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Abstract

Objective: The National Disaster Health Consortium is an interprofessional disaster training program. Using the Hierarchical Learning Framework of Competency Sets in Disaster Medicine and Public Health, this program educates nurses and other professionals to provide competent care and leadership within the interprofessional team. This study examined outcomes of this training. Methods: Training consisted of a combination of online and on-site training. Learning outcomes were measured by using the Emergency Preparedness Information Questionnaire (EPIQ) pre/post training and participant performance during live functional exercises with the use of rubrics based on Homeland Security Exercise and Evaluation principles. Results: A total of 64 participants completed the EPIQ before and after training. The mean EPIQ pre-training score of 154 and mean post-training score of 81 (reverse-scored) was found to be statistically significant by paired t-test (P<0.001). Performance was evaluated in the areas of triage, re-triage, surge response, and sheltering. Greater than 90% of the exercise criteria were either met or partially met. Participants successfully achieved overall objectives in all scenarios. Conclusions: Disaster response requires nurses and other providers to function in interprofessional teams. Educational projects, like the National Disaster Health Consortium program, offer the potential to address the need for a standardized, interprofessional disaster training curriculum to promote positive outcomes. (Disaster Med Public Health Preparedness. 2016;page 1 of 6).

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... Inter-professional training was commonly adopted in disaster nursing simulation training, such as the National Disaster Health Consortium program in the USA (Farra et al., 2016). The collaborators in the inter-professional training mainly included: a) military ; b) different universities to extend the resources for disaster simulation (Adams and Canclini, 2008); c) multi-disciplinary departments within the universities, such as architecture and environmental engineering departments (Wallis, 2013); and d) community partnership (Adams et al., 2015). ...
... For example, the Loma Linda University, USA, has progressed the first-day traditional lectures into online modules and advanced the second day into a hands-on disaster simulation in a 2-day compulsory on-campus disaster response course for all nursing graduates since 2016 (Kim et al., 2017). The National Disaster Health Consortium in Ohio State developed by Wright State University was another program which combined online, on-site, virtual, and hands-on simulation in disaster scenarios designed to develop decision-making, leadership, and disaster response skills for nurses (Farra et al., 2016). ...
... Finally, it was difficult to compare the pre-test and post-test in the different programs since different measuring scales were used in the studies (e.g. Bartley et al., 2006;Digregorio et al., 2019;Farra et al., 2016;Pang et al., 2009). ...
Article
Background Nurses play a pivotal role in disaster management across the globe. With the call for all nurses to be prepared for disasters, disaster nursing education and training programs have expanded globally. However, a clear picture of the development and coverage of disaster nursing education and training programs is lacking. Objectives This study aimed to establish an overall picture of the development of disaster nursing education and training programs in the last 20 years, outline the contents included, approaches adopted and outcomes reported. Methods A systematic search for relevant literature published between January 2000 to December 2019 was conducted using electronic databases including the CINAHL, MEDLINE, PubMed, Web of Science, and Scopus with the keywords on disaster nursing education and training. Findings A total of 75 eligible studies were identified from 3,395 potentially relevant articles. The numbers of disaster nursing education and training programs increased gradually over the past 20 years. They were offered in various countries with an unbalanced geographical distribution. Most of the existing programs focused on disaster preparedness and response, especially on the skills of triage during disaster response, instead of addressing the full spectrum of disaster management that included mitigation, preparedness, response, and recovery phases. Multiple approaches and technologies were adopted, including competency-based, all-hazard, inter-professional, flipped classroom, simulation, tabletop exercises, and virtual reality ones. Nearly half of the included programs adopted a pre- and post-test evaluation to examine the outcomes of learning and all of the programs reported significant increases in nursing professionals’ knowledge and skills of related content on disaster management covered in the training programs. Conclusions This review provides nurse leaders, educators and researchers in nursing with an understanding of the state-of-art of the existing disaster nursing education and training programs. More disaster nursing research are necessary to enhance the knowledge, skills and readiness of the nursing professionals for disaster management in meeting global disaster challenges.
... NIMS strategies have previously been used in training nurses and other health care professionals for emergency preparation and management (Farra, Smith, & Bashaw, 2016). In academic nursing, the NIMS framework has previously been applied to the implementation of medical relief missions in rural Haiti (Ortega, González, Sloane, Snowden, & de Tantillo, 2017). ...
