scholarly journals Disaster Preparedness Should Represent an Augmentation of the Everyday Trauma System – But Are We Prepared?

2020 ◽  
Author(s):  
Jørgen Joakim Jørgensen ◽  
Peter Wiel Monrad-Hansen ◽  
Christine Gaarder ◽  
Paal Aksel Næss
Keyword(s):  
Disaster Preparedness ◽  
Trauma System ◽  
Trauma Team ◽  
Mass Casualty ◽  
Trauma Centers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Team Members ◽  
Holiday Season ◽  
System Requirements

Abstract Background The increased frequency, geographical spread and the heterogenicity in mass casualty incidents (MCI), challenge healthcare systems worldwide. Trauma systems constitute the base for disaster preparedness. The largest MCI in Norway took place 22 July 2011 and several lessons were learnt. Norway is sparsely populated, with four regional trauma centers (TCs) and 35 hospitals treating trauma (non-trauma centers; NTCs). We wanted to assess whether hospitals fill the national trauma system requirements for competence, and the degree of awareness of MCI plans.Methods We conducted a cross-sectional survey of on-call trauma teams in all 39 hospitals during two time periods: July-August (HS; holiday season) and September-June (NHS; non-holiday season). A standardized questionnaire was used to evaluate the MCI preparedness.Results A total of 347 trauma team members participated (173 during HS and 174 during NHS). Over 95% of the team members were aware of the MCI plan, half had read the plan during the last 6 months, whereas 63% at the TCs and 74% at NTCs were confident with their designated MCI role. Trauma team exercises were conducted regularly and 86% had ever participated. Only 63% at the TCs and 53% at the NTCs had participated in an MCI exercise. The proportion of resident surgeons and anesthetists with >4 years clinical experience was significantly higher in TCs (88% and 63%) than in NTCs (27% and 17%). At NTCs 38% of the resident surgeons were on call from home. All the on-call consultant surgeons were at home, leaving interns in charge at several of the hospitals. All resident surgeons at the TCs were ATLS providers compared to 64% at the NTCs and almost 90% of the consultant surgeons had participated in advanced trauma surgical courses. Conclusion Despite increased national focus on disaster preparedness, we identified limited compliance with trauma system requirements concerning competency and training. Strict guidelines to secure immediate notification and early presence of consultants whenever a situation that might turn into an MCI occurs should be a prerequisite. The awareness and content of existing MCI plans should be continuously improved to be able to meet the challenges of future MCIs.

scholarly journals Disaster preparedness should represent an augmentation of the everyday trauma system, but are we prepared?

2021 ◽  
Vol 6 (1) ◽  
pp. e000760
Author(s):  
Jørgen Joakim Jørgensen ◽  
Peter Wiel Monrad-Hansen ◽  
Christine Gaarder ◽  
Paal Aksel Næss
Keyword(s):  
Disaster Preparedness ◽  
Trauma System ◽  
Trauma Team ◽  
Trauma Centers ◽  
Cross Sectional Survey ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Team Members ◽  
Holiday Season ◽  
System Requirements

BackgroundThe increased frequency, geographical spread and the heterogenicity in mass casualty incidents (MCIs) challenge healthcare systems worldwide. Trauma systems constitute the base for disaster preparedness. Norway is sparsely populated, with four regional trauma centers (TCs) and 35 hospitals treating trauma (non-trauma centers (NTCs)). We wanted to assess whether hospitals fill the national trauma system requirements for competence and the degree of awareness of MCI plans.MethodsWe conducted a cross-sectional survey of on-call trauma teams in all 39 hospitals during two time periods: July–August (holiday season (HS)) and September–June (non-holiday season (NHS)). A standardized questionnaire was used to evaluate the MCI preparedness.ResultsA total of 347 trauma team members participated (HS: 173 and NHS: 174). Over 95% of the team members were aware of the MCI plan; half had read the plan during the last 6 months, whereas 63% at the TCs and 74% at NTCs were confident with their MCI role. Trauma team exercises were conducted regularly and 86% had ever participated. Only 63% at the TCs and 53% at the NTCs had participated in an MCI exercise. The proportion of resident surgeons and anesthetists with >4 years’ clinical experience was significantly higher in TCs (88% and 63%) than in NTCs (27% and 17%). All the on-call consultant surgeons were at home, leaving interns in charge at several of the hospitals. All resident surgeons at the TCs were ATLS providers compared with 64% at the NTCs, and almost 90% of the consultant surgeons had participated in advanced trauma surgical courses.DiscussionDespite increased national focus on disaster preparedness, we identified limited compliance with trauma system requirements concerning competency and training. Strict guidelines to secure immediate notification and early presence of consultants whenever a situation that might turn into an MCI occurs should be a prerequisite.Level of evidenceLevel IV. Study type: cross- sectional.

