, EU/EEA experts selected 149 recommendations as core preparedness principles and prioritized 42. The recommendations were grouped in the seven domains: governance (57), capacity building and maintenance (11), surveillance (19), risk-assessment (16), risk- and crisis management (35), post-event evaluation (6) and implementation of lessons learned (5). Conclusions This prioritised set of consensus principles can provide a foundation for countries aiming to evaluate and improve their preparedness for public health emergencies. The recommendations are practical, support generic preparedness planning, and can be used by all countries irrespective of their current level of preparedness.

Inpatient Insulin Pen Implementation, Waste, and Potential Cost Savings: A Community Hospital Experience

2021 ◽  
pp. 193229682110025
Author(s):  
Urooj Najmi ◽  
Waqas Zia Haque ◽  
Umair Ansari ◽  
Eyerusalem Yemane ◽  
Lee Ann Alexander ◽  
...  
Keyword(s):  
Insulin Aspart ◽  
Community Hospital ◽  
Task Force ◽  
Hospital Setting ◽  
Cost Savings ◽  
Self Management ◽  
Self Administration ◽  
Potential Cost ◽  
Hospital Leadership ◽  
Insulin Pens

Background: Insulin pen injectors (“pens”) are intended to facilitate a patient’s self-administration of insulin and can be used in hospitalized patients as a learning opportunity. Unnecessary or duplicate dispensation of insulin pens is associated with increased healthcare costs. Methods: Inpatient dispensation of insulin pens in a 240-bed community hospital between July 2018 and July 2019 was analyzed. We calculated the percentage of insulin pens unnecessarily dispensed for patients who had the same type of insulin pen assigned. The estimated cost of insulin pen waste was calculated. A pharmacist-led task force group implemented hospital-wide awareness and collaborated with hospital leadership to define goals and interventions. Results: 9516 insulin pens were dispensed to 3121 patients. Of the pens dispensed, 6451 (68%) were insulin aspart and 3065 (32%) were glargine. Among patients on insulin aspart, an average of 2.2 aspart pens was dispensed per patient, but only an estimated 1.2 pens/patient were deemed necessary. Similarly, for inpatients prescribed glargine, an average of 2.1 pens/patient was dispensed, but only 1.3 pens/patient were necessary. A number of gaps were identified and interventions were undertaken to reduce insulin pen waste, which resulted in a significant decrease in both aspart (p = 0.0002) and glargine (p = 0.0005) pens/patient over time. Reductions in pen waste resulted in an estimated cost savings of $66 261 per year. Conclusions: In a community hospital setting, identification of causes leading to unnecessary insulin dispensation and implementation of hospital-wide staff education led to change in insulin pen dispensation practice. These changes translated into considerable cost savings and facilitated diabetes self-management education.

A Global Collaboration for Community-Based Disaster Preparation and Health Promotion: Fukushima to Zuunbayan in Mongolia

2020 ◽  
pp. 1-7
Author(s):  
Chieri Yamada ◽  
Bolormaa Tsedendamba ◽  
Amarbileg Shajbalidir ◽  
Teruko Horiuchi ◽  
Katsuko Suenaga ◽  
...  
Keyword(s):  
Emergency Preparedness ◽  
Nuclear Power ◽  
Information Dissemination ◽  
Good Health ◽  
Lessons Learned ◽  
Global Collaboration ◽  
Psychological Issues ◽  
Radiation Emergency ◽  
Disaster Preparation ◽  
And Behavior

Abstract Excessive radiation exposure has adverse effects on health. In Fukushima, psychological issues such as anxiety are still affecting people nine years after the Fukushima nuclear power plant accident in 2011. In light of the lessons learned from Fukushima communities, a joint Japanese and Mongolian research team introduced a community program to the Zuunbayan district in Mongolia, which is located near a uranium deposit, to promote good health by strengthening radiation emergency preparedness. The program, which commenced in 2017, aimed to increase community participation, education, information dissemination, and capacity of community preparedness. After two years a monitoring study showed that, out of 227 respondents, the proportions who thought that any level of radiation was dangerous decreased from 53.3% in 2017 to 33.9% in 2019. Moreover, half of the respondents knew that there were safe and unsafe radiation levels and that their community was safe. This global collaboration demonstrated that a lesson learned from a disaster can be applied to other countries and changed people’s recognition and behavior toward good health and disaster/emergency preparedness.

