The simulation is based on the natural disaster where different public health care specialists are to give their responses in reference to the summer storm. These professionals are inclusive of directors, nurses, and environmental specialists all in public health departments. Through the simulation, there is the identification of the emerging health concerns that these specialists meet where they give their responses depending on the most effective immediate action needed.
The public health personnel played a very significant role in the disaster inclusive of the public health nurse. They were involved in addressing both immediate and long-term public health care concerns. Some of the health concerns included the drinking water which needed to be boiled because it was already contaminated and food. The shelter was also an immediate concern that needed to be addressed like in the development of temporary housing. The health personnel was also involved in the response to command and emergency operations which were of many benefits to the society (Clark, 2007). The public health nurse involved himself in the door knocking where he identified different emergency problems and tried to offer the necessary responses and actions. The health personnel played very significant roles in the dissemination of the health information that was needed to the public.
A chain command was used in the simulation for the community health nurse. The incident commander briefed on the number of houses where electricity had gone out about 1500 and also where stabilization of waters had happened. The director in public health gave information concerning the vaccines provided initiatives on the assessment of the hotels. The public information officer promoted giving out of the appropriate as well as the adequate information to the general public. The operation chief gave information on the damages which had already occurred thus devising various ways of coping with the development in implementing strategies. The Logistics chief held the role of making things operational for the developmental strategies. The planning chief held the role of information analysis as well as its dissemination. The administration chief was responsible for all financial processes involved in the developmental strategies of coping up with the disaster. This command system helped in the organization of quick emergency response to the disaster. The community nurse should, in this case, report to the planning chief who is responsible for the collection and transmission of the information and making accurate decisions on that information.
Some of the situations were outside the nurse’s scope of practice. However, there were resources that were available to the community health nurse which assisted him in dealing with situations such as the boil water notice for about five minutes. Radio communication was also used since the telephone lines were out of work, mental health service providers helped in counseling the affected victims. The Mutual Aid Pack also helped the community health nurse in the services which were provided to the victims. The health specialist in the environmental field helped the community health in addressing the environmental hazards that were present and the means of dealing with them (Clark, 2003). The press as a resource helped in passing the relevant information and the updates to the victims that the health nurse was dealing with. The Health Alert Network played a great role in alerting the public to the best health tips which were to be effectively used.
The health nurse experienced some emergencies which needed to be addressed during the door-to-door interviews. For instance, where one explained that his basement was already flooded with some paints and oil, the health nurse had to send an environmental health specialist who was well conversant on the cleanup process since the paints and oil were hazardous. Another emergency the health nurse had to deal with it was when he was faced with a situation where the family had run out of everything. They had a small baby who needed the diapers; the family was also in need of food and drinking water. The husband to the family was away whereas he had brought his mother who added the cost of the expenses needed in the house. The action taken by the health nurse was depended more on the decision of the victim since she is already an adult on the suggestion of moving into a better shelter where there were electricity and the availability of hot meals.
The language barrier was another challenge that the health nurse encountered in the door-to-door interview. In one of the households, the owner only spoke Spanish but the nurse used gestures so as to have an assessment in the house of the resident where he realized that one of the sons was in the backyard where the generator was thus, he was able to instruct the son on how to handle the generator indoor. The health nurse also met someone who had blood pressure but the pills had run out. The action taken by the nurse was first the assessment of the blood pressure where he was to arrange for the delivery of the medication afterward as well as assessing other medical circumstances that needed an immediate action where he also arranged for the evacuation into a sheltered environment (Clark, 2003).
After the flooding people had difficulties in dealing with the situation out of the trauma but the health nurse played a very significant role in helping them to deal with the situation. One of the women found it difficult to deal with the husband who had lost his job out of the disaster where he used to yell a lot while the daughter had developed a habit of drawing moody pictures. the technique used by the health nurse in calming the woman’s fears was to make her understand that the husband and the daughter just like any other person were trying to adjust to the situation. She was also advised to attend counseling services to them that deals with mental health. One of the houses grew mold on the walls where the owner experienced weird headaches where the health officer took an action of involving the environmental specialist in dealing with the problem. Another residence made a call due to the massive reaction which happened to his kid where chemicals were involved and he was advised to call 911 to secure the environment and avoid such instances.
Interviewed people had to cope with stress and fear after the flooding; so, health care providers had to choose the methods to help them. In this respect, the community health nurse can be the health care representative to help people that suffered from the flooding to cope with their problems. As the psychological condition of the population, as well as their physical condition, could have been better, it was necessary to use certain techniques that could have been used to calm the fears of the people interviewed. Through group sessions that could be more appropriate in this situation, work therapy might have been used as well to distract people from their thoughts about the disaster and direct their emotions on attempts to help others. Other nursing personnel could be prepared to help in responding to a similar emergency with a much larger affected area, for instance, the effect of Hurricane Katrina. Teaching people to boil water and follow the easiest rules that can be applied to such situations can be the most appropriate help provided by nursing personnel. Though the nursing personnel is not sufficiently trained to respond to disasters of that scale, they can be trained to become the first responders in such situations. So, it is possible to train the nursing personnel to make appropriate decisions and report to people who are in charge of the situation and control the flow of information as well as decisions made on each separate case.
In conclusion, the community health nurse had successfully conducted a door-to-door interview but he was also needed to do some listings. In the listing, there was to be a press release on various information on coping strategies. Property inspection was also necessary where the information was to be passed to the EHS. Out of the trauma and the depression experience, the mental health service was meant to play a very significant role whereas the issue regarding the chemical incident was to be met by the EHS.
It is good for other nursing personnel to be always prepared when faced with such disasters or related health problems. I would therefore recommend them to improve the way the health information is transmitted. Announcements based on the food donations should always be made to avoid some being thrown away especially those that are homemade. They should also work with the federal agencies so as to reduce unnecessary legal issues that act as barriers to the emergency responses which are effective. Community assessment should be conducted so easier communication, especially with the diverse culture.
References
Clark, M. J. (2007). Community Health Nursing: Advocacy for Population Health. Chicago: Prentice-Hall.
Clark, M. J. (2003). Community health nursing: caring for populations. Chicago: Prentice-Hall.
Disaster is the biggest catastrophe that puts the lives of human beings in danger. Disasters can either be man-made such as terrorism or natural disasters such as hurricane or tornados. Public health nurses need to be well prepared in order to act immediately in case a disaster happens.
There are various roles that public health personnel or nurses need to perform in times of disaster. In this case, the public health personnel are given the responsibility of ensuring that the population is fed with the right information concerning the step by step occurrences at the scene of the disaster. It is the duty of the public health personnel or nurses to provide food and safe drinking water to the victims and ensure that food products delivered to the victims are safe for human consumption. The personnel are supposed to issue directions on how the food in refrigerators and stores can be used and stored safely to avoid contamination. Public health personnel are also supposed to issue press briefs to explain how the situation is and offer the various alternatives that can be used in order to ensure each individual is safe (University of Minnesota, 2011).
Public health personnel are also supposed to inspect all the temporary shelters erected for the purposes of evacuating the victims by ensuring that they are of recommended conditions in terms of hygiene and human safety. Public health personnel should also ensure that all medical facilities required are provided and inspected to ascertain that that they are suitable for human use. Such measures will ensure that people are not evacuated from stressful conditions to other condition that contains another form of stress.
The public health personnel should inspect the damage caused by the disaster and come up with a detailed report concerning the number of deaths that arise as result of the disaster. They should also establish the injuries sustained and those are still missing in order to advice the rescuing team. Lastly, the public health personnel should inspect all the restaurants, their employees and finally the overall hygiene standards of such restaurants.
The chain of command used in this simulation is very simple and well selected to ensure that the information flows from one unit to the next without any delays. A well-organized chain of command ensures that the rescue work flows well without any interference as each manager understands his or her responsibilities. The chain of command starts from Incident Command who is in charge of the whole team, each department should report to him or her. Under him is the Public Information Officer who is in charge of ensuring that the correct health information is disseminated to the public at the right time. He or she ensures that the public health personnel and other rescuing agents are well informed about the rescuing progress. In the same line with the Public Informational Officer is the Liaison Officer who acts as a point of support by assisting the rescuing agents in answering their questions and giving brief information of the rescue progress when necessary. He or she interlinks the rescuing team with other departments (University of Minnesota, 2011).
Below the Liaison Officer is the Operational Officer. A Liaison officer is responsible for developing and implementing various strategies and tactics to help in rescuing and evacuating the victims. He or she organizes, assigns and monitors or supervises the field resources used by the rescuing team. The next in line is the Planning Officer. He or she is in charge of the planning process and mobilizes an action plan to be taken. The other person in management chain is the Logical Officer. He or she is responsible for ensuring that all that is needed is in order for the job to be done. He or she ensures that equipment, space and any other necessary supplies that will increase the rescue efforts is provided at the right time. The last in chain is the Financial/ Administrative Officer who ensures that financial resources are available and well used.
There are a number of resources that can be used by the public nurses to perform the duties of rescuing communities at risk and ensuring that the population is out of any danger that could be caused by the disaster. The public health community should make sure that they liaise with various agents to assist them in delivering the services to the community at a satisfactory level. This agent may include the Mental Health Department which will assist in giving guidance and counseling to victims who have the sign of stress and are suffering from the aftershock caused by the disaster. They should also work hand in hand with Environmental Specialists in order to give guidance and procedures that should be used when cleaning the affected areas. Also, the public health nurses should work together with Environmental Specialist in assessing areas affected by chemicals and take the necessary measures to avoid further damages to the environment and people living around the affected areas (University of Minnesota, 2011).
Another resourceful agent that the public health officer should use when dealing with disaster is the Police Department. The Police Department will assist in maintaining order and restricting people from moving to prohibited areas where there might be spilled chemicals. The Police Department will also assist in evacuating stranded people to safer places. The last resourceful agent that the public health personnel should make use of is the media. This will assist in preventing the spread of rumors about the aftermath of the disaster. On the other hand, it will assist in calming down the population in large, as it will assure them that the public health personnel in conjunction with other rescuing agents are in the position of safely evacuating them.
The public health nurses have to take immediate action depending on the response given by the victims visited. One of the actions taken by the nurses is to advice the victims on how to keep themselves safe and avoid any danger that may be caused as a result of the disaster. The nurses should compile a report and send it immediately to the Emergency Operation Center so that the necessary actions can be taken. In case he or she comes across victims whose health condition is not fit. They should examine the patient and offer the necessary advice to the patient. If the victim’s condition is out of his of her ability to handle due to lack of necessary medical facilities, he or she should arrange for immediate evacuation by calling the Emergency Operation Center giving the detailed account of the patient and the immediate action needed to be taken.
