vTrain: A Novel Curriculum for Patient Surge Training in a Multi-User Virtual Environment (MUVE)

2013 ◽  
Vol 28 (3) ◽  
pp. 215-222 ◽  
Author(s):  
Laura S. Greci ◽  
Rameshsharma Ramloll ◽  
Samantha Hurst ◽  
Karen Garman ◽  
Jaishree Beedasy ◽  
...  
Keyword(s):  
Emergency Department ◽  
Virtual Environment ◽  
Emergency Preparedness ◽  
Disaster Preparedness ◽  
Teaching Method ◽  
Hospital Staff ◽  
Pilot Training ◽  
Care Utilization ◽  
Management Skills ◽  
Publication Type

AbstractIntroductionDuring a pandemic influenza, emergency departments will be overwhelmed with a large influx of patients seeking care. Although all hospitals should have a written plan for dealing with this surge of health care utilization, most hospitals struggle with ways to educate the staff and practice for potentially catastrophic events.Hypothesis/ProblemTo better prepare hospital staff for a patient surge, a novel educational curriculum was developed utilizing an emergency department for a patient surge functional drill.MethodsA multidisciplinary team of medical educators, evaluators, emergency preparedness experts, and technology specialists developed a curriculum to: (1) train novice users to function in their job class in a multi-user virtual environment (MUVE); (2) obtain appropriate pre-drill disaster preparedness training; (3) perform functional team exercises in a MUVE; and (4) reflect on their performance after the drill.ResultsA total of 14 students participated in one of two iterations of the pilot training program; seven nurses completed the emergency department triage course, and seven hospital administrators completed the Command Post (CP) course. All participants reported positive experiences in written course evaluations and structured verbal debriefings, and self-reported increase in disaster preparedness knowledge. Students also reported improved team communication, planning, team decision making, and the ability to visualize and reflect on their performance.ConclusionData from this pilot program suggest that the immersive, virtual teaching method is well suited to team-based, reflective practice and learning of disaster management skills.GreciLS, RamlollR, HurstS, GarmanK, BeedasyJ, PieperEB, HuangR, HigginbothamE, AghaZ. vTrain: a novel curriculum for patient surge training in a multi-user virtual environment (MUVE). Prehosp Disaster Med.2013;28(3):1-8.

scholarly journals Westgate Shootings: An Emergency Department Approach to a Mass-casualty Incident

2014 ◽  
Vol 29 (5) ◽  
pp. 538-541 ◽  
Author(s):  
Benjamin W. Wachira ◽  
Ramadhani O. Abdalla ◽  
Lee A. Wallis
Keyword(s):  
Emergency Department ◽  
Emergency Preparedness ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
University Hospital ◽  
Shopping Mall ◽  
Major Incident ◽  
Local Health ◽  
Publication Type ◽  
Communication Assessment

AbstractAt approximately 12:30 pm on Saturday September 21, 2013, armed assailants attacked the upscale Westgate shopping mall in the Westlands area of Nairobi, Kenya. Using the seven key Major Incident Medical Management and Support (MIMMS) principles, command, safety, communication, assessment, triage, treatment, and transport, the Aga Khan University Hospital, Nairobi (AKUH,N) emergency department (ED) successfully coordinated the reception and care of all the casualties brought to the hospital.This report describes the AKUH,N ED response to the first civilian mass-casualty shooting incident in Kenya, with the hope of informing the development and implementation of mass-casualty emergency preparedness plans by other EDs and hospitals in Kenya, appropriate for the local health care system.WachiraBW, AbdallaRO, WallisLA. Westgate shootings: an emergency department approach to a mass-casualty incident. Prehosp Disaster Med. 2014;29(5):1-4.