scholarly journals Disaster Preparedness Should Represent an Augmentation of the Everyday Trauma System – But Are We Prepared?

2020 ◽  
Author(s):  
Jørgen Joakim Jørgensen ◽  
Peter Wiel Monrad-Hansen ◽  
Christine Gaarder ◽  
Pål Aksel Næss
Keyword(s):  
Disaster Preparedness ◽  
Trauma System ◽  
Working Hours ◽  
Trauma Team ◽  
Trauma Centers ◽  
Team Members ◽  
National Trauma ◽  
The Everyday ◽  
Holiday Season ◽  
System Requirements

Abstract IntroductionMass casualty incidents (MCI) range from natural disasters to terrorist attacks. The increased frequency, geographical spread and the heterogenicity in type of terror incidents, challenge healthcare systems all over the world. Trauma systems constitute the base upon which disaster preparedness is being build. The largest MCI in Norway took place 22 July 2011 and several lessons were learnt including the importance of having designed the everyday trauma infrastructure to be able to increase activity and adjust according to needs. Norway is sparsely populated, with a national trauma system consisting of four regional trauma centers (TCs) and 35 acute care hospitals treating trauma (non-trauma centers; NTCs) We wanted to assess how well hospitals fill the national trauma system requirements for competence, and the degree of awareness of existing MCI plans.MethodsWe conducted a cross-sectional survey of the on-call trauma team in all 39 Norwegian hospitals during two time periods: July-August (HS; holiday season) and September – June (NHS; non-holiday season). A standardized questionnaire was used to evaluate the MCI preparedness.ResultsA total of 347 trauma team members participated with 173 during HS and 174 during NHS. Over 95% of the team members were aware of the hospital MCI plan, only half had read the plan during the last 6 months, whereas 63% at the TCs and 74% at NTCs were confident with their designated role in the event of an MCI. Trauma team exercises were conducted regularly and 86% had ever participated, primarily residents and nurses. Only 63% at the TCs and 53% at the NTCs had participated in an MCI exercise. The proportion of resident surgeons and anesthetists with >4 years clinical experience was significantly higher in TCs (88% and 63%) than in NTCs (27% and 17%). At NTCs 38% of the resident surgeons were on call from home after working hours. All the on-call consultant surgeons were at home after working hours, leaving interns in charge at several of the hospitals. All resident surgeons at the TCs were ATLS providers compared to 64% at the NTCs and almost 90% of the consultant surgeons had participated in advanced trauma surgical courses. ConclusionDespite increased focus on disaster preparedness at a national level after the 2011 attacks, we identified limited compliance with trauma system requirements concerning competency and training. Strict guidelines to secure immediate notification and early presence of consultants whenever a situation that might turn into an MCI occurs should be a prerequisite. The awareness and content of existing MCI plans should be continuously improved to be able to meet the challenges of future MCIs.

