bluuebunny/crossref_metadata_2025_split huggingface dataset:
(P1-29) Catastrophe Management Plan, Simulations and Results – An Experience of a Private Hospital in Brazil
Authors: Tucherman M. , Vaidotas M. , Sako Y.K. , Akamine N. , Smaletz D. , Barros C.G. 
Published: May 2011

IntroductionThe terms catastrophe and disaster have been frequently heard worldwide due to situations like earthquakes, floods and events provoked by man as the September 11th and Anthrax attack. Catastrophe means all situations where material and human resources available in a healthcare facility are not enough to assist a large number of victims admitted at the same time. Accreditation requires having a plan to manage effectively those situations, assessing safely as much victims as possible.ObjectiveTo describe the catastrophe plan and its management in a private hospital.MethodologyHospital Albert Einstein is located close to a huge soccer game stadium and near to the State Government Hall. This was the reason to have a plan focusing on casualties with a large number of victims. The literature was revised to choose the triage methodology. Triage to identify the priority of patients' assessment based on their condition, possibility of treatment and determining discharge for those without visible risk. Simulation was implemented, followed by debriefing to register lessons learned.ResultsAn algorithm was developed with a crisis center and defining care and support areas in the organizations to manage the victims at Emergency Room and triage field. The plan was effectively deflagrated twice: 47 victims from a bus accident and 25 from a policeman strike. Debriefing was done in all opportunities and communication is the main issue; 15 simulations have been done for training purpose, with specific goals.ConclusionHospital is a high risk environment itself for an internal or external incident depending on its localization. A disaster plan is necessary to improve everyone safety, to organize resources, to respond effectively to such situations and take the organization back to regular operation as soon as possible. Simulations are essential to guarantee staff competency and organization support and response to adverse situations.
(P1-32) Training Needs Assessment of the Public Health Nurse (Phn) Competency at Health Post in Nepal
Authors: Lamsal S. , Badhu A. 
Published: May 2011

ObjectiveThis study aimed to assess the training needs of public health nurses (PHN) and compare the job performed by them with job descriptions.Materials and MethodsA descriptive study was conducted by utilizing triangulation research method. It was conducted in Eastern and Central regions of Nepal with 13 PHNs (of 13 districts among 75 districts of Nepal) and their supervisors were included as the samples. Data was collected by using standardized tools.ResultsThe mean age of the PHNs was 43.69 ± 9.4 years. Near half (46%) had 10 to 20 years job experienced. Most of the respondents (85%) had done PCL Nursing. All most all (92%) subjects had undergone some in-service education. Most of them (57%) used to visit health posts. The majority of PHNs (85%) assisted in planning and implementation of program for a health post. The Majority (85%) were involved in educational activities. Most (85%) were used to supervise the staffs working at health post. The majority of PHNs (77%) were not involved in research activities. Most of them (85%) prioritized the needs of training on recent concepts to bridge the gap between traditional and recent concepts of public health.ConclusionPHNs have broad areas of nursing expertise and opportunities for work if needed in a sufficient manpower at the district level. Most of them completed PCL nursing a number of years previously and therefore need training on recent advances and need to recruit more PHNs to improve public health services in Nepal.
(P1-36) Mass Casualty Incident Awareness of Remote Location Staff in Western Australia
Authors: Goswami R. 
Published: May 2011

IntroductionThe state of Western Australia has a remote population spread throughout an immense area. Remote health and retrieval is strained on a day-to-day basis, let alone in mass casualty incidents (MCIs). Anecdotally, remote medical staff has minimal training in MCI response. There is no research into how aware these staff is on principles of MCI response.MethodologyAn online survey was devised to ascertain the awareness and knowledge of medical staff most likely to be involved in a disaster. Demographic as well as questions in scenario format were disseminated to rural general practitioners (GPs), nurses and paramedics. Data was collected over a 4-month period.Results117 surveys were completed online. Analysis revealed an astute awareness of resources and environment in a potential MCI but triaging was poor and complex decision-making results were equivocal. Trained respondents handled scenarios better than experienced (MCI involvement or planning) respondents.ConclusionsIn general, remote medical staff is aware of only certain MCI principles. Further training is warranted. Voluntary feedback from these staff also strongly corroborated this view.
(P1-39) Support for Functionally Insufficient Key Disaster Hospitals by Dmat for Large-Scale Disaster in Japan
Authors: Kodama T. , Ohara H. , Jinbo D. , Shiozawa H. , Fujino T. , Motodate N. , Wada T. , Matsumoto J. , Taira Y. 
Published: May 2011

