With the increase in natural disasters and the expected role of public health nurses (PHNs) in responding, it is crucial to develop evidence-based disaster preparedness and management training programs tailored to the needs of PHNs. This study evaluates the effectiveness of a flipped classroom approach in disaster training for PHNs.

A total of 42 PHNs completed a 5-hour online training program and an in-person 8-hour training session at a local nursing school. Surveys measuring self-reported confidence and knowledge were completed at the beginning and end of the online and in-person training.

The average years of experience as an RN and PHN were 12.3 years and 6.7 years, respectively. Approximately 64% of participants had never deployed during a disaster. The pre- and posttest demonstrated a large effect size, indicating the effectiveness of both online and in-person training. The online training resulted in significant changes in knowledge. The in-person training showed a statistically significant increase in confidence across all measures.

Online and in-person disaster preparedness training programs can effectively enhance the knowledge, skills, and attitudes of PHNs. The majority of participants expressed that the training better prepared them to work in disaster shelters.

In January 2022, Fiji was hit by multiple natural disasters, including a cyclone causing flooding, an underwater volcanic eruption, and a tsunami. This study aimed to investigate perceived needs among the disaster-affected people in Fiji and to evaluate the feasibility of the Humanitarian Emergency Settings Perceived Needs Scale (HESPER Web) during the early stage after multiple natural disasters.

A cross-sectional study using a self-selected, non-representative study sample was conducted. The HESPER Web was used to collect data.

In all, 242 people participated. The number of perceived serious needs ranged between 2 and 14 (out of a possible 26), with a mean of 6 (SD = 3). The top 3 most reported needs were access to toilets (60%), care for people in the community who are on their own (55%), and distress (51%). Volunteers reported fewer needs than the general public.

The top 3 needs reported were related to water and sanitation and psychosocial needs. Such needs should not be underestimated in the emergency phase after natural disasters and may require more attention from responding actors. The HESPER Web was considered a usable tool for needs assessment in a sudden onset disaster.

Studies have reported that minorities are disproportionately impacted by the COVID-19 pandemic. Few studies have elucidated the lived experiences of African American older adults, and the resiliency displayed in combatting the COVID-19 pandemic and other disasters.

This study used 4 recorded focus groups with 26 African American older adults who have spent most of their lives living in Houston, Texas to assess safety, economic, and health concerns related to the pandemic and similarities or differences with other types of disasters that are specific to Houston/ the Gulf Region of Texas, such as Hurricane Harvey.

Key themes emerged from the thematic analysis: 1) previous disasters provided important coping and preparation skills, although each occurrence was still a major stressor, 2) while telehealth was a significant benefit, regular health maintenance and chronic disease management were not completed during the COVID-19 pandemic, 3) information from the federal and state authorities were inconsistent and spurred fear and anxiety, 4) participants experienced few to no disruptions to their income but were heavily called on to support family members, and 5) participants experienced anxiety and isolation, but many used existing social connections to cope.

These findings demonstrate how African American older adults navigate disaster response and recovery through experience and community. Providing unambiguous information to older adults could prove useful in preparing for future disaster events and coping with disasters.

For hospitals, learning from disaster response efforts and adapting organizational practices can improve resilience in dealing with future disruptions. However, amidst global disruptions by climate change, the coronavirus disease 2019 (COVID-19) pandemic, and other disasters, hospitals’ ability to cope continues to be highly variable. Hence, there are increasing calls to improve hospitals’ capabilities to grow and adapt towards enhanced resilience.

This study aims two-fold: (1) to characterize the current state of knowledge about how hospitals are gaining knowledge from their responses to disasters, and (2) to explore how this knowledge can be applied to inform organizational practices for hospital resilience.

This study used Preferred Reporting Items of Systematic Reviews and Meta-Analysis (PRISMA) guidelines for data collection and framework for data analysis, Covidence software, and Medical Subject Headings (MeSH) terms and keywords relevant to “hospitals,” “learn,” “disaster response,” and “resilience.” The quality appraisal used an adapted version of the Mixed Methods Assessment Tool (MMAT).

