bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disaster Nursing: Trends in the Professional Literature
Authors: Cohen Odeya , Stewart David , Kanbara Sakiko , Catton Howard , Shamian Judith 
Published: May 2019

Introduction:Nurses’ broad knowledge and treatment skills are instrumental to disaster management. Roles, responsibilities, and practice take on additional dimensions to their regular roles during these times. Despite this crucial position, the literature indicates a gap between their actual work in emergencies and the investment in training and establishing response plans.Aim:To explore trends in disaster nursing reflected in professional literature, link these trends to current disaster nursing competencies and standards, and reflect based on the literature how nursing can better contribute to disaster management.Methods:A systematic literature review, conducted using six electronic databases, and examination of peer-reviewed English journal articles. Selected publications were examined to explore the domains of disaster nursing: policy, education, practice, research. Additional considerations were the scope of the paper: local, national, regional, or international. The International Nursing Councils’ (ICN) Disaster-Nursing competencies are examined in this context.Results:The search yielded 171 articles that met the inclusion criteria. Articles were published between 2001 and 2018, showing an annual increase. Of the articles, 48% (n = 82) were research studies and 12% (n = 20) were defined as dealing with management issues. Classified by domain, 48% (n = 82) dealt with practical implications of disaster nursing and 35% (n = 60) discussed educational issues. Only 11% of the papers reviewed policy matters, and of these, two included research. Classified by scope, about 11% (n =18) had an international perspective.Discussion:Current standards attribute a greater role to disaster-nursing in leadership in disaster preparedness, particularly from a policy perspective. However, this study indicates that only about 11% of publications reviewed policy issues and management matters. A high percentage of educational publications discuss the importance of including disaster nursing issues in the curricula. In order to advance this area, there is a need to conduct dedicated studies.
The Forgotten Patients in Cyclones: The Continuation of Opioid Replacement Therapy Program
Authors: O’Dwyer Niamh , Cliffe Harrison , Watson Kaitlyn E. , McCourt Elizabeth , Singleton Judith A. 
Published: May 2019

Introduction:Cyclones are expected to increase in frequency and intensity, significantly impacting communities and healthcare services. During these times, those with chronic diseases such as opioid dependence are at an increased risk of disease exacerbation due to treatment regimen interruptions. Disruptions to the continuity of the opioid replacement therapy (ORT) service can be detrimental to both clients and the community which can potentially lead to relapse, withdrawal, and risky behaviors.Aim:To explore the impacts of cyclones on opioid treatment programs within community and hospital pharmacies in Queensland.Methods:Qualitative research methods were used in this study with two methods of data analysis employed: the text analytics software, Leximancer®, and manual coding. Interviews were conducted with five hospital and five community pharmacists and four Queensland opioid treatment program (QOTP) employees. Participants worked in Mackay, Rockhampton, Townsville, and Yeppoon in a community impacted by a cyclone and involved with ORT supply.Results:The themes developed in the manual coding were “impact on essential services,” “human experience,” “healthcare infrastructure,” “preparedness,” and “interprofessional networks.” These themes were aligned with those identified in the Leximancer® analysis. The community pharmacists focused on client stability, whereas, the hospital pharmacists and QOTP employees focused on the need for disaster plans to be implemented.Discussion:The greatest concern for participants was maintaining the stability of their clients. Communication amongst the dosing sites and ORT stakeholders was most concerning. This led to a lack of dosing information in a timely manner with pharmacists being hesitant to provide doses and takeaways due to legislative restrictions. A review of coordinated efforts and the legislative constraints is recommended to ensure continuity of ORT supply during cyclones.
Unsuccessful, Unwanted, and Unwarranted Resuscitation: Exploring Ambulance Personnel Preparation and Support for Death in the Field
Authors: Anderson Natalie , Slark Julia , Gott Merryn 
Published: May 2019

