Emergency nurses’ experiences in disaster drills in Saudi Arabia
Creators: name: Alanazi, Majed Awad M
Publisher: name: RMIT University
Year: 2024
Subjects: classificationCode: 420599
subject: Nursing not elsewhere classified

description: Background: As the largest group of healthcare workforce and the bulk of frontline disaster responders, nurses play a significant role in the management of disasters. In managing disaster situations emergency departments (ED) are referred to as the ‘front door of the hospital’ and given this, ED nurses need to be prepared to manage disasters properly. Disaster drills are considered as the most common and effective form of training to enhance healthcare providers including nurses’ skills for disaster management.

Aim: The overall aim of this study was to explore emergency nurses’ experiences of disaster drills in the Kingdom of Saudi Arabia (KSA).
Method: This study adopted a mixed-methods research design to investigate the experiences of ED nurses in Saudi Arabia. The mixed-methods sequential explanatory design included quantitative data (questionnaire) and qualitative data (semi-structured interviews). The study was undertaken at four general public hospitals in Riyadh.

To date there are a limited number of instruments designed to assess the effectiveness of disaster drills. Both the Emergency Preparedness Information Questionnaire (EPIQ) and Disaster Preparedness Evaluation Tool (DPET) are used to assess organisational disaster preparedness and nurses perceived familiarity of this. Existing tools that could be transferable for this research exploring nurses’ experiences with disaster drills, was unable to be found. Hence, there is a need to develop valid and reliable instruments which can explore nurses’ experiences of disaster drills and assess whether their preparedness levels are heightened based on their knowledge, skills and confidence. The Disaster Drills Effectiveness Questionnaire (DDEQ) was developed by the researcher and was utilised to obtain data from the participants. In addition, participants completed a demographic data survey. The DDEQ consisted of 43 items which required ED nurses’ perceptions on statements based on their disaster drills knowledge, skills and confidence on a 6-point Likert scale. Data was also collected on ED nurses’ experience of disaster drills, real disaster and disaster education, as well as roles they had undertaken during disaster drills.

Prior to undertaking the research study, ethics approval was obtained from the College of Human Ethics Advisory Network (CHEAN) of the Royal Melbourne Institute of Technology University (SEHAPP 40-18 KIMPTON-ALANAZI) and the Saudi Arabia Ministry of Health. A convenience sample of 800 ED nurses with a minimum of one-year nursing experience from the four public general hospitals were invited voluntarily to participate in the study.

Results: A sample size of 605 ED nurses participated in the study with a response rate of 76%. The results indicated that the majority of the participants were female, aged between 23 to 56 years. The majority of participants had a bachelor degree, were clinical nurses and overwhelmingly expatriate, mainly from India and Philippines. In terms of work experience, the majority of participants had greater than 4 to 6 years of experience as a registered nurse, 1 to 3 years of nursing experience in Saudi Arabia, and 1 to 3 years of ED experience. Based on the DDEQ scale scores, almost all ED nurses believed that disaster drills have a moderate to strong positive influence on their preparedness for disaster. The roles undertaken by ED nurses during disaster drills, triaging and ensuring the safety of patients were the more common roles. Those ED nurses who were Indian, aged between 34 to 56 years, had a diploma qualification, and work experience greater than 10 years, nursing experience in KSA greater than 10 years, ED experience greater than 10 years, were most likely to have a higher DDEQ score. Nurses who had participated in 4 or more disaster drills tended to have the highest DDEQ scores. Participation in fire drills was the most common disaster drill type and had the highest overall mean DDEQ score. The majority of ED nurses had participated in a real disaster response and
appeared to be fully aware of the impacts of participating in disaster drills and how they helped them enhance their preparedness and responses in real disasters. The most common type of disaster responded to by ED nurses was fire. The highest DDEQ score for knowledge was that of ED nurses’ participation in disaster drills raising their awareness of equipment and facilities locations needed in disaster response. Whilst in terms of skills, disaster drills improved ED nurses’ ability to manage different types of disasters and use of relevant equipment for disaster response. Psychometric testing of the DDEQ revealed to be valid and reliabl with the exploratory factor analysis identifying two factors: knowledge and skills

The main themes identified from the qualitative data analysis included the following: Perceptions of disaster response, Disaster drills experience, Their roles in disaster drills, Advantages of disaster drills, Challenges of disaster drills, Recommendations for effective disaster drills and Preferred to do disaster drills with colleagues.

Discussion: The exploration of the study insights was from the basis of literature that examined disaster preparedness overall. This exploration revealed that this research has contributed a number of insights in terms of the literature and contributed to new knowledge.

Conclusion: This study provides an evidence base for nursing disaster management practices in Saudi Arabia. This includes development of a new instrument to assess disaster drills effectiveness. The study presents an insight into the experiences of ED nurses of disaster drills and the role of disaster drills in disaster preparedness. It identified factors that positively influenced ED nurses’ disaster preparedness when undertaking disaster drills as well as some deficiencies of disaster drills including type and allocated resources. Given the critical role of disaster drills in preparedness, nursing administrators should ensure these deficiencies are identified and effectively addressed. This could be achieved through development of education and training programs including drills and exercises for readiness whilst also increasing disaster knowledge and awareness. This study helps identify opportunities for improvement of disaster drills and the ED nurses’ preparedness in Saudi Arabia which is expected to improve the healthcare services in Saudi Arabian hospitals. A recommendation from this research is a need for an expansion of this study to include other regions of Saudi Arabia which will facilitate generalisability of the research findings and improve nursing disaster management practices.