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Analysis of Emergency Health Care Workforce and Service Readiness for a Mass Casualty Event in the Republic of Ireland

Published online by Cambridge University Press:  21 May 2018

Tener Goodwin Veenema ,
Fiona Boland ,
Declan Patton ,
Tom O’Connor ,
Zena Moore  and
Sarah Schneider-Firestone
Tener Goodwin Veenema
Affiliation:
Department of Acute and Chronic Care
Fiona Boland
Affiliation:
Johns Hopkins University School of Nursing, Baltimore, MD; Data Science Centre, Royal College of Surgeons in Ireland, Dublin 2, Ireland
Declan Patton
Affiliation:
RCSI School of Nursing, Royal College of Surgeons in Ireland, Dublin 2, Ireland
Tom O’Connor
Affiliation:
RCSI School of Nursing, Royal College of Surgeons in Ireland, Dublin 2, Ireland
Zena Moore
Affiliation:
RCSI School of Nursing, Royal College of Surgeons in Ireland, Dublin 2, Ireland
Sarah Schneider-Firestone
Affiliation:
Supporting Professional Advancement in Nursing (SPAN) Program
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Abstract

Objective

Ultimately, a country’s capacity for a large-scale major emergency response will be directly related to the competence of its health care provider (HCP) workforce and communication between emergency responders and hospitals. The purpose of this study was to assess HCP preparedness and service readiness for a major emergency involving mass casualties (mass casualty event or MCE) in Ireland.

Methods

A cross-sectional study using a 53-item survey was administered to a purposive sample of emergency responders and HCPs in the Republic of Ireland. Data collection was achieved using the Qualtrics® Research Suite. Descriptive statistics and appropriate tests of comparison between professional disciplines were conducted using Stata 13.

Results

A total of 385 respondents, registered nurses (43.4%), paramedics (37.9%), medical doctors (10.1%), and administrators/managers (8.6%), participated in the study. In general, a level of knowledge of MCEs and knowledge of clinical response activities and self-assessed clinical competence varied drastically across many aspects of the survey. Knowledge and confidence also varied across professional disciplines (P<0.05) with nurses, in general, reporting the least knowledge and/or confidence.

Conclusions

The results demonstrate that serious deficits exist in HCP knowledge, skills, and self-perceived abilities to participate in a large-scale MCE. Results also suggest a poor knowledge base of existing major emergency response plans. (Disaster Med Public Health Preparedness. 2019;13:243–255)

Keywords

health care providersmajor emergencyprehospital carepreparednessworkforce development
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 13 , Issue 2 , April 2019 , pp. 243 - 255
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2018 