The nurses should advice the owners of the houses on the right procedures to be followed when cleaning up the apartment. They should assess the situation and recommend specialists where need be in order to assist in the cleaning process with the necessary equipment that can be used in cleaning without causing any harm or damage to the environment.
The public health nurse plays a major role in assisting people affected by the disaster to cope with the situation in various ways. One, they ensure that all people interviewed are given the right advice concerning their current situation. Secondly, those in need of medical attention are referred to the right personnel or the specialist is sent to assist in examining them and giving them the correct treatment.
Thirdly, those in need of assistance in cleaning up their houses are given advice on how to go about with the cleaning process. In cases where there is chemical contamination, environmental specialists are sent to advice on the best cleaning procedures (Vogt, and Kulbok, 2008). Fourthly, those in need of specific supplies such as food, water and other house commodities are linked with the right department which supplies them with the necessities to assist them in continuing with their lives normally until the situation is fully settled. Fifthly, those whose houses are fully destroyed are linked with the right departments which are supposed to assist them in rebuilding their houses.
In order to calm the fears, the public health personnel should ensure that they give the correct response to the question asked by the people. They should ensure that they do not give uncertain answers. Uncertain answers increase fear as they neither address the situation nor give solutions. They should be brief and direct to the point (Vogt, and Kulbok, 2008). They should ensure that they link the interviewed persons with the right personnel who can offer the needed support and advice to the interviewed person. They should record all details about the person interviewed such as house number, the street, number of people stranded in the compound, what the family needs in order to keep them surviving and any other necessary information. This will enable the person interviewed to feel that all his or her needs are being catered for and thus, he or she has nothing to worry about.
The public health personnel needs to be well trained in various fields such as communication skills in order to be able to disseminate and convey the information to the victims and the public in general without creating panic, fear or uncertainty. The public health department should organize training in order to educate the nurses on how to use the Emergency Communication System in case the cell and land line controlling towers are not functioning. Still under communication skills they need to be trained on how to use sign language to enable them communicate with people speaking different languages from theirs and overcome all form of language barriers.
Another area they need to be trained on is in the management skills as they need to integrate various departments in order to achieve their motives of saving life. Therefore, they should be well trained on management skills and leadership skills (Williams, Nocera and Casteel, 2008).
References
University of Minnesota. (2011). Disaster in Franklin County Simulation. Web.
Vogt, V. & Kulbok, P., A. (2008). Care of Client in Disaster Settings Community Health Nursing: Advocacy for Population Health. 5th Ed., Vol. 2. New Jersey: Pearson Prentice Hall.
Williams, J., Nocera, M. and Casteel, C. (2008). The effectiveness of disaster training for Health care workers: A systematic review. Annals of Emergency Medicine, 52(1), Pp. 211-222.
The 7.0 magnitude earthquake that faced Haiti in 2010 was a major blow to nurses and other healthcare professionals. Various credible sources indicated that the natural disaster affected about 3.5 million people who required immediate medical and counseling services besides food, water, and shelter. This essay provides a detailed analysis of various primary, secondary, and tertiary nursing interventions that were related to the disaster.
The Role of the Nurses in the Site of Earthquake
Primary Interventions
The need for primary prevention in the Haiti earthquake was paramount to the protection of the people against injuries and various diseases. For example, the nurses were charged with the prevention of communicable, airborne, and vector-borne diseases (Waring & Brown, 2005). The post-disaster strategies that were laid to prevent such occurrences included the provision of emergency medical care, shelters, proper site planning, clean water and sanitation, safe food, vector control, and education for the victims and humanitarian workers (Waring & Brown, 2005).
Secondary Intervention
The secondary intervention at the site was conducted to ensure the reduction of various effects of the diseases and injuries on the victims. The procedure for conducting the secondary interventions involved immediate detection and treatment of the injuries and diseases to halt their progress, implementing strategies for preventing the re-occurrence of the injuries. The secondary interventions also entailed the initiation of programs that helped the victims recover their original health statuses besides reducing long-term problems. For example, most nurses were involved in the regular examination of patients, provision of proper diet, modification of work for the injured people who wished to resume work, and administration of the appropriate drug dosages among others (Barzilay et al., 2013).
Tertiary Intervention
The primary aim of the tertiary intervention conducted by the health practitioners was to reduce the effect of the diseases and injuries that occurred because of the Haiti earthquake. For example, various programs were initiated to manage stroke, depression, permanent injuries, stress, and post-traumatic disorders among others. The nurses developed support groups to help the victims share their strategies with a view of coping with the situations that prevailed. There were also vocational programs to ensure that workers who were moderately affected either retained or found new jobs upon recovery (Raviola, Eustache, Oswald, & Belkin, 2012).
Phases of the Disaster
The first phase of the intervention involves rescuing the victims by offering them life maintenance services. Both the secondary and tertiary phases fall under the relief and recovery levels. They are used to putting the situation under control by ensuring that the victims pick various strategies to restore their lives back to normal (Raviola et al., 2012).
Various agencies to facilitate the interventions
Various individuals and agencies that helped in ensuring the implementation of the interventions included non-governmental organizations such as the World Health Organization (WHO), Red Cross, St. John’s Ambulance, the United Nations, donors, and well-wishers among others (Raviola et al., 2012).
Conclusion
The essay has explored the role of the nurses in the aftermath of the Haiti earthquake in 2010. The establishment of primary, secondary, and tertiary care interventions is critical in the event of natural disasters. The nurses are required to work with various agencies in ensuring that they minimize further loss of lives. As a result, a multidisciplinary approach should be proficiently implemented to prevent the occurrence of illnesses in an attempt to promote healthy recovery.
Reference List
Barzilay, E., Schaad, N., Magloire, R., Mung, K., Boncy, J., Dahourou, G.,…Tappero, J. (2013). Cholera surveillance during the Haiti epidemic: the first 2 years. New England Journal of Medicine, 368(7), 599-609.
Raviola, G., Eustache, E., Oswald, C., & Belkin, G. (2012). Mental health response in Haiti in the aftermath of the 2010 earthquake: a case study for building long-term solutions. Harvard review of psychiatry, 20(1), 68-77.
Waring, S., & Brown, B. (2005). The threat of communicable diseases following natural disasters: a public health response. Disaster Management & Response, 3(2), 41-47.
The city of Mecca has been attracting a large mass of people who come for the pilgrims on a regular basis. It is one of the leading tourists’ attraction centers in the Middle East. This means that mass gatherings are very common in this city. Both the Saudi nationals and citizens of the international community gather in this city regularly for prayers. Hammad, Arbon and Gebbie (2011, p. 12) define mass gathering as “Events attended by a sufficient number of people to the level that strain the planning and response resources of the host where it is being held.” On the other hand, Imran and McLeod (2012, p. 59) says, “A mass gathering shall mean one which is likely to attract 5,000 people or more and continue for one hour or more.” In mass gatherings, there are numerous risks that may affect the people because of the high number of people. Some of the common risks at such events include accidents, stampede, spread of infectious diseases, and terrorism among others (Higgins, Wainright, Ning & Carrico 2004, p. 330). In case of emergency arising from any of the risks mentioned above, there will be a strain in the local healthcare facilities. In the city of Mecca, there are four main acute hospitals where the victims of such occurrences would be rushed in order to get some help. This means that the nurses at these health facilities should be prepared for such eventualities in order to know how to deal with such situation. This will help in reducing the number of casualties from such cases of emergencies (Kija & Arbon 2008, p. 140). This research will focus on the nurse emergency and disaster preparedness during mass gatherings in the city of Mecca.
Research aims and objectives
The healthcare facilities are always ignored when planning for tourism which one of the main economic activities in this country. During the Hajj mass gatherings, a high number of Muslim faithful from this country and the international society face various risks which may lead to disaster (Arbon & Ranse 2013, p. 55). The Saudi government rarely factors in this huge population when budgeting for the hospitals. It means that these hospitals must be ready to manage the little resources they have to deal with cases of emergencies to protect lives in cases of disaster (Ranse, Shaban & Considine 2013, p. 59). The following are the specific objectives that the researcher seeks to achieve from this study.
Creation of knowledge on how to manage disasters that may strike in mass gathering within the city of Mecca.
Creation of awareness of some of the possible risk factors that may result into serious bodily harm.
Defining the roles of nurses in the events of disasters at mass gatherings
Creation of an understanding of previous disaster response experience among the current nurses in Mecca.
The above objectives will define the nature of the research. The medical practitioners in this city have limited capacity to prevent some of the risks from taking place (Duong 2009, p. 89). For instance, the nurses may not protect the masses from stampede. However, they can do something to the casualties in order to spare their lives. Finding what the medical practitioners can do, and how they can do it in the best manner possible, is the ultimate aim of this study.
Significance of the research
The city of Mecca remains one of the most important cities in Saudi Arabia, not only because of the number of tourists it attracts on a yearly basis, but also because of its symbolic nature to the people of this country. Hajj mass gatherings is common in this society and this increases chances that one of the risk factors may occur, which may lead to cases of emergency medical needs (Rassin, Avraham, Anat & Idelman 2007, p. 57). When this happens, it would mean that the hospitals will have to deal with cases beyond their capacity. The healthcare infrastructure in these four facilities may not be able to sustain the pressure of the population, and this means that the emergency unit will be faced with a massive challenge of offering healthcare services to the large crowd (Qanta, Yaseen & Ziad 2006, p. 1010). This means that it will be necessary to develop emergency and disaster preparedness measures that can be used in such cases.
This topic is interesting because it helps develop an approach that can be used by nurses at the four acute care hospitals in Mecca in cases of emergency during mass gathering (Arbon, Cusack, Ranse & Shaban 2013, p. 108). The study is particularly important to the nurses and management of these healthcare centers because it seeks to find the strategy that can be used to address such emergencies. The nurses will be prepared to deal with the emergencies when the disasters related to mass gatherings strike. They will know how to attend to as many clients as possible using the strained resources. To the management, this study will try to find a way of managing emergencies that arise from disasters in mass gatherings within the city of Mecca (Hammad, Arbon, Gebbie & Hutton 2012, p. 240). They will know how to plan for their resources in cases of emergency. The study will clearly state how these challenges can be address in a way that will minimize casualties without overstraining the existing resources. The researcher focused on the emergency department of hospitals because of the risk associated with mass gatherings. The city is sensitive to the country and any disaster may affect so many people and this may reduce its attractiveness to the international society (Williams, Maryalice & Carri 2008, p. 12). The emergency department of the hospitals needs to be ready for such occurrences in order to help minimize fatalities in case the disaster strikes.