Public Health Preparedness for Mass-Casualty Events: A 2002 State-by-State Assessment

2004 ◽  
Vol 19 (3) ◽  
pp. 245-255 ◽  
Author(s):  
N. Clay Mann ◽  
Ellen MacKenzie ◽  
Cheryl Anderson
Keyword(s):  
Disaster Preparedness ◽  
Communication Systems ◽  
Terrorist Attack ◽  
Trauma System ◽  
State Level ◽  
Mass Casualty ◽  
Protective Equipment ◽  
Cross Sectional Survey ◽  
Disaster Plan ◽  
Cross Sectional

AbstractIntroduction:The ongoing threat of a terrorist attack places public agencies under increasing pressure to ensure readiness in the event of a disaster. Yet, little published information exists regarding the current state of readiness, which would allow local and regional organizations to develop disaster preparedness plans that would function seamlessly across service areas. The objective of this study is to characterize state-level disaster readiness soon after September 2001 and correlate readiness with existing programs providing an organized response to medical emergencies.Methods:During the first quarter of 2002, a cross-sectional survey assessing five components of disaster readiness was administered in all 50 states. The five components of disaster readiness included: (1) statewide disaster planning; (2) coordination; (3) training; (4) resource capacity; and (5) preparedness for biological/chemical terrorism.Results:Most states reported the presence of a statewide disaster plan (94%), but few are tested by activation, (48%) and still fewer contain a bioterrorism component (38%). All states have designated disaster operations centers (100%), but few states have an operating communications system linking health and medical resources (36%). Approximately half of states offer disaster training to medical professionals; about 10% of states require the training. Between 22–48% of states have various contingency plans to treat victims when service capacity is exceeded. Biochemical protective equipment for health professionals is lacking in all but one state, and only 10% of states indicate that all hospitals have decontamination capabilities. States with a functioning statewide trauma system were significantly more likely to possess key attributes of a functioning disaster readiness plan.Conclusion:These findings suggest that disaster plans are prevalent among states. However, key programs and policies were noticeably absent. Communication systems remain fragmented and adequate training programs and protective equipment for health personnel are markedly lacking. Statewide trauma systems may provide a framework upon which to build future medical disaster readiness capacity.

scholarly journals Disaster preparedness in French paediatric hospitals 2 years after terrorist attacks of 2015

2018 ◽  
Vol 104 (4) ◽  
pp. 322-327 ◽  
Author(s):  
Guillaume Mortamet ◽  
Noella Lode ◽  
Nadia Roumeliotis ◽  
Florent Baudin ◽  
Etienne Javouhey ◽  
...  
Keyword(s):  
Disaster Preparedness ◽  
Mass Casualty ◽  
University Hospitals ◽  
Cross Sectional Survey ◽  
Disaster Plan ◽  
Cross Sectional ◽  
Paediatric Hospital ◽  
Mass Casualty Event ◽  
Hospital Preparedness ◽  
Prehospital Emergency

ObjectiveWe aimed to determine paediatric hospital preparedness for a mass casualty disaster involving children in both prehospital and hospital settings. The study findings will serve to generate recommendations, guidelines and training objectives.Design and settingThe AMAVI-PED study is a cross-sectional survey. An electronic questionnaire was sent to French physicians with key roles in specialised paediatric acute care.ResultsIn total, 81% (26 of 32) of French University Hospitals were represented in the study. A disaster plan AMAVI with a specific paediatric emphasis was established in all the paediatric centres. In case of a mass casualty event, paediatric victims would be initially admitted to the paediatric emergency department for most centres (n=21; 75%). Paediatric anaesthesiologists, paediatric surgeons and paediatric radiologists were in-house in 20 (71%), 5 (18%) and 12 (43%) centres, respectively. Twenty-three (82%) hospitals had a paediatric specialised mobile intensive care unit and seven (25%) of these could provide a prehospital emergency response. Didactic teaching and simulation exercises were implemented in 20 (71%) and 22 (79%) centres, respectively. Overall, physician participants rated the level of readiness of their hospital as 6 (IQR: 5–7) on a 10-point readiness scale.ConclusionPaediatric preparedness is very heterogeneous between the centres. Based on the study findings, we suggest that a national programme must be defined and guidelines generated.

