Disaster planning is among the issues that require precise attention, written in “Emergency preparedness. Healthy People 2030.” It is possible to assume that health communication is the critical underrepresented objective because it might significantly increase people’s well-being and minimize potential adverse outcomes of the disaster. Therefore, the goal of “increasing the proportion of emergency messages in news stories that show empathy, accountability, and commitment” is an underrated objective in disaster planning (Office of Disease Prevention and Health Promotion, 2022). People do not know the optimal way to react in critical situations because they do not have role models providing sufficient examples. Altruistic help for others and showing empathy is more complicated than behaving egoistically, but it significantly improves the situation during disasters. For this reason, emphasizing the importance of kindness, altruism, and commitment in daily news stories increases public awareness of this role model and popularizes this behavior.
Community health nurses have the primary role in meeting this objective by personal example. Cultural preparedness for disasters is a critical factor in the adequate response to the problem in the crucial situation (Demarco, Healey-Walsh, 2019). Community nurses can show episodes from their work on social media and popularize knowledge about selfless conduct in cases when other people need assistance. These messages create the right cultural background that influences the ways people perceive disasters and their responsibilities during these events. For instance, a community nurse can increase public awareness about first aid to people who suffer from disasters using their blog or social media accounts. It is possible to show how to talk to the disaster survivors and how to calm down. Most people usually perceive this content quickly, and it becomes the background knowledge they can apply automatically in case of a disaster.
References
Demarco, R. F., Healey-Walsh, J. (2019). Community and public health nursing. Wolters Kluwer Health.
Office of Disease Prevention and Health Promotion. (2022). Emergency preparedness. Healthy people 2030. Web.
Within the American Red Cross structure, Cincinnati is supported by the Central and Southern Ohio Region branch. The unity it total serves 47 counties of Ohio, Northern Kentucky, Southeast Indiana, thus, helping nearly six million people (American Red Cross, 2021). The activities of the American Red Cross are focused on providing feed, shelter, and care to victims of disasters. Particularly, this also includes mental health assistance and emotional support. Therefore, nurses and volunteers have to be appropriately trained to be able to handle crisis situations.
To ensure an effective disaster response, the American Red Cross utilizes several essential tools. The process of recruitment and training is organized based on the nursing network, which promotes leadership and collaboration among high-ranked professionals. Moreover, the Red Cross provides education programs, including the ones related to mental health, to healthcare organizations (American Red Cross, 2021). The Central and Southern Ohio Region branch holds both offline and virtual classes aimed to boost preparedness for mental crisis and other effects of a disaster.
Local and National Community Resources
On a national level, there is SAMHSA, Substance Abuse and Mental Health Services Administration. The organization provides utilized tools for communicating helpful information on disaster behavioral health care, such as e-magazine, tip sheets, and literature archives (SAMSHA, 2021). On a local level, there is a program held by the Ohio administration and is expected to combat mental health crisis by training police officers and paramedics on psychological assistance (Jewell, 2021). Thus, national and local sources address citizens’ meant health.
8 Core Actions for Psychological First Aid
There are eight core actions that constitute psychological first aid. Further, they will be listed and describe practical examples (NCTSN, 2018).
Contact and Engagement. At this step, a caregiver is expected to respond to survivors’ requests or initiate contact with people in a compassionate and no-intrusive form. For example, a victim of a natural disaster may be asked by a volunteer or a nurse directly whether they need emotional support or using suggestive questions.
Safety and Comfort. A victim should be provided with emotional comfort and a feeling of security. This can be ensured by keeping calm and being companionate.
Stabilization (when needed). Sometimes a situation might be overwhelming, thus, making a person extremely anxious and stressed. In those cases, it is needed to calm a victim and orient them in the external and internal distractions.
Information Gathering on Current Needs and Concerns. For further assistance, it is necessary to collect certain essential information regarding the needs and concerns of a person who suffered a mental health crisis. For example, a caregiver may ask if the victim wants to tell how they feel or rather be actively calmed.
Practical Assistance. At this stage, victims are offered practical help in overcoming their concerns. A volunteer could ask if a person feels a need to get any more profound psychological therapy.
Connection with Social Supports. Once the first contact so well established, a caregiver can reach other sources of potential emotional support for a victim. For instance, it is most common to call family or friends or other psychological support groups.
Information on Coping. A caregiver would want to consult on how it is better to deal with a victim’s issues using specific concepts and tools – this could be done verbally and in written form. For example, meditation, or in some cases, medicine, can be recommended.
Linkage with Collaborative Services. Finally, a caregiver is expected to connect to share support services contacts. Thus, if a victim finds it necessary, they will contact those services and get professional help.
Emergency management becomes more and more relevant with the increase of population and the advancement of technology. The National Disaster Medical System (NDMS) is designed to address disaster-related issues, which impact national healthcare and citizen wellbeing. The purpose of the paper is to determine the primary goals and objectives of the NDMS as well as identify its structure and functions. The paper also aims on investigating program funding aspects and NDMS’s correlation with the principles of emergency management on diverse levels. The methodology included an examination of relevant literature and governmental financial statements. It was found that NDMS plays a significant role in the emergency management of the United States and may require more funding.
Introduction
As technology developed, humanity learned to control almost every aspect of human life. Medical advancements increased life expectancy significantly, huge cities were built, and traveling around the world became highly accessible. People learned to overcome most limitations and challenges introduced by nature itself. However, there are important exceptions, which are impossible to control. It may not be possible to prevent such natural disasters as hurricanes, earthquakes, or tornadoes. Moreover, in some cases, humanity may play a considerable role in causing these disasters. The list also includes events such as fires, hazardous spills, and even floods that are closely linked with human activity. As it may not always be possible to prevent such events from occurring, it is vital to introduce highly efficient frameworks to handle the consequences.
It is critical to successfully overcome the damage of emergency situations regardless of their origin as quickly as possible. Disasters may deliver a devastating blow to the functionality of the community, may destroy infrastructure, and may lead to a large number of victims (Wang, 2017). Therefore, there is a number of aspects that require consideration in terms of the impact of the disaster. First, there are victims who need a wide variety of supporting measures, including medical support. Second, it is essential to deal with socio-economic consequences to recover stability. The National Disaster Medical System (NDMS) focuses primarily on the first aspect as it provides the victims of the above-mentioned emergencies with the required help. It might be economically rational to maintain the volume of healthcare services that correspond with the amount of average demand. Nonetheless, such an approach may lead to insufficient medical equipment, low numbers of ambulance cars, lack of medical staff and hospital space in case of an emergency. Therefore it may be vital to utilize a program such as the NDMS to prevent such consequences.
The NDMS is a system coordinated on a federal level, which is designed to provide necessary humanitarian emergency-related support. Disaster management consists of three fundamental elements, including preparedness, response, and mitigation. In some cases, recovery is included as an essential component of disaster management (Wang, 2017). These four elements are fully reflected in the principle of the NDMS. As already mentioned, there is a wide variety of disasters, which may cause distinct types of damage. Different disasters require a different approach to preparing, responding, mitigating, and recovering. It is particularly true in terms of medical support as the harm may vary from physical injuries to chemical burns or poisoning. Disaster medicine might be an inseparable part of comprehensive emergency management, and hence it should be adequately introduced to combat health-related consequences of natural and manmade disasters.