BackgroundJapanese Disaster Medical Assistance Team (DMAT) has important duties to support and reinforce functionally insufficient key disaster hospitals in the large-scale disasters. However, it is difficult for Japanese DMAT to fulfill these duties in the current circumstances, because the DMAT consists of individual institutions and Teams have less experience to work in the other institutions. To resolve the issues, disaster drills for some DMATs which consist of several institutions have been held since 2008. We evaluated the effectiveness of the drills and educational system.MethodsInvestigation was performed by surveillance questionnaires to 129 participants in the drill (staffs from DMATs, Red Cross and local government, and sham patients). The questionnaires are: A. Was the cooperative medical practice performed smoothly? B. Was the support for hospitals conducted effectively?, C. Was the medical record for wide-area transportation completed? (for our staffs only), D. Was our activity enough? (for participants excluding us), and E. Was the drill beneficial?Results85 participants including 30 staffs in our institution answered the questionnaires (65.9%). The number of participants who answered ‘Yes’ was as follows: A. 48 (56.5%), B. 64 (75.3%), C. 8 (26.7%), D. 44 (83.0%) and E. 81 (95.3%).DiscussionAlthough the cooperative medical practice was not so smooth, it was recognized that members in DMATs got mutual trust by their high knowledge and skills. And it was suggested that DMAT could not command and control the hospital staffs without their understanding the equipments and documentations used by DMAT. And it is ideal to change the mindset of hospital top managements towards the disaster medicine through the repeated drills.ConclusionThe repeated disaster drills at the local area is essential to make DMAT function sufficiently.
(P1-42) The Educational Effects of a Triage Program in Senior High School
Authors: Suzuki K. , Tanaka H. , Takyu H. , Ninomiya N. 
Published: May 2011

BackgroundJapan is one of the world's famous countries for natural disaster. Seven years ago, The Japanese government indicated the necessity of providing disaster prevention education in schools. However, such education has not yet been introduced.ObjectiveThe aim of this study was to evaluate the 90min triage program in senior high schools.MethodSixty nine students attended the program. The effects of the program were evaluated using pre and post examination by paired t-test and McNemar's test.ResultCompare pre-test with post-test, the average score of the tests was a significant increased. Compare pre-questionnaire with post-questionnaire, the number of interested students in a regional disaster drill has increased.DiscussionThe results showed that this program increased the interest in disaster prevention and provided students with a chance to participate in disaster drills in their own resident area.ConclusionCarrying out this program in senior high schools, would provide students with a chance to learn disaster prevention.
(P1-60) Clinico-Epidemiological Pattern and Management Options in Patients with Ocular Injuries in the Emergency Room of a Rural Hospital
Authors: Baisakhiya S. , Bhatt M. , Agrawal A. 
Published: May 2011

