Using Mixed Methods to Assess Pediatric Disaster Preparedness in the Hospital Setting

2014 ◽  
Vol 29 (6) ◽  
pp. 569-575 ◽  
Author(s):  
Rita V. Burke ◽  
Tae Y. Kim ◽  
Shelby L. Bachman ◽  
Ellen I. Iverson ◽  
Bridget M. Berg
Keyword(s):  
Mixed Methods ◽  
Emergency Response ◽  
Disaster Preparedness ◽  
Disaster Response ◽  
Hospital Setting ◽  
Mass Casualty ◽  
Disaster Victims ◽  
Qualitative Feedback ◽  
Disaster Exercise ◽  
Communication Equipment

AbstractIntroductionChildren are particularly vulnerable during disasters and mass-casualty incidents. Coordinated multi-hospital training exercises may help health care facilities prepare for pediatric disaster victims.ProblemThe purpose of this study was to use mixed methods to assess the disaster response of three hospitals, focusing on pediatric disaster victims.MethodsA full-functional disaster exercise involving a simulated 7.8-magnitude earthquake was conducted at three Los Angeles (California USA) hospitals, one of which is a freestanding designated Level I Pediatric Trauma Center. Exercise participants provided quantitative and qualitative feedback regarding their perceptions of pediatric disaster response during the exercise in the form of surveys and interviews. Additionally, trained observers provided qualitative feedback and recommendations regarding aspects of emergency response during the exercise, including communication, equipment and supplies, pediatric safety, security, and training.ResultsAccording to quantitative participant feedback, the disaster exercise enhanced respondents’ perceived preparedness to care for the pediatric population during a mass-casualty event. Further, qualitative feedback from exercise participants and observers revealed opportunities to improve multiple aspects of emergency response, such as communication, equipment availability, and physician participation. Additionally, participants and observers reported opportunities to improve safety and security of children, understanding of staff roles and responsibilities, and implementation of disaster triage exercises.ConclusionConsistent with previous investigations of pediatric disaster preparedness, evaluation of the exercise revealed several opportunities for all hospitals to improve their ability to respond to the needs of pediatric victims. Quantitative and qualitative feedback from both participants and observers was useful for comprehensively assessing the exercise's successes and obstacles. The present study has identified several opportunities to improve the current state of all hospitals’ pediatric disaster preparedness, through increased training on pediatric disaster triage methods and additional training on the safety and security of children. Regular assessment and evaluation of supplies, equipment, leadership assignments, and inter-hospital communication is also suggested to optimize the effectiveness and efficiency of response to pediatric victims in a disaster.BurkeRV, KimTY, BachmanSL, IversonEI, BergBM. Using mixed methods to assess pediatric disaster preparedness in the hospital setting. Prehosp Disaster Med. 2014;29(6): 1-7.

Ten (+1) lessons from conducting a mass casualty in situ simulation exercise in a Canadian academic hospital setting

2021 ◽  
Vol 19 (3) ◽  
pp. 253-265
Author(s):  
Jeffrey T. Tochkin, MA, CEM ◽  
Hung Tan, MSc ◽  
Caroline Nolan ◽  
Harrison Carmichael, MD ◽  
Andrew Willmore, MD ◽  
...  
Keyword(s):  
Disaster Preparedness ◽  
Hospital Setting ◽  
Mass Casualty ◽  
First Century ◽  
System Level ◽  
In Situ Simulation ◽  
Hospital Administrators ◽  
Simulation Based ◽  
Disaster Exercise

Providing care in a twenty-first century urban emergency department (ED) and trauma center is a complex high-pressure practice environment. The pressure is intensified during patient surge scenarios commonly seen during mass casualty incidents, such that response must be practiced regularly. Beyond clinical mastery of individual patient trauma care, a coordinated system-level response is essential to optimize patient care during these relatively infrequent events. This paper highlights the need to perform exercises in hospitals while providing practical advice on how to utilize in situ simulation for mass casualty testing. Eleven lessons are presented to assist other emergency management professionals, hospital administrators, or clinical staff to achieve success with in situ simulation. Based upon our experience designing and executing an in situ mass casualty simulation within an ED, we offer lessons applicable to any type of disaster exercise. Simulation offers a powerful tool for the conduct of disaster preparedness exercises for staff across multiple hospital departments and professions.

