Nurses readiness regarding disaster

Nurses readiness regarding disaster ….

DescriptionTopic:Nurses readiness regarding disaster preparedness

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Literature Review
It is generally accepted that nurses have insufficient knowledge about disaster preparedness due to a lack of acceptance of core competencies and the absence of disaster preparedness in nursing curricula.
A cross-sectional research design was used by Tzeng, Feng, Cheng, Lin CH, Chiang, Pai, & Lee. (2016) to analyse the perceived readiness of hospital nurses for a disaster response and the factors influencing their report for work outside the hospital environment. Result showed majority of hospital nurses’ demonstrated poor readiness for disaster responses. Scores on the four domains were most associated with nurses’ disaster-related training, experience in disaster response and emergency/intensive care experience.
A quantitative, non-experimental, descriptive study conducted by Al Thobaity, Plummer, Innes, & Copnell, (2015) to explore nurses’ knowledge and sources of knowledge, and skills as they relate to disaster management in Saudi Arabia, where more than 4660 people have died, 32,000 people have been affected, and US$4.65 billion in damage has been caused by disaster since 1980. Results revealed that nurses in Saudi Arabia have moderate knowledge concerning disaster preparedness. However, nurses in military hospitals possess more knowledge than those who work in government hospitals. The majority of nurses gained their knowledge and skills from disaster drills.
A cross-sectional survey was conducted by Al Khalaileh, Bond, & Alasad, (2012) to assess Jordanian RNs’ perceptions regarding their knowledge, skills, and preparedness for disaster management using Disaster Preparedness Evaluation Tool (DPET®). Results Four hundred and seventy-four participants completed the survey. Sixty-five per cent of respondents described their current disaster preparedness as weak: 18% medium: 12% good; and 5% felt their preparation was very good. Thirty-one per cent received disaster education in undergraduate programs; 8% in graduate nursing programs; 31% in facility drills, and 22% in continuing education courses. Eleven per cent had participated in a real disaster. Four hundred and thirty RNs wanted to learn more about RNs role in disasters, including knowledge and skills.
An anonymous national survey of PNPs was conducted by Goodhue, Burke, Ferrer, Chokshi, Dorey, & Upperman, (2012) to examine factors associated with pediatric nurse practitioners (PNPs) reporting to work in the event of a disaster. Result revealed that the factors associated with increased likelihood of responding included gender (being a male PNP), military experience, and disaster training. The most significant factor associated with an increased likelihood of responding to work during a disaster was having a specified role in the workplace disaster plan. PNPs with a specified role were three times more likely to respond than were those without a specified role.
An integrative review of literature was conducted by Jose, & Dufrene, (2014) to determine the suitable disaster preparedness competencies for undergraduate nursing curriculum and methods of instruction to deliver disaster preparedness content. The result shows that there was no uniformity of intended competencies among the studies, though all studies used resources from reputed national and international organizations. All the studies reviewed adhered to a systematic approach in delivering content and used eclectic methods including multiple technologies to enhance the educational outcomes. Most of the studies had incorporated simulation in different ways involving low to high fidelity simulators, virtual simulation and live actors. Content and length of the programs were greatly varied but stayed focused on the general principles of disaster management and appropriate for the level of the students within the programs.
Labrague, .Hammad, Gloe, McEnroe-Petitte, Fronda, Obeidat, Leocadio, Cayaban, & Mirafuentes. (2017) conducted a systematic review to explore peer-reviewed publications that measure nurses’ preparedness for disaster response. Result showed factors that increase preparedness for disaster response include previous disaster response experience and disaster-related training. However, it is widely reported that nurses are insufficiently prepared and do not feel confident responding effectively to disasters.
A cross-sectional study conducted by Ahayalimudin, Ismail, & Saiboon, (2012) to determine the knowledge, attitude and practice of emergency nurse and community health nurse towards disaster management among 468 nurses working in emergency departments and health clinics . Result revealed that both groups of nurses had similar inadequate knowledge but portrayed positive attitude towards disaster management. Emergency nurses who have been involved in disaster response are more likely to report adequate practice (95% CI=1.691-9.504) while those who attended disaster-related education/training are more likely to have adequate knowledge (P<0.05, AOR=3.807, 95% CI=1.584-9.153) and practice (P=0.001, AOR=4.145, 95% CI=1.804- 9.525).