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.

scholarly journals Perception of disaster preparedness and participation in training are associated with disaster preparedness among health workers

2019 ◽  
Vol 7 (1) ◽  
pp. 8
Author(s):  
I Made Dwie Pradnya Susila ◽  
Pande Putu Januraga ◽  
Ni Wayan Arya Utami
Keyword(s):  
Disaster Management ◽  
Disaster Preparedness ◽  
Health Workers ◽  
Binary Logistic Regression ◽  
Bivariate Analysis ◽  
Continuous Training ◽  
Cross Sectional Survey ◽  
Chi Square ◽  
Cross Sectional ◽  
Disaster Training

Background and purpose: Disaster preparedness is crucial for health workers in order to provide relief to communities affected by disasters quickly and precisely. However currently there are only few health workers who are prepared to face disasters. This study aims to determine the association between knowledge, perception, participation in training and experience in disaster management with disaster preparedness in health workers.Methods: A cross sectional survey was conducted among health workers at Petang and Abiansemal public health centres (PHCs). Of the six PHCs, four were randomly selected consisting of one PHC in Petang Sub-district and three PHCs in Abiansemal Sub-district. All health workers (271 people) in the four PHCs were selected as respondents. Individual face-to-face interviews were conducted by the first author during April 2018 in the workplaces of each respondent using a pre-tested questionnaire. Data collected consisted of socio-demographic characteristics, knowledge, perceptions, participation in training, experiences in disaster management and disaster preparedness. Questions consisted of three components namely knowledge (12 items), perception (32 items) and disaster preparedness (25 items). Bivariate analysis was conducted with chi square test and multivariate analysis with binary logistic regression to determine the association between knowledge, perception, participation in training and experience in disaster management with disaster preparedness.Results: The results showed that 70.9% of respondents had attended disaster training, 40.6% had good knowledge, 24.7% had participated in disaster management and 49.1% had a high level of disaster preparedness. The variables significantly associated with disaster preparedness were perceptions (AOR=6.40; 95%CI: 3.71-10.99) and participation in disaster training (AOR=2.68; 95%CI: 1.44-4.97).Conclusion: Perception and participation in training are significantly associated with disaster preparedness. Continuous training is needed to increase disaster preparedness among health workers.

scholarly journals Emergency nurse’s perceptions of hospital facility support and disaster preparedness

2020 ◽  
Vol 9 (4) ◽  
pp. 347
Author(s):  
Dewa Gede Sanjaya Putra ◽  
Kuswantoro Rusca Putra ◽  
Noorhamdani AS
Keyword(s):  
Disaster Preparedness ◽  
Assessment Tool ◽  
Health Workers ◽  
Health Sector ◽  
Rank Test ◽  
P Value ◽  
Evaluation Tool ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Hospital Facility

Disasters cause material losses, morbidity, and deaths. Support for the role of hospitals and health workers, especially nurses, is needed to reduce the number of victims in each disaster. Using a cross-sectional survey design, this study aims to analyze the relationship between nurse’s perceptions of hospital facility support and disaster preparedness. One hundred sixty seven respondents were selected using proportional random sampling. Disaster preparedness evaluation tool (DPET) was used to assess the participants’ readiness, and the Health Sector Self-Assessment Tool for Disaster Risk Reduction was used to assess nurse’s perceptions of hospital facility support. The final results of the analysis using the Spearman Rank test showed a significant correlation between hospital infrastructure support and emergency nurse’s preparedness in disaster preparedness with a p-value (0.00). The higher the nurse’s perceptions of hospital facility support, the higher their preparedness in disaster management is. Strengthening guidelines of disaster planning in hospitals, especially regarding the ability of hospitals to overcome the impacts of disasters, will provide optimal support for emergency nurses during a disaster crisis.

scholarly journals Variation in Use of Damage Control Laparotomy for Trauma By Trauma Centers in the United States, Canada, and Australasia