... It is recommended that nursing and other interprofessional university administrators and leaders receive ongoing NIMS and other emergency management training to safeguard the university's emergency management plan and faculty readiness for disaster response (Farra et al., 2016). The Comprehensive Vulnerability Management (CVM) paradigm proposed by McEntire (2020) provides further insight into additional training that may be needed specifically for pandemic emergencies. ...
Article
Unprecedented financial and logistical barriers in educating nurses during COVID-19 have threatened nursing education. The purpose of this article is to provide a template to facilitate the maintenance and stability of teaching and learning in a pandemic environment for nursing school administration and faculty leaders. The National Incident Management System (NIMS), previously used in training nurses for emergency preparation and response, has been applied as a guiding framework. The framework consists of five elements: Preparedness, Communication/Information Management, Resource Management, Command and Ongoing Management/Maintenance. This paper addresses how schools of nursing may apply each of these elements to address both the needs of the institution and community. The Comprehensive Vulnerability Management paradigm is further offered as a lens for professional development. Free preparedness education is showcased from leading nursing and healthcare professional and government organizations. Finally, the Quality and Safety Education for Nurses competencies are used for integrating NIMS and social dimensions of disaster. Such tools may equip academic leaders at schools of nursing to surmount challenges posed by the pandemic, and to ensure educational readiness to respond to global health crisis through use of the NIMS framework.
... A total of 25 (100%) participants, 14 men (56%) and 11 women (44%), took the pre-and post-training knowledge tests (Table 1, Figure 2). The median (Q1, Q3) of age and number of career years of the total of 25 participants were 35 (28,38) years and 6 (2. 11) years, respectively (Tables 1, 2). ...
Article
Background With the occurrence of a number of major disasters around the world, there is growing interest in chemical disaster medicine. In South Korea, there is a training program for mass casualty incidents (MCI) and backup by legal regulations by the Framework Act on the Management of Disasters and Safety. However, there is no program focusing on chemical disasters. Thus, the authors newly created a program, the Chemical-Mass Casualty Incident Response Education Module (C-MCIREM) in September 2019. This was a pilot study to verify the educational effect of the program. Method A pre/post study was conducted of a chemical MCI training program based on simulation. A total of 25 representative and qualified participants were recruited from fire departments, administrative staff of public health centers, and healthcare workers of hospitals in the Gyeonggi-do province of South Korea. They participated in a one-day training program. A knowledge test and confidence survey were provided to participants just before training, and again immediately following the training online. The authors compared improvements of pre/post-test results. In the tabletop drill exercise, quantified qualitative analyses were used to measure the educational effect on the participants. Results In the knowledge test, the mean (standard deviation) scores for all 25 participants at baseline and after training were 41.72 (15.186) and 77.96 (11.227), respectively (p < 0.001). In the confidence survey for chemical MCI response for all 25 participants, all the sub-items concerning personal protective equipment selection, antidote selection, antidote stockpiling and passing on knowledge to colleagues, zone setup and decontamination, and chemical triage were improved compared to the baseline score (p < 0.001). The tabletop exercise represented a prehospital setting and had 11 participants. The self-efficacy qualitative survey showed pre- and post-exercise scores of 64/100 and 84/100 respectively. For a hospital setting exercise, it had 14 participants. The survey showed pre/post-exercise scores of 26/100 and 73/100 respectively. Twenty-two (88%) participants responded to the final satisfaction survey, and their overall mean scores regarding willingness to recommend this training program to others, overall satisfaction with theoretical education, overall satisfaction with tabletop drill simulation, and opinion about whether policymakers need this training were all over 8 out of 10 respectively. Conclusion C-MCIREM, the newly created chemical MCI program, provided effective education to the selected 25 participants among Korean chemical MCI responders in terms of both knowledge and practice at a single pilot trial. Participants were highly satisfied with the educational material and their confidence in disaster preparedness was clearly improved. In order to prove the universal educational effect of this C-MCIREM in the future, more education is needed.