Aims and ObjectivesSuccessful patient outcomes in the setting of ocular emergencies depend on correct recognition and assessment as well as appropriate initial management. The purpose of this study is to describe the clinico-epidemiological findings and management options in patients with ocular injuries in the emergency room of a rural hospital.Material and MethodsIn this retrospective review the records of patients who were treated for ocular trauma from June 2010 to December 2010 in the emergency room of MM Institute of Medical Sciences and Research, Mullana (Ambala) were reviewed. The following data for all patients were recorded: age, sex, date and time of injury, involved eye, circumstance and mechanism of injury, initial visual acuity, details of appropriate investigation, immediate management and outcome.ResultsA total 46 patients were included in the study. Young adult male patients were more commonly involved. Most of the patients presented within 12hours of injury. Left eye was involved in 14 patients; right in 12 and 10 patients had injuries to both eyes. Most common mode of injury was mechanical. The patients who sustained bilateral ocular injuries were due to chemical burns (7 cases) and electrocution (3 cases). Most of the patients were managed conservatively. The surgical treatment offered were repair of corneal tears, removal of foreign bodies. The visual outcome was excellent in most of the patients.ConclusionsOcular injuries can have wide range of etiological factors and presentation and assessment of ocular emergencies can be made difficult by a lack of sophisticated facilities. However, a concise patient history, general observation and basic ocular tests can lead to a firm diagnosis and thereby appropriate management.
(P1-63) Post-Tsunami Hospital Evacuation Preparedness Improved by Development of Portable Medical Supply Caches
Authors: Bouslough D.B. , Peters E. , Peters C. , Tuato'o S. 
Published: May 2011

BackgroundOn September 29, 2009, an earthquake-caused tsunami struck American Samoa with only 20 minutes warning. Personnel successfully evacuated patients from the hospital within 20 minutes. The organization and transportation of medical supplies required for patient care took 90 minutes.ObjectiveTo describe a hospital evacuation exercise designed to identify critical medical supplies, and test their transport, and use in a field-hospital setting.MethodsA retrospective review of hospital emergency preparedness and Boy Scout Eagle Project minutes, participant surveys, and key-informant interviews was performed. Descriptive statistics were used to evaluate data.ResultsUnit supervisors hospital-wide were tasked with designing portable supply caches for the care of typical unit patients for 72 hours. Nine hospital units participated (ED, Surgery, Medicine, Pediatrics, Labor & Delivery, Maternity, Nursery/NICU, ICU, Hemodialysis) in the exercise. Unit evacuation teams (1 physician & 2 nurses) carried caches by foot to a nearby field clinic site (1/4 mile). Cache transport times ranged from 3 minutes (maternity ward) to 15.5 minutes (hemodialysis), averaging 11.2 minutes. Hospital leadership arrived in 4 minutes, and maintenance staff with portable power and oxygen in 23 minutes. Fifty-seven community volunteers (age 9 months – 60 years) under Eagle Scout candidate leadership were prepared as moulaged mock patients. Unit teams used evacuated supplies to provide medical care for 6 mock patients each, listing missing or insufficient supplies at exercise end. Cache supply deficits noted by participating teams included: portable oxygen (66%), blood pressure cuffs (44%), thermometers (44%), select pharmaceuticals (44%), and others. Reported cache deficits and exercise lessons learned were reported hospital-wide for incorporation into preparedness planning.ConclusionThe hospital unit medical supply cache exercise was effective in addressing prior evacuation deficits. Hospital collaboration with community service volunteers provides exercise realism for participants and increases community awareness for emergency preparedness.
(P1-68) Experiences from the “Emergency Care for Trauma” Course for Support of Health System in Afghanistan as a NATO ISAF Medical Force
Authors: Durusu M. , Cicek E.I. , Akyildiz R. , Arziman I. , Kaldirim U. , Eyi Y.E. , Tuncer S.K. , Eryilmaz M. 
Published: May 2011