Introduction:In many countries, ambulance personnel are authorized to start or stop resuscitation efforts in accordance with clinical guidelines. Research shows that decisions to withhold or terminate resuscitation and manage patient death scenes can be particularly challenging.Aim:To identify preparation and support mechanisms for ambulance personnel who are authorized to withhold or terminate resuscitation efforts, and manage patient death in the field.Methods: A scoping review provided an overview of international research in this area. A qualitative exploratory study was then undertaken. Focus groups were held with senior ambulance personnel currently working in clinical education, managerial, or pastoral support roles across New Zealand.Results:Well-supported clinical experiential learning and resolved personal experiences with grief and death were considered most useful to increase self-efficacy and coping with patient death. Participants felt some of the personal and interpersonal skills needed to manage death in the field were difficult to teach. Relatively little time is spent preparing ambulance personnel for the non-technical skills associated with resuscitation decision-making, particularly communicating with family and bystanders. Ambulance personnel responses and support-needs during or after the event are idiosyncratic. Ambulance personnel appear to primarily rely on colleagues and managers checking in and offering informal debriefing.Discussion:Results from this study identify opportunities for improvement in the preparation and support of ambulance personnel faced with managing patient death in the field. Clinical experience with supportive mentoring may provide the best opportunities for learning, but novices may not get exposure to patient death in this context. Ambulance personnel may benefit from training, which includes opportunities to role-play death notification and communication with family and bystanders at the scene of a patient death. Ambulance employers should allow downtime to facilitate personalized peer and managerial support where needed.
The Illinois EMSC Pediatric Preparedness Checklist Does Impact Pediatric Disaster Planning and Preparedness in Chicago: A Comparison of 2012 and 2016 EMSC Facility Recognition Surveys
Authors: Severin Paul , Lyons Evelyn , Weber Elisabeth 
Published: May 2019

Introduction:The Illinois EMSC Pediatric Facility Recognition Program was implemented in 1998. The objective was to identify the capability of a hospital to provide optimal pediatric emergency and critical care. Beginning in 2004, steps were taken to integrate pediatric disaster preparedness into the facility recognition process.Aim:The goal of this study was to identify the impact of the EMSC Pediatric Preparedness Checklist across time in Chicago hospitals undergoing Pediatric Facility Recognition.Methods:Chicago hospitals were evaluated during the 2012 and 2016 Pediatric Facility Recognition Program. The following components were surveyed as they relate to pediatrics: Overall Emergency Operations Plan (EOP), Surge Capacity, Decontamination, Reunification/Patient Tracking, Security, Evacuation, Mass Casualty Triage/JumpSTART, Children with Special Health Care Needs/Children with Functional Access Needs, Pharmaceutical Preparedness, Recovery, Exercise/Drills/Trainings. Data from 2012 and 2014 checklist categories were compared and p-values were computed utilizing Fisher’s Exact Test. A p-value <0.05 was considered statistically significant.Results:Stockpiling of staging areas or having ready access to resuscitation supplies increased 46% (p < 0.05), testing of pediatric surge capacity in previous 24 months decreased 43% (p < 0.05), maintaining warmed water source for decontamination decreased 43% (p < 0.05), and having familiarity of evacuation procedures in ED, pediatric, and nursery personnel decreased 42% (p < 0.05). Although not statistically significant, the training of pediatric staff with JumpSTART triage increased 59%, EOP containing a pediatric reunification process increased by 36%, the presence of specific staff plans to allow care of dependents increased for children (29%), elderly (32%) and pets (35%), integration of a pediatric component into hospital EOP increased by 29%, and identification of an alternate treatment site for children decreased by 25%.Discussion:Integrating the EMSC Pediatric Preparedness Checklist surveys into the facility recognition process impacts pediatric disaster preparedness and planning, and identifies areas of improvement in hospitals.
Getting There: Evidence-Based Decision-Making in Road Trauma Prehospital Transport and Care in Queensland
Authors: Andrews Robert , Wynn Moe , ter Hofstede Arthur , Vallmuur Kirsten , Bosley Emma , Elcock Mark , Rashford Stephen 
Published: May 2019

Introduction:Process mining, a branch of data science, aims at deriving an understanding of process behaviors from data collected during executions of the process. In this study, we apply process mining techniques to examine retrieval and transport of road trauma patients in Queensland. Specifically, we use multiple datasets collected from ground and air ambulance, emergency department, and hospital admissions to investigate the various patient pathways and transport modalities from accident to definitive care.Aim:The project aims to answer the question, “Are we providing the right level of care to patients?” We focus on (i) automatically discovering, from historical records, the different care and transport processes, and (ii) identifying and quantifying factors influencing deviance from standard processes, e.g. mechanisms of injury and geospatial (crash and trauma facility) considerations.Methods:We adapted the Cross-Industry Standard Process for Data Mining methodology to Queensland Ambulance Service, Retrieval Services Queensland (aero-medical), and Queensland Health (emergency department and hospital admissions) data. Data linkage and “case” definition emerged as particular challenges. We developed detailed data models, conduct a data quality assessment, and preliminary process mining analyses.Results:Preliminary results only with full results are presented at the conference. A collection of process models, which revealed multiple transport pathways, were automatically discovered from pilot data. Conformance checking showed some variations from expected processing. Systematic analysis of data quality allowed us to distinguish between systemic and occasional quality issues, and anticipate and explain certain observable features in process mining analyses. Results will be validated with domain experts to ensure insights are accurate and actionable.Discussion:Preliminary analysis unearthed challenging data quality issues that impact the use of historical retrieval data for secondary analysis. The automatically discovered process models will facilitate comparison of actual behavior with existing guidelines.
The Future of Disaster Medicine is Based on Primary Care Involvement
Authors: Burns Penelope , Douglas Kirsty , Hu Wendy , Aitken Peter 
Published: May 2019