History, Goals, and Objectives
The history of the NDMS dates back to the Cold War, as the initial idea occurred as a response to potential war casualties. During its development, the NDMS has undergone significant changes, which forged it into a system that is designed to provide medical support in case of any disasters. The system consists of three major elements, which directly correlate with its primary functions and goals. First, it provides medical assistance and supplies required equipment to the disaster area. The decision-making is conducted by State or local authorities as they evaluate the severity of the situation and request help. The first component is mainly provided by Federal Intermittent Employees, who are medically trained civilians.
The second component is patient evacuation, which is primarily provided by the Department of Defense. In many cases, it may be possible to prevent health-related threats by evacuating people from the area before the disaster happens. However, may not be possible to accurately predict the occurrence of disasters, and hence patient evacuation is required to handle the consequences. The Department of Defense provides a wide variety of transportation methods to achieve that goal. Timely evacuation regardless of the possibility to predict the disaster is the key to minimizing victim numbers and providing sufficient medical help. Patient evacuation also serves several related functions, including patient reporting and regulating. Another vitally important aspect is comprehensive planning of special places, which are suitable to accommodate survivors and provide them with needed food and sleeping areas.
Definitive medical care is one of the most important components of the NDMS, as providing sufficient and timely medical help is its key objective. The third component is closely linked with the second, as it is only possible to provide the necessary medical care in the areas unaffected by the disaster. Therefore, it is critical to evacuate the patient to the hospital outside the area to provide help. Definitive medical care also implies medical equipment delivery to different affected areas. It is maintained by the Civilian Military Contingency Hospital System. The NDMS played a significant role in coordinating the actions of several agencies and utilized both the public and the private sector resources. Conclusively, hospital support, medicine distribution, patient reception, and medical assistance are the key functions of the third component of NDMS.
NDMC functions are maintained by several teams, which focus on various critical aspects of emergency management. There are six teams and two centers, which are normally active for fourteen days if necessary. These teams include Disaster Medical Assistance Teams (DWAT), Trauma and Critical Care Teams (TCCT), Disaster Mortuary Operational Response Teams (DMORT), National Veterinary Response Team (NVRT), and Incident Response Coordination Team (IRCT). Two centers are the Federal Coordinating Centers (FCCs) and Victim Information Center (VIC) (Dawson, 2020). Each of these teams provides necessary help on different levels and areas.
DMATs are responsible for the provision of medical care and support in case of any emergencies related to manmade or natural disasters. The list also includes acts of terrorism, virus outbreaks, and some other emergency-related events. DMAT is provided with sufficient resources to maintain its work for three days without the need to resupply. Health care providers and non-clinical support staff represent the main labor resources available to DMAT. Staff is typically divided into teams of seven, fourteen, or thirty-five people who are ready to deploy within seven hours to provide required medical help (Dawson, 2020). TCCT is essential in terms of trauma and critical care as they provide highly professional medical workers who support DMAT in critical situations. Their main responsibilities are patient evacuation, medical facility support, and field hospitals organization. TCCT are typically divided into groups of nine, ten, twenty-eight, or forty-eight medical professionals to provide trauma and critical care in distinct areas.
DMORTs are responsible for managing the facilities, which are affected by the emergency. DMORTs have many functions, such as victim identification, fatality assessment, and morgue operations management. These teams also play a significant role in providing relevant information regarding the emergency. NVRT is designed to help animals affected by natural or manmade disasters and other emergency events (Dawson, 2020). It consists of one team of veterinaries who are trained to provide animal care in emergency situations. IRCT plays a significant role in coordinating help on jurisdictional, State, Tribal, and local levels. The team is designed to maintain cooperation between agencies of different levels and responsibility fields.
As mentioned before, there are also two centers, which are an inseparable part of the NDMS. FCCs are essential in terms of recruiting hospitals and maintaining cooperation with the NDMS on local levels. Moreover, these centers are responsible for patient reception-related issues, including planning and coordination. VIC’s area of responsibility is local too, as it works with local authorities to maintain antemortem data collection and communication with victim’s families. In general, VICs are designed to help DMORT on local levels.
Program Funding
NDMS program funding changes are closely linked with the recent pandemic. COVID-19 has shown that NDMS is not provided with sufficient funding and hence is not able to introduce comprehensive medical care in case of a global emergency. Therefore, program funding was significantly increased in 2019 and 2021. NDMS costs are primarily covered by the HHS Public Health and Social Services Emergency Fund. Even though the funding amount was increased to $73 million in 2019, only $57 million were provided in 2020 (US Department of Health and Human Services, 2021). The budget was increased to $88 million in 2021 in order to address a number of essential issues (ASPR FY 2020 Budget-In-Brief, 2020). First, the pediatric care program received an additional $20 million to build o progress made in 2019. Second, both the infectious disease response program and portable dialysis unit maintenance program received $5 million each. Finally, the enPOWER program, which is designed to improve federal-to community awareness, adoption mechanisms, and innovation implementation, received an additional $1 million.
As already mentioned, NDMS has a large number of functions and utilizes a wide variety of teams and agencies in order to address distinct emergencies. The recent pandemic inflicted significant damage worldwide and has proven that modern healthcare is not fully capable of handling such emergencies. Hence, it may be highly beneficial to increase NDMS funding even further. However, it may also be critical to comprehensively assess the vulnerabilities of the program to introduce adequate systematic funding, which may improve NDMS’s efficiency.
Relation to Emergency Management at the State and Local Levels
NDMS is a relatively universal program, which addresses a large number of emergency-related problems. A significant number of teams, which implement distinct functions, allows NDMS to provide sufficient medical support on different levels. According to some sources, the NDMS supports state, local, and tribal authorities to handle the consequences of manmade or natural disasters (Mihalek, 2016). Therefore, NDMS represents a well-structured system that has specific mechanisms to react to emergencies on state and local levels. For example, FCCs and VICs are specifically designed to address local issues and help local facilities. In contrast, DMAT and TCCT are controlled by the state and may handle emergencies regardless of their size.
A large number of teams allows NDMS to rationally utilize forces depending on the severity of the disaster. Furthermore, in many cases, there are multiple areas affected by a disaster, and hence it may be critical to providing several teams. In addition, there are teams of various sizes, which allows NDMS to deploy forces in accordance with the need. Local public health communities also play a significant role in emergency management. They have been proven to be particularly effective during the pandemic as a sufficiently staffed local health community can adequately respond to such events (Rubin, 2020). Conclusively, NDMS provides a comprehensive emergency management framework with high flexibility, which allows it to provide high-quality support on both state and local levels.
Conclusion
Emergency management is becoming more and more relevant as the world’s population increases and more unsafe areas are inhabited. In addition, COVID-19 has shown that the world community is not able to effectively handle infection-related emergencies, and hence further development of emergency management is needed. The National Disaster Medical System plays a key role in the emergency management of the United States. Human life is the most significant value, which requires comprehensive support and protection on different levels. NDMS is the primary program that is related to protecting human lives in case of emergencies. Therefore, it may be vitally important to introduce sufficient funding and expand its capabilities in order to provide effective emergency management. NDMS represents a large interrelated system that consists of diverse entities and addresses a considerable number of problems. I believe that it may be one of the most important emergency-related programs, which requires broader attention. NDMS provides multi-level medical care regardless of location and emergency characteristics. Therefore, I think it may be possible to significantly improve emergency management in general by improving the principles of NDMS.