Level of Disaster Preparedness in Patients Visiting the Emergency Department: Results of the Civilian Assessment of Readiness for Disaster (CARD) Survey

2013 ◽  
Vol 28 (2) ◽  
pp. 127-131 ◽  
Author(s):  
Nicholas A. True ◽  
Juliana D. Adedoyin ◽  
Frances S. Shofer ◽  
Eddie K. Hasty ◽  
Jane H. Brice
Keyword(s):  
Emergency Department ◽  
Vulnerable Populations ◽  
Disaster Preparedness ◽  
Single Parents ◽  
Public Hospitals ◽  
University Hospital ◽  
Future Research ◽  
Cross Sectional Survey ◽  
Publication Type ◽  
Cross Sectional

AbstractBackgroundPatients seeking care in public hospitals are often resource-limited populations who have in past disasters become the most vulnerable. The objective of this study was to determine the personal disaster preparedness of emergency department (ED) patients and to identify predictors of low levels of preparedness. It was hypothesized that vulnerable populations would be better prepared for disasters.MethodsA prospective cross-sectional survey was conducted over a one-year period of patients seeking care in a public university hospital ED (census 65,000). Exclusion criteria were mentally impaired, institutionalized, or non-English speaking subjects. Subjects completed an anonymous survey detailing the 15 personal preparedness items from the Federal Emergency Management Agency's disaster preparedness checklist as well as demographic characteristics. Summary statistics were used to describe general preparedness. Chi-square tests were used to compare preparedness by demographics.ResultsDuring the study period, 857/1000 subjects completed the survey. Participants were predominantly male (57%), Caucasian (65%), middle-aged (mean 45 years), and high school graduates (83%). Seventeen percent (n = 146) reported having special needs and 8% were single parents. Most participants were not prepared: 451 (53%) had >75% of checklist items, 393 (46%) had food and water for 3 days, and 318 (37%) had food, water, and >75% of items. Level of preparedness was associated with age and parenting. Those aged 44 and older were more likely to be prepared for a disaster compared to younger respondents. (43.3% vs 31.1%, P = .0002). Similarly, single parents were more likely to be prepared than dual parenting households (47.1 vs 32.9%, P = .03).ConclusionsThis study and others have found that only the minority of any group is actually prepared for disaster. Future research should focus on ways to implement disaster preparedness education, specifically targeting vulnerable populations, then measuring the effects of educational programs to demonstrate that preparedness has increased as a result.TrueNA, AdedoyinJD, ShoferFS, HastyEK, BriceJH. Level of disaster preparedness in patients visiting the emergency department: results of the Civilian Assessment of Readiness for Disaster (CARD) survey. Prehosp Disaster Med.2013;28(2):1-5.

Survey of Emergency Department Chemical Hazard Preparedness in Michigan, USA: A Seven Year Comparison

2016 ◽  
Vol 31 (2) ◽  
pp. 224-227 ◽  
Author(s):  
Justin B. Belsky ◽  
Howard A. Klausner ◽  
Jeffrey Karson ◽  
Robert B. Dunne
Keyword(s):  
Emergency Department ◽  
Emergency Departments ◽  
Disaster Preparedness ◽  
The State ◽  
Hazardous Material ◽  
Publication Type ◽  
Chemical Hazard ◽  
Surgical Masks ◽  
Survey Responses ◽  
Training Opportunities

AbstractObjectiveTo compare the state of chemical hazard preparedness in emergency departments (EDs) in Michigan, USA between 2005 and 2012.MethodsThis was a longitudinal study involving a 30 question survey sent to ED directors at each hospital listed in the Michigan College of Emergency Physician (MCEP) Directory in 2005 and in 2012. The surveys contained questions relating to chemical, biological, radiological, nuclear, and explosive events with a focus on hazardous material capabilities.ResultsOne hundred twelve of 139 EDs responded to the 2005 survey compared to 99/136 in 2012. Ten of 27 responses were statistically significant, all favoring an enhancement in disaster preparedness in 2012 when compared to 2005. Questions with improvement included: EDs with employees participating in the Michigan voluntary registry; EDs with decontamination rooms; MARK 1 and cyanide kits available; those planning to use dry decontamination, powered air purifiers, surgical masks, chemical gloves, and surgical gowns; and those wishing for better coordination with local and regional resources. Forty-two percent of EDs in 2012 had greater than one-half of their staff trained in decontamination and 81% of respondents wished for more training opportunities in disaster preparedness. Eighty-four percent of respondents believed that they were more prepared in disaster preparedness in 2012 versus seven years prior.ConclusionsEmergency departments in Michigan have made significant advances in chemical hazard preparedness between 2005 and 2012 based on survey responses. Despite these improvements, staff training in decontamination and hazardous material events remains a weakness among EDs in the state of Michigan.BelskyJB, KlausnerHA, KarsonJ, DunneRB. Survey of emergency department chemical hazard preparedness in Michigan, USA: a seven year comparison. Prehosp Disaster Med. 2016;31(2):224–227.