According to Hammad, Arbon and Gebbie (2011, p. 65), people who visit this facilities need medical services because of a number of reasons, top of which is the change in the weather conditions. The locals may also need to visit healthcare facilities in case they contract infectious diseases from the visitors. The neighboring countries have several terror groups that have been targeting large crowds to unleash their terror. Although Mecca is regarded as a holy land, this may not stop them from committing crime. In fact, the mass gatherings common at Mecca could offer them a perfect opportunity to attack innocent people as a way of passing their message to people in leadership (Qanta, Barbeschi & Memish 2009, p. 230). In the past, there has not been a major disaster that has struck the mass gatherings. However, cases of infectious diseases have been common, and this always strains the facilities at the four acute care facilities in the city. Finding an appropriate solution would be very appropriate to all the stakeholders involved. This makes the research very important to the visitors, the local community, the medical practitioners, especially the nurses working in the emergency departments, and all other stakeholders who may be affected by such disasters directly or indirectly.
Research Methods
Research design
A cross-sectional survey is proposed to be used to collect data on hospital emergency and disaster preparedness from nurses working in the emergency departments of four hospitals in Mecca, Saudi Arabia. The cross-sectional survey will be conducted using self-administered questionnaire including a combination of structured and open ended questions.
Data collection
The questionnaire will be piloted and then applied amongst our hospitals in Saudi Arabia in Mecca City. The questionnaire will be circulated to managers in each of the selected hospitals via individual emails. The hospital managers will be asked to distribute this questionnaire among the nurses and other staffs in their hospitals within a period of two weeks. The questionnaire will include five main areas of questioning; demographics, knowledge, awareness, roles of nurses in disasters and the previous disaster response experience.
Data analysis
Choosing the right research method is very important in finding the solution in a given piece of research. At this section, the focus will be on the analysis of the primary data. The data collected from the registered nurses will be analyzed quantitatively in order to arrive at a given answer. As mentioned previously, this is an empirical study that will involve analyzing the information from the field in order to support a given argument or develop a new knowledge that would help improve the preparedness of the nurses when disaster strikes mass gatherings. The researcher will use SPSS (Statistical Package for Social Scientists) in order to analyze data collected from the field. SPSS software was chosen because of its ease to use and the ability to give various values whenever this is necessary. The raw data in the questionnaires will be corded in the SPSS spreadsheet. This will enable the researcher to obtain various values from the data collected. Some of the important values would be standard deviation, mean, mode, and median values. The data obtained from the spreadsheet can easily be presented in charts and figures to make it easy to understand. Some of the common figures would include graphs and charts to help summarize the information into graphics.
List of References
Arbon, P & Ranse, J 2013, Australasian emergency nurses’ willingness to attend work in a disaster, Australasian Emergency Nursing Journal, vol. 16. no. 1, pp. 52-57.
Arbon, P, Cusack, L, Ranse, J & Shaban, R 2013, Exploring staff willingness to attend work during a disaster: A study of nurses employed in four Australian emergency departments, Australasian Emergency Nursing Journal, no. 16. no. 5, pp. 103-109.
Duong, K 2009, Disaster education and training of emergency nurses in South Australia, Australasian Emergency Nursing Journal, vol. 12. no. 1, pp. 86-92.
Hammad, K, Arbon, P & Gebbie, K 2011, Emergency nurses and disaster response: An exploration of South Australian emergency nurses’ knowledge and perceptions of their roles in disaster response, Australasian Emergency Nursing Journal, vol. 7 no. 7, pp. 14, 87—94.
Hammad, K, Arbon, P, Gebbie, K & Hutton, A 2012, Nursing in the emergency department (ED) during a disaster: A review of the current literature, Australasian Emergency Nursing Journal, vol. 15. no. 5, pp. 235-244.
Higgins, W, Wainright, C, Ning, L & Carrico, R 2004, Assessing hospital preparedness using an instrument based on the Mass Casualty Disaster Plan Checklist: Results of a statewide survey, Bowling Green and Louisville, vol. 32. no. 6, pp 327-332.
Imran, K & McLeod, R 2012, Managing Hajj crowd complexity: Superior Throughput Satisfaction Health & Safety, Kuwait Chapter of Arabian Journal of Business and Management Review, vol. 2, no.4, pp. 45-59.
Kija, C & Arbon, P 2008, Are nurses ready? Disaster preparedness in the acute setting, Australasian Emergency Nursing Journal, vol. 11. no. 1, pp. 135-144.
Qanta, A, Barbeschi, B & Memish, Z 2009, The quest for public health security at Hajj: The WHO guidelines on communicable disease alert and response during mass gatherings, Travel Medicine and Infectious Disease, vol. 7. no. 22, pp. 226-230.
Qanta, A, Yaseen, A & Ziad, M 2006, Health risks at the Hajj, Review, vol. 367. no. 3, pp. 1008-1015.
Ranse, J, Shaban, R & Considine, J 2013, Disaster content in Australian tertiary postgraduate emergency nursing courses, Australasian Emergency Nursing Journal, vol. 16. no. 4, pp. 58-63.
Rassin, M, Avraham, M, Anat, N & Idelman, S 2007, Emergency Department Staff Preparedness for Mass Casualty Events Involving Children, DMR, vol. 5. no. 2, pp. 36-44.
Williams, J, Maryalice, N & Carri, C 2008, The Effectiveness of Disaster Training for Health Care Workers: A Systematic Review, Annals of Emergency Medicine, vol. 52. no. 3, pp. 1-14.
The human kind tends to believe that it is the strongest on the planet. We create megalopolises, build factories, power plants, and dams, subjugate animals, and so on and so forth. Actually, we can control and predict many things. Nevertheless, that is only a huge illusion. There will always be one thing that is hard to predict and impossible to control. That is the nature. And a large number of disasters that regularly occur throughout the world is the greatest proof. Floods, hurricanes, tornados, earthquakes, volcanic eruptions, tsunamis – they always happen unexpectedly, and all that remains for us to do is to recover from the consequences. In addition to natural disasters, there also are manmade ones. If floods or hurricanes can be predicted at least for some time before they happen, terrorist attacks, for example, are much less predictable (Gebbie & Qureshi, 2002, p. 49). As a result, they are harder to prepare for. According to a study conducted by Markenson, DiMaggio, and Redlener (2005), the majority of the health care workers who participated in it admitted that they felt more prepared for natural disasters than for terrorism (p. 518).
It is hard to define a disaster, and probably there is no “single agreed-upon definition” of it, but all definitions address the events that cause the widespread destruction, lead to “human, material, economic or environmental losses” and make people unable to respond adequately using their own resources (World Health Organization and International Council of Nurses, 2009, p. 3). So, no matter if it is a natural disaster or a manmade one, it does have irreparable consequences. The most disturbing fact is that disasters happen more often presently. According to Birnbaum (2002), during the last fifty years, their number has been steadily increasing, and the biggest rise has happened in the last decade. In confirmation of this, World Disasters Report states that there have been 60% more disasters in the world in the last decade in comparison with the previous one (World Health Organization and International Council of Nurses, 2009, p. 3). The same report said that the number of victims increased by 20 percent, and the number of death almost doubled (World Health Organization and International Council of Nurses, 2009, p. 3).
All of this confirms the need to have a well-prepared and skilled workforce that will be able to respond effectively when a disaster comes. And out of all health care workers, “nurses are often the first medical personnel on site after disaster strikes” (World Health Organization and International Council of Nurses, 2009, p. 4). They assist in providing first aid to sufferers, rescue lives, and help people to overcome both physical and psychological issues. They are the first responders, and that is especially true about the nurses of emergency department since EDs are overloaded with victims in times of disasters. That is why nurses should be aware of how to act at any stage of disaster management, starting with preparedness and ending with a recovery phase (Gebbie & Qureshi, 2002, p. 47). This paper examines the core competencies of disaster nursing, including competing issues in this matter, discusses those on a scope of an emergency department, talks about ethical practice and nurses’ ability to response and finally gives a conclusion with my own perspective on the problem.
Competencies and Competing Issues
Competencies in General
The term competency refers to the behavior of an individual who performs a specific role in a certain situation (Loke & Fung, 2014, p. 3290). In other words, it can be defined as “a combination of the knowledge, skills, abilities and behavior needed to carry out a job or special task” (Loke & Fung, 2014, p. 3290).
In their article, Gebbie & Qureshi (2002) identify several core competencies to be followed by nurses and their departments. First of all, a health care center, a department or a unit should decide what tactic to choose when a disaster strikes. In other words, it is necessary to determine if the range of provided services will change or if a unit will function as usual. For instance, when a disaster happens, nurses can either stay at the hospitals and perform their routine services or go to the hotspots, evacuate people and provide first aid. Secondly, “well-orchestrated teamwork” is necessary (Gebbie & Qureshi, 2002, p. 48). Everyone should know their role and place and be aware of the planning and logistics. Otherwise, it will be impossible to respond quickly and efficiently. Thirdly, every nurse should be familiar with the concepts of a disaster response plan and know where it can be found. Apparently, they should know all of the core aspects before a disaster happens.
The next step to think about is the gap between knowledge and practice. Nurses should not only be taught what to do if a disaster arises – they should be taught that in practice. A disaster response plan has to be tested. For example, there is an issue of equipment. All nurses are already well familiar with the equipment, which they use from day to day, but in the case of a disaster they will probably be required to use another, unfamiliar one. To avoid the mistakes connected with this, nurses should be taught how to use it in advance.
Particular attention should be paid to communication equipment. Communication failures are crucial, and they have already made the consequences of many disasters even more complicated. The prime example is Hurricane Katrina. The communication systems failed, which is why local and state governments could not deliver the resources to the places where those were needed: for example, they had buses to evacuate people, they just did not have those in the right places. As a result, many people were not evacuated in time, and that caused more injuries and deaths. Another example is a terrorist attack on September 11, 2001. The evacuation orders were sent to both police and firefighters; police heard the order, but the equipment the firefighters used could not receive it (Peha, 2007, p. 61). Consequently, although they had enough time to evacuate (nearly half an hour after the first order was transmitted), they did not, and 121 lives were lost (Peha, 2007, p. 61). Communication failures cause a slow reaction, higher levels of stress, loss of critical thinking skills, an inadequacy of decision-making, and, as a result, the mistakes, which a person would have never made in other circumstances. An emergency department operates just like any other organization, and poor communication affects it as well. However, in this case, it will cost more people’s lives. Not all nurses are familiar with the communication equipment, which is why all of them should be taught how to use it beforehand.