scholarly journals (P2-17) “Burning Valentine,” a Simulated Evacuation Exercise of a Burn Unit (BU)

2011 ◽  
Vol 26 (S1) ◽  
pp. s141-s141
Author(s):  
E.L. Dhondt ◽  
T. Peeters ◽  
L. Orlans
Keyword(s):  
Emergency Preparedness ◽  
Fire Detection ◽  
Lessons Learned ◽  
Mitigation Measures ◽  
Simulated Patients ◽  
Military Hospital ◽  
Incident Management ◽  
Hospital Emergency ◽  
Burn Care ◽  
Evacuation Drills

BackgroundAccording to the Belgian Hospital Disaster Planning Act, all hospitals are required to have written disaster plans and to routinely conduct annual disaster drills. In 2010, the management of the Military Hospital decided to organize an evacuation exercise of the newly built 24-bed BU.AimTo evaluate this new BU's evacuation plan and drills and the overall hospital emergency incident response and command system.Methods and ResultsIt was decided to conduct a simulated evacuation exercise following an internal fire, before the BU effectively was put into use, thereby deploying fashioned simulated patients and visitors but bringing into action the regular attending medical, nursing and logistic staff. A multidisciplinary design and organizing team was launched, consisting of the hospitals disaster preparedness coordinator, the EMS-staff, external burn care, emergency incident management and operational engineering experts. The appointed objectives for evaluation were the knowledge of the regular evacuation drills, especially the clearance of an intensive care room; access to evacuation routes; visibility of safety guidelines; mission and tasks of the hospital's first response team and the medical incident manager; communication and information flow and the establishment of the hospital's coordination committee. In the mean time and following lessons learned, a number of mitigation measures have been instituted: adequate identification of evacuated rooms, new configuration of the fire detection alarm, optimized access to stairwells and elevators, adjustment of action cards and specific fire fighting training for hospital staff. Finally the decision was made not to purchase specific evacuation equipment for the movement of patients.ConclusionTaking advantage of the BU's provisional vacancy, a simulated hospital evacuation exercise increased the hospital emergency preparedness, awareness and response to disasters within the hospital, in particular in a critical care department, otherwise difficult to assess.

Transportation Fuel Resiliency: Case Study of Tampa Bay

2021 ◽  
pp. 036119812110416
Author(s):  
Alexander Kolpakov ◽  
Austin Marie Sipiora ◽  
Caley Johnson ◽  
Erin Nobler
Keyword(s):  
Alternative Fuels ◽  
The United States ◽  
Tampa Bay ◽  
Lessons Learned ◽  
Transportation Fuel ◽  
Fuel Supply ◽  
Preparedness Planning ◽  
The Past ◽  
Hurricane Irma

This case study presents findings from an analysis of the emergency preparation and response for Hurricane Irma, the most recent hurricane impacting the Tampa Bay region. The Tampa Bay region, in particular, is considered one of the most vulnerable areas in the United States to hurricanes and severe tropical weather. A particular vulnerability stems from how all petroleum fuel comes to the area by marine transport through Port Tampa Bay, which can be (and has been in the past) impacted by hurricanes and tropical storms. The case study discussed in this paper covers previous fuel challenges, vulnerabilities, and lessons learned by key Tampa Bay public agency fleets during the past 10 years (mainly as a result of the most recent 2017 Hurricane Irma) to explore ways to improve the area’s resilience to natural disasters. Some of the strategies for fuel-supply resiliency include maintaining emergency fuel supply, prioritizing fuel use, strategically placing the assets around the region to help with recovery, investing in backup generators (including generators powered by alternative fuels), planning for redundancies in fuel supply networks, developing more efficient communication procedures between public fleets, hurricane preparedness-planning, and upgrading street drainage systems to reduce the threat of local flooding.