Disaster management among pediatric surgeons: Preparedness, training and involvement

2008 ◽  
Vol 3 (1) ◽  
pp. 5-14 ◽  
Author(s):  
Nikunj K. Chokshi, MD ◽  
Solomon Behar, MD ◽  
Alan L. Nager, MD, FAAP ◽  
Fred Dorey, PhD ◽  
Jeffrey S. Upperman, MD, FAAP, FACS
Keyword(s):  
Emergency Response ◽  
Disaster Response ◽  
Online Survey ◽  
The United States ◽  
Mass Casualty ◽  
Leadership Role ◽  
Training Methods ◽  
Disaster Victims ◽  
Disaster Experience ◽  
Mass Casualty Events

Introduction: Contemporary events in the United States (eg, September 2001, school shootings), Europe (eg, Madrid train bombings), and the Middle East have raised awareness of mass casualty events and the need for a capable disaster response. Recent natural disasters have highlighted the poor preparation and infrastructure in place to respond to mass casualty events. In response, public health policy makers and emergency planners developed plans and prepared emergency response systems. Emergency response providers include first responders, a subset of emergency professionals, including firemen, law enforcement, paramedics, who respond to the incident scene and first receivers, a set of healthcare workers who receive the disaster victims at hospital facilities. The role of pediatric surgeons in mass casualty emergency response plans remains undefined. The authors hypothesize that pediatric surgeons’ training and experience will predict their willingness and ability to be activated first receivers. The objective of our study was to determine the baseline experience, preparedness, willingness, and availability of pediatric surgeons to participate as activated first receivers.Methods: After institutional review board approval, the authors conducted an anonymous online survey of members of the American Pediatric Surgical Association in 2007. The authors explored four domains in this survey: (1) demographics, (2) disaster experience and perceived preparedness, (3) attitudes regarding responsibility and willingness to participate in a disaster response, and (4) availability to participate in a disaster response. The authors performed univariate and bivariate analyses to determine significance. Finally, the authors conducted a logistic regression to determine whether experience or preparedness factors affected the respondent’s availability or willingness to respond to a disaster as a first receiver.Results: The authors sent 725 invitations and received 265 (36.6 percent) completed surveys. Overall, the authors found that 77 percent of the respondents felt “definitely” responsible for helping out during a disaster but only 24 percent of respondents felt “definitely” prepared to respond to a disaster. Most felt they needed additional training, with 74 percent stating that they definitely or probably needed to do more training. Among experiential factors, the authors found that attendance at a national conference was associated with the highest sense of preparedness. The authors determined that subjects with actual disaster experience were about four times more likely to feel prepared than those with no disaster experience (p 0.001). The authors also demonstrated that individuals with a defined leadership position in a disaster response plan are twice as likely to feel prepared (p _ 0.002) and nearly five times more willing to respond to a disaster than those without a leadership role. The authors found other factors that predicted willingness including the following: a contractual agreement to respond (OR 2.3); combat experience (OR 2.1); and prior disaster experience (OR 2.0). Finally, the authors found that no experiential variables or training types were associated with an increased availability to respond to a disaster.Conclusions: A minority of pediatric surgeons feel prepared, and most feel they require more training. Current training methods may be ineffectual in building a prepared and willing pool of first receivers. Disaster planners must plan for healthcare worker related issues, such as transportation and communication. Further work and emphasis is needed to bolster participation in disaster preparedness training.

scholarly journals Disaster Management in Wetland Settlement at Ogan Komering ILIR Regency, South Sumatera

2019 ◽  
Vol 8 (2S9) ◽  
pp. 44-50
Keyword(s):  
Disaster Management ◽  
Emergency Response ◽  
Disaster Preparedness ◽  
Disaster Response ◽  
Local Community ◽  
Tropical Region ◽  
Specific Procedure ◽  
Key Informant ◽  
Dry Seasons ◽  
Collaborative Efforts

Ogan Komering Ilir (OKI) Regency is part of the South Sumatra Province whose area is prone to flooding and fire. As for the tropical region, OKI also has two extreme seasons between the rainy and dry seasons. In the dry season is a prone period of forest and land fires, while in the raining season, its prone to flooding. This study aimed to conduct Disaster Management in Wetland Settlements at Ogan Komering Ilir Regency. The method was using qualitative study design with six informant that consist of six local community and two key informant from worker of Badan Penanggulangan Bencana Daerah and Dinas Kesehatan OKI. The result showed that disaster management was classified into four phase. First, the phase of prevention and mitigation that analyzed socialization efforts conducted in OKI were distribution of leaflets and posters. Then, phase of disaster preparedness showed preparedness program in OKI has not been implemented optimally. In disaster emergency response phase discovered no specific procedure in disaster management. Moreover, the phase of disaster recovery indicated that collaborative efforts with multi-sector stakeholders have been conducted. It can be concluded to prepare Disaster Response Village Programs in Ogan Komering Ilir.