References
ASPR FY 2020 Budget-In-Brief. (2020). Public Health Emergency. Web.
Dawson, L. (2020). The National Disaster Medical System (NDMS) and the COVID-19 Pandemic. KFF. Web.
Mihalek, D. J. (2016). When disaster strikes in the U.S., the National Disaster Medical System responds. EMS1. Web.
Rubin, R. (2020). Better HHS Planning Needed for National Disaster Medical System. JAMA, 324(4), 326. Web.
Wang, S.-J. (2017). Comprehensive Disaster Medical System to Threat of Nuclear Emergency and Disaster. Prehospital and Disaster Medicine, 32(S1). Web.
Since its discovery in 1976, the Ebola virus has killed many people (WP Editorial Board, 2014). In the past, it has often manifested in small outbreaks that kill dozens, or hundreds of people, before containment. However, the 2014 Ebola outbreak in West Africa was the deadliest (WP Editorial Board, 2014). The outbreak affected some West African countries, including Nigeria, Senegal, Liberia, Ivory Coast, Guinea and Senegal (Sun, 2014). Internationally, the disease also affected America and some European countries. Although some of these countries are now Ebola-free, recent health reports show that the death toll, from the outbreak, is nearing 9,000 people (WP Editorial Board, 2014). The same report shows that the fatality rate for the disease is 71% (Sun, 2014). Poor preparedness and poor coordination are mainly responsible for the high number of fatalities associated with this health disaster (WP Editorial Board, 2014). In line with this observation, this paper shows how the affected countries could better prepare for the disaster.
How might federal, state, and local resources be coordinated to respond to this Ebola outbreak in West Africa?
Coordination in health disaster management should occur at different levels. At a federal level, governments should screen the people leaving or coming into a country for Ebola. At a state level, the government should mobilize state resources to contain the disaster (Centers for Disease Control and Prevention, n.d.). This step involves freeing state resources to create a working health infrastructure for containing the outbreak. Locally, there should be a “grass root” support, where community organizations could volunteer their services and provide resource support to state and federal health agencies (Public Health Informatics Institute, n.d.). Furthermore, people should be willing to volunteer information to authorities concerning sick people, or people they suspect to have contracted the virus. Such initiatives should stop cases of family members hiding some of their loved ones for fear of isolation (Sun, 2014). If authorities implemented these initiatives during the Ebola outbreak, there could have been a limited spread of the virus and fewer fatalities.
How might state and local agencies and officials work together to plan and respond to this Ebola outbreak in West Africa?
Coordinating health care activities during the Ebola outbreak involves the use of different strategies. Based on the factors highlighted in this paper, different health agencies could have done a better job managing the disaster by coordinating their efforts. They could have done so in two ways. First, they could have used a common technological platform to manage their activities. This way, they would have known what each agency is doing (Public Health Informatics Institute, n.d.). This platform could have provided them with real-time response initiatives on the ground. Similarly, the health agencies could have formed a crisis center to coordinate their activities. This central post could have helped them to eliminate redundancies in emergency responses (Public Health Informatics Institute, n.d.). Collectively, these two strategies show how state and local agencies could have worked together to plan and respond to the Ebola outbreak.
Assuming the role of a public health leader in this situation, suggest tasks involved in the preparation for a future Ebola outbreak and explain why you are suggesting them
Proper health crisis management depends on a country’s level of preparedness. In this regard, health agencies could have managed the Ebola outbreak through proper planning and preparedness. As a public health leader, I would adopt the health management plan outlined in the Centers for Disease Control and Prevention, Office of Public Health Preparedness and Response (2011) framework. This plan outlines seven important steps in the management and preparation of health disasters. They include:
improving the capability of health workers to respond to an outbreak
enhancing stewardship of public health preparedness funds
strengthening health infrastructure
increasing the application of science in public health preparedness
advancing surveillance and epidemiology
promoting resilient individuals in the community
integrating the public health care system with emergency management.
I choose these steps because the CDC has proven that they outline effective methods for preventing and mitigating threats to public health.
Who was in command of that incident? Explain whether you think the right organization and individuals were in command. Provide a rationale for your answer
Disorganization and a lack of coordination characterized the 2014 Ebola outbreak in West Africa (Sun, 2014). Based on these factors, state authorities and local authorities oversaw different facets of health disaster management separately. Internationally, “doctors beyond borders” offered invaluable help to the affected nations (Sun, 2014). The World Health Organization (WHO) also offered support in the same manner. Nonetheless, the confusion that characterized the outbreak undermined their response to the disaster. The WHO should have commanded the outbreak because it has enough resources and knowledge to do so. Furthermore, the health crisis affected different countries that had independent health care systems. It was difficult to coordinate the activities of these health care agencies without a common oversight body to harmonize their efforts. The WHO could have played an instrumental role in this regard because its activities are cross-border and it has accumulated vast knowledge regarding how to manage such disasters in Africa and other parts of the world.
References
Centers for Disease Control and Prevention. (n.d.). Emergency preparedness and response. Web.
Centers for Disease Control and Prevention, Office of Public Health Preparedness and Response. (2011). A national strategic plan for public health preparedness and response. Web.
Public Health Informatics Institute. (n.d.). Common ground: Transforming public health information systems. Web.
Sun, L. (2014). Global response to Ebola marked by lack of coordination and leadership, experts say. Web.
WP Editorial Board. (2014). West Africa can’t manage the Ebola outbreak. Web.
The elderly population is one of the most vulnerable when natural or manmade disasters strike. The bulk of life lost in disasters is mainly that of the elderly, which is either directly or indirectly from the effects of the disaster. Accordingly, the objective of this systematic review was
To summarise the best available evidence that described medicines management for elderly patients during disasters
Make recommendations towards the promotion of disaster preparedness with the elderly in mind
Inclusion Criteria
The review considered qualitative research that focused on previous disasters, management of the elderly in those disasters, and the recommendations that resulted. The main articles selected were those that considered disaster victims in their old age. The age selected was 60 years. Those articles with this age and above were considered for the review. The preferred language of article publication was English. Any other language was not considered in the final review. The articles selected also had to be recent. Therefore, those between the years 2000 and 2012 fit the selection criteria. This is in light of the progressive and continuous change in medical practice.
Search Strategy
The search strategy sought to find both published and unpublished research papers (limited to the English language). An extensive search was performed using the following databases: CINAHL, EMBASE, PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), Premiere, PsycINFO, and Healthsource. Nursing/Academic edition, Science.gov, scricus.com, and Robert Wood Johnson Institute, Dissertations Abstract International were used also. Furthermore, the reference lists of the identified papers, as well as relevant worldwide websites were searched to capture all pertinent materials for the review.
Methodological Quality
Two reviewers for methodological quality assessed each paper before inclusion in the review using the critical appraisal instrument (Qualitative Assessment and Review Instrument (QARI) from software developed by the Joanna Briggs Institute (JBI).
Results
Eighteen articles were selected from the initial literature search. These were mostly journal articles with forty-four initially identified and most excluded because they did not meet the inclusion criteria. The results are summarised below and relevant findings are included for this review.
Conclusion
In all the materials reviewed, the elderly are described as one of the most vulnerable cohorts when disasters strike. This, according to the findings, is due to their reduced mobility, their poor health, and inadequate social support systems. The elderly are also the biggest group with chronic conditions. They are therefore always taking medicines for control. In times of disaster, the articles reviewed suggest special attention to the elderly. Their medication should be included in the list of items for appropriate disaster preparedness.