Baack, & Alfred, (2013) conducted a descriptive analysis of rural nurses’ perceived readiness to manage disaster situations. Findings revealed that most nurses are not confident in their abilities to respond to major disaster events. The nurses who were confident were more likely to have had actual prior experience in disasters or shelters. Self-regulation of behavior (motivation) was a significant predictor of perceived nurse competence to manage disasters only in regard to the nurse’s willingness to assume the risk of involvement in a disaster situation.
In Oman, Achora, & Kamanyire, (2016) conducted a study to highlight the current state of nursing education and training in disaster management, both generally and in Oman and discuss the significance of disaster preparedness training and recommendations for its inclusion in nursing practice and education. They concluded that there is an urgent need to include disaster preparedness content in undergraduate nursing curricula, both globally and within Oman. WHO and ICN Framework of Disaster Nursing Competencies is recommended for inclusion within nursing education.
In Egypt, a quasi experimental research study with pre-test post-test time series and follow up assessment was conducted by Diab, & Mabrouk, (2015) to evaluate the effect of a guidance booklet on knowledge and attitude about disaster preparedness among nurses. The results of this study showed that, majority of nurses scored weak estimation in knowledge, awareness and attitudes level at pre-test measurement. Conversely, lowest percentages had moderate level, and good level of knowledge related to general disaster, while only 12.6% of nurses were satisfactory awareness about hospital disaster preparedness and 37.5% had positive attitude towards disaster management.
A descriptive, cross-sectional research was carried out by Labrague, Yboa, Petitte, Lobrino, & Brennan, (2016) to examine the perceived level of disaster preparedness in Philippine nurses. They found three fourths of the respondents (n = 136, 80%) indicated that they were not fully prepared to respond to disasters, while only 20% (n = 34) acknowledged that they felt they were adequately prepared. Respondents believed that they could function in the primary roles of educator (n = 107, 62.94%), caregiver (n = 104, 61.17%), and counselor (n = 82, 48.24%). More than half of the respondents (n = 98, 57.7%) were not aware of existing protocols of disaster management in the workplace. Courses taken in such areas as first aid (n = 79, 46.4%), field triage (n = 43, 25.29%), and basic cardiac life support (n = 57, 33.53%) were cited as important in preparing for disasters.
Saudi Arabia, cross-sectional descriptive study was conducted by Ibrahim, (2014) to examine nurses’ knowledge, attitudes, practices and familiarity regarding disaster and emergency preparedness-Saudi Arabia. The study findings revealed that the knowledge level was 21.2 ± 6.0. A highly significant difference was found for attitude and practice regarding disaster preparedness as well familiarity concerned emergency preparedness P≤.000. Based on the present study results; lacking of knowledge and practices with acceptable level of attitude regarding disaster preparedness and neutral familiarity with emergency preparedness were concluded.
Singhal, Bhatnagar, Lal, & Paliwal, (2016) to access the knowledge, attitudes, and practices of medical internship students regarding disaster preparedness. Materials and Methods: Study design is facility-based, descriptive, cross-sectional survey. The study population included the medical internship students. The study duration was 1 month. The study was conducted utilizing a self-administered, pretested, prestructured questionnaire. Result revealed that 87 of the 102 internship students completed a self-administered questionnaire. The response rate was 85.29%. Medical internship students exhibit an excellent basic knowledge of disaster plan and preparedness in the hospital. Their awareness and attitude for the disaster plan and preparedness were significantly positive. They were deficient in the knowledge and attitude regarding their functions during drill. The practices regarding disaster preparedness training and performance of drills were largely negative, and sincere work needs to be done in this direction. Majority of students responded positively to include the disaster training in internship program.
A cross-sectional study was conducted by Tzeng, Feng, Cheng, Lin, Chiang, Pai, & Lee. (2016) to analyse the perceived readiness of hospital nurses for a disaster response and the factors influencing their report for work outside the hospital environment. A sample of 311 registered nurses participated in this study using a 40-item researcher-designed, self-administered questionnaire found to have satisfactory reliability and validity. The result showed that majority of hospital nurses demonstrated poor readiness for disaster responses. Scores on the four domains were most associated with nurses’ disaster-related training, experience in disaster response and emergency/intensive care experience.
Baack, & Alfred, (2013) conducted a descriptive analysis of rural nurses’ perceived readiness to manage disaster situations. Findings revealed that most nurses are not confident in their abilities to respond to major disaster events. The nurses who were confident were more likely to have had actual prior experience in disasters or shelters. Self-regulation of behavior (motivation) was a significant predictor of perceived nurse competence to manage disasters only in regard to the nurse’s willingness to assume the risk of involvement in a disaster situation. Healthcare climate (job satisfaction) was not a determinant of disaster preparedness.