scholarly journals Enhancing disaster preparedness of specialty nurses on a national scale

2016 ◽  
Vol 25 (1) ◽  
pp. 11-26 ◽  
Author(s):  
Marion L. Mitchell ◽  
Loretta McKinnon ◽  
Leanne M Aitken ◽  
Sarah Weber ◽  
Sean Birgan ◽  
...  
Keyword(s):  
Disaster Preparedness ◽  
Disaster Response ◽  
Clinical Group ◽  
Content Type ◽  
Executive Staff ◽  
Response Team ◽  
Tertiary Hospitals ◽  
Specialist Nurses ◽  
National Disaster ◽  
Disaster Exercise

Purpose – The number of disasters has increased by 30 per cent worldwide in the past 30 years. Nurses constitute the largest clinical group within a hospital and their ability to respond to disasters is crucial to the provision of quality patient care. The purpose of this paper is to evaluate a four-year disaster preparedness partnership between two tertiary hospitals from the perspective of executive staff, senior clinical managers and specialist nurses. The national disaster response centre was situated in one hospital and the other hospital was located 3,500 km away. Design/methodology/approach – The intervention involved selected nurses working at the partner hospital to enable familiarisation with policies, procedures and layout in the event of a request for back-up in the event of a national disaster. A mixed-methods design was used to elicit the strengths and limitations of the partnership. Surveys, in-depth interviews and focus groups were used. Findings – In total, 67 participants provided evaluations including ten executive staff, 17 clinical management nurses and 38 nurses from the disaster response team. Improvements in some aspects of communication were recommended. The successful recruitment of highly skilled and committed nurses was a strength. A disaster exercise resulted in 79 per cent of nurses, able and willing to go immediately to the partner hospital for up to 14 days. Research limitations/implications – During the four year partnership, no actual disaster occurred that required support. This limited the ability to fully trial the partnership in an authentic manner. The disaster exercise, although helpful in trialling the processes and assessing nurse availability, it has some limitations. Originality/value – This innovative partnership successfully prepared specialist nurses from geographically distant hospitals for a disaster response. This together with a willingness to be deployed enhanced Australia’s capacity in the event of a disaster.

Evaluating the efficacy of the AAP “Pediatrics in Disaster” course: The Chinese experience

2012 ◽  
Vol 7 (3) ◽  
pp. 231-248 ◽  
Author(s):  
Lindsey Cooper, MD ◽  
Hongyan Guan, MD ◽  
Kathleen M. Ventre, MD ◽  
Yaohua Dai, MD ◽  
Zonghan Zhu, MD ◽  
...  
Keyword(s):  
Disaster Preparedness ◽  
Disaster Response ◽  
Emotional Impact ◽  
Disaster Victims ◽  
Post Test ◽  
Cognitive Knowledge ◽  
Disaster Preparedness And Response ◽  
The Impact ◽  
First Time ◽  
Relief Efforts

Objective: “Pediatrics in Disasters” (PEDS) is a course designed by the American Academy of Pediatrics to provide disaster preparedness and response training to pediatricians worldwide. China has managed to sustain the course and adapt its content for local needs. China has also experienced several natural disasters since the course’s inception, providing an opportunity to evaluate the impact of courses that took place in Beijing and Sichuan, in 2008-2010.Methods: We used pretesting/post-testing, participant surveys, and in-depth interviews to evaluate whether the course imparted cognitive knowledge, was perceived as useful, and fostered participation in relief efforts and disaster preparedness planning.Results: In Beijing and Sichuan, post-test scores were 16 percent higher than pretest scores. On immediate postcourse surveys, 86 percent of Beijing and Sichuan respondents rated the course as very good or excellent. On 6-month surveys, participants identified emotional impact of disasters, planning/triage, and nutrition as the three most useful course modules. Twelve of 75 (16 percent) of Beijing respondents reported direct involvement in disaster response activities following the course; eight of 12 were first-time responders. Participant interviews revealed a need for more training in providing nutritional and psychological support to disaster victims and to train a more diverse group of individuals in disaster response.Conclusions: PEDS imparts cognitive knowledge and is highly valued by course participants. Emotional impact of disasters, planning/triage, and nutrition modules were perceived as the most relevant modules. Future versions of the course should include additional emphasis on emotional care for disaster victims and should be extended to a broader audience.