Introduction
The management of medicines in the elderly population in times of disasters is very important considering their large numbers and the frequency of disasters. It has been suggested that the elderly population is at a greater risk of reduction in the standards of living after disasters compared to the younger generation of victims (Bolin, & Klenow 1988, p.29–43). In the previous disasters, power failure has led to the challenge of medication provided to the elderly and the population in general. For those with chronic conditions requiring power to administer medication such as home nebulizers, this has provided a risk of missing their medication, getting the associated complications, and even death (Geehr, & Salluzzo 1989, p.604). The reduction of the incidences of this happening in disasters is therefore important in the reduction of disaster-associated mortality.
Background
The preparedness, response, and recovery of disaster victims are dependent on factors beyond their control. Some of these factors include the type of event, the duration of the event, and the warning systems that are in place. Some individual factors include the victims’ state of health and the resources available to them. Individuals who are isolated and restricted to houses with impaired mobility and poor social support have the worst response to disasters and recovery from the resultant complications. This also includes those relying on regular medications, nursing care, or even on treatment services. Some other vulnerable people include those reliant on volunteer services for their food and essential care.
The elderly population in Florida and California, both of which are disaster-prone geographical areas, is on the rise with the population forecasted by the United States Census Bureau doubling its 1993 number (Hobbs, & Damon 1996, p.23). The increased elderly population poses a challenge in disaster preparedness and the response that follows. Knowledge of the best medical management practices for the elderly population is therefore important to adequately prepare for the future disasters besides preventing unnecessary loss of life. This review is also important to geriatric physicians and nurses, as it will equip them with the best available medical skills for disaster management.
Method
The search strategy aimed at finding both published and unpublished studies. In this search, a three-step approach was utilized for this review. The initial step involved a limited search of the keywords in the title of the article, the abstract in MEDLINE, and CINAHL. The second step involved the search of the same keywords in the included databases. In the last step, the reference lists of all the identified reports and articles were searched for additional relevant studies. Only studies done and published in the English language were included in the analysis. The search period was from the inception of the databases to the current date, and the selected articles ranged from the year 2000 publications to the year 2012.
The databases searched include CINAHL, EMBASE, PubMed, The Cochrane Central Register of Controlled Trials (CENTRAL), Premiere, PsycINFO, and Healthsource: Nursing/Academic edition. The search for unpublished studies included those in the databases such as Science.gov, scricus.com, Robert Wood Johnson Institute, and Dissertations Abstract International. The appraisal of the selected studies utilized the JBI form.
Results
From the literature search, eighteen were selected for the review since they had relevance to the subject. In the research review, most of the articles elected were done in the wake of disasters that have taken place in the United States in recent times. In most of them, an interview was conducted with the general population in the disaster areas. Later, these were grouped into age cohorts. The elderly population was the focus of this review. Therefore, this cohort was selected.
Paper 1: (Anetzberger 2002, p.611-625),
Finding 1: Need for a reassessment of existing programs
In the first article by Anetzberger (2002, p.620), the use of community resources by the elderly population is focused on the conclusion that there is need for their reassessment. It is noted that the programs providing services are not fully utilized with the results of only 20% of the elderly reporting to have used any community services in the previous year. Worth noting is that most the elderly people prefer help from friends and family to other sources.
Finding 2: Utilisation of services
The only services reported to be sufficiently utilized include the educational programs, the World Wide Web, and case management. An estimated 15% of the elderly population adequately cope with depression, and about 10% of them had dementia (Anetzberger 2002, p.615). Few were utilizing the medical services especially those associated with mental health due to the stigma associated with them. In the findings, fewer elderly people were utilizing any form of medical services. The adult day health care centers, senior housing centers, and community centers should be prepared to handle the number of elderly patients with the desire to use these services especially in disasters.
Paper 2: (Chou et al. 2003, p.792-798)
Finding 3: Emotional response to disasters
In this paper, the researchers did a study on the emotional response of the elderly, the middle-aged, and young people after two technological disasters that were traumatic to them (Chou et al. 2003, p.796). These people had been involved in an airplane crash in the year 1994 and later a train collision in the year 1996. Half of those involved in each event were used for the study. They numbered one hundred and forty-eight. Interviews on how they coped with the traumatic event began with conclusions being derived from them.
Finding 4: Age affects response
It was found that the response to the disaster depended not on age, but on the disaster type and the intensity that the people were subjected to. All the specified age groups reacted and adapted in the same manner with the catastrophes and the resulting complications. Other factors affecting the response included how close the respondents were to the disaster when it occurred, the symptoms that they displayed after the event and the level of care given including medical care. This research however did not support the theory that age was significant in the response and that previous disasters would ease the response to subsequent traumatic conditions.
Paper 3: (Fernandez et al 2002, p.70)
Finding 5: Vulnerability of the elderly
In this paper, the authors did a literature search for medical materials and a review of Websites, news reports, and government training materials (Fernandez et al 2002, p.67). The aim of this was to key out and implement schemes of handling the risk of exposure of the aged members of the society in the event of a tragedy. They identified factors leading to the vulnerability of the elderly during disasters. They stated them to be pre-existing medical impairment, diminished sensory awareness, and impaired physical mobility, as well as social and economic constraints (Fernandez et al 2002, p.64).
Finding 6: Strategies
According to the authors, three categories result in their intervention strategies, and these include personal strategy, agency, and community strategies. Personal strategies include educating the elderly on disaster preparedness, as well as how to manage their medication in a bid to make sure they can last for a few days. They also include the education of elderly on how to respond in times of emergencies and disasters. Community and agency strategies aim at making use of the existing basic resources. Healthcare access is a component of community strategy, and this involves stocking important drugs for use in emergencies.
Finding 7: Transport of medicines
The article emphasizes transportation as one of the major demands of the aged in times of disasters besides being one of the constraining elements. The authors conclude that medical help for the elderly should be transported to them if they cannot be transported to the medical centers themselves (Fernandez et al 2002, p.74).
Paper 4: (Ford et al 2006)
Finding 8: Chronic illnesses
In this paper, the researchers analyzed data from people above the age of 18 years participating in the Behavioural Risk Factor Surveillance System (BRFSS) in 2004 (Ford et al 2006). They aimed at estimating the number of people suffering from chronic illnesses such as hypertension, diabetes, and stroke living in New Orleans at the time Hurricane Katrina struck. In the month of August 2005, 9% of the adult population there had diabetes, and most of them (79.4%) were on oral hypoglycemic agents for diabetes control. This is against a background of higher diabetes incidence in the elderly. 29% of the respondents reported being hypertensive with 81.1% of them taking antihypertensive drugs.
Finding 9: Medication dependence
Approximately, “4.6% of the adult population interviewed reported coronary heart disease or angina pectoris, 3% reported having a myocardial infection and 2% were stroke victims” (Ford et al 2006). After the hurricane, widespread destruction of roads and other transport infrastructures was apparent. This meant that the patients could not access their medication. From this study, it is clear that disaster teams should put into focus the treatment of chronic conditions in their programs when there is a disaster. Public health officials also need to take this consideration when putting appropriate disaster preparedness measures in their planning.
