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Preparing Emergency Personnel in Dialysis: A Just-in-Time Training Program for Additional Staffing During Disasters

Published online by Cambridge University Press:  15 August 2013

Genevieve B. Stoler ,
James R. Johnston ,
Judy A. Stevenson  and
Joe Suyama
Genevieve B. Stoler*
Affiliation:
University of Pittsburgh Medical Center
James R. Johnston
Affiliation:
University of Pittsburgh Medical Center
Judy A. Stevenson
Affiliation:
ESRD Network 4
Joe Suyama
Affiliation:
University of Pittsburgh Medical Center
*
Address correspondence and reprint requests to Dr Genevieve B. Stoler, Department of Emergency Medicine, University of Pittsburgh Medical Center, 230McKee Pl, Suite 500, Pittsburgh, PA 15213 (e-mail [email protected]).
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Abstract

Background

There are 341 000 patients in the United States who are dependent on routine dialysis for survival. Recent large-scale disasters have emphasized the importance of disaster preparedness, including supporting dialysis units, for people with chronic disease. Contingency plans for staffing are important for providing continuity of care for a technically challenging procedure such as dialysis. PReparing Emergency Personnel in Dialysis (PREP-D) is a just-in-time training program designed to train individuals having minimum familiarity with the basic steps of dialysis to support routine dialysis staff during a disaster.

Methods

A 5-module educational program was developed through a collaborative, multidisciplinary effort. A pilot study testing the program was performed using 20 nontechnician dialysis facility employees and 20 clinical-year medical students as subjects.

Results

When comparing pretest and posttest scores, the entire study population showed a mean improvement of 28.9%, with dialysis facility employees and medical students showing improvements of 21.8% and 36.4%, respectively (P < .05 for all comparisons).

Conclusions

PREP-D participants were able to demonstrate improved tests scores when taught in a just-in-time training format. The knowledge gained by using the PREP-D program during a staffing shortage may allow for continuity of care for critical services such as dialysis during a disaster. (Disaster Med Public Health Preparedness. 2013;7:272-277).

Keywords

just-in-time trainingdialysisdisaster preparednesseducation
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 7 , Issue 3 , June 2013 , pp. 272 - 277
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2013 