Does Hospital Disaster Preparedness Predict Response Performance During a Full-scale Exercise? A Pilot Study

2014 ◽  
Vol 29 (5) ◽  
pp. 441-447 ◽  
Author(s):  
Ahmadreza Djalali ◽  
Luca Carenzo ◽  
Luca Ragazzoni ◽  
Massimo Azzaretto ◽  
Roberta Petrino ◽  
...  
Keyword(s):  
Pilot Study ◽  
Disaster Preparedness ◽  
Comprehensive Evaluation ◽  
Control Function ◽  
Hospital Staff ◽  
Full Scale ◽  
Publication Type ◽  
Response Performance ◽  
Hospital Disaster Preparedness ◽  
The Impact

AbstractIntroductionThe assessment of hospital disaster preparedness and response performance is a way to find and remove possible gaps and weaknesses in hospital disaster management effectiveness. The aim of this pilot study was to test the association between the level of preparedness and the level of response performance during a full-scale hospital exercise.MethodThis pilot study was conducted in a hospital during a full-scale exercise in the Piedmont region of Italy. The preparedness evaluation was conducted by a group of three experts, three days before the exercise, and the response evaluation was conducted during the exercise. The functional capacity module was used for preparedness evaluation, and the response performance of the “command and control” function of the hospital was evaluated by nine semiquantitative performance indicators.ResultsThe preparedness of the chosen hospital was 59%, while the response performance was evaluated as 70%. The hospital staff conducted Simple Triage and Rapid Transport (START) triage while they received 61 casualties, which was 90% correct for the yellow group and 100% correct for the green group.ConclusionThis pilot study showed that it is possible to use standardized evaluations tools, to simultaneously assess the relationship between preparedness elements and response performance measures. An experimental study including a group of hospitals, also using more comprehensive evaluation tools, should be done to evaluate the correlation between the level of preparedness and the response performance of a hospital, and the impact of hospital disaster planning, on the outcome of disasters victims.DjalaliA,CarenzoL,RagazzoniL,AzzarettoM,PetrinoR,Della CorteF,IngrassiaPL.Does hospital disaster preparedness predict response performance during a full-scale exercise? A pilot study.Prehosp Disaster Med.2014;29(4):1-7.

THE ROLE OF EDUCATION ON DISASTER PREPAREDNESS CASE STUDY OF 2012 INDIAN OCEAN EARTHQUAKES ON THAILAND’S

2018 ◽  
Author(s):  
Raya Muttarak ◽  
Wiraporn Pothisiri
Keyword(s):  
Indian Ocean ◽  
Emergency Preparedness ◽  
Disaster Preparedness ◽  
Formal Education ◽  
Disaster Experience ◽  
Individual Household ◽  
The Indian Ocean ◽  
The Individual

In this paper we investigate how well residents of the Andaman coast in Phang Nga province, Thailand, are prepared for earthquakes and tsunami. It is hypothesized that formal education can promote disaster preparedness because education enhances individual cognitive and learning skills, as well as access to information. A survey was conducted of 557 households in the areas that received tsunami warnings following the Indian Ocean earthquakes on 11 April 2012. Interviews were carried out during the period of numerous aftershocks, which put residents in the region on high alert. The respondents were asked what emergency preparedness measures they had taken following the 11 April earthquakes. Using the partial proportional odds model, the paper investigates determinants of personal disaster preparedness measured as the number of preparedness actions taken. Controlling for village effects, we find that formal education, measured at the individual, household, and community levels, has a positive relationship with taking preparedness measures. For the survey group without past disaster experience, the education level of household members is positively related to disaster preparedness. The findings also show that disaster related training is most effective for individuals with high educational attainment. Furthermore, living in a community with a higher proportion of women who have at least a secondary education increases the likelihood of disaster preparedness. In conclusion, we found that formal education can increase disaster preparedness and reduce vulnerability to natural hazards.