Introduction:When disasters happen, people experience broad environmental, physical, and psychosocial effects that can last for years. Researchers continue to focus on the acute physical injuries and aspects of patient care without considering the person as a whole. People who experience disasters also experience acute injury, exacerbations of chronic disease, mental and physical health effects, effects on social determinants of health, disruption to usual preventative care, and local community ripple effects. Researchers tend to look at these aspects of care separately, yet an individual can experience them all at once. The focus needs to change to address all the healthcare needs of an individual, rather than the likely needs of groups. Mental and physical care should not be separated, nor the determinants of health. The person, not the population, should be at the center of care. Primary care, poorly integrated into disaster management, can provide that focus with a "business as usual" mindset. This requires comprehensive, holistic coordination of care for people and families in the context of their local community.Aim:To examine how Family Doctors (FDs) actually contribute to disaster response.Methods:Thirty-seven disaster-experienced FDs were interviewed about how they contributed to response and recovery when disasters struck their communities.Results:FDs reported being guided by the usual evidence-based care characteristics of primary practice. The majority provided holistic comprehensive medical care and did not feel they needed many extra clinical training or skills. However, they did wish to understand the systems of disaster management, where they fit in, and their link to the broader disaster response.Discussion:The contribution of FDs to healthcare systems brings strengths of preventative care, early intervention, and ongoing local surveillance by a central, coordinating, and trusted health professional. There is no reason to not include disaster management in primary care.
Challenges and Opportunities for Interprofessional Collaboration within the Post-disaster Psychosocial Support Network in a Terrorism Scenario in the Netherlands: A Network Analysis
Authors: Jacobs Jurriaan , Maessen Jacklien , Dückers Michel 
Published: May 2019

Introduction:Post-disaster psychosocial support (PSS) is an indispensable element of disaster management. A variety of studies contributed to the development of guidelines, information about guideline implementation, and evidence-based practice, as well as the status of local PSS planning and delivery systems in different European regions. However, the multi-disciplinary nature of the organization of post-disaster PSS requires interprofessional and inter-organizational collaboration, but is presently insufficient institutionalized on individual, organizational, and governmental levels, locally, within the region, and nationally.Aim:Objective of this research is to map the existing post-disaster PSS network in the Netherlands in the context of a terrorism scenario, and to identify probable collaboration problems rooted in weak ties and lack of alignment between actors at different levels.Methods:Focus groups were organized in Belgium, France, Norway, and the United Kingdom to learn from the inter-agency response to recent terrorist attacks. Next, social network analysis methods were used to analyze the structure of the collaborative network for post-disaster PSS in the Netherlands. A scenario-based questionnaire was distributed amongst relevant stakeholders through snowballing methods. Respondents were asked to identify organizations they collaborate with on different PSS activities during the preparedness, acute, and recovery phase.Results:The international focus groups resulted in valuable lessons for the Dutch PSS network. Data collection for social network analysis is currently in progress. Based on previous research we expect limited ties between disciplines during the preparedness phase and during the “registration of affected persons” in the acute phase. Most of the interactions between agencies will be linked to one-stop-shop service delivery, and less to commemorations and health monitoring.Discussion:Lessons from the focus groups, verification of whether or not the expectations are supported by the social network data, and reflections on opportunities for improvement will be presented at the conference in Brisbane.
Comprehensive Safe Hospital Implementation in Rural Area of Indonesia
Authors: Alim Ahmad , Santosa Budi , Husein Rahmawati , Nurkholis Arif , Nihayati Zuhdiyah , Rintawan Corona , Afik Al , Inayah Iin , Arliono Tri , Haedar Ali , Alim Syahirul , Syamsu Danang , Supartini Eny , Nurjuman Husnan 
Published: May 2019