Paper 5: (Hastings, & Mitchell 2005, p.978-986)
Finding 10: Medication and recovery
In this research paper, the authors set to determine the research done relating to the commonly held theory that patients recover better and quicker when they receive adequate care in the emergency departments. Their homes are used as transition points. They surveyed publications in CINAHL and MEDLINE that link with the aged patients and casualty maintenance. Several interventions targeting the elderly population were found to include “discharge of patients to their primary physician with a referral note, geriatric assessment using specially trained nurses, and continuous home-based care and follow-up” (Hastings, & Mitchell 2005, p.980). A substantial discovery from the research is that aiming at the Most at Risk Populations (MaRPs) such as the aged in the intercessions proposed, brought appealing outcomes in relation to an open intercession. Further research was suggested to determine which of the strategies is more effective in the management of the elderly in disasters and emergencies.
Paper 6: (HelpAge International, London 2006)
Finding 11: Guideline available
The guide by HelpAge International, which is an umbrella of nonprofit organizations working with disadvantaged old people, has the information necessary for elderly patient care in disasters. In the guide, a stress is made on the importance of managing the medications of the elderly with chronic illnesses during a disaster. Other resources that are recognized as being of equal significance include shelter and nutrition for the elderly during this crucial period. Other issues handled in the book are defending the elderly from ill-treatment and management of their composite psychosocial demands. This guide is well suited for planning disasters management for the elderly.
Paper 7: (Jeste, Blazer, & First 2005, p.265-271)
Finding 12: Medical psychiatric illnesses after a disaster
This is among the few studies done investigating the incidence and prevalence of medical psychiatric illnesses other than dementia in a population of elderly patients. This study recommended that further studies focus on differentiating the illnesses in the elderly from those of psychiatric origin. In their findings, a confusion of physical and psychiatric illnesses was found to be common in the management of the elderly especially in the emergency centers (Jeste, Blazer, & First 2005, p.270). A common reason was the under-reporting of symptoms that the elderly were prone to.
Finding 13: Medications provided for non-organic conditions
In the past, the medications supplied to the elderly in disaster areas have mainly been to treat organic conditions and physical injuries with fewer, if any, medicines for any mental health issues that may arise. The study therefore suggests the inclusion of psychiatric drugs in the list of emergency drugs for the elderly in times of disasters.
Paper 8: (Knight, Gatz, Heller, & Bengston 2000, p.627-634)
Finding 14: Age, depression and medication after a disaster
This report is from data obtained from a longitudinal study involving generations of families. “Multiple generation families numbering 250 were initially sampled in the year 1970 and surveyed after every three years” (Knight, Gatz, Heller, & Bengston 2000, p.627-634). The Northridge earthquake in California preceded a survey that was to be done in 1994. The information garnered from the survey was noteworthy in substantiating the feedback to the earth’s tremor calamities in relation to various ages. The levels of depression after the earthquake were higher in the people with some degree of depression before the earthquake compared to those with lower levels or no depression. The patients in the “ages between 55 and 75 years had the lowest levels of depression both after and before the earthquake” (Knight, Gatz, Heller, & Bengston 2000, p.634). They, therefore, proved that exposure to disasters reduces the posttraumatic symptoms in subsequent disasters though this was weakly supported by their findings.
In this study, “800 Hondurans were studied after Hurricane Mitch in 1998 for their psychopathological responses” (Kohn, Levav, Garcia, Machuca, & Tamashiro 2005, p.841). The aged people used in this research had an age of 60 and beyond with the consideration of the state of life expectancy evident in the area of study. The tools that were used included a self-reported interview and a questionnaire. They found that posttraumatic reactions in people over 60 years were the same as those in the younger population. This is despite the reduced ability to cope with the trauma and the posttraumatic events that the elderly have.
Finding 16: Psychiatric epidemiology
In the research, it was noted, “little is known of the psychiatric epidemiology in the developing countries like the Honduras” (Kohn, Levav, Garcia, Machuca, & Tamashiro 2005, p.841). The study therefore suggested room for further research on this issue. This was in light of the existing differences between the elderly population in the developed and developing countries. There exists a solid support and disaster preparedness in the developed countries with well-laid down guidelines on disaster management compared to the developing countries.
Paper 10: (Kuo et al. 2003, p.249-251)
Finding 17: Post-traumatic stress disorder and treatment
In this research, 120 people who lost their relatives in the 1999 earthquake in Taiwan were surveyed. Of the few reviewed, 53% displayed some form of Post-traumatic Stress Disorder. Most also experienced some form of remorse besides portraying increased signs of sorrow compared to other younger population cohorts. Despite the observed high prevalence of PTSD in this population, only about 25% of these patients sought medical treatment for the condition (Kuo et al. 2003, p.251). This means that, in the management of the elderly in times of disasters, mental health issues should adequately be planned for with appropriate medication being put in place. The research also emphasized the need for schemes for carrying on with the sorrowing individuals in Asia, which should vary from those in western countries due to ethnic deviations.
Paper 11: (McKain et al 2004, p.704-710)
Finding 18: Treatment at a specialized center
This study was done in Australia by a physiotherapist, a social worker and three nurses, and nine patients admitted or transferred to a rehabilitation unit undertook a semi-structured interview in the rehabilitation center. The research sought to find out whether the sick had enough entropy before admittance to the reclamation section regarding their status and anticipations. The patients did not mind this problem because they thought that their referral to this unit of the medical center was because they were almost being discharged. The authors concluded that, in times of emergencies and disasters and the periods following that, elderly patients should be well informed of the medications they receive, any transfers or admissions, and the necessity of the same in their management (McKain et al 2004, p. 710).
Paper 12: (Miller & Campbell 2004)
Finding 19: Eldercare supportive interventions
The investigators in this discipline probed the effectualness “of the of the Elder.
Care Supportive Interventions Protocol (ECSIP), family-based interventions, and nursing care in reducing any discomfort in those patients with delirium and dementia” (Miller & Campbell 2004). The study took place in a geriatric medical unit with a 34-bed capacity belonging to an academic hospital. However, they developed a bias that reportedly arose from the sampling limitations and a small nursing staff. The findings indicated that there was no noteworthy deviation between the initial status and the treatment situation for the length of stay of the sick, physical role, and penetrative discombobulation in the patients involved in the analysis. A finding that was of importance is that the “undergraduate nursing students in the hospital serving the elderly as assistants had positive effect on the family, lowered hospital costs and improved on staff satisfaction” (Miller & Campbell 2004).
Paper 13: (Mudur, 2005, p.422)
Finding 20: Disaster response and medication
In December of 2004, a tsunami hit the Asian coast killing 300,000 people and displacing another 92,000 elderly people (adults over 60 years). In this paper, the response and attention are given to the elderly in relation to their special needs during a disaster take the centre stage. The special needs included the medications for the many elderly people with chronic conditions. In this article, it is noted that the elderly had a hard time getting relief and medication that was to be distributed by the aid agencies and special government agencies (Mudur, 2005, p.422). They also received little attention relating to their nutritional needs besides even getting money and allowance that was distributed. It concludes that more emphasis should go to the special medical and other requirements of the aged whenever artificial or natural calamities strike.