An Emergency Preparedness Response to Opioid-Prescribing Enforcement Actions in Maryland, 2018-2019

2021 ◽  
Vol 136 (1_suppl) ◽  
pp. 9S-17S
Author(s):  
Jessica C. Acharya ◽  
B. Casey Lyons ◽  
Vijay Murthy ◽  
Jennifer Stanley ◽  
Carly Babcock ◽  
...  
Keyword(s):  
Emergency Preparedness ◽  
Data Access ◽  
Opioid Use Disorder ◽  
Lessons Learned ◽  
Mitigation Strategies ◽  
Federal State ◽  
Opioid Use ◽  
Time Data ◽  
Enforcement Action ◽  
State And Local

Federal and state enforcement authorities have increasingly intervened on the criminal overprescribing of opioids. However, little is known about the health effects these enforcement actions have on patients experiencing disrupted access to prescription opioids or medication-assisted treatment/medication for opioid use disorder. Simultaneously, opioid death rates have increased. In response, the Maryland Department of Health (MDH) has worked to coordinate mitigation strategies with enforcement partners (defined as any federal, state, or local enforcement authority or other governmental investigative authority). One strategy is a standardized protocol to implement emergency response functions, including rapidly identifying health hazards with real-time data access, deploying resources locally, and providing credible messages to partners and the public. From January 2018 through October 2019, MDH used the protocol in response to 12 enforcement actions targeting 34 medical professionals. A total of 9624 patients received Schedule II-V controlled substance prescriptions from affected prescribers under investigation in the 6 months before the respective enforcement action; 9270 (96%) patients were residents of Maryland. Preliminary data indicate fatal overdose events and potential loss of follow-up care among the patient population experiencing disrupted health care as a result of an enforcement action. The success of the strategy hinged on endorsement by leadership; the establishment of federal, state, and local roles and responsibilities; and data sharing. MDH’s approach, data sources, and lessons learned may support health departments across the country that are interested in conducting similar activities on the front lines of the opioid crisis.

scholarly journals Scale of adverse events associated to nursing practices: a psychometric study in Portuguese hospital context

2018 ◽  
Vol 26 ◽  
Author(s):  
Teresa Neves ◽  
Vitor Rodrigues ◽  
João Graveto ◽  
Pedro Parreira
Keyword(s):  
Adverse Events ◽  
Public Hospital ◽  
Hospital Setting ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Stable Factor ◽  
Hospital Units ◽  
Northern Regions ◽  
Structural Invariance ◽  
The Stability

Objective to contribute to the validation study of the Scale of Adverse Events associated with Nursing Practices in the hospital context. Method cross-sectional study, in public hospital units, in the central and northern regions of Portugal. The exploratory factor analysis of the Scale of Adverse Events associated to Nursing Practices was conducted with a sample of 165 nurses and the confirmatory factorial analysis was made with a sample of 685 nurses. Reliability, internal consistency and construct validity were estimated. The invariance of the model was evaluated in two subsamples to confirm the stability of the factorial solution. Results the global sample consisted of 850 nurses aged between 22 and 59, mostly licensed professionals. The model had a good overall fit in the subscales (Nursing Practices: χ2/df = 2.88, CFI = 0.90, GFI = 0.86, RMSEA = 0.05, MECVI = 3.30; Adverse Events: χ2/df = 4.62, CFI = 0.93, GFI = 0.95, RMSEA = 0.07, MECVI = 0.39). There was a stable factor structure, indicating strong invariance in the subscale Nursing Practices and structural invariance in the subscale Adverse Events. Conclusion the refined model of the Scale of Adverse Events associated with Nursing Practices revealed good fit and stability of the factorial solution. The instrument was adjusted to evaluate the perception of nurses about adverse events associated with health care, precisely nursing care, in the hospital setting.

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