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References

REFERENCES

1. Ben-Ishay, O, Mitaritonno, M, Catena, F, et al. Mass casualty incidents – time to engage. World J Emerg Surg. 2016;11(8):doi: 10.1186/s13017-016-0064-7.Google Scholar
2. Barbisch, DF, Koenig, KL. Understanding surge capacity: essential elements. Acad Emerg Med. 2006;13(11):1098-1102.Google Scholar
3. Welzel, TB, Koenig, KL, Bey, T, Visser, E. Effect of hospital staff surge capacity on preparedness for a conventional mass casualty event. West J Emerg Med. 2010;11(2):189-196.Google Scholar
4. Schenk, E, Wijetunge, G, Mann, NC, et al. Epidemiology of mass casualty incidents in the United States. Prehosp Emerg Care. 2014;18(3):408-416. doi: 10.3109/10903127.2014.882999.Google Scholar
5. Osgood, R, Scanlon, C, Jotwani, R, et al. Shaken but prepared: analysis of disaster response at an academic medical centre following the Boston Marathon bombings. J Bus Contin Emer Plan. 2015;9(2):177-184.Google Scholar
6. Timbie, JW, Ringel, JS, Fox, DS, et al. Systematic review of strategies to manage and allocate scarce resources during mass casualty events. Ann Emerg Med. 2013;61(6):677-689. doi: 10.1016/j.annemergmed.2013.02.005.Google Scholar
7. Hsu, EB, Thomas, TL, Bass, EB, et al. Healthcare worker competencies for disaster training. BMC Med Educ. 2006;6(1). doi: 10.1186/1472-6920-6-19.Google Scholar
8. Subbarao, I, Lyznicki, JM, Hsu, EB, et al. A consensus-based educational framework and competency set for the discipline of disaster medicine and public health preparedness. Disaster Med Public Health Prep. 2008;2(01):57-68. doi: 10.1097/dmp.0b013e31816564af.Google Scholar
9. Gebbie, KM, Hutton, A, Plummer, V. Update on competencies and education. Annu Rev Nurs Res. 2012;30(1):169-192.Google Scholar
10. Klein, KR, Burkle, FM Jr, Swienton, R, et al. Qualitative analysis of surveyed emergency responders and the identified factors that affect first stage of primary triage decision-making of mass casualty incidents. PLoS Curr. 2016. doi: 10.1371/currents.dis.d69dafcfb3ad8be88b3e655bd38fba84.Google Scholar
11. Walsh, L, Craddock, H, Gulley, K, et al. Building health care system capacity: training health care professionals in disaster preparedness health care coalitions. Prehosp Disaster Med. 2015;30(02):123-130. doi: 10.1017/s1049023x14001460.Google Scholar
12. Paganini, M, Borrelli, F, Cattani, J, et al. Assessment of disaster preparedness among emergency departments in Italian hospitals: a cautious warning for disaster risk reduction and management capacity. Scand J Trauma Resusc Emerg Med. 2016;24(1). doi: 10.1186/s13049-016-0292-6.Google Scholar
13. Veenema, TG, Losinski, SL-A, Hilmi, LM. Increasing emergency preparedness. Am J Nurs. 2016;116(1):49-53. doi: 10.1097/01.naj.0000476169.28424.0b.Google Scholar
14. Khoury, A, Halberthal, M, Hymes, G, et al. Civilian hospital role in mass casualty event (MCE). In: Orthopedics in Disasters. Berlin, Heidelberg: Springer; 2016:61-81.Google Scholar
15. Gebbie, K, Qureshi, K. A historical challenge: nurses and emergencies. Online J Issues Nurs. 2006;11(3):1-14. https://search.proquest.com/docview/229621216?pq-origsite=gscholar. Accessed January 02, 2018.Google Scholar
16. Chapman, K, Arbon, P. Are nurses ready? Disaster preparedness in the acute setting. Australas Emerg Nurs J. 2008;11(3):135-144. doi.org/10.1016/j.aenj.2008.04.002.Google Scholar
17. Baack, S, Alfred, D. Nurses’ preparedness and perceived competence in managing disasters. J Nurs Scholarsh. 2013;45(3):281-287. doi: 10.1111/jnu.12029.Google Scholar
18. Veenema, TG. Disaster nursing and emergency preparedness for chemical, biological, and radiological terrorism and other hazards, 3rd ed. New York: Springer Publishing Company; 2013.Google Scholar
19. Veenema, TG, Griffin, A, Gable, AR, et al. Nurses as leaders in disaster preparedness and response – a call to action. Am J Nurs. 2016;48(2):187-200. doi: 10.1111/jnu.12198.Google Scholar