After applying inclusion and exclusion criteria and quality appraisal, out of the 420 articles retrieved, 22 articles remained for thematic and content analysis. The thematic analysis included the hospital’s functional (operational) and physical (structural and non-structural) sections. The content analysis followed nine learning areas (Governance and Leadership, Planning and Risk Assessment, Surveillance and Monitoring, Communication and Network Engagement, Staff Practices and Safety, Equipment and Resources, Facilities and Infrastructure, Novelty and Innovation, and Learning and Evaluation).

On applying the Deming cycle, only four studies described a completed learning cycle wherein hospitals adapted their organizational structures using the prior experience and evaluation gained in responding to disaster(s).

There is a gap between hospitals’ organizational learning and institutionalized practice. The conceptualized Hybrid Resilience Learning Framework (HRLF) aims to guide the hospitals’ decision makers in evaluating organizational resilience and knowledge.

In the face of disasters, both the stressful factors and the coping strategies that affect the health care workers (HCWs) should be substantially considered.

The COVID-19 pandemic resulted in millions of deaths worldwide and is considered a significant mass-casualty disaster (MCD). The surge of patients and scarcity of resources negatively impacted hospitals, patients and medical practice. We hypothesized ICUs during this MCD had a higher acuity of illness, and subsequently had increased lengths of stay (LOS), complication rates, death rates and costs of care. The purpose of this study was to investigate those outcomes.

This was a multicenter, retrospective study that compared intensive care admissions in 2020 to those in 2019 to evaluate patient outcomes and cost of care. Data were obtained from the Vizient Clinical Data Base/Resource Manager (Vizient Inc., Irvine, Texas, USA).

Data included the number of ICU admissions, patient outcomes, case mix index and summary of cost reports. Quality outcomes were also collected, and a total of 1304981 patients from 333 hospitals were included. For all medical centers, there was a significant increase in LOS index, ICU LOS, complication rate, case mix index, total cost, and direct cost index.

The MCD caused by COVID-19 was associated with increased adverse outcomes and cost-of-care for ICU patients.

Effective incident management is essential for coordinating efforts of multiple disciplines and stakeholders when responding to emergencies, including public health disasters such as the ongoing coronavirus disease 2019 (COVID-19) pandemic.

Existing research frameworks tend to focus on formal structures and doctrine (eg, ICS-NIMS); however, organizational processes that underlie incident management have not been systematically assessed and synthesized into a coherent conceptual framework.

The lack of a framework has hindered the development of measures of performance that could be used to further develop the evidence base and facilitate process improvement. To address this gap, we present a conceptual framework of incident management drawn from expert feedback and a review of literature on incident management and related fields. The framework features 23 measurement constructs grouped into 5 domains: (1) situational awareness and information sharing, (2) incident action and implementation planning, (3) resource management and mobilization, (4) coordination and collaboration, and (5) feedback and continuous quality improvement.

As such, the article provides a first step toward the development of robust measures for assessing the performance and effectiveness of incident management systems.

On August 4, 2020, a massive explosion struck the Beirut Harbor in Lebanon. Approximately 220 people were killed and around 7,000 were injured, of which 12% were hospitalized. Despite being weakened by economic crisis and increasing numbers of coronavirus disease 2019 (COVID-19) cases, the national health care system responded promptly. Within a day, international health care assistance in the form of International Emergency Medical Teams (I-EMTs) started arriving. Previous studies have found that I-EMTs have arrived late and have not been adapted to the context and dominating health care needs. The aim of this study was to document the organization, type, activity, and timing of I-EMTs deployed to Beirut and to discuss their relevance in relation to medical needs.

Data on all deployed I-EMTs were retrieved from all available sources, including internet searches, I-EMT contacts, and from the World Health Organization (WHO) EMT coordination cell (EMT CC) in Lebanon. The WHO EMT classification was used to categorize deployed teams. Information on characteristics, timing, and activities was retrieved and systematically assessed.