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References

1.US Renal Data System. USRDS 2007 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2007.Google Scholar
2.Counts, CS. Disaster preparedness: is your unit ready? Nephrol Nurs J. 2001;28(5):491-499.Google Scholar
3.Kopp, JB, Ball, LK, Cohen, A, et al. Kidney patient care in disasters: emergency planning for patients and dialysis facilities. Clin J Am Soc Nephrol. 2007;2(4):825-838.Google Scholar
4.Duley, MG. The next pandemic: anticipating an overwhelmed health care system. Yale J Biol Med. 2005;78(5):355-362.Google Scholar
5.Toner, E, Waldhorn, R, Maldin, B, etal. Hospital preparedness for pandemic influenza. Biosecur Bioterror. 2006;4(2):207-217.Google Scholar
6.Hick, JL, Hanfling, D, Burstein, JL, etal. Health care facility and community strategies for patient care surge capacity. Ann Emerg Med. 2004;44(3):253-261.CrossRefGoogle ScholarPubMed
7.Lam, C, Waldhorn, R, Toner, E, Inglesby, TV, O'Toole, T. The prospect of using alternative medical care facilities in an influenza pandemic. Bio-secur Bioterror. 2006;4(4):384-390.Google Scholar
8.Ellis, KJ. Disaster readiness: lessons from Katrina. Nephrol Nurs J. 2007;34(1):82-83, 98.Google Scholar
9.Shapira, Y, Marganitt, B, Roziner, I, Shochet, T, Bar, Y, Shemer, J. Willingness of staff to report to their hospital duties following an unconventional missile attack: a state-wide survey. Isr J Med Sci. 1991;27(11-12):704-711.Google Scholar
10.Secor-Turner, M, O'Boyle, C. Nurses and emergency disasters: what is known. Am J Infect Control. 2006;34(7):414-420.Google Scholar
11.French, ED, Sole, ML, Byers, JF. A comparison of nurses’ needs/concerns and hospital disaster plans following Florida's Hurricane Floyd. J Emerg Nurs. 2002;28(2):111-117.Google Scholar
12.Franco, C, Toner, E, Waldhorn, R, Maldin, B, O'Toole, T, Inglesby, TV. Systemic collapse: Medical care in the aftermath of Hurricane Katrina. Bio-secur Bioterror. 2006;4(2):135-146.Google Scholar
13.Arrieta, MI, Foreman, RD, Crook, ED, Icenogle, ML. Providing continuity of care for chronic diseases in the aftermath of Katrina: from field experience to policy recommendations. Disaster Med Public Health Prep. 2009;3(3):174-182.CrossRefGoogle ScholarPubMed
14.Kopp, JB, Ball, LK, Cohen, A, etal. Kidney patient care in disasters: lessons from the hurricanes and earthquake of 2005. Clin J Am Soc Nephrol. 2007;2(4):814-824.Google Scholar
15.Sever, MS, Erek, E, Vanholder, R, etal. Features of chronic hemodialysis practice after the Marmara earthquake. J Am Soc Nephrol. 2004;15(4):1071-1076.Google Scholar
16.Leach, A, Haun, DE. Deliver the lesson now: just-in-time training. MLO Med Lab Obs. 2003;35(7):42-46.Google Scholar
17.Schatell, D, ed. Core Curriculum for the Dialysis Technician: A Comprehen-sive Review ofHemodialysis, 3rd ed. Thousand Oaks, CA: Amgen Inc; 2006.Google Scholar
18.Nichols, AA, Palmer, DG. Cross-training in perinatal units. J Perinat Neonatal Nurs. 1994;8(3):33-45.Google Scholar
19.Riley, J. Cross-training: maximizing staffing flexibility. Nurs Manage. 1990;21(6):48I-48J.Google Scholar
20.Crissman, S, Jelsma, N. Cross-training: practicing effectively on two levels. Nurs Manage. 1990;21(3):64A-64D, 64D, 64H.Google Scholar
21.Altimier, LB, Sanders, JM. Cross-training in 3-D. Nurs Manage. 1999;30(11):59-62.Google Scholar
22.Snyder, J, Nethersole-Chong, D. Is cross-training medical/surgical RNs to ICU the answer? Nurs Manage. 1999;30(2):58-60.Google Scholar
23.Phillips, CR, Griffin, T. Cross-training: does it really promote safe and effective perinatal nursing care? MCN Am J Matern Child Nurs. 1999;24(3):120-121.Google Scholar
24.Komara, C, Stefaniak, K. Cross-training for obstetrics using an internship program. J Nurses Staff Dev. 1998;14(3):154-158.Google Scholar
25.Kozlowski, S. Cross-training. Concepts, considerations, and challenges. MLO Med Lab Obs. 1996;28(2): 50, 52-54.Google Scholar
26.del Bueno, DJ, Barker, F, Christmyer, C. Implementing a competency-based orientation program. J Nurs Adm. 1981;11(2):24-29.Google Scholar
27.Benedek, DM, Ritchie, EC. “Just-in-time” mental health training and surveillance for the Project HOPE mission. Mil Med. 2006;171(10) (Suppl 1): 63-65.Google Scholar
28.Chotani, RA, LaPorte, RE, Linkov, F, Dodani, S, Ahmed, D, Ibrahim, KM. Just-in-time lectures: SARS. Lancet. 2003;361(9373):1996.Google Scholar
29.Linkov, F, Ardalan, A, Dodani, S, etal. Building just-in-time lectures during the prodrome of Hurricanes Katrina and Rita. Prehosp Disaster Med. 2006;21(2):132.Google Scholar
30.Kahn, CE Jr, Santos, A, Thao, C, Rock, JJ, Nagy, PG, Ehlers, KC. A presentation system for just-in-time learning in radiology. J Digit Imaging. 2007;20(1):6-16.Google Scholar
31.Kahn, CE Jr, Ehlers, KC, Wood, BP. Radiologists’ preferences for just-in-time learning. J Digit Imaging. 2006;19(3):202-206.Google Scholar
32.Agency for Healthcare Research and Quality. Project XTREME: Model for Health Professionals’ Cross-Training for Mass Casualty Respiratory Needs. Rockville, MD: Agency for Healthcare Research and Quality; 2007.Google Scholar
33. Department of Health and Human Services. October 24, 2009 - President Obama Signs Emergency Declaration for H1N1 Flu. http://pandemicflu.gov/professional/federal/h1n1emergency10242009.html. Accessed April 19, 2011.Google Scholar