A learning project was launched to prepare for natural disasters such as earthquakes and floods. Competencies were developed for clinical nurses in the Initial phase of disasters as an indicator to build a bridge between daily training and actions during crises. There are two predominant features of the competencies that differ from other works. First was to concentrate only on “the initial phase” of a crisis outbreak. The second was to associate each competence with services and roles of clinical nurses.

The development has been conducted in accordance with the ibstpi® competency development model. First, 50 outlining competencies from earlier studies were selected, like ICN Framework and Disaster Nursing Core Competency for undergraduates in Japan. Then a web-based questionnaire was carried out with a four-point scale of “able,” “probable,” “impossible,” and “cannot understand meaning” for incumbent nurses in order to gauge their adequacy.

There were 86 responses with an average of 14 years (1-40) of nursing experience. We compared them in three groups; those with a job post (G1), those with experience of longer than five years (G2), and those with experience of fewer than five years (G3). The average competency score (total 150 points) was 96.7 (67-129) in G1, 88.2 (53-145) in G2 and 80.2 (59-114) in G3.

The results imply, even in G1, the average score is low at 65/100 points. This may indicate most clinical nurses should make efforts to develop their skills and knowledge of disaster nursing through daily work. Only 32 competencies (G1), 14 (G2), and 5 (G3) were marked as “able” or “probable” by over 80% of responders. Thus with consideration, depending on the result and expert reviews, the competencies determined to be “required” for clinical nurses were finally refined down to 35 items including the premise of ten.

Prehospital emergency care is a vital and integral component of health systems, particularly in resource-constrained countries like Uganda. It can help to minimize deaths, injuries, morbidities, disabilities, and trauma caused by road traffic incidents (RTIs). This study identifies the weaknesses and capacities affecting the prehospital emergency care for the victims of RTIs in the Greater Kampala Metropolitan Area (GKMA).

A cross-sectional study was conducted in the GKMA using a three-part structured questionnaire. Data related to the demographics, nature of RTIs and victims’ pre-hospital experience and existing Emergency Medical Services (EMS) were collected from victims and EMS specialists in 3 hospitals and 5 EMS institutions, respectively. Data were descriptively analyzed, and a principal component analysis was employed to identify the most influential weaknesses and capacities affecting the prehospital emergency care for the victims of RTI in the GKMA.

From 459 RTI victims (74.7% males and 25.3% females) and 23 EMS specialists (91.3% males and 8.7% females) who participated in the study between May and June 20164. key weaknesses and 5 key capacities were identified to affect the prehospital emergency care for RTI victims in the GKMA. Although some strengths exist, (e.g., ambulance facilitation, EMS structuring, and coordination), the key weaknesses affecting the pre-hospital care for victims were noted to relate to the absence of predefined EMS systems, particularly in the GKMA and Uganda as a whole. They were identified to involve poor quality first aid treatment, insufficient skills/training of the first responders, inadequate EMS resources, and avoidable delays to respond and transport RTI victims to medical facilities.

Though some strengths exist, the weaknesses affecting prehospital care for RTI victims primarily emanate from the absence of predefined and well-organized EMS systems in the GKMA and Uganda as a whole.

With the development of the economy and the expansion of the hazardous chemicals industry in one city, it is necessary for the city to establish an evaluation model of emergency medical rescue capability for hazardous chemicals production, storage, and exposure risk.

Establish an emergency medical rescue capacity evaluation model for secondary and higher hospitals in a city to deal with exposure risks of hazardous chemicals.

1. 1. Develop an expert consultation form

2. 2. Develop a survey on the status quo of emergency medical rescue capacity of hospitals in secondary and above hospitals in response to exposure and risk of hazardous chemicals production and storage.

3. 3. Calculate the weights of the first, second, and third-grade indicators, and establish a comprehensive evaluation model for the rescue capacity assessment of Chengdu hospitals.

Five levels of first-level indicators were obtained, namely, the weights of the five indicators of “centralized admission ability,” “hospital comprehensive ability,” “emergency management ability,” “material equipment capability,” and “health emergency team” were 0.2884, 0.2219, 0.1938, 0.1507, and 0.1453, respectively.

The establishment of an emergency medical rescue capacity evaluation model for the risk of exposure and storage of hazardous chemicals in secondary and higher hospitals in a city is related to five capabilities, the most important of which is the ability to focus on admission.