A study of Alzahrani, & Kyratsis, (2017) conducted in 4 public hospitals in Mecca, Saudi Arabia to assess hospital emergency nurses’ self-reported knowledge, role awareness and skills in disaster response with respect to the Hajj mass gathering in Mecca. Results showed that nurses reported limited knowledge and awareness of the wider emergency and disaster preparedness plans, including key elements of their hospital strategies for managing a mass gathering disaster. Over half of the emergency nurses in Mecca’s public hospitals had not thoroughly read the plan, and almost 1 in 10 were not even aware of its existence. Emergency nurses reported seeing their main role as providing timely general clinical assessment and care; however, fewer emergency nurses saw their role as providing surveillance, prevention, leadership or psychological care in a mass gathering disaster, despite all these broader roles being described in the hospitals’ emergency disaster response plans. Emergency nurses’ responses to topics where there are often misconceptions on appropriate disaster management indicated a significant knowledge deficit with only 1 in 3 nurses at best or 1 in 6 at worst giving correct answers. Respondents identified 3 key training initiatives as opportunities to further develop their professional skills in this area: (1) hospital education sessions, (2) the Emergency Management Saudi Course, (3) bespoke short courses in disaster management.
The study conducted by Zagelbaum, Heslin, Stein, Ruzek, Smith, Nyugen, & Dobalian, (2014) aimed to identify factors that impact willingness to deploy in the event of an emergency. This analysis was based on responses from 2,385 survey respondents (response rate, 29%). Latent variable path models were developed and tested using the EQS structural equations modeling program. Background demographic variables of education, age, minority ethnicity, and female gender were used as predictors of intervening latent variables of DEMPS Volunteer Experience, Result shows Disaster Emergency Medical Personnel System (DEMPS) Volunteer Experience and a Positive Attitude about Training were associated with Readiness to Deploy. Stress was associated with decreased Readiness to Deploy. Female gender was negatively correlated with Readiness to Deploy; however, there was an indirect relationship between female gender and Readiness to Deploy through Positive Attitude about Training.
The study of Yamashita, & Kudo, (2014) to analyse preparedness Following the Great East Japan earthquake (the Big Quake) that hit the northeastern parts of Japan on March 11, 2011, aid was dispatched from multiple levels of organizations including the Japanese Nurses Association (JNA). Evidence indicates that the JNA did not play an effective role in the aid efforts, since the professional organization had pulled out and stopped sending nursing personnel from the end of April 2011. In view of the way that things were handled in terms of aid efforts immediately, a year, or two years after the Big Quake occurred, the authors of this paper have identified issues related to nurse’s role at the time of the disaster. By looking back at what happened, we have gained insights into how to prepare for future disasters.
Mbewe, & Jones, (2013) identified the competencies necessary to survive natural hazards and disasters. In addition, it held that these competencies are best identified by the (1) people involved in disaster risk reduction like planners, managers, and responders and the (2) survivors of major disasters like earthquake, landslide, volcanic eruption, and typhoon. The former have the training and experience in saving lives during critical times while the latter have directly experienced dangers and eventually triumphed over fatal conditions. Competencies gathered through focus group discussions and interviews were grouped into two: preparedness competencies and response competencies. The identified competencies include possession of disaster kit, ability to use disaster imagination, obedience to authority, trained in disaster preparedness or survival skills, application of science in decision-making, presence of mind, and possession of right attitude like optimism and being proactive. Finally, this research recommends that intensive disaster education and training in the schools and in the community be done, survivors’ experiences in crafting disaster education and training programs be included and taught, non-skill competencies like behavior and attitude during disaster education and training.
A descriptive survey was conducted by Whetzel, Walker-Cillo, Chan, & Trivett, (2013) to assess nurses’ perception regarding their role in a disaster and their perceived susceptibility to a disaster. In addition, basic knowledge and role preparation was reviewed. The 56-question survey was developed for the purpose of this study. The results reflect that many emergency nurses have not taken basic actions to prepare themselves for a disaster, either personally or professionally.

References

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