2021 ◽  
Author(s):  
Derek J. Roberts ◽  
Peter D. Faris ◽  
Chad G. Ball ◽  
Andrew W. Kirkpatrick ◽  
Ernest E. Moore ◽  
...  
Keyword(s):  
United States ◽  
Damage Control ◽  
High Volume ◽  
The United States ◽  
Trauma Centers ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Frequency Of Use ◽  
Volume Level ◽  
Level 1

Abstract Background: It is unknown how frequently damage control (DC) laparotomy is used across trauma centers in different countries. We conducted a cross-sectional survey of trauma centers in the United States, Canada, and Australasia to study variations in use of the procedure and predictors of more frequent use of DC laparotomy.Methods: A self-administered, electronic, cross-sectional survey of trauma centers in the United States, Canada, and Australasia was conducted. The survey collected information about trauma center and program characteristics. It also asked how often the trauma program director estimated DC laparotomy was performed on injured patients at that center on average over the last year. Multivariable logistic regression was used to identify predictors of a higher reported frequency of use of DC laparotomy.Results: Of the 366 potentially eligible trauma centers sent the survey, 199 (51.8%) trauma program directors or leaders responded [United States=156 (78.4%), Canada=26 (13.1%), and Australasia=17 (8.5%)]. The reported frequency of use of DC laparotomy was highly variable across trauma centers. DC laparotomy was used more frequently in level-1 than level-2 or -3 trauma centers. Further, high-volume level-1 centers used DC laparotomy significantly more often than lower volume level-1 centers (p=0.02). Nearly half (48.4%) of high-volume volume level-1 trauma centers reported using the procedure at least once weekly. Significant adjusted predictors of more frequent use of DC laparotomy included country of origin [odds ratio (OR) for the United States vs. Canada=7.49; 95% confidence interval (CI)=1.39-40.27], level-1 verification status (OR=6.02; 95% CI=2.01-18.06), and the assessment of a higher number of severely injured (Injury Severity Scale score >15) patients (OR per-100 patients=1.62; 95% CI=1.20-2.18) and patients with penetrating injuries (OR per-5% increase=1.27; 95% CI=1.01-1.58) in the last year.Conclusions: The reported frequency of use of DC laparotomy was highly variable across trauma centers. Those centers that most need to evaluate the benefit-to-risk ratio of using DC laparotomy in different scenarios may include high-volume, level-1 trauma centers, particularly those that often manage penetrating injuries.

scholarly journals Hubungan Peran Ketua Tim dengan Kinerja Perawat dalam Dokumentasi Asuhan Keperawatan di Rumah Sakit Jiwa Provinsi Jambi

2021 ◽  
Vol 10 (1) ◽  
pp. 196
Author(s):  
Fithriyani Fithriyani ◽  
Miko Eka Putri
Keyword(s):  
Nursing Care ◽  
Significant Relationship ◽  
Sampling Technique ◽  
Team Leader ◽  
P Value ◽  
Cross Sectional Survey ◽  
Chi Square ◽  
Cross Sectional ◽  
Team Members

The quality of service can be determined from the performance of the nurse in providing nursing care. The success of the team method in carrying out the nursing process is determined by the ability of the team leader to assign tasks to team members and direct work to the team. This study aims  to knowing  the relationship between the role of the team leader and the performance of nurses in documenting nursing care at the Jambi Provincial Psychiatric Hospital. A quantitative method with a cross-sectional survey using self-administered questionnaires The sampling technique was total sampling so that the sample size was 106 nurseswith analysis using the chi square test. The data were analyzed using statistical software. This study investigates the role of team leaders and nurses' performance in documenting nursing care. the role of the team leader in documenting nursing care was 54.1% good. the performance of nurses in documenting nursing care was 53.2% good. The statistical test results showed that the p value (0,000) <0.05, which means that there is a significant relationship between the role of the team leader and the performance of nurses in nursing care documentation.This significant relationship explains that the role of the team leader will have a good influence on the documentation of nursing care carried out by the nurse in charge

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