Finally, no matter how well you are prepared and how well you know a disaster response plan, many things will go out of control, and many ethical issues will arise. That is why the most important competencies in the case of a disaster are the problem-solving skills and critical but flexible thinking. For instance, if communication systems have already failed, all that remains to do is to try to find the alternatives, up to use a runner to send a message.
Competing Issues of Competencies
Considering all of this, two most important competing issues of competencies can be identified. Those are the education of nurses and their experience in managing disasters. Both of them are equally important.
Education
Since presently there are no accepted standards of how to teach students to handle disaster management, the first competing issue is education (Hsu et al., 2006, p. 2). Firstly, some nursing schools simply do not have such an option. As the research conducted by Usher and Mayner (2011) revealed, very few Australian schools that took part in the survey included the disaster nursing content in their curricula. Besides, even those that did include it focused more on the theory, not practice. Hsu et al. (2006) state the same – they say that the majority of the currently taught practices in this area are “neither evidence-based nor standardized” (p. 1). Weiner, Irwin, Trangenstein, and Gordon (2006) proved with their study that the number of hours that educational establishments offered on the topic of disaster preparedness and management actually did not change over the years, despite “the accelerated pattern of worldwide terrorism” and “the magnitude of recent natural disasters” (p. 338). They also identify several reasons for that to happen. First of all, nursing school curricula is already overloaded (Weiner et al., 2006, p. 338). And secondly, there still is a deficiency of literature in the area of disaster management, which can be proven by the fact that almost the half of the study participants say that they get the information on the websites, and 44% say that they read journal articles; only 37% use books (Weiner et al., 2006, p. 338). However, nurses definitely should be provided with appropriate training programs, since otherwise it will be impossible for them to respond to disasters quickly and efficiently.
Experience
Although education is crucial, it is still not enough. As Saifan, AbuRuz, and Masa’deh (2015) write, there is always “a clear gap between what is taught in the classroom and what the student nurses experience in the clinical area” (p. 20). To preserve critical thinking, resist stress and be able to make right decisions during a disaster, an experience is essential. According to the survey conducted by Loke and Fung (2014), more than 80% of nurses who took part in their study admitted that they had zero experience in disaster management and response (Loke & Fung, 2014, p. 3290). In addition to this statistic, the authors also revealed the competencies that turned out to be the most neglected in this case. The majority of nurses did not know their particular roles in disaster management, were not aware of their task to prepare people for disaster and did not prepare for it correctly by themselves (Loke & Fung, 2014, p. 3301). They also did not understand the nature of a disaster, did not train their communication skills and could neither identify vulnerable populations nor help them psychologically (Loke & Fung, 2014, p. 3301). And this list can be greatly expanded. However, the most important reason why untrained nurses are not prepared for working during a disaster is that they are not ready for it physiologically by themselves. Lia, Turalec, Stoned, and Petrinia (2015) described the experience of fifteen unprepared register nurses providing the health care after Wenchuan Earthquake. As the authors stated, they were “certainly naive about what to expect after a large earthquake” (Lia et al., 2015, p. 47). They had to deal with ethical issues, sometimes even decide who should and who should not receive the health care, work in resource-limited settings, critically and quickly make hard decisions. Even when the participants were interviewed five years after their experience of the Wenchuan Earthquake, they still were very emotional about it.
Expanded Scope of Practice
Presently, the idea of the expanded scope of nursing practice becomes more and more attractive. The scope of practice can be defined as a set of actions and roles, which a healthcare practitioner (in this case, a nurse) has the right to undertake; accordingly, an expanded scope of practice refers to a broader range of those roles and actions (Lowe, 2010). By broadening the range of tasks that nurses can perform, emergency departments can increase their productivity, decrease the waiting time for patients, provide more time for doctors to accurately cure acutely ill people, and even improve the patients’ outcomes (Expanding the scope of practice of nurses in emergency departments, n.d., par. 10). This approach can help to deal with an increasing demand for the healthcare, as well as nursing and physician shortages. Additionally, it can be helpful in the case of disasters since those usually require the healthcare practitioners to expand the range of tasks they perform in their day-to-day duties. As the proof, Menon et al. (2012), who are physicians and nurses, describe their experience of responding to the earthquake in Haiti in 2010. They admitted that they had to expand their scope of practice greatly to help those critically injured victims. If nurses train to do this in advance, they will be more prepared and physiologically ready for big loading and critical tasks during a disaster. In such a case, emergency departments will be able to provide their services to sufferers quicker and better, which will save many people’s lives. Gebbie and Qureshi (2002) state that emergency departments are usually better prepared for disasters than other care facilities (p. 46). Particularly, the ED nurses know both the concepts of a disaster response plan and their roles in it. However, even that will not be enough when a disaster strikes, so the programs aimed to expand nurses’ roles beforehand indeed are useful.
Ethical Practice
When a disaster arises, an ethical issue becomes one of the greatest concerns, which is why it should also be addressed in this paper and taken into account when it comes to the core competencies. The point is that during a disaster, nurses should be concerned about the greater good and the well-being of the majority rather than about the benefit of one particular person. Besides, in the view of scarce resources and supplies, an enormous number of sufferers and a very limited number of physicians and nurses who are willing to work in conditions of a disaster, does the American Association of Nurses Code of Ethics still work in the same way? That is doubtful. During a disaster, nurses sometimes have to reuse the supplies, which would have been discarded in other situations, or provide only a partial care to a patient because the resources are scarce. Obviously, any of this actions can be considered as right in other circumstances but “ethics are certainly not black and white, and in a disaster situation, they become even more blurred” (Brewer, 2010, p. 3).
Another significant issue is the following. Nurses, physicians, and other frontline workers manage to save many lives when a disaster strikes. However, they also worry about their own health and the well-being of their families. The question is should the priority of evacuation or treatment be given to the families of those working on the front lines? If nurses do not have to care about the safety of their families, they will be more concentrated on work and will help more people. Besides, that will increase their willingness to help during a disaster. Indeed, as Qureshi et al. (2005) claim, there is a big difference between an ability and willingness to respond to a disaster, and such factors as fear for children, parents or disabled family members significantly reduce the willingness to respond. Schroeter (2008) states that every nurse should decide from the very beginning what level of risk she can possibly accept and under what conditions she is willing to respond to a disaster. For the same reason, they should be involved in the development of disaster response plans since that is how they can suggest their own ideas and be sure that ethical dilemmas they are concerned of are taken into account. Chapman and Arbon (2008) also prove that this will be helpful since according to their findings, Australian nurses are not satisfied with the way how disaster plans are developed and implemented.
Ability to Response
With all of this in mind, it can be concluded that the nurse’s ability to quickly and adequately respond to disasters is determined by three following factors: physical, mental, and physiological readiness for it.
Firstly, nurses should be well-trained and in good physical shape to be ready to deal with a massive influx of wounded and perform their duties as quickly as possible. Secondly, mental characteristics are crucial. This group includes such factors as an education, a level of experience, abilities to think both critically and creatively and be flexible in decision-making. Finally, as the study conducted by Lia et al. (2015) proves, physiological readiness is essential. People who are not physiologically prepared for disasters and their consequences have wrong expectations and can hardly be able to resist stresses or make right decisions. This factor is imperative when it comes to ethical dilemmas – it is very easy to make the wrong choice here, and psychological instability will only contribute to that.
The absence of any of these factors will affect the remaining ones, which is why all of them in the complex are necessary to deal with disasters.
Conclusion
Both natural and manmade disasters have devastating consequences and lead to large-scale environmental, economic, material, and human losses. Disasters are hard to predict and control, and what is even more disturbing, they happen more often presently. During the last fifty years, their number has been increasing, and the biggest rise could be seen in the last decade (Birnbaum, 2002). Since nurses play a significant role in every stage of disaster management, from preparedness to the recovery phase, and since an emergency department is the first place where sufferers are usually taken, the ED nurses should be aware of every core competency of disaster nursing.
Among other things, nurses should know the ED tactic in the case of a disaster and the concepts of a disaster response plan in advance. They should also clearly realize their own roles and do their best to provide “well-orchestrated teamwork” (Gebbie & Qureshi, 2002, p. 48). In addition to knowing their tasks, they should practice those; for example, they should train to use unfamiliar equipment, paying particular attention to communication equipment.
The most important competing issues in preparing for a disaster are the education of nurses and their experience. Presently, not all nursing schools provide enough content regarding disaster management, and even those that do rely more on theory than practice (Hsu et al., 2006, p. 1). In addition, the majority of nurses do not have any experience in this area, which results in wrong expectations and psychological unpreparedness (Lia et al., 2015).
Finally, no matter how good a nurse is educated and prepared, disasters are uncontrolled. They demand nurses to expand their scope of practice and perform duties, which lie outside their usual domain. Ethical issues that inevitably arise in times of disasters are even more complicated. I am deeply convinced that nurses are able to adequately respond to disasters only if they are ready for them physically (in good physical shape, well-trained), mentally (well-educated, have experience, can think critically and find flexible solutions), and psychologically (stress-proof, ready for ethical dilemmas). Additionally, nurses should also be involved in the development of disaster response plans because that will increase their willingness to help during a disaster.
References
Birnbaum, M. L. (2002). Disaster medicine: status, roles, responsibilities, and needs. Prehospital and Disaster Medicine, 17(3), 117–118.
Brewer, K. (2010). Who will be there? Ethics, the law, and a nurse’s duty to respond in a disaster. Web.
Chapman, K., & Arbon, P. (2008). Are nurses ready? Disaster preparedness in the acute setting. Australasian Emergency Nursing Journal, 11(3), 135-144.
Expanding the scope of practice of nurses in emergency departments. (n.d.). Web.
Gebbie, K., & Qureshi, K. (2002). Emergency and Disaster Preparedness: Core Competencies for Nurses. The American Journal of Nursing, 102(1), 46-51.
Hsu, E. B., Thomas, T. L., Bass, E. B., Whyne, D., Kelen, G. D., & Green, G. B. (2006). Healthcare worker competencies for disaster training. BMC Medical Education, 6(19), 1-9.