Paper 14: (Nates 2004, p.686-690)
Finding 21: Essential factors when disaster strikes
In June 2001, the tropical storm Allison resulted in severe damage to Houston Medical Centre after it produced about three feet of rainfall. In this report, the response of Memorial Hermann Hospital to this disaster after its emergency system failed is put into perspective. It is among the two grade-I trauma sections in Houston. The study presents the reaction to the situation by its faculty with or without electricity, as well as the critical hospital routines during the predicament. The author states nine essential factors in addressing internal problems when disaster strikes. These include “electricity, water and other important supplies, patient ventilation, communication, human response coordination, essential services protection, patient-logging system, media communication, and a plan on evacuation” (Nates 2004, p.690). These are important in the medical management of patients in the times of disaster.
Paper 15: (Rockwood et al. 2005, p.489-495)
Finding 22: Effectiveness of clinical frailty scale
In this research, 2,305 aged patients taking part in the second round of the “Canadian Study of Health and Aging (CSHA) had their frailty levels” (Rockwood et al. 2005, p.495) measured. The ultimate objective was to track the efficiency of the clinical infirmity scale after a subsequent analysis of this group of people for half a decade after they partook of the CSHA. They proved that this scale is important and effective in the assessment of clinical frailty of the elderly population, and it is easy to use and train others in its use. They also concluded that this tool would be important to measure the frailty in elderly patients who were victims of a disaster (Rockwood et al. 2005, p.489). This is important in the medical management of patients during a disaster.
Paper 16: (Romano 2005, p.6)
Finding 23: Surge hospitals
This paper focuses on the measures set up to accelerate health responses and emergency care in times of disasters and emergencies (Romano 2005, p.6). Since September 11, 2001 and the recent disasters that have taken place in the US, the officials in government and those specifically concerned with disaster preparedness have developed various suggestions for taking control of the resulting humanitarian crisis after disasters. Surge hospitals are one of the models that have been suggested as effective ways to deliver healthcare during a disaster.
Finding 23: Extending existing facilities
In this proposal, hospitals have to extend their services to the facilities that exist or are at close sites to cope with the great number of patients after a disaster. An example is in “Washington DC where a section of the Washington Hospital Centre is being changed to surge unit with a bed capacity of 350 patients” (Romano 2005, p.6). A better idea involves the transformation of non-medical areas such as a stadium into a medical facility. An example is the successful use of Astrodome that took place in September 2005.
Paper 17: (Saltvedt et al 2002, p.792-798)
Finding 24: Management at a geriatric clinic
In this paper, the researchers performed a randomized control trial determining whether treatment in geriatric evaluation and management care units (GEMU) contributed to cutting down mortality rates for patients. This research was conducted in the University Hospital of Trondheim, Norway. The staff consisted of a “geriatrician about two resident nurses, a physiotherapist and an occupational therapist” (Saltvedt et al 2002, p.790). The mean patient age for the study was roughly 82 years in the case of GEMU and a mean of the same for the case of cosmopolitan examination wards. The conclusion was that treatment at the GEMU considerably reduced the mortality rate for these elderly patients. Following the set period of the research, the death rates of these patients in the GEMU and the cosmopolitan examination wards leveled off. The study’s implication in the medical management of the elderly patients in disasters is that management in a specialized unit specifically for geriatrics has better results. Thus, the elderly should be targeted in disasters for specialized medical support.
Paper 18: (Watanabe, Okumura, Chiu, & Wakai 2004, p.63-67)
Finding 25: Levels of depression and medication
This is a report of the research conducted in Taiwan after the 1999 earthquake six months and a year later. The longitudinal study sought to determine the level of depression in the elderly patients displaced by the earthquake. The level of depression remained unchanged in the periods of six months and one year after the earthquake, but the study had a small sample size. Displaced elderly had higher levels of depression compared to those who were not displaced according to the study. The level was also higher in those elderly patients who had little or no social support systems. The elderly with immediate family supporting them did better compared to those without. The depressive symptoms were also lower in those elderly patients with support from neighbors (Watanabe, Okumura, Chiu, & Wakai 2004, p.67).
This study concludes that a social support system for the elderly is crucial in times of disasters in addition to medical management. During disasters and the period thereafter, the elderly need people close to them to assist in their management since most of them are not aware of the medication outlets available during this time. The reduced mobility, poor health, and increased vulnerability to injuries mean that the elderly disaster victims have reduced chances of getting their medications and thus the need for the social support.
Categorization and synthesis of findings
Categorization of common themes from the findings enables the grouping into categories and production of single synthesis findings. The 25 findings were grouped into three synthesized and directive findings for use as a basis for the best evidence-based practice.
Synthesis 1
In this synthesis, categorization of the findings with results of how the elderly are affected by disasters is the criteria. It includes ten of the findings from the review. In most of them, the elderly are described as frail and immobile with little access to help in disasters.
Synthesis 2
In the second synthesis, four studies looking at the medical management of the elderly are the main content. The authors look at the medicines and their management in disasters, as well as their relevance to the elderly.
Synthesis 3
In this synthesis, eleven studies focusing on the psychiatric effects of disasters on the elderly are the focus of the studies. Most of them measured the depression levels of the elderly after a major disaster with some comparing with the results before the disaster with those after.
Discussion
The literature above addresses the impact that disasters such as floods, earthquakes, and tornados had on the elderly population involved, as well as the emergency medical measures put to cope with their injuries. The majority of the findings give attention to the psychological impacts that these disasters had on the elderly patients. However, they also mention the management of medications in geriatric emergencies. Most of them propose a system of delivering the medication to the patients or taking the patients to the medication center. The initial step considered is adequate preparation strategies before the disaster happens. In this plan, all the necessary medications should be stocked with dissemination of information through the media and educational programs on where to get the medication being put in place. The programs available should also be married to ensure the elderly have few intermediaries between them and their drugs during disasters.
Pre-existing physical impairment in the elderly population limits their response to disasters (Imperiale 1991, p.8–10), and this may slow them down in getting to the medication outlets in disasters. A proposal to have a special transport system to deliver medication to the elderly disaster victims is also featured in the literature, and this may be useful in addressing the problem of medication supply. Another proposal to have temporary institutions set up in times of disasters features in the literature review. This would go a long way in easing the access to medication for the elderly victims of disasters. Another limitation to access of medication for the elderly in disasters is the loss of power in multi-story buildings. This means they cannot use the elevators and pump water to their residences (Krause 1987, p.69). The above-suggested strategy may also be used to cope with this issue.
The elderly have few if any sources of income. Most are dependent on their family members, the society, and the government. In the event of disasters, the elderly have reduced chances of getting their desired medication especially if the price is unfavorable (Bolin, & Klenow 1982, p.297). Thus, their medical conditions are likely to worsen. In the literature review, the role of social support for the elderly by their friends, neighbors, and family are emphasized. The role played by aid agencies is also taken into account, and a suggestion for creation of special agencies dealing with the elderly during disasters is given.
In the above review, the importance of the inclusion of mental health drugs in the emergency drug list for the elderly is suggested. In most of the studies that have mainly focused on the psychiatric implications of disasters on the elderly, appropriate mental health conditions management was not considered. This contributed to negative outcomes for the disasters. Therefore, future consideration of mental health in disasters is necessary. In the literature review, the suggestion of temporary medical services for patients with chronic conditions in disaster areas is evident. In this plan, a transport system would be set up to distribute and administer the medication to the elderly.
In the medical management of the elderly in disasters, nutrition is described as part of the medical management of these patients (Meals on Wheels of Central Maryland 2012). A suggestion is made to deliver meals free to the disaster victims especially the weak and those unable to access help centers. In the review, aid organizations are reported to deliver relief to the victims of disasters around the world. The aid agencies should also deliver medication to the elderly population along with food rations.