Developing a Hospital Disaster Preparedness Plan for Mass Casualty Incidents: Lessons Learned From the Downtown Beirut Bombing

2017 ◽  
Vol 12 (3) ◽  
pp. 379-385 ◽  
Author(s):  
Mazen El Sayed ◽  
Ali F. Chami ◽  
Eveline Hitti
Keyword(s):  
Disaster Preparedness ◽  
Disaster Response ◽  
Hospital Staff ◽  
Mass Casualty ◽  
Lessons Learned ◽  
Mass Casualty Incidents ◽  
Preparedness Plan ◽  
Security Issues ◽  
Response System ◽  
General Response

AbstractMass casualty incidents (MCIs) are becoming more frequent worldwide, especially in the Middle East where violence in Syria has spilled over to many neighboring countries. Lebanon lacks a coordinated prehospital response system to deal with MCIs; therefore, hospital preparedness plans are essential to deal with the surge of casualties. This report describes our experience in dealing with an MCI involving a car bomb in an urban area of downtown Beirut, Lebanon. It uses general response principles to propose a simplified response model for hospitals to use during MCIs. A summary of the debriefings following the event was developed and an analysis was performed with the aim of modifying our hospital’s existing disaster preparedness plan. Casualties’ arrival to our emergency department (ED), the performance of our hospital staff during the event, communication, and the coordination of resources, in addition to the response of the different departments, were examined. In dealing with MCIs, hospital plans should focus on triage area, patient registration and tracking, communication, resource coordination, essential staff functions, as well as on security issues and crowd control. Hospitals in other countries that lack a coordinated prehospital disaster response system can use the principles described here to improve their hospital’s resilience and response to MCIs. (Disaster Med Public Health Preparedness. 2018; 12: 379–385)

scholarly journals (A108) Hospital Disaster Planning: The Structured Approach

2011 ◽  
Vol 26 (S1) ◽  
pp. s30-s30
Author(s):  
G.E.A. Khalifa
Keyword(s):  
Emergency Preparedness ◽  
Disaster Preparedness ◽  
Disaster Response ◽  
Emergency Services ◽  
Disaster Planning ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Disaster Plan ◽  
Preparedness Plan ◽  
Hospital Disaster Preparedness

BackgroundDisasters and incidents with hundreds, thousands, or tens of thousands of casualties are not generally addressed in hospital disaster plans. Nevertheless, they may occur, and recent disasters around the globe suggest that it would be prudent for hospitals to improve their preparedness for a mass casualty incident. Disaster, large or small, natural or man-made can strike in many ways and can put the hospital services in danger. Hospitals, because of their emergency services and 24 hour a day operation, will be seen by the public as a vital resource for diagnosis, treatment, and follow up for both physical and psychological care.ObjectivesDevelop a hospital-based disaster and emergency preparedness plan. Consider how a disaster may pose various challenges to hospital disaster response. Formulate a disaster plan for different medical facility response. Assess the need for further changes in existing plans.MethodsThe author uses literature review and his own experience to develop step-by-step logistic approach to hospital disaster planning. The author presents a model for hospital disaster preparedness that produces a living document that contains guidelines for review, testing, education, training and update. The model provides the method to develop the base plan, functional annexes and hazard specific annexes.

Specialized retrieval systems

2016 ◽  
Keyword(s):  
Critical Care ◽  
Medical Care ◽  
Emergency Response ◽  
Disaster Response ◽  
Country Of Origin ◽  
Mass Casualty ◽  
Medical Emergency ◽  
Retrieval Systems ◽  
Mass Casualty Events ◽  
Care Response

Civilian and military retrieval services commonly respond to mass casualty events and international disasters. It is necessary to adapt usual practices to achieve the most for many. The structures, systems, language, and discipline take on a military flavour in civilian disaster response. This brings some order to the chaos and facilitates multiagency cooperation. Triage, treatment, and transport must occur in unfavourable environments. This is exemplified in military scenarios where there is ongoing risk to casualties and retrieval teams. Medical care provided by retrieval teams will depend on risk and resources. Staged retrieval may be required. This is also the case with civilian international retrieval where the patient may be transferred to an intermediate destination facility for immediate care, before being repatriated to their country of origin. Also included, is a section on medical emergency response teams which provide a critical care response to deteriorating patients in a hospital ward setting.