20. Department of Defence, Office of Emergency Planning. Major emergencies; 2017. https://www.emergencyplanning.ie/emergencies.aspx. Accessed June 29, 2017.Google Scholar
21. Department of Environment, Heritage and Local Government Inter-Agency Review Working Group. Framework for major emergency management; 2006. http://mem.ie/wp-content/uploads/2015/05/A-Framework-For-Major-Emergency-Management.pdf. Accessed June 29, 2017.Google Scholar
22. Health Service Executive, Republic of Ireland, Emergency Department Task Force Implementation Group. System wide escalation framework and procedures. Published December 21, 2015. https://www.inmo.ie/tempDocs/ED%20Escalation%20Framework%2021st%20December%202015.pdf. Accessed January 02, 2018.Google Scholar
23. Garbutt, SJ, Peltier, JW, Fitzpatrick, JJ. Evaluation of an instrument to measure nurses familiarity with emergency preparedness. Mil Med. 2008;173(11):1073-1077. doi: 10.7205/milmed.173.11.1073.Google Scholar
24. Kaiser, HE, Barnett, DJ, Hsu, EB, et al. Perspectives of future physicians on disaster medicine and public health preparedness: challenges of building a capable and sustainable auxiliary medical workforce. Disaster Med Public Health Prep. 2009;3(04):210-216. doi: 10.1097/dmp.0b013e3181aa242a.Google Scholar
25. Stata Statistical Software. Release 13. College Station, TX: StataCorp; 2013.Google Scholar
26. Adini, B, Peleg, K. Integrated care concerning mass casualty incidents/disasters: lessons learned from implementation in Israel. In: Amelung V, Stein V, Goodwin N, et al, eds. Handbook Integrated Care. Cham, Switzerland: Springer; 2017:439-448.Google Scholar
27. Lynn, M. Mass casualty incidents: the nuts and bolts of preparedness and response for acute disasters. New York: Springer-Verlag; 2016.Google Scholar
28. Khoury, A, Halberthal, M, Hymes, G, et al. Civilian hospital role in mass casualty event (MCE). In: Wolfson N, Lerner A, Roshal L, eds. Orthopedics in Disasters. Berlin, Heidelberg: Springer; 2016:61-81.Google Scholar
29. Moran, CG, Webb, C, Brohi, K, et al. Lessons in planning from mass casualty events in UK. BMJ. 2017;359:j4765.Google Scholar
30. Carles, M, Levraut, J, Gonzalez, JF, et al. Mass casualty events and health organisation: terrorist attack in Nice. Lancet. 2016;388(10058):2349-2350.Google Scholar
31. TheJournal.ie. Private hospital beds to be used to ease emergency department overcrowding. Published January 8, 2018. http://www.thejournal.ie/trolley-crisis-3787352-Jan2018/. Accessed February 12, 2018.Google Scholar
32. Liston, P, Conyngham, G, Brady, M, et al. Growing old in the emergency department. Ir Med J. 2017;110(8):621.Google Scholar
33. Ryan, A, Hunter, K, Cunningham, K, et al. STEPS: lean thinking, theory of constraints and identifying bottlenecks in an emergency department. Ir Med J. 2013. http://hdl.handle.net/10147/281738.Google Scholar
34. Brick, C, Lowes, J, Lovstrom, L, et al. The impact of consultation on length of stay in tertiary care emergency departments. Emerg Med J. 2014;31(2):134-138.Google Scholar
35. TheJournal.ie. The doctor revamping emergency departments in the US has some advice for Irish hospitals. Published November 6, 2016. http://www.thejournal.ie/richard-zane-emergency-departments-3057026-Nov2016/. Accessed February 12, 2018.Google Scholar
36. Lowe, D, Millar, JE, Dignon, N, Ireland, A. Top 10 lessons from the Glasgow major incidents. Emerg Med J. 2016;33:596-597. doi: 10.1136/emermed-2015-205626.Google Scholar
37. Steinemann, S, Kurosawa, G, Wei, A, et al. Role confusion and self-assessment in interprofessional trauma teams. Am J Surg. 2016;211(2):482-488.Google Scholar
38. Pedersen, M, Gjerland, A, Rund, B, et al. Emergency preparedness and role clarity among rescue workers during the terror attacks in Norway. PLoS One. 2016;11(6):e0156536. https://doi.org/10.1371/journal.pone.0156536.Google Scholar
39. Gates, JD, Arabian, S, Biddinger, P, et al. The initial response to the Boston Marathon bombing: lessons learned to prepare for the next disaster. Ann Surg. 2014;260(6):960-966. doi: 10.1097/SLA.0000000000000914.Google Scholar