Lia, Y., Turalec, S., Stoned, T. E., & Petrinia, M. (2015). A grounded theory study of ‘turning into a strong nurse’: Earthquake experiences and perspectives on disaster nursing education. Nurse Education Today, 35(9), 43-49.
Loke, A. Y., & Fung, O. V. M. (2014). Nurses’ Competencies in Disaster Nursing: Implications for Curriculum Development and Public Health. International Journal of Environmental Research and Public Health, 11, 3289-3303.
Lowe, G. (2010). Scope of emergency nurse practitioner practice: where to beyond clinical practice guidelines? Australian Journal of Advanced Nursing, 28(1), 74-82.
Markenson, D., DiMaggio, C., & Redlener, I. (2005). Preparing Health Professions Students for Terrorism, Disaster, and Public Health Emergencies: Core Competencies. Academic Medicine, 80(6), 517-526.
Menon, A. S., Norris, R.L., Racciopi, J., Tilson, H., Gardner, J., McAdoo, G.,…Auerbach, P.S. (2012). The expanded scope of emergency medical practice necessary for initial disaster response: lessons from Haiti. Journal of Special Operations Medicine, 12(1), 31-36.
Peha, J. M. (2007). Improving Public Safety Communications. Issues in Science & Technology, 23(2), 61-68.
Qureshi, K., Gershon, R. R. M., Sherman, M. F., Straub, T., Gebbie, E., McCollum, M.,…Morse, S. S. (2005). Health Care Workers’ Ability and Willingness to Report to Duty During Catastrophic Disasters. Journal of Urban Health, 82(3), 378-388.
Saifan, A., AbuRuz, M. E., & Masa’deh, R. (2015). Theory Practice Gaps in Nursing Education: A Qualitative Perspective. Journal of Social Sciences, 11(1), 20-29.
Schroeter, K. (2008). Nurses, Ethics, and Times of Disaster. Perioperative Nursing Clinics, 3, 245-251.
Usher, K., & Mayner, L. (2011). Disaster nursing: A descriptive survey of Australian undergraduate nursing curricula. Australasian Emergency Nursing Journal, 14(2), 75-80.
Weiner, E., Irwin, M., Trangenstein, P., & Gordon, J. (2005). Emergency Preparedness Curriculum in Nursing Schools in the United States. Nursing Education Perspectives, 26(6), 334-339.
World Health Organization and International Council of Nurses. (2009). ICN Framework of Disaster Nursing Competencies. Web.
Pertussis, also known as Whooping Cough, is a highly contagious disease that affects both adults and children. An outbreak of Pertussis may be considered a disaster in some cases, especially when it affects young children whose immune systems are not strong enough to deal with the infection. Before the vaccine for this disease was found, Gantz (2006) says that it killed about 10,000 people on an annual basis in the United States. However, this changed when a vaccine became available.
The report by Edberg (2006) shows that cases of Pertussis are on the rise once again and this poses serious threats, especially among children below 5 years. To deal with this problem, it is important to have a disaster response system that can be used to arrest such outbreaks to eliminate possible causes of casualties. Rapid response to such a disaster is not a responsibility of a specific institution. All healthcare institutions, both public and private, must come together to coordinate closely in responding to such disasters.
According to Edberg (2006), regional health information organizations (RHIO) have become the common platform for sharing relevant data in such cases. Using electronic health records (EHRs), the practitioners can share the relevant data within the shortest time possible to respond effectively to disasters. Developing a comprehensive plan on how the information is to be shared, and how to respond to the disaster is important, especially when such eventualities cannot be addressed elsewhere. In this proposal, the researcher seeks to evaluate the use of electronic health records as an interoperable approach to disaster and response planning.
Available Resources
Pertussis was considered a serious disease in the 1950s when the vaccine had not been found. However, it ceased to be a serious threat when its vaccination became available. For this reason, many healthcare centers never considered having piles of medicine because of the reduced cases of the disease. Edberg (2006) says that this is dangerous because cases of outbreaks of this disease have become common in the country, and the need for an immediate response is now relevant.
Having the right medication, a team of staff and the right information is very important in defeating this disease. The disaster planning committee has several resources that are available through the regional health information organization (RHIO). Gantz (2006) says that to manage this disease, there must be effective structures in place to respond to emergencies. Currently, most healthcare centers have medicines that are used in the treatment of the disease.
These hospitals have the right antibiotics that can be administered to patients diagnosed with the disease. These hospitals also have the right testing kits needed when diagnosing a patient for the disease. Apart from the infrastructural needs and medications, other resources may also be very important when responding to the disease. In the United States, various non-governmental agencies have been working very closely with government agencies to help manage outbreaks of such diseases like whooping cough. According to McCaffrey (2012), these non-governmental organizations have been very instrumental in offering various services.
This is very important in enhancing early detection of the disease because they are always in close contact with the community. What makes them even more important is that they are always willing to take part in community awareness campaigns. This way, it is easy to detect any outbreaks before more members of society are affected. These organizations also have various instruments that can help in battling the disease.
They have vehicles that can be used in the rapid response system. These can be used in rushing patients to the hospitals for immediate medication. Other than these vehicles, facilities are equipped with improved communication systems needed to coordinate various agencies and individuals who are responsible for responding to the outbreaks (Youngberg, 2013). These communication systems play an important role in ensuring that knowledge management is effectively implemented.
Informatics that Would Support Consumer Education Needs
As members of this committee, we need to understand the relevant informatics that will be needed to support consumer education needs. According to Buckeridge and Goel (2001), health informatics is very important when responding to cases of emergency during the outbreak of whooping cough. To manage this disease, it is important to have an integrated communication system supporting that various entities could coordinate easily to ensure that knowledge is shared effectively among various health experts. Sullivan and Wyatt (2005) say that informatics will be needed by these experts in various areas to avoid duplication of work.
One of the reasons why disaster management has faced many challenges is because, in most of the cases, there was always no direct communication link between various professionals. This may result in a situation where a patient spends a very long time before he or she can get proper medical attention. Health informatics seeks to address this problem effectively. Nursing informatics will be necessary for the proper management of patients, especially those who are admitted. By having all the relevant data needed by the nurses, it is possible to identify the problems that may arise within this department early enough.
Edberg (2006) says that nursing informatics is vital in disaster management when there is limited time for the nurses to move around collecting duplicate data from the patients. Pharmacy informatics may also be necessary for the effective administration of medicines. When prescribing medicine for the patients, there is some important information that should be available to avoid cases of administering wrong medications. The patient may be allergic to some medicines, or a given condition of a patient may not require a given type of medicine. In fact, Coiera (2005) says that effective pharmacy informatics may make it possible for the doctor to communicate with the patient through technological systems and inquire about any other relevant information without having to move to the physical location of the patient.
It may be necessary to organize education forums for the public or health experts who are directly involved in the management of Pertussis. The public should be informed on how to detect the disease, and on the importance of seeking medication early enough. The health experts should know how to respond to cases of outbreaks. Knowing easily accessible makes the learning process simpler, and more enjoyable. The informatics may also be very beneficial in a community awareness campaign to enhance their knowledge about the disease.
How Decision Support Systems would be Integrated
To manage Pertussis, it is important to have an effective decision support system that will be used by the relevant authorities. According to Eysenbach (2000), the traditional stand-alone decision support systems (DSS) have been facing serious challenges in terms of performance. An integrated decision support system (IDSS) has become very popular in the current society, and it will be needed in this decision.
To integrate the current DSS, we will use the information technology to link up various data and individuals at various departments. This will ensure that every decision made is informed by holistic facts taken from various departments. It will also eliminate cases where only the top management unit does the decision-making. This will enhance the quality of patient care. Making an informed decision guarantees the patient’s safety by eliminating erratic decisions.
How interoperable EHRs contribute to the success of nursing and medical efforts in a disaster
Interoperable electronic health records play an important role in ensuring that there are successful medical and nursing efforts in the process of disaster management (Wyatt & Liu, 2002). When managing a disaster, different doctors will need information about the patients at different stages. Interoperable electronic health records help in ensuring that the information about the patient is effectively stored so that any subsequent doctor may know the diagnosis and the conclusions of the previous doctors. This will help in speeding up the medical processes, as duplication of works will be eliminated.
Doctors will be able to share their findings and find a common course of addressing a given problem. The nurses will need the history of the patient’s medication process and the nature of medicine that a patient should be given. When this information is available electronically, it becomes easy to administer the medicine and monitor the progress of the patient. This also helps the nurses to know how to plan for the admission of such patients into the wards to avoid cases of re-infection.
How interoperable EHRs contribute to progress in research and EBP
Electronic health records are very important in enhancing medical research and evidence-based practice. According to Coiera (2005), to achieve success in research, the researchers must share the knowledge they gather to find a common course towards a given project. Electronic health records make it possible to share this kind of information amongst the researchers, enhancing their ability to expand their knowledge in a specific area. This is very important in enhancing evidence-based practice. Medical experts can find a common solution to a given problem through coordinated and intensive research.
The role of nurses in this proposal
Nurses will play an important role in this plan because they are an integral part of this hospital. Nurses are the caregivers for the patients. During the process of managing a disaster, nurses will be at the center stage because they will be needed in almost all the departments. At the reception where the patients are received, nurses will be needed to take the patients to the right units. At the wards, nurses will be responsible for the general care of the patients. They will also need to discharge and give medicines to the patients. This makes them the central players in this plan.
Conclusion
Managing Pertussis is very important, especially given its highly contagious nature. Using electronic health records in hospitals is very important in managing the patients’ data and for close coordination of health professionals. Although this plan may cost the hospital a substantial amount of financial resources to purchase and install the system, the facility will reap higher benefits not only due to the effective management of the patients but also due to enhanced research and evidence-based practice. It will help manage the possible outbreak of this disease.
References
Buckeridge, D. & Goel, V. (2001). Health Informatics Education: An Opportunity for Public Health in Canada. Canadian Journal of Public Health, 92(3), 233-236.
Coiera, E. (2005). Four rules for the reinvention of health care. British Medical Journal, 328(7449), 1197-1199.
Edberg, S. (2006). Global Infectious Diseases and Epidemiology Network: A World Wide Web-Based Program for Diagnosis and Informatics in Infectious Diseases. Clinical Infectious Diseases, 40(1), 123-126.
Eysenbach, G. (2000). Recent Advances: Consumer Health Informatics. British Medical Journal, 320(7251), 1713-1716.