IntroductionThe experiences Afghan medical personnel gained from the “Emergency Care for Trauma” course are described in this presentation.MethodThe course was conducted 14–15 April, 2010 in Kabul, Afghanistan. It was evaluated retrospectively for: (1) course curriculum; (2) training instructors; (3) participant characteristics; (4) participant evaluations and course of events; (5) preparation; (6) execution; and (7) results.ResultsThe course included 13 hours of theoretical discussion, six hours of skill practice stations, and 19 hours of training. The organization committee was composed of a president, two secretaries, six trainers, and six assistant trainers. There were three language interpreters. A total of 24 medical personnel attended the course. Pre- and post-tests were administered to the participants in order to evaluate the effectiveness of the course. Simultaneous translation was performed during the training sessions. The correct response rates for test questions increased from 34.6% prior to the course, to 80.3% after the course. At the end of course, reviews from the participants were discussed.DiscussionThe participants suggested that the course should be repeated every six months. It was decided that there should be more time for the practical portion of the course. It was determined that the course would be integrated into the Afghan health system.ConclusionPost-graduate courses are important components of the modern health care system. In many developed countries, these courses have become compulsory and are conducted regularly. However, standardized and regularly performed courses should be supported in developing countries.
(P1-76) Descriptive Study of Poisoning Victims Patients at a Tertiary Medical Center in Northern Thailand
Authors: Inboriboon P.C. , Narongchai P. 
Published: May 2011

BackgroundPoisoning is a public health problem that effects all ages, genders, and ethnicities, but certain populations are at increased risk. Unintentional poisoning disproportionately affects lower- and middle-income countries. The epidemiological pattern of poisoning can differ significantly within countries. In Thailand, national poisoning data is collected by voluntary reporting to a poison control center in the capital, Bangkok. Limited poisonings are reported from Chiang Mai, a province in Northern Thailand, though it has the highest suicide rate in the country.ObjectiveThe aim of this study is to describe poisoning epidemiology, examine differences between intentional and unintentional poisonings and, to develop a multivariate predictive model of intentional poisonings in Northern Thailand.MethodsA total of 550 poisoning admissions were identified at Chiang Mai's University Hospital from 01 January 2005 to 31 December 2005. Demographic data were collected retrospectively by manual chart review. Chi-square and t-tests were used to examine differences in poisoning by intent. A step-wise logistic regression analysis was performed to develop a predictive model of intentional poisonings. Factors significantly associated with intentional poisoning were used in a logistic progression model to identify predictors of intentional poisoning.ResultsYounger age was significantly associated with intentional poisoning. There was no demonstrated difference in gender and poisoning intent. Predictors of intentional poisonings were use of chemical agents, high-risk medications (analgesics and psychiatric), unemployment, and younger age.ConclusionsInterventions should focus on factors that put young adults and the unemployed at greater risk for intentional poisonings. Further interventions are also needed to limit access to potentially lethal doses of chemical agents and high risk medications.
(P1-79) Regional Medical Command and Control Management of Influenza A (H1N1) Mass-Vaccination in the County of Östergötland, Sweden
Authors: Jonson C. , Nilsson H. , Lundin R. , Rüter A. 
Published: May 2011

IntroductionOn 11 June 2009, an Influenza A (H1N1) pandemic was declared by the World Health Organization (WHO). The Major Medical Incident Regional Command and Control Protocol in the County Council of Östergötland, Sweden was activated. After vaccinations were competed, it was decided that the operation should be evaluated in a retrospective study. This study aims to increase knowledge regarding regional management of a pandemic flu.MethodsAll protocols from regional command meetings were studied together with central data regarding, logistics, vaccination site reports, incident reports, and all written correspondence between involved departments. Information from results of a questionnaire that was distributed to all vaccination site managers were summarized and studied. In addition, an interview was performed with the chief of medical operations.ResultsOut of the approximately 426,000 inhabitants of the county, a total of 224,780 (53%) were vaccinated during a five and a half month period. The mean pace was 1,246 vaccinated per day (range 0–9643). Regional command had 41 recorded meetings resulting in a collected number of about 740 working hours. Three hundred sixty-six employees were involved in the vaccination, working 38,741 hours. Twenty-eight safety and 52 security incidents were reported. Uncertainty about vaccine delivery and keeping the public's interest were reported to be of concern for the management.DiscussionEven with the large scale of the operation, there were only a few security and safety issues. Although the goal of vaccinating 75–80% of the inhabitants was not reached, it could be assumed that the pandemic was dampened. Given the public's high initial interest, it could be considered that vaccination should not start until a large number of doses have been delivered.ConclusionThe medical incident command structure and protocol successfully can be adapted to a mass vaccination event. Information from the Östergötland County Council operation yielded significant experience for future mass vaccinations.
(P1-80) Issues and Challenges in Preparedness and Response to Infectious Public Health Emergencies in Hospitals of Developing Countries
Authors: Devnani M. , Gupta A.K. , Goel S. 
Published: May 2011