scholarly journals Delivering and Embedding Dementia-Friendly Training in a Healthcare System

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 160-161
Author(s):  
Ellen Schneider ◽  
Maureen Dale ◽  
Krista Wells ◽  
John Gotelli ◽  
Carol Julian ◽  
...  
Keyword(s):  
North Carolina ◽  
Self Efficacy ◽  
Hospital Staff ◽  
Clinical Staff ◽  
Pilot Training ◽  
Readmission Rates ◽  
Dementia Patients ◽  
People With Dementia ◽  
Aging And Health ◽  
The University

Abstract Alzheimer’s disease is the 4th leading cause of death in North Carolina for people 65 and older. People with dementia are hospitalized more often and have prolonged stays, poorer outcomes, higher costs, and increased readmission rates. Hospital employees have expressed the desire to have specialized training to learn how to more effectively communicate with and provide better care to patients with dementia. To address identified patient and hospital employee needs, the University of North Carolina (UNC) Center for Aging and Health is disseminating hospital-specific dementia-friendly training at five hospitals within the UNC Health System. The training is being delivered via online modules and follow-up didactic sessions over a three-year period to clinical and non-clinical staff who interact with patients. To date, 1,948 employees at three of the five hospitals have launched the online training; 1,102 have completed the training. The pilot training took place at the UNC Hospitals--Hillsborough Campus (“Hillsborough Hospital”) in 2019. Hillsborough Hospital staff (n=195) who participated in the dementia friendly training completed a survey to assess their ability to recognize symptoms and provide appropriate care to dementia patients pre- and post-training. Clinical staff answered 23 Likert scale self-efficacy questions; non-clinical staff answered the first 12 of these questions. Positive change in self-efficacy ratings from pre- to post-training was significant for every question (p < .0001). Additional results will be included in the poster. The dementia-friendly hospital initiative is preparing employees to provide better care for people with dementia and is effective in increasing employee self-efficacy.

scholarly journals Emergency department and inpatient health care utilization among patients who require interpreter services

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Jane W. Njeru ◽  
Jennifer L. St. Sauver ◽  
Debra J. Jacobson ◽  
Jon O. Ebbert ◽  
Paul Y. Takahashi ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Health Care Utilization ◽  
Care Utilization ◽  
Interpreter Services

School-Based Education Programs for Preparing Children for Natural Hazards: A Systematic Review

2021 ◽  
pp. 1-13
Author(s):  
Hamed Seddighi ◽  
Homeira Sajjadi ◽  
Sepideh Yousefzadeh ◽  
Mónica López López ◽  
Meroe Vameghi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Natural Hazards ◽  
Emergency Preparedness ◽  
Disaster Preparedness ◽  
English Language ◽  
Education Programs ◽  
School Based ◽  
Disaster Education ◽  
The Difference ◽  
And Gender

Abstract Schools have a significant role in disaster education to children. This study investigates the research works about school-based education programs in order to discover challenges and best practices. We conducted a systematic review of English language papers published in peer-review journals. The search identified 2577 publications and 61 articles meeting selection criteria and included in the review. Reviewed studies indicated that disaster education in schools is effective but yet insufficient in many countries. Lack of equipment, financial resources, policy gaps, and teachers’ knowledge are common problems in programs. Main outcomes of this systematic review are showing methods used for health emergency preparedness of children of different ages and gender differences in school-based disaster preparedness, as well as the difference in their lifesaving skills in disasters. This study shows that some disaster education programs reported in the papers reviewed were not high-quality enough, which may lead to insufficient preparedness of children in disasters and consequently may put their health at risk, considering the increasing number of natural hazards.

scholarly journals P070: Mixed effectiveness of emergency department diversion strategies: a systematic review

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S102
Author(s):  
S.W. Kirkland ◽  
A. Soleimani ◽  
B.H. Rowe ◽  
A.S. Newton
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Emergency Department ◽  
Health Care Services ◽  
Grey Literature ◽  
Study Data ◽  
Care Utilization ◽  
Alternative Source ◽  
Increased Risk ◽  
The Impact