Gantz, N. (2006). Manual of Clinical Problems in Infectious Disease. Philadephia: Lippincott Williams & Wilkins.
McCaffrey, R. (2012). Doctor of nursing practice: Enhancing professional development. Philadelphia: Davis Company.
Sullivan, F. & Wyatt, J. (2005). ABC Of Health Informatics: Improving Services With Informatics Tools. British Medical Journal, 331(7526), 1190-1192.
Wyatt, J. &. Liu, L. (2002). Basic Concepts in Medical Informatics. Journal of Epidemiology and Community Health, 56(11), 808-812.
Youngberg, B. (2013). Patient safety handbook. Burlington: Jones & Bartlett Learning.
My community is the city of Portsmouth in Virginia, and a potential natural disaster likely to affect the area is flooding. Information from the Portsmouth Virginia Department of Emergency Management (2021) shows that hurricane season starts in June and ends in November. Still, the peak point for this calamity is between August and October (Council et al., 2018). Coastal communities such as Portsmouth face the risk of powerful storms that cause an abnormal rise in water levels in the oceans. When hurricanes make landfall, they create a significant water push onto the shore. Elevation and proximity of beaches enable storms to travel far inland in the Portsmouth community, creating massive destruction. Nearly every year, when it rains or during hurricanes, floodwaters are a threat. Portsmouth community faces immediate health impacts from flooding, including injuries, hypothermia, animal bites, drowning, and waterborne illnesses (Council et al., 2018). Other associated risks include loss of health workers, destruction of health infrastructure such as drug supplies, and patient evacuation. Council et al. (2018) inform that, commonly, floods increase the likelihood of waterborne disease transmissions such as typhoid fever, hepatitis A or E, and cholera. Some vector-borne diseases such as malaria, West Nile fever, and dengue can affect community members.
The risk of waterborne disease infections is high, and they can be acquired through direct contact with contaminated waters. Although some illnesses such as throat infection, dermatitis, and wound infections are not a threat, they pose significant harm to people along with other severe risk factors. Flooding is associated with contamination of drinking water, which leads to serious diseases like typhoid. Prone infections are directly transmissible by bacteria when skin gets in contact with contaminated water. During the disaster, the Portsmouth community needs to watch poor hygiene as it is a major cause of disease outbreaks.
The Nursing Response
The first action of a response plan is to initiate warnings for potential flood events to the community. The Environmental Agency (EA) is responsible for managing and warning of possible flooding from severe weather while providing daily guidance statements. Daily updates or guidance on floods are issued by the Flood Forecasting Center (FFC) (Portsmouth Virginia Department of Emergency Management, 2021). Warning services are issued by the EA, which split floodplain in Portsmouth into warning areas with respect to risk or level of defense. The EA department uses key flood codes to notify the level of risk.
Most flood events take place on a small scale and can be dealt with by local authorities, emergency service centers, and other agencies within the response plan. When the actual impact of flooding is severe, emergency services must contact support from various response teams. An example of external assistance contacted includes diversions, evacuation measures, and road closure. Public warning and alert messages are issued to community members upon identification of the threat. The level of disaster response requires coordinated efforts using Portsmouth multi-agency flood plan.
Preventive actions are necessary to avoid the occurrence or escalation of risks during the flooding event. In Portsmouth’s community response plan, prevention measures include floodgate operations, closing shoreline roads, distributing sandbags as stand-by, informing the public, and protecting critical infrastructures such as electricity and communication lines. During actual flooding, actions taken are gulley pumping, road closures, establishing emergency helpline services, opening flood response rooms or centers, evacuating, and implementing business continuity plans. The key priority for action is paid to people, houses, roads, commercial property, and infrastructures.
Based on local website evaluation, the level of intervention on flooding in the city of Portsmouth is maintained through a proper reporting system (Portsmouth Virginia Department of Emergency Management, 2021). During flood response practices, the emergency department in the community structure procedures for use by the city council and establish twenty-four hours call out details. Communication flow is maintained to alert various response teams and residents of warnings (Portsmouth Virginia Department of Emergency Management, 2021). Nurses play a crucial role during a natural disaster such as flooding, as they help victims prevent and manage illnesses resulting from the incidents. The professional do this by educating the community about waterborne diseases and how to reach care upon symptoms onset. Also, the fundamental attribute of nurses is to give care to the injured, help individuals and their families to manage physical or emotional issues.
Evidence-based practice guidelines pinpoint key issues concerning sustainable prevention, protection, and mitigation of flooding from literature work (Behr et al., 2016). Specific guidelines include identifying the nature of the risk, building a community response team, making vital information accessible to people, updating and alerting on procedures. Natural events continue to exist, and human interference must be prevented. Assessment of community needs must incorporate existing knowledge about floods or community members and should be flexible. From a nursing perspective, community needs are essential to give an overview of how to better respond in a disaster outbreak. While much attention is paid to most likely diseases that are waterborne related during floods, studies point that mental health consequences are an area worth considering. For example, post-traumatic stress disorder can affect community members, and these health issues should be incorporated into the recovery plan. The risks of suicides after natural disasters like flooding is high due to depression from loss experienced.
Community Preparedness
Portsmouth has experienced storms and flooding, and instead of focusing on how to respond to the events, the community should focus on improving drainage systems. Hurricanes are recurrent natural events: hence, there is a need to ensure sufficient equipment types to lessen impacts. Also, it can be concluded that the community’s preparedness for flood calamity is not enough because health issues are not well addressed. Disease surveillance is essential and must be included in the plan to detect changing patterns of common illnesses or other outbreaks. The probability of epidemics when a population is displaced is high aid interruption to healthcare systems. Long-term health impacts such as mental illnesses should be considered in the plan as victims suffer a severe loss that might induce stress, panic, or anxiety. Disaster occurrence impact challenges, some of which are predictable, while others can be difficult to perceive. As such, the Portsmouth community preparedness plan requires regular updates.
References
Behr, J. G., Diaz, R., & Mitchell, M. (2016). Building resiliency in response to sea-level rise and recurrent flooding: Comprehensive planning in Hampton roads. The Virginia News Letter, 92(1), 1-7. Web.
The Emergency Severity Index (ESI) is a triage system that allows for sorting patients according to the severity of their states and evaluating the necessary resources. Level 1 implies that a nurse should assess whether a patient needs life-saving interventions or not. If yes, the nurse refers the patient to the corresponding unit and procedure, including hemodynamics, electrical therapy, breathing, et cetera (Hong et al., 2015). If level 1 is marked by “no”, the nurse proceeds with patient evaluation, focusing on the risks, resources needed, and the overall, urgency of the situation. Considering the threat of terrorist attacks and explosions, the hospital should be prepared for severe burns, suffocation from smoke, and other related issues. Children are at a high risk of dehydration, skin contamination, anxiety, and post-traumatic stress (Council & Committee on Pediatric Emergency Medicine, 2015). Accordingly, to set level 1 triage, the nurse should observe the patient’s body and pay attention to clinical signs of breathing and consciousness.
Level 2 refers to the case when a patient does not have life-sustaining procedures at the time of sorting. However, if he or she is in a high-risk situation, disoriented, or experiences panic, his state is to be identified as level 2. If the danger zone vitals, such as saturation, pulse, and respiratory rate, are normal, the patient is assigned level 3 triage (Hong et al., 2015). Depending on the resources needed, the patient is given levels 4 and 5, respectively. Thus, the main benefit of this system is a structured and quick assessment based on meaningful clinical vitals, which allows for sorting out the flow of patients in an emergency.
Additional Precautions
Since the flow of patients is expected to be high, it is critical to prepare resources that can be used to rapidly help them. In particular, first aid for wound care and initial treatment resources are to be prepared in advance, which can involve cleansing agents, intubation, dressing, grafting, and medications. Among the relevant resources for non-life-saving processes, there should be diagnostic tests, oxygen administration, medications, and so on (Council & Committee on Pediatric Emergency Medicine, 2015). The hospital’s staff should be reminded of burn trauma management and protocols of action. With sufficient resources in the hospital, it would be more effective to address patients’ health needs and achieve greater coordination between care providers.
Another area of additional precautions is related to the workforce that would be directly involved in the emergency care process. First, one or two triage clinicians should be chosen to be responsible for sorting the patients, and it is preferable to assign this role to experienced staff members. Second, professionals who would provide first aid care are given certain areas of responsibility, including but not limited to wound management, resuscitation, and so on. Third, the hospital needs more nurses to ensure that all the patients receive the necessary procedures on time. Since the case implies mass casualties, it is critical to have qualified and educated staff.
Agencies Involved
The agencies to be involved are law enforcement agencies, both local and state ones, which is important for having minimal losses. The counter-terrorism measures of these agencies may include border patrol and airport security to timely detect terrorists (Petkova et al., 2017). Among other preventative efforts, there can be community engagement and education to recognize the signs of terrorism. For example, intelligence-led policing can be realized through the Neighborhood Watch programs. However, as terrorists are relatively rare, it is significant to educate the population and provide them with information brochures.
In addition, police agencies should be contacted to notify them of the threat, so that they can be ready for organizing people and ensuring social order while transporting affected children to the hospital. The contribution of the military law enforcement agency can be necessary in case of an armed force encounter or the need to protect the community members (Petkova et al., 2017). Another potential development of this situation is a siege of the school. If the local and state agencies would be unable to resolve the case, it is essential to contact federal agencies that have more resources and workforce. It is also important to ensure that all the agencies coordinate with each other and make sure that their actions are not contradictory.
Community Emergency and Disaster Management Team
The Community Emergency and Disaster Management Team should be a liaison with the involved agencies, the hospital, the school, and the parents of students. Considering that the members of this team are volunteering citizens, they would be able to provide qualified assistance and guide other people. For example, their help can be useful until the arrival of medical services and the police. At the same time, they can act as care assistants in transporting and instructing patients and their families (Goralnick et al., 2017). In case of an identified emergency disaster, this team can offer basic care to minimize the damage and reduce further deterioration of patients’ health outcomes. In addition, the team can be involved in disaster preparedness by educating teachers, medical staff, and citizens in general.
The cooperation with media is an integral part of any emergency as the local press would highlight the event and keep the viewers aware of the recent decisions and results. In the given case, a leader of the Community Emergency and Disaster Management Team can be assigned the role of a person who would speak with the media representatives. It is better, however, to engage the hospital leadership in this important issue as well, which would provide more comprehensive information (Magruder et al., 2016). The paramount goal of journalists is to offer verifiable information to avoid misunderstanding. Nevertheless, this information should be balanced and accurate, without exaggeration to cause fear in citizens. Every citizen has a right to access information, and the role of the response team is to serve as the link that aggregates information and translates it to the local press.