India has witnessed many major infectious public health emergencies (PHE) during 21st century. They include outbreaks of Severe Acute Respiratory Syndrome (SARS) 2002–03, avian flu in 2006, chikungunya in 2006–07, and the H1N1 pandemic in 2009. Periodic dengue and Japanese Encephalitis epidemics also are common. The premier institute of the country, PGIMER Chandigarh, always has received a huge inflow of patients from North India during such emergencies. These patients pose special challenges to hospital administration in terms of effective and efficient management of crisis situation, and require special measures. The authors' experience has shown that the major challenges faced are allocation of scares resources, capacity building, motivation of employees, infection control, and inter-sectoral coordination. The response during the initial phase is erratic due to a lack of clear guidelines and prior preparedness. Learning from these experiences, a contingency plan was prepared after consultation with all stakeholders. It was implemented during 2009 influenza pandemic. The contingency plan identifies: (1) area responsibilities; (2) disaster and screening areas for the handling of patients; (3) isolation and critical care facilities; (4) deployment of manpower; (5) allocation of drugs, consumables, equipment, and sterile supplies; (6) communication and reporting system; (7) awareness, education, and training; and (8) decision-making hierarchy and effective inter-sectoral collaboration. Also, a disaster plan has been prepared that includes standard operating procedures (SOPs) to be followed during infectious PHEs. A hospital infection control manual also has been prepared to address the issue of hospital acquired infections. The contingency plan and SOPs were effective during recent 2009 influenza pandemic in streamlining the response.ConclusionA well-documented contingency plan prepared in consultation with concerned stakeholders and implemented by a motivated and committed administration is essential in ensuring uninterrupted services during PHEs. It emphasizes that sound PHE plan is never an accident; it is always a result of high intentions, sincere efforts, intelligent direction, and skillful execution.
(P1-87) Preparedness of Healthcare Facilities for an Influenza Pandemic - Protecting the Healthcare Workers
Authors: Hollingworth A.L. 
Published: May 2011

AimTo assess the preparedness of hospitals with respect to protecting health care workers (HCWs) during a pandemic.MethodsA self-administered questionnaire was performed between November 2009 and January 2010, and a scoring system was developed to provide a quantifiable measure of preparedness.ResultsA total of 12 hospitals in NSW, Australia, were approached – six regional hospitals (RHs) and six tertiary referral centres (TRCs). The study was extended to assess three hospitals in England, allowing a limited comparison between the hospitals in Australia that had faced the initial wave of the H1N1 (“swine flu”) pandemic and the hospitals in the UK that had more time to prepare for the outbreak. Response rates were 66% from the TRCs, 33% from the RHs, and 100% from the English hospitals. The overall preparedness scores were relatively high, with a median TOTAL score (adjusted) of 50.75 out of 70. The demographic that scored the highest Total was tertiary referral centres in Sydney. All English hospitals scored below the median. However, the range of scores across hospitals was quite narrow (45.1 – 57.1 adjusted). Scores were generally high for the areas of Preparedness, Infection control, Education and Training. Scores for Vaccination were more variable. The category that consistently demonstrated the lowest scores was that of Psychosocial Welfare and Assistance, despite this being found in previous research to be an integral part of that which HCWs have identified as important.ConclusionsGiven their integral role in pandemic response, protecting HCWs must be a priority as part of any pandemic preparedness plan. This goes beyond protection from infection, extending into aspects of physical and psychological wellbeing. Identifying these issues and addressing them is the key to maximising staff support and morale, and minimising staff absenteeism at such a crucial time.