Disaster Nursing Study Notes

Disaster Nursing

Types of Disasters

• Natural Disasters: Events caused by natural forces such as earthquakes, hurricanes, floods, etc.

• Man-made Disasters: Events resulting from human actions, including industrial accidents, terrorist attacks, and other human-induced crises.

Emergency Operations Plan (EOP)

• Definition: An Emergency Operations Plan is a mandatory preparedness plan that healthcare facilities must develop and maintain.

• Key Components of EOP:

  • Evaluation of Community Characteristics: Understand typical types of natural and man-made disasters that might affect the community along with the resources available

  • Activation Response: Procedures outlining how the EOP is activated in case of a disaster.

  • Internal and External Communication Plan: Strategies to manage information dissemination within the facility and to external stakeholders.

  • Coordinated Patient Care Plan: Ensuring effective management of patient care during an emergency.

  • Security Plans: Mechanisms to ensure the safety of patients and staff.

  • Identification of External Resources: Listing available external resources to assist during emergencies.

  • People Management and Traffic Flow Plans: Strategies for managing patient and personnel movement during a crisis.

  • Data Management Strategy: Mechanisms to handle and analyze data related to the incident.

  • Demobilization Response: A plan for ending operations and returning to normal.

  • After-action Report or Corrective Plan: Evaluation of the incident and improvements for future responses.

  • Practice Drills: Regular training to ensure readiness and familiarize staff with the EOP.

  • Anticipated Resources: Identification of material and personnel resources needed in emergencies.

  • Mass Casualty Incident (MCI) Planning: Preparedness for events involving multiple casualties.

  • Education Plan: Ongoing training and education related to disaster management practices.

Initiating the Emergency Operations Plan

• Key Steps:

  • Patient Identification and Documentation: Ensure accurate identification and medical records for patients.

  • Triage: Assessing the condition of patients to prioritize treatment based on urgency.

  • Managing Internal Problems: Address any operational challenges faced during the incident.

  • Communicating with Media and Families: Craft and disseminate accurate information to the media and family members.

  • Media Requests Management: Handle inquiries from the media regarding patient information and updates.

  • Family Care: Address the emotional and logistical support for families of affected patients.

  • Nurse's Role: Active involvement, assessment, and care amid the chaos of a disaster situation.

  • Stress Management: Implement strategies to help mitigate stress among healthcare staff and patients.

Disaster Triage

• Concept: The process of prioritizing patient treatment based on the severity of their condition and available resources.

  • Routine Triage: Focused on critically ill patients within normal operations.

  • Disaster Triage: Aims to allocate resources effectively to serve the greatest number of individuals.

  • Decision Factors: Decisions are made considering the likelihood of survival and resource consumption per patient.

  • Color-coded Tagging System:

  • Red: Immediate need for treatment (critical patients).

  • Yellow: Delayed need for treatment (serious but stable).

  • Green: Minimal needs (walking wounded).

  • Black: Expectant (deceased or unlikely to survive).

  • SALT Triage System:

  • Sort: Categorize patients based on condition.

  • Assess: Examine patients to determine needs.

  • Lifesaving interventions: Administer immediate care where necessary.

  • Treatment/Transport: Ensure proper follow-up care or transportation to facilities.

Nurse’s Role in Disaster Response Plans

• Duties: Nurses may need to perform outside their usual areas of expertise during disasters, adopting responsibilities typically held by other classifications of providers.

• Clarity in Leadership: It must be evident who is in command of patient care, ensuring well-defined scopes of practice for nurses.

• Patient Safety: Emphasize maintaining patient safety and delegating tasks appropriately.

• Resource Allocation: In disaster situations, prioritize community needs over individual patient care.

• Knowledge of Hospital Disaster Plans: Familiarize oneself with the facility's disaster plan, participate in relevant drills, and sharpen competencies related to disaster management.