... Insufficient pre-emptive training in preparation for crisis situations as a barrier to HCW preparedness is not unique to Australian HCWs or the COVID-19 pandemic [10,[28][29][30]. Competency-based training programs for nontechnical skills have been shown to significantly improve learning outcomes [31] and increase HCW confidence in resource management when faced with a crisis situation [32]. The rapid development of the COVID-19 outbreak in Australia limited the ability to preemptively train HCWs beyond those in the most direct contact, though lessons from this pandemic should inform competency-based programs in preparation for ongoing and future infectious disease outbreaks. ...
Article
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Background: The COVID-19 crisis has caused prolonged and extreme demands on healthcare services. This study investigates the types and prevalence of occupational disruptions, and associated symptoms of mental illness, among Australian frontline healthcare workers during the COVID-19 pandemic. Methods: A national cross-sectional online survey was conducted between 27 August and 23 October 2020. Frontline healthcare workers were invited to participate via dissemination from major health organisations, professional associations or colleges, universities, government contacts, and national media. Data were collected on demographics, home and work situations, and validated scales of anxiety, depression, PTSD, and burnout. Results: Complete responses were received from 7846 healthcare workers (82.4%). Most respondents were female (80.9%) and resided in the Australian state of Victoria (85.2%). Changes to working conditions were common, with 48.5% reporting altered paid or unpaid hours, and many redeployed (16.8%) or changing work roles (27.3%). Nearly a third (30.8%) had experienced a reduction in household income during the pandemic. Symptoms of mental illness were common, being present in 62.1% of participants. Many respondents felt well supported by their workplaces (68.3%) and believed that workplace communication was timely and useful (74.4%). Participants who felt well supported by their organisation had approximately half the risk of experiencing moderate to severe anxiety, depression, burnout, and PTSD. Half (50.4%) of respondents indicated a need for additional training in using personal protective equipment and/or caring for patients with COVID-19. Conclusions: Occupational disruptions during the COVID-19 pandemic occurred commonly in health organisations and were associated with worse mental health outcomes in the Australian health workforce. Feeling well supported was associated with significantly fewer adverse mental health outcomes. Crisis preparedness focusing on the provision of timely and useful communication and support is essential in current and future crises.
Article
Nurses are the largest group of healthcare providers, constituting one of the most vital human resources for society to cope with disasters. For this reason, it is necessary to determine whether the nurses are ready for a disaster or not as well as the factors that affect their preparedness. This study is a descriptive study designed to evaluate nurses' preparedness for disaster and the influencing factors. The sample of the study consisted of 266 nurses who agreed to participate in the study. A questionnaire prepared by the researchers was used as a data collection form. In the study, statistical significance was found between the marital status of the participants, their status of having disaster preparedness education, and their preparedness for disaster situations at home and their preparedness for disasters (p < 0.05). Among the participants, disaster preparedness of those who received disaster preparedness training was found to be 3571 times higher than those who did not (95% CI 1.701–7.498). It was determined that those who were prepared for disasters at home basic disaster supplies kit were more prepared than those who were not. In this study, it was observed that preparedness of nurses, who play a key role in health care, for special situations such as disasters were affected by marital status, being prepared for disasters at home, and education. Therefore, it was concluded that it would be beneficial to include disaster trainings in the nursing curriculum and to repeat in-service trainings in hospitals regularly.
Article
During emergency responses, public health leaders frequently serve in incident management roles that differ from their routine job functions. Leaders’ familiarity with incident management principles and functions can influence response outcomes. Therefore, training and exercises in incident management are often required for public health leaders. To describe existing methods of incident management training and exercises in the literature, we queried 6 English language databases and found 786 relevant articles. Five themes emerged: (1) experiential learning as an established approach to foster engaging and interactive learning environments and optimize training design; (2) technology-aided decision support tools are increasingly common for crisis decision-making; (3) integration of leadership training in the education continuum is needed for developing public health response leaders; (4) equal emphasis on competency and character is needed for developing capable and adaptable leaders; and (5) consistent evaluation methodologies and metrics are needed to assess the effectiveness of educational interventions. These findings offer important strategic and practical considerations for improving the design and delivery of educational interventions to develop public health emergency response leaders. This review and ongoing real-world events could facilitate further exploration of current practices, emerging trends, and challenges for continuous improvements in developing public health emergency response leaders.