Communication with the parents of the students who can be affected by the explosion or otherwise in the given emergency is probably one of the most complicated tasks. It should be put on nurses who were trained to speak about problematic health issues and who are ready to provide the first psychological aid. In this case, some part of communication can be taken by the emergency management team since their community members can be impacted (Goralnick et al., 2017). For both nurses and the team, it is of great importance to providing reliable information regarding their children’s conditions and risks. In addition, the families of the involved children should be offered psychological assistance and medical services, if necessary.
References
Council, D. P. A., & Committee on Pediatric Emergency Medicine. (2015). Ensuring the health of children in disasters. Pediatrics, 136(5), 1407-1417.
Goralnick, E., Van Trimpont, F., & Carli, P. (2017). Preparing for the next terrorism attack: Lessons from Paris, Brussels, and Boston. JAMA Surgery, 152(5), 419-420.
Hong, R., Sexton, R., Sweet, B., Carroll, G., Tambussi, C., & Baumann, B. M. (2015). Comparison of START triage categories to emergency department triage levels to determine need for urgent care and to predict hospitalization. American Journal of Disaster Medicine, 10(1), 13-21.
Magruder, K. M., Kassam-Adams, N., Thoresen, S., & Olff, M. (2016). Prevention and public health approaches to trauma and traumatic stress: A rationale and a call to action. European Journal of Psychotraumatology, 7(1), 1-9.
Petkova, E. P., Martinez, S., Schlegelmilch, J., & Redlener, I. (2017). Schools and terrorism: Global trends, impacts, and lessons for resilience. Studies in Conflict & Terrorism, 40(8), 701-711.
The turn of 2019-2020 went down in history as a pandemic of the new coronavirus infection COVID-19. This emergency situation posed a threat to national and international security. The COVID -19 pandemic turned out to be one of the most unexpected events in healthcare service. This is due to the fact that the virus had three characteristics at the same time, which allowed it to affect healthcare around the world. The coronavirus combined various characteristics of a virus that had never before infected people on a permanent basis. Unexpected effects on healthcare service were due to its extreme effectiveness in relation to human-to-human transmission and relatively high morbidity and mortality rates, especially among the elderly and those with comorbidities. The only way against its uncontrolled spread was a global lockdown. The COVID-19 pandemic required the adoption of decisive, coordinated, global measures in healthcare services.
As part of the pandemic, a significant event in healthcare services for Saudi Arabia was the spread of a new genetic line of SARS-CoV-2 in the country. This strain spread across Arabia 56-70% faster than the source, and led to the death of patients more often than the classic COVID-19 virus (Banaj, 2018). It also overcame the natural immunity of the already ill population. The COVID-19 pandemic has revealed the weaknesses of Saudi Arabia’s healthcare systems, while accelerating the development of innovative approaches in medicine. Pharmaceutical companies and small biotech startups have launched dozens of clinical trials aimed at finding a solution to combat coronavirus. Some of these developments will influence what the healthcare of the future will be like in Saudi Arabia.
Impact of Infectious Outbreaks on the Health System
The number of infectious diseases and the associated mortality rate are declining, but they continue to pose a serious threat around the world. Some infectious diseases (such as tuberculosis) occur in Saudi Arabia, placing a heavy but predictable burden on the country. The health threats posed by outbreaks and epidemics, and the fear and panic that accompany them, come with a variety of economic risks.
The first, and perhaps the most obvious, is the cost to both public and private healthcare systems of treating the infected and controlling the disease. A serious outbreak can overwhelm the health system in Saudi Arabia, limiting the ability to address current issues and exacerbating the problem. In addition to shocks to health care, epidemics keep sick people and their caregivers from working or reduce their efficiency, causing productivity to fall.
Fear of infection can lead to social isolation, the closure of schools, businesses, commercial establishments, the cessation of transport and public services. All this undermines the economic and other socially significant areas of activity in Saudi Arabia. Fear of the spread of even a relatively small outbreak of the disease can lead to a decrease in trade volumes (Neef and Pauli, 2020). The number of tourists and other visitors to the region may decrease. Besides, some long-term epidemics limit foreign direct investment (Coppola, 2020). The authorities and physicians of Saudi Arabia are proposing a number of reforms in providing medical care to the population and responding to the spread of infectious diseases. The COVID-19 pandemic has exposed some of the health concerns in the country.
Public Health Emergency
First of all, it must be noted that it was the COVID-19 pandemic that created the public health emergency in Saudi Arabia. This is due to many reasons, one of which is the unpreparedness of the entire healthcare system and the lack of specialists. In addition, a separate dangerous element is the contagiousness and severity of the disease that affects existing doctors and volunteers, which also exacerbates the crisis of care in Saudi Arabia. In 2022, the situation came under almost complete control thanks to the retooling of organizations, the emergence of a large number of people willing to help, and the development of a vaccine (Raju, 2021). However, it is not possible to designate a way out of an emergency. The fact is that the virus creates new strains that differ from the previous ones and create new waves of victims in Saudi Arabia, both human and economic.
Possible Frameworks for Disaster Risk Reduction in Healthcare
The Hyogo Framework & The Sendai Framework for Disaster Risk Reduction
To combat disasters in 1994, the first UN World Conference on Disaster Risk Reduction was held in Yokohama. It resulted in the adoption of the Yokohama Strategy and Action Plan for a Safer World: Guidance on Disaster Protection, Preparedness, and Mitigation. The Yokohama Strategy became the first international document that fixed the main directions of the world community’s activities in the field of disaster risk reduction (Yokomatsu and Hochrainer-Stigler, 2020). Further development of the system of principles and directions of activity of the international community and individual states in disaster risk reduction was reflected in the Hyogo Framework for Action for 2005-2015 (HFA). The conference was attended by over 6,500 delegates from 186 countries, 25 heads of state, vice presidents and heads of government, more than 60 ministers, as well as the UN Secretary General and Emperor of Japan Akihito (Yokomatsu and Hochrainer-Stigler, 2020, p. 101). It is important to note that this Hyogo Framework was a preparatory stage for the development of a full-fledged program.
The main document for disaster risk reduction is the Sendai Framework for Disaster Risk Reduction 2015-2030 (SRR). The result of the implementation of the PSA is a significant reduction in disaster risk and lives’ losses, loss of livelihoods, and deterioration in the health of people (Yokomatsu and Hochrainer-Stigler, 2020). To achieve the result of the implementation of the PDS at the global, national and local levels, global targets have been defined:
Achieve a significant reduction in disaster deaths by 2030 to the average number of such deaths per 100,000 people was less than in 2005-2015;
Reduce, by 2030, direct economic losses from disasters in relation to the global gross domestic product (GDP);
By 2030, reduce disaster damage to critical infrastructure and disruption to essential services, including health and education facilities, including by strengthening their resilience;
Increase international cooperation with developing countries by providing them with sufficient and continuous support to support their national efforts to implement this framework by 2030 (Yokomatsu and Hochrainer-Stigler, 2020);
By 2030, improve the availability of and access to multi-hazard early warning systems and disaster risk information and assessments.
Resilient Health System
Promoting better health is an inherent duty of every country. However, at the time of the activity of the second strain, Saudi Arabia could not cope with the problem of providing the population with medical services on its own. Therefore, the use of the resilient health system software framework in this case will be aimed at the most important areas for improving the health of various segments of the population.
First of all, it is fighting SARS-CoV-2; achieving the goals within the resilient health system in Saudi Arabia is extremely important, as they reflect universal human values and rights, including the right to health. Providing the population with medical services is of great importance for all its social strata. Prompt and effective treatment is crucial to prevent the dangerous virus and increase the likelihood of recovery of those who become ill in Saudi Arabia (Shammah, 2018). It is the desire to achieve this goal that determines the vector of development of healthcare systems in the country. This, in turn, leads to an increase in its sustainability and an increase in opportunities to ensure universal access to medical services. One of the main elements of the Saudi Arabian healthcare system, which cannot be ignored, is the provision of medicines to the population. Of particular importance are medicines used in the treatment and prevention of deadly diseases, such as COVID-19.
Within the resilient health system framework, universal access to health services is not only the result of the sustainability of health systems. The desire to provide such access to the citizens of Saudi Arabia makes it necessary to reform the healthcare system, as well as other state and even interstate institutions (Felemban et al, 2021). In particular, economic initiatives can increase the availability of medicines for the population. In addition, the development of educational systems will undergo reform – indicators at the stages of prevention of diseases will be improved.
Disaster Risk Reduction
The modern world community is actively developing, new spheres of international relations, their regulators and forms of interaction are emerging. Along with different countries, as subjects of international law, international intergovernmental organizations also work. International disaster protection is one of the areas of interstate cooperation (Alruwaili et al, 2021). The work is also carried out in the format of various conferences, in which Saudi Arabia also participates. Such events, as a rule, have a narrow topic, for example, problems related to the SARS-CoV-2 strain, and gather specialists in their field.
One of the most effective forms of international cooperation in the field of healthcare for Saudi Arabia is precisely such meetings in the field of disaster protection. The Disaster Risk Reduction Platform is a bilateral multi–stakeholder forum (Liu et al, 2021). It reviews progress, shares knowledge, and discusses recent developments and trends in disaster risk reduction. The opportunity to participate in the platform is open. Any interested person, scientist, organization or commercial enterprise can register and apply for specific events within the framework of the forum (Mansour et al, 2020). Therefore, it is quite effective to review progress, exchange knowledge, discuss the latest developments and trends of Saudi Arabia with other countries.
It is the work with the global platform that can become a regular global forum for the exchange of information, coordination of actions and evaluation of the results achieved by Saudi Arabia. Multifactoriality is aimed at solving disaster risk reduction with the involvement of experts and practitioners (Ghayebzadeh et al, 2020). The adjustment of plans for further work and the formation of new joint projects will allow Saudi Arabia to reduce the risk of disaster. Such events make it possible to unite in one place specialists from different fields involved in disaster protection (Wang et al, 2021). In addition, it is possible to show problems and the possibilities of their solution at the local level inside Saudi Arabia, which is of particular importance if there is no other format for these questions.