Introduction:Located on the Pacific Ring of Fire, Indonesia has to cope with the constant risk of many disasters. Hospitals in Indonesia are very vulnerable. Around 1,300 hospitals suffered damage since the Aceh tsunami (2006), with losses reaching 3 billion USD. Muhammadiyah is an Indonesian non-governmental organization (NGO) that has more than 300 hospitals. It is one of the forerunners in the Safe Hospital Initiative in Indonesia and has implemented a program named Hospital Preparedness and Community Readiness for Emergency and Disaster (HPCRED), which strengthened PKU Muhammadiyah hospitals in Bima (West Nusa Tenggara), the only hospital in Bima City, and in Palangkaraya (Central Borneo), funded by the Australian government.Methods:HPCRED improved the hospital through implementing two trainings (Hospital Disaster Management and Disaster Medical Officer), three workshops (Disaster Risk Management Policy, Hospital Emergency Response Plan, and Forming Hospital Disaster Management Committee and Disaster Medical Team), four exercises (Medical Skill Drill, Table Top, Command Post, and Full Scale). The improvement was evaluated through Muhammadiyah Safe Hospital Standard and Assessment Tool, which assessed four standards based on WHO Comprehensive Safe Hospital Framework (2015): (1) Management, (2) Human Resource, (3) Structure and Infrastructure, and (4) Integration and Cooperation.Results:After two years of program, both hospitals improved significantly. The PKU Muhammadiyah Palangkaraya index improved from 53 to 331 while the PKU Muhammadiyah Bima Hospital index improved from 83 to 374.Discussion:Before the program, hospitals were not ready to face disasters. The PKU Muhammadiyah Bima Hospital collapsed during a flash flood in December 2016. PKU Muhammadiyah Palangkaraya was overwhelmed during a haze disaster that occurred in April 2016. After the program, the hospitals were safe and ready to face similar disasters. They also already had the ability to respond to disasters on other islands, such as the earthquake in Lombok and Palu (2018).
Medical Coordination Rescue Members’ and Ambulance Nurses’ Perspectives on Emergency Mass Casualty and Terrorism Preparedness in the Netherlands - A Qualitative Study
Authors: De Cock Johan , Berben Sivera , Vloet Lilian 
Published: May 2019

Introduction:Mass casualty incidents, specifically incidents with chemical, biological, radiological, and nuclear agents (CBRN) or terrorist attacks, challenge medical coordination, rescue, and ambulance care. Recently in the Netherlands, a new model for emergency preparedness for large-scale mass casualties and a specific approach dealing with terrorist attacks was introduced (2016).Aim:To provide insight into the first experiences with this approach in order to identify strengths and pitfalls.Methods:The study had a qualitative design and was performed between January 2017 and June 2018. A semi-structured interview included topics that were selected based on available literature. All interviews were typed out verbatim and were analyzed using a structured approach of labeling and clustering of the response.Results:The main issues raised by the respondents included the following:
The interpretation of definitions introduced in the new model for the mass casualty preparedness model and the terrorist attack approach differed among respondents.All respondents supported the six points of departure in the CRBN and terrorist attack approach.Awareness of optimal personal safety (‘safety first principle’) specific for CBRN and terrorism is lacking.Respondents reported that several rescue workers did not feel competent to perform specific newly introduced tasks, such as the command and control of the first ambulance arriving at the scene and the coordination task of emergency transport by the dispatch nurse.Current regional differences in preparedness may complicate interregional collaboration.Discussion:As the approach is new and experience is primarily based on the outcome of exercises, the systematic planning and evaluation of exercises, and sharing of opinions and knowledge, as a result, is important to ensure an unambiguous approach in a real situation.
Implementation of Periop Disaster Response Exercise Program at Gold Coast Health
Authors: Donohue Andrew , Lamdark Tenzin , Lavin Jo , Hupalo Natalia , Wullschleger Martin 
Published: May 2019

Introduction:With the move into Gold Coast University Hospital, a new disaster plan was developed in 2017. To assess preparedness for the Commonwealth Games (April 2018), a number of mass casualty exercises were conducted, including a large multi-agency exercise with Queensland Police and Ambulance Services. During this preparation phase, senior clinicians from the perioperative area clarified their sub-plans and developed a novel model of periop response.Aim:This study assesses this model of response and evaluates it within the context of periop disaster exercises.Methods:The periop response model evolved through multi-disciplinary key stakeholder engagement into a defined model of surgical, anesthetic, and periop nursing responses with dedicated roles and parallel communication streams from ED to OR by the respective specialties. Throughout different disaster exercises, this model of response was tested, refined, and evaluated by formal post-exercise debriefs and group meetings.Results:Since May 2017, seven different mass casualty exercises with periop response were performed; firstly, a table-top (EmergoTrainSystem) format was used, which revealed communication and logistical deficiencies. After model refinement, further exercises were accomplished, all within the clinical environment, including movements of mock patients from ED to OR. These exercises generated improvements in communication, coordination, and logistics. Every exercise was also used to test more detailed information, communication, and organizational tasks of the various involved craft groups, such as notification, call-in lists, whiteboard structure, transport facilitation, and many more. Overall, our newly developed periop response model proved to be robust and successful, even with rotating personnel through different roles.Discussion:Apart from the success of the periop response model, other hospital areas (ICU, bed and ward management) became involved. With growing interest and staff turn-over a regular periop disaster response exercise program has now been established. This model of periop response has potential for use in other health systems.