Article
Background: Nursing education must prepare graduates for disasters. The purpose of this study was to develop a list of critical disaster nursing competencies to be assessed as part of baccalaureate nursing education. Method: The International Council of Nurses (ICN) and World Health Organization (WHO) Framework of Disaster Nursing Competencies was used to develop an online survey. RNs with experience in disaster nursing and disaster education were asked to divide the disaster competencies into two categories-baccalaureate/entry-level or master's/doctorate-advanced practice level. The results were analyzed using one-sample binomial test. Results: Sixty-five RNs completed the online survey. Fifteen (12%) of the ICN and WHO disaster competencies were categorized as more appropriate for master's/doctorate nursing education. Conclusion: This project has developed a list of disaster nursing competencies for use by baccalaureate nursing programs, as well as a list of competencies specific for community and public health nurse educators. [J Nurs Educ. 2019;58(4):229-233.].
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As the largest profession of health care providers, nurses are an integral component of disaster response. Having clearly delineated competencies and developing training to acquire those competencies are needed to ensure nurses are ready when disasters occur. This article provides a review of nursing and interprofessional disaster competencies and development of a new interprofessional disaster certification. An overview of a standardized disaster training program, the National Disaster Health Consortium, is provided as an exemplar of a competency-based interprofessional disaster education program.
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Effective preparedness, response, and recovery from disasters require a well-planned, integrated effort with experienced professionals who can apply specialized knowledge and skills in critical situations. While some professionals are trained for this, others may lack the critical knowledge and experience needed to effectively perform under stressful disaster conditions. A set of clear, concise, and precise training standards that may be used to ensure workforce competency in such situations has been developed. The competency set has been defined by a broad and diverse set of leaders in the field and like-minded professionals through a series of Web-based surveys and expert working group meetings. The results may provide a useful starting point for delineating expected competency levels of health professionals in disaster medicine and public health. ( Disaster Med Public Health Preparedness . 2012;6:44–52)
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The events of September 11, 2001, and the 2005 devastation of Hurricane Katrina have emphasized the importance of educating all nurses in emergency preparedness and bioterrorism. Further evaluation (secondary data analysis) of the Emergency Preparedness Information Questionnaire (EPIQ) was conducted, to assess nurses familiarity with emergency preparedness. This study confirmed that the EPIQ, as revised, has sound psychometric characteristics (construct validity and internal reliability) as a tool to measure nurses' self-reported level of familiarity with emergency preparedness. Additional studies using the revised EPIQ should provide data to assist civilian and military nurse educators and to facilitate the development of competency-based, relevant, emergency preparedness curricula.
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This article reports findings from a research study designed to assess the level of familiarity Wisconsin nurses have regarding their response to large-scale emergency events. The research process identified 8 emergency preparedness dimensions, which were then investigated in the study. Efforts were also undertaken to determine the types of educational offerings and class-scheduling options most preferred by nurses.
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Disaster education is important for everyone and especially nurses. Being informed, making individual and family communication plans, and creating the needed supplies to shelter in place or evacuate for one's self and family are required core readiness behaviors. Nurses also need to understand their role within the employer's emergency plans and incident command structure. All of these behaviors help the nurse to be ready and available to care for patients during disaster and emergency incidents.
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This integrative review of literature was conducted to determine (1) what are the suitable disaster preparedness competencies for undergraduate nursing curriculum? and (2) what are the suitable methods of instruction to deliver disaster preparedness content? A literature search was conducted on three major electronic databases: Ovid MEDLINE, PubMed and the Cumulative Index of Nursing and Allied Health Literature (CINAHL) using the keywords; Disaster Preparedness, Disaster and nursing education; disaster response and nursing education. Limiters used were published within the last 10years and in nursing field. Out of the 190 articles retrieved, eight were research articles that met the inclusion criteria. These articles were carefully reviewed and the results are summarized in two sections to answer the research questions. There was no uniformity of intended competencies among the studies, though all studies used resources from reputed national and international organizations. All the studies reviewed adhered to a systematic approach in delivering content and used eclectic methods including multiple technologies to enhance the educational outcomes. Most of the studies had incorporated simulation in different ways involving low to high fidelity simulators, virtual simulation and live actors. Content and length of the programs were greatly varied but stayed focused on the general principles of disaster management and appropriate for the level of the students within the programs. More rigorous research is needed in this area since all published articles had deficiencies in the methodologies, especially in data collection and analysis. Disaster preparedness education was found to be a suitable activity for interprofessional education.