In the development of policies related to emergency response, more attention should be given to the needs of the elderly disasters. In most of the research done and reviewed above, a common sentiment is that medication management for the elderly is a key pillar of disaster preparedness. It is therefore important to consider the stocking, information distribution and delivery of medical supplies to the elderly in disasters.
Conclusion
In conclusion, the management of medicines for the elderly in the occurrence of disasters is a very important topic of review. In the findings, the elderly are a vulnerable population in the absence of disasters, and the risk is higher when they do occur. In disaster preparedness, therefore, special attention to the needs of the elderly should be a key priority. A consideration that the elderly population constitutes the bulk of patients with chronic illnesses and in dire need of medication is also necessary. When a disaster or emergency takes place, the response has been general with no special program for the elderly. In the above studies, a suggestion is given for special disaster response units dedicated to the elderly population in the society. Aid agencies have been suggested as a major arm of disaster management and that they should be involved in the distribution of drugs to the elderly sick along with nutritional support. In the literature, the development of a system to transport medication to the elderly is noted to be important with previous disasters leading to large losses of the elderly since they cannot access the medical services available at the time. Mobile units for the delivery of drugs are therefore suggested.
Implications for Practice
This review has several implications for the management of medicines for the elderly in times of disaster. As a common principle, the elderly are considered weak and vulnerable with most of them suffering from chronic medical conditions. An implication is that all states need to put in place a sound disaster-preparedness strategy with frequent drills. A proper method of disseminating information to the elderly in the population as to what to do in times of disasters also needs to be taken into account. Past failures in the transport and power distribution systems in disaster times mean that authorities should have special places for storage of emergency medicines in populations with a large number of elderly people especially those with chronic medical conditions and in need of the medicines.
Implications for research
The majority of research included in the review was conducted in the United States with only a few taking place in the developing countries. This is a probable cause of cultural bias in the response to the studies. Disaster response in different countries and cultures varies with the developing nations setting different strategies from those in the developed ones. There is therefore a need for further qualitative research from other countries to account for the cultural bias in the establishment of the best practices for medicines management for the elderly in disasters. In most of the research reviewed, a focus was made on the mental health issues that developed for the patients. The findings were that, despite the high prevalence of depression, PTSD, and other psychiatric conditions after a disaster, there was a limited medication included for these conditions in the list of emergency medicines. In future disasters, preparedness will involve the stocking of antipsychotic medication and other mental health drugs.
References
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Bolin, R & Klenow, D 1988, ‘Older people in disaster: A comparison of black and white victims’, Intl. J Aging and Human Development, vol. 26 no1, pp.29–43.
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Krause, N 1987, ‘Exploring the impact of a natural disaster on the health and psychological well-being of older adults’, Journal of Human Stress, vol. 13 no. 2, pp.61–69.
Kuo, C, Tang, H, Say, C, Lin, S, & Hu, W 2003, ‘Prevalence of psychiatric disorders among bereaved survivors of a disastrous earthquake in Taiwan’, Psychiatric Services, vol. 54 no. 2, pp. 249-251.
McKain, S, Henderson, A, Kuys, S, Drake ,S, & Kerridge, L 2004, ‘Exploration for patients’ needs for information on arrival at a geriatric and rehabilitation unit’, Journal of Clinical Nursing, vol. 14 no. 3, pp.704-710.
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Miller, J & Campbell, J 2004, ‘Elder care supportive interventions protocol’, Journal of Gerontologicalal Nursing, vol. 1 no. 2, pp. 10-18.
Mudur, G 2005, ‘Aid agencies ignored the special needs of elderly people after tsunami’, British Medical Journal, vol. 331 no. 1, pp. 422.
Nates, J 2004, ‘Combined external and internal hospital disaster: Impact and response in a Houston trauma center intensive care unit’, Critical Care Medicine, vol. 32, no. 3, pp.686-690.
Rockwood, K et al. 2005, ‘The elderly in disaster’, Canadian Medical Association Journal, vol. 173, no. 5, pp.489-495.
Romano, M 2005, ‘At capacity and beyond: Ideas such as “surge” hospitals are getting a more careful look as healthcare wrestles with planning for large-scale disasters’, Modern Healthcare, vol. 35, no. 39, p. 6.
Saltvedt, I, Opdahl, Mo, E, Fayers, P, Kaasa, S, Sletvold, O 2002, ‘Reduced mortality in treating acutely sick, frail older patients in a geriatric evaluation and management unit, A prospective randomised trial’, Journal of the American Geriatric Society, vol. 50 no. 2, pp.792-798.
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Disaster experience may cause negative psychological and spiritual effects on personal well-being. It can be short-term and long-term distress, a sense of anxiety, and alienation. In addition, different religions address traumatic events differently: they can overcome difficulties through prayer, crying, or stoic affect (Falkner, 2018). To address these issues, spiritual considerations play an integral role. Spiritual concerns that are prevalent among disaster victims are lack of meaning, hopelessness, separation from the community, and guilt. Falkner (2018) indicates that “regardless of religious affiliation, chaplains play an important role in supporting the communities’ emotional needs during and after a devastating event” (para 50). Thus, the academic community agrees that religious people may impact the spiritual well-being of victims. The peculiarity lies in the fact that the chaplains also have the psychological skills to work with the victims, which makes their work doubly effective.
Discussion
However, community health nurses can also provide spiritual care to those affected by natural and manmade disasters. For this purpose, nurses should have specific cultural competencies to work with endangered individuals of different religions and ethnicities (Falkner, 2018). The reason is that even a single wrong word may bring severe existential anxieties to disaster victims. As for the whole community, nurses should realize how to allocate resources to assist mostly those who are unable to do it on their own. Marginalized groups who were affected by oppression before a disaster may feel higher levels of spiritual suffering than other people.
Conclusion
Lastly, the spiritual well-being of self and colleagues is also important. It can be achieved through religion and close contact with colleagues. Only spiritually healthy nurses, who have definite answers about the meaning of life, will be able to provide the highest quality spiritual assistance to others.
Reference
Falkner, A. (2018). Disaster management. In A. Falkner & S. Z. Green (Eds.), Community & public health: The future of health care. Grand Canyon University.
Historically, the licensing process, which has been in existence in virtually every state, successfully eliminated fraudsters who purposefully misled and deceived the public. The medical licensure procedure in each state has a long history of safeguarding patients and assuring high standards of treatment (McMichael, 2020). Today, some claim that licensing is largely used to safeguard the licensed group’s economic interests. State licensing regulations for health care, on the other hand, provide a number of advantages that cannot be overlooked.
Due to public health licensing regulations, medical education and practice standards have grown. The availability of qualified medical practitioners in medical practice serves a critical societal purpose of protecting vulnerable people from untrustworthy and self-taught practitioners and institutions (Iserson, 2020). The necessity that physicians get a license to practice medicine protects the public against doubtful and inefficient therapies.
Unlike possible national licensing, state licensing ensures local responsibility in the event of patient care issues. Local accountability is more in line with the balance of patient and physician protection that is required. Patients may find it simpler to report suspected medical malpractice or misconduct if the specialist has a state license. Local authorities may be more accessible to patients than national authorities, and physician conduct hearings may be held locally (Iserson, 2020). The mechanism of the IMLC (Interstate Medical Licensing Treaty) became an effective mechanism in this regard. The state requirements are a significant aspect of healthcare regulations. State licensure is important not only for patients but also for specialists due to occasional differences in the educational process and its emphasis.