As the number of disasters caused by natural and non-natural hazards increase, so does the emphasis placed on healthcare security planning for the influx of patients that often accompany such events. This presentation expands on a previously published examination of national healthcare security systems and emphasizes the role of security in the hospital environment during disasters in China, India, and Japan. National emergency preparedness planning systems and disaster type are examined. Elements of planning for a mass-casualty incident (MCI) that most directly impact security planning include mass-notification alert systems, patient routing processes to hospitals (from an MCI scene) and within hospitals (emergency department flow), staffing, disaster triage, patient identification, tracking and discharge, volunteer tracking, and the adaptability and flexibility of space and processes.

Researchers conducted extensive literature reviews of country-specific health care and physical security elements of patient surge. The comparative analysis was augmented by communication with national healthcare security experts.

Positive associations exist between increased disasters and the level of priority and funding given to healthcare security measures in disaster planning. National characteristics of governance, landmass, disaster history, and population influenced the development of healthcare security systems and planning for patient surge incidents. Planning for the mental health impact of terrorism victims, and its subsequent impact to patient surge into hospitals was more relevant in the literature for both India and Japan.

Violent incidents (VI) in emergency departments (EDs) are under-reported concerns for emergency care providers (ECP). There are limited data from EDs in India.

This is a study of pattern and factors associated with VIs in the ED of a Level-1 Trauma Center.

A qualitative survey questionnaire was distributed to 42 ECPs who worked in the ED of the All India Institute of Medical Sciences. Responses of ECPs were compiled and analyzed.

A total of 78.6% of nurses, 19.1% doctors, and 2.4% registration clerks participated in the study. A total of 54.8% were female. A total of 85.7% had five years of work experience in the ED. A total of 59.5% witnessed and experienced verbal abuse; 19.04% witnessed and experienced physical abuse. The remaining experienced and witnessed verbal abuse as well as physical abuse. A total of 57.1% had experienced VI multiple times in last six months. Of these, 88.2% faced the incident between 8 pm and 8 am. The ECP reported the incident to hospital authority's 54.8% of the time, 19.1% reported it to the police, and 14.29% did not report, while 7.1% reported to police and hospital administration. Eighty-five percent experienced insecurity & emotional disturbance. Patient-related factors included intoxication and anxiety. Healthcare system-related factors included delay in investigations, non-availability of beds, overcrowding of ED, and lack of staff. A total of 47.7% of participants felt that there was improper communication between healthcare workers and 40.1% felt that non-availability of senior doctor were the system deficiency factors. A total of 16.6% of ECPs had formal training regarding communication skills, and 11.9% had grief counseling. All respondents felt that steps should be taken to decrease and mitigate the VIs in the ED.

Verbal and physical abuse of emergency care workers is common.

Smallpox has been eradicated, but advances in synthetic biology have increased the risk of its re-emergence. Residual immunity in individuals who were previously vaccinated may mitigate the impact of an outbreak, but there is a high degree of uncertainty regarding the duration and degree of residual immunity.

A systematic literature review using the PRISMA criteria was conducted to quantify the duration and extent of residual immunity to smallpox after vaccination. 29 papers related to quantifying residual immunity to smallpox after vaccination were identified.

Duration of protection of >20 years was consistently shown in the 16 retrospective cross-sectional studies, while the lowest estimated duration of protection was 11.7 years among the modeling studies. Childhood vaccination conferred longer duration of protection than vaccination in adulthood. Multiple vaccinations did not appear to improve immunity. Most studies suggest a longer duration of residual immunity (at least 20 years) than assumed in smallpox guidelines. Estimates from modeling studies were less but still greater than the 3-10 years suggested by the WHO Committee on International Quarantine or US CDC guidelines. These recommendations were probably based on observations and studies conducted while smallpox was endemic. The cut-off values for pre-existing antibody levels of >1:20 and >1:32 reported during the period of endemic smallpox circulation may not be relevant to the contemporary population but have been used as a threshold for identifying people with residual immunity in post-eradication era studies.

Of the total antibodies produced in response to smallpox vaccination, neutralizing antibodies have shown to contribute significantly to immunological memory. Although the mechanism of immunological memory and boosting is unclear, revaccination is likely to result in a more robust response. There is a need to improve the evidence base for estimates on residual immunity to better inform planning and preparedness for re-emergent smallpox.