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Effectiveness of Hospital Staff Mass-Casualty Incident Training Methods: A Systematic Literature Review

Published online by Cambridge University Press:  28 June 2012

Edbert B. Hsu*
Affiliation:
Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
Mollie W. Jenckes
Affiliation:
Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
Christina L. Catlett
Affiliation:
Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
Karen A. Robinson
Affiliation:
Department of Epidemiology, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
Carolyn Feuerstein
Affiliation:
Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
Sara E. Cosgrove
Affiliation:
Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
Gary B. Green
Affiliation:
Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
Eric B. Bass
Affiliation:
Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA Department of Epidemiology, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA Department of Health Policy and Management, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
*
201 N. Charles Street, Suite 1400Baltimore, MDUSA21201 E-mail: [email protected]

Abstract

Introduction:

Recently, mass-casualty incident (MCI) preparedness and training has received increasing attention at the hospital level.

Objectives:

To review the existing evidence on the effectiveness of disaster drills, technology-based interventions and tabletop exercises in training hospital staff to respond to an MCI.

Methods:

A systematic, evidence-based process was conducted incorporating expert panel input and a literature review with the key terms: “mass casualty”, “disaster”, “disaster planning”, and “drill”. Paired investigators reviewed citation abstracts to identify articles that included evaluation of disaster training for hospital staff. Data were abstracted from the studies (e.g., MCI type, training intervention, staff targeted, objectives, evaluation methods, and results). Study quality was reviewed using standardized criteria.

Results:

Of 243 potentially relevant citations, twenty-one met the defined criteria. Studies varied in terms of targeted staff, learning objectives, outcomes, and evaluation methods. Most were characterized by significant limitations in design and evaluation methods. Seventeen addressed the effectiveness of disaster drills in training hospital staff in responding to an MCI, four addressed technology-based interventions, and none addressed tabletop exercises. The existing evidence suggests that hospital disaster drills are effective in allowing hospital employees to become familiar with disaster procedures, identify problems in different components of response (e.g., incident command, communications, triage, patient flow, materials and resources, and security) and provide the opportunity to apply lessons learned to disaster response. The strength of evidence on other training methods is insufficient to draw valid recommendations.

Conclusions:

Current evidence on the effectiveness of MCI training for hospital staff is limited. A number of studies suggest that disaster drills can be effective in training hospital staff. However, more attention should be directed to evaluating the effectiveness of disaster training activities in a scientifically rigorous manner.

Type
Comprehensive Review
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2004

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