Overall, despite its criticism, the state licensing regulations for health care have their advantages, even though they can be developed or revised in some instances. Some of the critics opt for the elimination of licensing process as a whole, while some argue for national licensing. However, the issue is multifaceted, as state licensing requirements proved to be reliable in serving their main purpose – protecting the population’s health.
References
Iserson, K. V. (2020). Augmenting the disaster healthcare workforce. Western Journal of Emergency Medicine, 21(3), 490.
McMichael, B. J. (2020). Healthcare licensing and liability. Indiana University Bloomington, 9(5), 821. Web.
Electronic health record (EHR) systems are so meaningful today that many healthcare organizations cannot provide adequate service if they are unavailable. Information technological solutions can stop working in case of a natural disaster, and a massive flood is a typical example. This event can render some essential servers intolerable or break the electricity supply. Under such conditions, an EHR becomes useless because healthcare professionals cannot access it to insert or retrieve patient information. That is why medical facilities should create a plan to determine what specific procedures their staff members can take to respond to a natural disaster.
Disaster response planning is an essential step for every organization. A risk management approach should be utilized to predict a future crisis and explain how to mitigate it. According to Gettingger and Cross (2018), a facility should ensure that its EHR system regularly develops backup copies. This step is necessary to guarantee that information will not be lost in case of disaster. Furthermore, medical organizations should subject their employees to regular training. Staff members will understand how they should deal with patient data during the disaster (paperwork is a suitable response) and how information should be inserted into the system after the crisis (Gettingger & Cross, 2018). This approach seems an effective way of responding to a natural disaster.
One should add that disaster planning is a complicated task requiring many resources and efforts. Thus, data analytics should be a basis for developing disaster response procedures. This activity analyzes raw data to make reasonable conclusions about some future events (Chapter 1, n.d.). That is why organizations should invest in their data analytics teams to prove that crises can be predicted or, at least, an effective response will be developed.
References
Chapter 1. (n.d.). Introduction to computers and health information management [PDF document].
Gettingger, A., & Cross, J. (2018). Disaster planning your health IT [PDF document].
Spirituality is a humanistic approach that relates to how people seek as well as disclose significance and purpose in their lives. The above can be shown in religious forms such as prayers, non-religious forms, and values that include showing love and presence. Spirituality could play a significant role in aiding persons as well as society to survive and recover from calamities (Haynes et al., 2017). This paper examines whether spirituality plays a role in easing a disaster’s effects and community health nurses’ role in these cases.
Disasters often cause considerable challenges within the health sector in service delivery. They make people associate with spirituality as they relate disasters to suffering and death. In the wake of a disaster, people relook at the nature and purpose of their existence. In collaboration with other medical staff, community nurses ought to guarantee the affected individuals’ emotional and physical well-being (Haynes et al., 2017). Disasters are among the most traumatic events in people’s lives, often leaving a community devastated. Their sudden and intense loss has a staggering and long-lasting effect. The emotional well-being of families and affected individuals during and after a disaster is very important in their physical recovery. Assisting people to rely on their spiritual outlook as a source of strength, hope, and healing aids recovery.
Spiritual help and care are given as psychological first aid through respectful, sensitive, and appropriate support to individuals affected by these traumatic events. Community health nurses undergo specific training to assist those in need during and after disasters. They reinforce survivors’ confidence, support grieving individuals, and uplift first responders (Newton & McIntosh, 2009). Nurses, therefore, play a crucial role as they provide the necessary spiritual support to families and communities through ethical solutions.
Much as spirituality assists during recovery, people struggle to find meaning in their losses and trauma. Some may begin to doubt their spirituality, resulting in psychological and spiritual issues. Survivors’ ability to cope and find meaning during recovery is much influenced by their spiritual and religious beliefs and values (Lalani, 2019). A helpless person feels insecure, which may result in depression and spiritual distress. Nurses need to understand behaviors and actions and plan appropriate interventions to promote resilience in the recovery phase.
References
Haynes, W. C., Van Tongeren, D. R., Aten, J., Davis, E. B., Davis, D. E., Hook, J. N., Boan, D. & Johnson, T. (2017). The meaning as a buffer hypothesis: Spiritual meaning attenuates the effect of disaster-related resource loss on posttraumatic stress. Psychology of Religion and Spirituality, 9(4), 446–453.
Lalani, N. (2019). Spiritual distress among novice nurses during role transition at a university teaching hospital in Pakistan. Nursing Practice Today.
Newton, A., & McIntosh, D. (2009). Associations of general religiousness and specific religious beliefs with coping appraisals in response to hurricanes Katrina and Rita. Mental Health, Religion & Culture, 12(2), 129-146.
An earthquake is a natural disaster that, despite the ability to be predicted by scientists, results in unpredicted scopes of severity for the population every time the rupture happens. In terms of primary prevention of such a disaster, it is necessary to establish a public body or organization responsible for the creation of an extensive network of food, water, and first-aid kits to last people through the first days while waiting for backup. This prevention may be secured by the community health nurses, as they directly communicate with public organizations on the matter of support (Abdi et al., 2020). This prevention stage is held during the so-called interseismic phase of the elastic building prior to the earthquake, as this stage may exist a long time before the actual rupture.
Secondary prevention, being the most emergent challenge for medical workers, comprises a variety of interventions. When it comes to nurses’ competence during this stage, they are obliged to secure management of the injured patients and patients with prior medical conditions that put them at higher risk of suffering the consequences (Rezaei et al., 2020). Secondary prevention takes place almost immediately after the rupture, during the phase of earthquake aftermath.
Finally, the most important intervention during tertiary prevention is the follow-up on the survivors’ physical and mental rehabilitation. With an already stable pattern of health care providers in the area, local nurses could organize a system of regular check-ups for the patients who require special attention after the disaster (Abdi et al., 2020). This stage also takes place in the aftermath phase of an earthquake. Both interseismic and aftermath phases of the disaster were chosen for the interventions due to the fact that earthquake rupture that takes place between the phases does not allow for explicit medical intervention. Preventive measures and rapid disaster response, in their turn, fall into the nurses’ responsibilities.
In terms of facilitating various organizations, it is necessary for the community health nurses to cooperate with the local government. For example, the US Department of the Interior (DOI) secures the functioning of the Natural Disaster Response and Recovery Program, which aims at developing strategies and planning relief missions in case of an emergency (USDOI, n.d.). When cooperating with them, community health nurses are capable of developing a health care blueprint for natural disasters. The other significant source of facilitation is the NGOs, who might secure a number of volunteers to assist the relief mission in case of emergency.
References
Abdi, A., Vaisi-Raygani, A., & Najafi, B. (2020). Reflecting on the Challenges encountered by nurses at the great Earthquake in the West of Iran: A qualitative study. Web.
Rezaei, S. A., Abdi, A., Akbari, F., & Moradi, K. (2020). Nurses’ professional competencies in providing care to the injured in the earthquake: A qualitative study. Journal of Education and Health Promotion, 9(1), 188.
US Department of Interior [USDOI]. (n.d.). Natural disaster response and recovery. Web.