Disaster Risk Management
One of the ways to improve the efficiency and quality of medical care is the introduction of a risk management system. It allows to identify, assess the consequences and develop counteraction tactics aimed at limiting accidental events that cause physical and moral damage to potential patients (Baker et al, 2019). In order to form the organization’s resilience to accidents, accidents, and losses, a risk management concept was formed. It makes it possible to detect hidden sources of danger and develop countermeasures.
One of the fundamental principles of quality management in Saudi Arabia in the conditions of SARS-CoV-2 is the use of a process approach. It is optimal to assess risks in the context of business processes existing in the state. As a rule, there are two main groups of processes: basic (therapeutic) and auxiliary (Alruwaili et al, 2019). Some healthcare service risks in Saudi Arabia are associated with the process of providing medical care. They may relate to diagnostic risks: risks of incorrect diagnosis, or defects in information interaction (Antoni et al, 2018). Therapeutic risks are also widespread: risks of pharmacotherapy, risks of interaction of specialists and continuity of medical care. The risks of auxiliary processes in Saudi Arabia are related to finances: lack of funds, failure to provide reports on time. Moreover, there is a problem is poor-quality cleaning of medical institutions and the occurrence of nosocomial infections.
The essence of risk management is to build a system of measures to counteract risks. For Saudi Arabia, two approaches to risk management are applicable: human-oriented and systemic (organizational). The human-oriented approach focuses on individual mistakes related to forgetfulness, incompetence, inattention or immorality (Bajow et al, 2018). The organizational approach focuses on the conditions in which people work and is based on building a protection system that prevents mistakes or compensates for their consequences.
Disaster Cycle
The disaster cycle hypothesis implies that there is a frequency of global disasters in the health sector. Since the 14th century, in every 20th year of the new century there has been a strong outbreak of a deadly infectious disease (Dano, 2020). In the last 700 years, every 20th year of the century, a massive epidemic of a deadly disease broke out (AlQahtanya and Abubakarb, 2019). History is cyclical and that there are special periods when the probability of an outbreak of a deadly disease or the outbreak of war is much stronger than at other times. Thus, the health authorities of Saudi Arabia should take this fact into account and have increased readiness in designated periods of time.
SARS-CoV-2 will continue to circulate in the population for a long time, until the appearance of effective vaccines and etiotropic treatment. As a result, medical organizations in Saudi Arabia need to adapt their work practices to new conditions and problems and prepare for the emergence of new strains (Farghaly et al, 2022). According to the disaster cycle framework, new variations of the virus will continue to appear.
Pharmaceutical companies in Saudi Arabia are able to help healthcare prepare for situations like the current pandemic. First of all, this is feasible through increasing the efficiency of the pharmaceutical business. This increases both patient satisfaction and trust in companies on the part of partners. One of the main tools for increasing efficiency is digitalization and automation of processes. Disaster cycle framework provides training in some areas at once. For Saudi Arabia, one of these areas is electronic document management (Tammar et al, 2020). On the one hand, this makes it possible to refuse many face-to-face meetings that are undesirable against the background of an unstable epidemiological situation (Sultan et al, 2021). On the other hand, the working time that used to be spent on servicing contracts and other interactions with customers is reduced (Nofal et al, 2018). The transfer of processes to an electronic format provides tangible savings. Healthcare minimizes expenses that do not bring added value to the healthcare services. For example, the costs of courier services or forwarding correspondence are reduced.
Healthcare Crisis Management
The anti-crisis management framework is viewed from the perspective of healthcare management in the context of a general crisis. The basis of crisis management is an assessment of the current situation and prospects, allowing to make informed management decisions. At this stage, specific economic calculations are not yet required (Harthi et al, 2020). Based on the knowledge of the general forms of manifestation of the crisis, its impact on various aspects of healthcare. It is also necessary to assess the main problems that healthcare has already faced or that it will have to face.
The next stage is to identify specific priorities for Saudi Arabia. In the most general terms, they will consist in ensuring the provision of the previous volumes of medical care without reducing the quality, preserving both personnel and logistical medical potential. At the same time, taking into account the specifics of the country (sources of financing, territorial location), additional priorities may be either obtaining additional income and minimizing costs. This is followed by the development of an action plan to overcome the crisis situation (Brinjee et al, 2021). To make it vital, it is necessary to make a large number of specific management decisions in various areas of activity. It is advisable, in particular, to develop recommendations on certain areas of rationalization (optimization of the wage fund, the consumption of medicines in Saudi Arabia, etc.).
Fundamentally important anti-crisis tasks are to increase income and reduce costs, therefore, an important place in the development of an anti-crisis strategy should be given to financial services. The economic service, the department of paid services and other departments in Saudi Arabia should work in the mode of generating new ideas (Azeez et al, 2020). Of course, the implementation of the adopted plans must be ensured. However, what is meant is not the desire to carry out all the planned activities, but constant monitoring of the situation and correction of the decisions taken.
Public Healthcare Emergency
The implementation of health regulations in the field of combating infectious diseases in Saudi Arabia corresponds to the public health emergency framework. It defines the strategy of its implementation in modern conditions. The emergence of SARS-CoV-2 required the adjustment of the basic conceptual apparatus in the field of anti-epidemic preparedness and rapid response (Rizqillah and Suna, 2018). In Saudi Arabia, specialized anti-epidemic brigades were also used. There was a need to define a unified object of supervision and control at the national level. Within the framework of the public health emergency framework, on the one hand, it must comply with an international standard (Almukhlif et al, 2021). On the other hand, it should be isolated for practical purposes from the widely interpreted concept of emergency adopted in Saudi Arabia.
The purpose of using public health emergency is to prevent the international spread of diseases, protect against them, and fight them. In addition, Saudi Arabia has been guided by it in the process of taking public health responses that are commensurate with and limited to public health risks. At the same time, they should not have created unnecessary obstacles to international transportation and trade. The basic principle is proactive risk management aimed at early detection and elimination of an outbreak of an infectious disease before the formation of an international threat (Thobaity et al, 2019). The conceptual novelty of public health emergency in Saudi Arabia is the definition of such a concept as a public health emergency of international importance as a global object of supervision and control. The structural and functional organization of healthcare service is designed to prevent, verify and eliminate such emergencies in Saudi Arabia (Alyami et al, 2021). The tactics of using this framework allows to solve problems when providing assistance to territorial health care structures in a wide range of crisis situations in the emergency zone.
The Role of the Disaster Risk Reduction System in Saudi Arabia
The reason for the special position of Saudi Arabia is the location of the country’s territory in a zone of increased risk of natural disasters. The population of Saudi Arabia suffers from drought and sandstorms, characteristic of the desert climate. This explains the relevance and necessity of the disaster risk reduction system for the state. In particular, the strategy to reduce the risk of disasters and their consequences allows the state to not lose a huge amount of the population due to a lack of food due to reserves (Raju, 2021). In addition, Saudi Arabia is rapidly moving out of poverty, which leads to the availability of food and quality housing for the vast majority of the population. As a result, all this led to a decrease in mortality and casualties among people.
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Antoni, S., Bantan, R., Taki, H., Anurogo, W., Lubis, M., Dubai, T. and Al-Zubieri, A. (2018) ‘The extent of agricultural land damage in various tsunami wave height scenarios: Disaster management and mitigation’, GeoInformation for Disaster Management, 8(21), pp. 51–57.
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Nursing responsibilities in disaster planning include an estimated analysis of the elimination of health consequences. It is necessary to calculate the possible sanitary losses among the population and the failure of medical institutions and medical personnel in a disaster. Further, the duties of nurses include calculating the required number of medical units, medical personnel, and an additional bed fund. Moreover, medical workers should make a list of the necessary stocks of a sanitary, medical and special property, transport and other material and technical means to eliminate the medical and sanitary consequences of a disaster. In addition, it is necessary to analyze the real state of the bed fund of medical institutions and the possibility of its re-profiling and deployment of an additional bed fund.
Preparedness
The common tasks for all nurse facilities to prepare for work in disaster conditions are as follows. This is the organization of protecting personnel and material assets from damaging factors, taking into account the predicted situation. Moreover, the joint efforts of the nursing staff are improving the stability of the functioning of the facility in disaster. If a medical institution is exposed to the damaging factors of a disaster, nurses must, first of all, ensure the protection of patients, staff, unique equipment and other material resources. Nurses, in accordance with the plan, should also alert the medical formations of the disaster medicine service created on the basis of the medical institution. Their role is to participate in re-profiling the bed network of individual departments and ensuring the reception of the affected population, providing them with qualified and specialized medical care.
Response
During the response to the disaster, nurses are required to comply with the basic medical diagnostic and some organizational principles of the medical service. These actions consist of medical evacuation of the affected population in an emergency situation. Medical evacuation support is a system of scientifically based measures to provide medical assistance to victims. Nurses also carry out their treatment with simultaneous evacuation to specialized medical institutions.
Recovery
During the recovery phase, nurses are required to carry out treatment and rehabilitation of victims. Nurses participate in the assessment of the magnitude and nature of the emerging sanitary losses. They also satisfy the needs of the affected in various types of medical care. Nurses assess the sanitary-hygienic and sanitary-epidemiological situation that has developed as a result of an emergency. At the same time, their efforts at the hospital stages will primarily be aimed at helping the victims.
Florida Plan for Preparedness & Disaster Management
Florida is a state with an increased risk of disaster. It arises in the region due to the fact that hydrometeorological and geological hazards interact with vulnerability factors of a physical, social, economic and environmental nature. Therefore, the state has a fairly effective disaster preparedness and management plan. The Florida strategy defines the main tasks for the coming years regarding the adoption of more systematic measures (Abukhalaf & Meding, 2020). They are aimed at addressing disaster risks in the context of sustainable development. The plan also allows for counteraction by strengthening local capacity to manage risk and reduce this risk. Several points can be attributed to the most priority areas in the development of measures to combat natural disasters in Florida (Scott et al., 2022). First of all, it is the identification, assessment and monitoring of disaster risk factors and the improvement of early warning. It also includes the use of knowledge, innovative solutions and education to create a safe environment and counteraction potential at all levels.
References
Abukhalaf, A. H., & Meding, J. V. (2020). Communication challenges in campus emergency planning: The case of Hurricane Dorian in Florida. Natural Hazards, 104(4), 1535-1565.
Scott, B. L., Montoya, M., Farzan, A., Cruz, M., Jaskela, M., Smith, B., LaGoy, M., & Marshall, J. (2022). Barriers and opportunities for the MCH workforce to support hurricane preparedness, response, and recovery in Florida. Maternal and Child Health Journal, 26(6), 556-564.