Nine I-EMTs were deployed to Beirut following the explosion. Five were equivalent to EMT Type 2 (field hospitals), out of which three were military. The first EMT Type 2 arrived within 24 hours, while the last EMT set up one month after the explosion. Four civilian I-EMTs provided non-clinical support as EMT Specialized Care Teams. A majority of the I-EMTs were focused on trauma care. Three of the four I-EMT Specialized Care Teams were rapidly re-tasked to support COVID-19 care in public hospitals.

A majority of the deployed I-EMT Type 2 were military and focused on trauma care rather than the normal burden of disease including COVID-19. Re-tasking of EMTs requires flexible EMTs. To be better adapted, the I-EMT response should be guided by a systematic assessment of both health care capacities in the affected country as well as the varying health effects of hazards before deployment.

The aim of this study was to describe the results of food environment assessments completed after Hurricane Florence in North Carolina (2018) and Hurricane María in Puerto Rico (2017), and provide recommendations for assessing disaster food environments.

Adapted structured observation protocols were used to conduct rapid assessments of the availability, price, and quality of specific foods in retail markets.

In both settings, unhealthful food items (soda, chips, fruit-flavored drinks) and milk were widely available and at lower prices than domestic averages. The adapted instrument in Puerto Rico allowed for documentation of greater availability of canned items compared with fresh or frozen foods. In both settings, researchers noted the inability of the instrument to document items that are important to assess postdisaster: ready-to-heat and ready-to-eat foods; food preparation facilities and supplies; hygiene supplies; and empty shelf-space.

The instruments, despite their limitations, were able to capture food availability issues in postdisaster environments. Future instrument adaptation is necessary to capture availability of all major food groups, healthful and unhealthful options, shelf-stable, ready-to-eat, and ready-to-heat foods versus other formats (fresh, frozen), and cooking and hygiene supplies.

In the wake of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, rapid identification of pediatric mental health risk is extremely important. The Western Regional Alliance for Pediatric Emergency Management held an integrated, interdisciplinary national tabletop exercise to familiarize mental health and non-mental health professionals with Psychological Simple Triage and Rapid Treatment (PsySTART), an evidence-based triage and incident management system used to evaluate new mental health risk impacts following exposure to traumatic events, such as coronavirus disease (COVID-19).

Participants Participants were exposed to 3 practice cases that reflected a combination of “all hazards” scenarios and were asked to triage each case using PsySTART. Participants were asked to interpret results at both an individual site and aggregate county and/or state level.

The exercise had a total of 115 participants with a total of 156 discrete triage encounters. A user-defined operating picture was created with graphs of aggregate mental health risk data, generating cross-regional, real-time situational awareness. After the exercise, a vast majority of the participants reported confidence in their ability to use PsySTART in their practices.

Participants are now better equipped with tools to perform mental health triage for early intervention during COVID-19 and other disasters and understand risk on a population level.

The aim of this study was to provide insights learned from disaster research response (DR2) efforts following Hurricane Harvey in 2017 to launch DR2 activities following the Intercontinental Terminals Company (ITC) fire in Deer Park, Texas, in 2019.

A multidisciplinary group of academic, community, and government partners launched a myriad of DR2 activities.

The DR2 response to Hurricane Harvey focused on enhancing environmental health literacy around clean-up efforts, measuring environmental contaminants in soil and water in impacted neighborhoods, and launching studies to evaluate the health impact of the disaster. The lessons learned after Harvey enabled rapid DR2 activities following the ITC fire, including air monitoring and administering surveys and in-depth interviews with affected residents.

Embedding DR2 activities at academic institutions can enable rapid deployment of lessons learned from one disaster to enhance the response to subsequent disasters, even when those disasters are different. Our experience demonstrates the importance of academic institutions working with governmental and community partners to support timely disaster response efforts. Efforts enabled by such experience include providing health and safety training and consistent and reliable messaging, collecting time-sensitive and critical data in the wake of the event, and launching research to understand health impacts and improve resiliency.