Disaster Preparedness in Hospitals in the Middle East: An Integrative Literature Review

2019 ◽  
Vol 13 (4) ◽  
pp. 806-816 ◽  
Author(s):  
Abdullah Alruwaili ◽  
Shahidul Islam ◽  
Kim Usher
Keyword(s):  
Middle East ◽  
Emergency Response ◽  
Disaster Preparedness ◽  
Mass Casualty ◽  
Eligibility Criteria ◽  
Factors Affecting ◽  
Mass Casualty Events ◽  
Review Study ◽  
Meta Analyses ◽  
Key Terms

ABSTRACTDisasters occur rarely but have significant adverse consequences when they do. Recent statistics suggest that millions of lives and billions of US dollars have been lost in the last decade due to disaster events globally. It is crucial that hospitals are well prepared for disasters to minimize their effects. This integrative review study evaluates the preparedness level of hospitals in the Middle East for disasters using the Preferred Reporting Items for Systematic and Meta-Analyses (PRISMA) guidelines. The key terms include disaster preparedness OR disaster management OR emergency response AND Middle East AND hospitals. The study reviews articles published between January 2005 and December 2015, which focused on the hospitals’ preparedness for disasters in the Middle East nations. Based on their meeting 5 eligibility criteria, 19 articles were included in the review. Twelve of the articles focused on both natural and man-made disasters, whereas 6 of them were based on mass casualty events and 1 on earthquake. Thirteen of the reviewed articles ranked the level of preparedness of hospitals for disasters to be generally “very poor,” “poor,” or “moderate,” whereas 6 reported that hospitals were “well” or “very well prepared” for disasters. Factors affecting preparedness level were identified as a lack of contingency plans and insufficient availability of resources, among others. (Disaster Med Public Health Preparedness. 2019;13:806–816).

Use of Medical Reserve Corps Volunteers in a Hospital-based Disaster Exercise

2016 ◽  
Vol 31 (3) ◽  
pp. 259-262 ◽  
Author(s):  
Ramon Gist ◽  
Pia Daniel ◽  
Andrew Grock ◽  
Chou-jui Lin ◽  
Clarence Bryant ◽  
...  
Keyword(s):  
Avian Influenza ◽  
Infection Control ◽  
Disaster Response ◽  
Hospital Staff ◽  
The United States ◽  
Mass Casualty ◽  
Full Scale ◽  
Publication Type ◽  
Medical Reserve Corps ◽  
Disaster Exercise

AbstractIntroductionThe Medical Reserve Corps (MRC) is a national network of community-based volunteer groups created in 2002 by the Office of the United States Surgeon General (Rockville, Maryland USA) to augment the nation’s ability to respond to medical and public health emergencies. However, there is little evidence-based literature available to guide hospitals on the optimal use of medical volunteers and hesitancy on the part of hospitals to use them.Hypothesis/ProblemThis study sought to determine how MRC volunteers can be used in hospital-based disasters through their participation in a full-scale exercise.MethodsA full-scale exercise was designed as a “Disaster Olympics,” in which the Emergency Medicine residents were divided into teams tasked with completing one of the following five challenges: victim decontamination, mass casualty/decontamination tent assembly, patient triage and registration during a disaster, point of distribution (POD) site set-up and operation, and infection control management. A surge of patients potentially exposed to avian influenza was the scenario created for the latter three challenges. Some MRC volunteers were assigned clinical roles. These roles included serving as members of the suit support team for victim decontamination, distributing medications at the POD, and managing infection control. Other MRC volunteers functioned as “victim evaluators,” who portrayed the potential avian influenza victims while simultaneously evaluating various aspects of the disaster response. The MRC volunteers provided feedback on their experience and evaluators provided feedback on the performance of the MRC volunteers using evaluation tools.ResultsTwenty-eight (90%) MRC volunteers reported that they worked well with the residents and hospital staff, felt the exercise was useful, and were assigned clearly defined roles. However, only 21 (67%) reported that their qualifications were assessed prior to role assignment. For those MRC members who functioned as “victim evaluators,” nine identified errors in aspects of the care they received and the disaster response. Of those who evaluated the MRC, nine (90%) felt that the MRC worked well with the residents and hospital staff. Ten (100%) of these evaluators recommended that MRC volunteers participate in future disaster exercises.ConclusionThrough use of a full-scale exercise, this study was able to identify roles for MRC volunteers in a hospital-based disaster. This study also found MRC volunteers to be uniquely qualified to serve as “victim evaluators” in a hospital-based disaster exercise.GistR, DanielP, GrockA, LinC, BryantC, KohlhoffS, RoblinP, ArquillaB. Use of Medical Reserve Corps volunteers in a hospital-based disaster exercise. Prehosp Disaster Med. 2016;31(3):259–262.

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