Introduction: Diverting patients away from the emergency department (ED) has been proposed as a solution for reducing ED overcrowding. The objective of this systematic review is to examine the effectiveness of diversion strategies designed to either direct patients seeking care at an ED to an alternative source of care. Methods: Seven electronic databases and grey literature were searched. Randomized/controlled clinical trials and cohort studies assessing the effectiveness of pre-hospital and ED-based diversion interventions with a comparator were eligible for inclusion. Two reviewers independently screened the studies for relevance, inclusion, and risk of bias. Intervention effects are reported as proportions (%) or relative risks (RR) with 95% confidence intervals (CI). Methodological and clinical heterogeneity prohibited pooling of study data. Results: From 7,306 citations, ten studies were included. Seven studies evaluated a pre-hospital diversion strategy and three studies evaluated an ED-based diversion strategy. The impact of diversion on subsequent health services was mixed. One study of paramedic practitioners reported increased ED attendance within 7 days (11.9% vs. 9.5%; p=0.049) but no differences in return visits for similar conditions (75.2% vs. 72.1%; p=0.64). The use of paramedic practitioners was associated with an increased risk of subsequent contact with health care services (RR=1.21, 95% CI 1.06, 1.38), while the use of deferred care was associated with no increase in risk of subsequently seeking physician care (RR=1.09, 95% CI 0.23, 5.26). While two studies reported that diverted patients were at significantly reduced risk for hospitalization, two other studies reported no significant differences between diverted or standard care patients. Conclusion: The evidence regarding the impact of pre-hospital and ED-based diversion on ED utilization and subsequent health care utilization is mixed. Additional high-quality comparative effectiveness studies of diversion strategies are required prior to widespread implementation.

scholarly journals (P1-54) Healthcare Worker's Perception towards Individual and Institution Disaster Preparedness

2011 ◽  
Vol 26 (S1) ◽  
pp. s116-s116
Author(s):  
G.H. Lim
Keyword(s):  
Family Support ◽  
Emergency Preparedness ◽  
Disaster Preparedness ◽  
Disaster Response ◽  
Healthcare Workers ◽  
Health Workers ◽  
Response Training ◽  
The Family ◽  
Training Opportunities ◽  
H1n1 Outbreak

Background and AimDisaster and MCI events are occurrences that healthcare institutions must be prepared to respond to at all times. The events of September 11 2001 have rekindled our attention to this aspect of preparedness amongst our healthcare institutions. In Singapore, the SARS experience in 2003 and the recent H1N1 outbreak have thrust emergency preparedness further into the limelight. While priorities had been re-calibrated, we feel that we still lack far behind in our level of preparedness. This study is conducted to understand the perception of our healthcare workers towards their individual and the institution preparedness towards a disaster incident.MethodA questionnaire survey was done for this study for the doctors, nurses and allied health workers in our hospital. Questions measuring perception of disaster preparedness for themselves, their colleagues and that of the institution were asked. This was done using a 5-point likert scale.ResultsThe study was conducted over a 2-month period from 1st August 2010 till 30th September 2010. 1534 healthcare workers participated in the study. 75.3% felt that the institution is ready to respond to a disaster incident; but only 36.4% felt that they were ready. 12.6% had previous experience in disaster response. They were more likely to be ready to respond to future incidents (p = 0.00). Factors that influenced perception of readiness included leadership (p = 0.00), disaster drills (p = 0.02), access to disaster plans (p = 0.04), family support. 80.7% were willing to participate in future disaster incident response training. 74.5% felt that being able to respond to a disaster incident constitute part of their professional competency. However, only 31% of the respondents agreed that disaster response training was readily available and only 27.8% knew where to go to look for these training opportunities.ConclusionThere is an urgent need to train the healthcare workers to enhance their capability to respond to a disaster incident. While they have confidence in the institutions capability they were not sure of their own capability. Training opportunities should be made more accessible. We should also do more to harvest the family support that these worker value in order for them to be able to perform their roles in a disaster incident.

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