Competencies Scope of Practice in Disaster - Coursework Example

Competencies Scope of Practice in Disaster Name: University: Date: Competencies Scope of Practice in Disaster Introduction Competencies as mentioned by Vathanophas and Thai-ngam (2007) support assessment as well as learning, and they double up as a resource or guild for training programmes, ongoing education and curriculum review and development. Basically, competencies promote reliability in what skills as well as knowledge are anticipated and taught on the job. Competencies facilitate the assessment of a person’s skills and knowledge as well as recognition of the need for more training. During disaster, being able to ascertain gaps in skills and knowledge as well as offer certain training associated with the discovered gaps is important. Applying competencies systematically help reduce the risks associated with response to disaster. According to Burke et al. (2005), competencies act as the footing for development of standards, research, practices based on evidence and research. Besides that, they are crucial means for generating orientation programmes and job descriptions. A person ability to utilise competencies for self-assessment of KSAs (knowledge, skills and abilities) is most important. Given that, comprehending limitations en individual to enables a person make suitable decisions concerning needs further education and work assignments. As mentioned by Hoyt and Proehl (2011), the exclusive facets of a certain area of practice are delineated by competencies, which also offer a paradigm of entering into that practice. For this reason, competencies can be defined as a set of detailed, concise and clear training standards, which can be utilised for ensuring staff competency in particular situations, have been developed. In my opinion, competencies are utilised in academic environments as a curricula foundation; therefore, exhibiting competency in a certain area of practice is crucial for disaster preparedness, response and recovery. In this paper, the author will talk about competencies scope of practice in disaster with emphasis on competencies, expanded scope, ethical practices, and ability to respond. Main Body Competencies As stated by Kako and Mitani (2010), a competency is a crucial concept utilised in the assessment of the capability of health professionals to carry out their assigned roles. Competency has been defined by the International Council of Nurses (ICN) as a level of performance that exhibits successful application of judgement, skill and knowledge. As stated by Brumfitt (2008), competence concentrates on the role performance. Of late, different health practitioners have joined the realm of disaster management because of the increased awareness as well as the actuality that conflict-based disasters, failures of human systems and natural disasters are happening with augmented frequency and magnitude across the globe. Therefore, a successful health response to disaster needs a coordinated and well-thought-out effort with scores of experienced as well as trained professionals capable of applying expert knowledge and skills in situations that are critical. According to Kako and Mitani (2010), to make sure that such health professionals are prepared adequately for public health emergencies as well as disasters, knowledge, skills as well as attitudes must first be effective. It is only then when health professionals can be prepared sufficiently through the appropriate training and education. As stated by Gursky and Hrečkovski (2012), core competencies offer a key foundation for collective learning and facilitate in ensuring reliable knowledge utilisation and translation into practice. Ledlow et al. (2010) assert that competencies are perceived as performance indicators or measures in the place of work, similar to KSAs in different job classifications. Competencies need contextual measurement, and normally are exhibited all through the long time periods. Most importantly, all sets of competencies have to describe the targeted person to whom the set is applicable. With regard to disaster health care, Daily and Williams (2013) posits that the targeted person can be described by particular occupation (administrator, doctor, paramedic, nurse), by role (first responder, manager), or just as a healthcare personnel. In this case, if the description of the targeted person is as a healthcare personnel or by profession, Daily, Padjen, and Birnbaum (2010) posit that the competency have to be indicated in terms of the function or role of the person at the time of the disaster. Preferably, identifying the needed healthcare providers’ competencies for disaster management arises from evidence got from: observations of healthcare providers’ ideal performances or understanding of existing gap between services required as well as services provided at the time of real disaster. Without these data, contribution from renowned disaster specialists, which includes the end-learner as well as key stakeholders, can be used in identifying the needed competencies. These specialists have to involve disaster experts in the targeted occupation(s) who can use both qualitative as well as quantitative data in identifying the needed competencies. The techniques utilised in identification of these experts and the technique utilised in defining the selected competencies have to be described, says. Daily and Williams (2013). As mentioned by Lester (2014), developing certain competencies must be carried out in some system or framework context. In view of this, a framework offers: exact language and common definitions for every user; professional regulatory bodies as well as educators’ conceptual source whereupon to build suitable competencies for a certain environment and role. In the 21st century, expansion into the global market has coerced professionals across the globe to search for recognition at international level; therefore, competencies’ setting has become crucial for individuals search for international professional recognition. Similar situation is represented by a disaster situation to health professionals regardless of where they live, given that every health professional is expected to organize as well as coordinate their disaster relief efforts at international level. In such state of affairs, competencies facilitate health professionals to be furnished with consistent knowledge and skills for successful disaster relief. As pointed out by ICN and WHO (2009), the health system and humanitarian effects of disaster are overwhelming considering that between 1998 and 2008, almost one million died because of disasters, over three million were seriously injured and a staggering two billion were affected in one way or another. Basically, health systems, which includes physical infrastructures and human resources although they are crucial for the survival of the population they are exceedingly vulnerable to major disasters and emergencies. According to Warn and Adamo (2014), such situation will continue getting worse due to factors such as increased construction in disaster prone areas, climate change, uncontrolled urban migration, and lack of systems providing warning or moving people to safe areas. In Australia, the Sumatra-Andaman Earthquake and Tsunami in 2004 what Australian exhibits what was experience by Australian nurses during the disaster response. The nurses as cited by Arbon et al. (2006) were expected to work in situations that were disorganized, difficult as well as resourced poorly. In this case, the health services were offered by any personnel available. In such setting, nurses can be easily exposed to illnesses and injuries, which are hardly encountered in Australian healthcare settings. This in consequence can limit their scope of practice and will be forced to draw not just on their clinical skills but as well in their somewhat exclusive nursing profession skills in the management as well as re-establishment of health care environments like hospitals. Hitherto, competencies for disaster preparedness precisely for United States’ nurses working were yet to be identified. For this reason, Centres for Disease Control and Prevention (CDC) requested an author known as Kristine Gebbie to develop a set of competencies for disaster preparedness, specifically for public health personnel (Walsh et al., 2012). Besides that, the US federal government has increased its interest on integrating competencies of disaster medicine and public health (DMPH) into public health as well as clinical education. The enactment of the Pandemic and All-Hazards Preparedness Act (PAHPA) in 2006 created the need for developing consistent, interdisciplinary and integrated curricula for medical and public health disaster response. In consequence it generated opportunities for disaster preparedness education standardisation by means of different programmes at the local, state, and federal levels. Walsh et al. (2012) posit that, even though different sets of competency are existent in US, until now non has concentrated on integrating cross cutting models suitable for nearly all possible health system responders. Historically, participation of nurses in disaster can be traced back to 1919 during the influenza epidemic where nurses with different competencies, both volunteer and paid took part in caring for the patients. Towards the end of 20th century, deliberation on emergency preparedness resulted in two crucial developments: key competencies identification required by health care providers for successful response to disasters and emergencies as well as augmented attention to practicing and planning for disaster response.in the past there were no competency sets identified for disaster nurses; therefore responding to disasters was carried out by all types of healthcare providers. Currently, there are sets of competencies are identified for different health settings as well as professionals, and such competency sets offer a template that ensures nurses are equipped to respond to all forms of disasters. This was facilitated by the creation of the International Nursing Coalition for Mass Casualty Education (INCMCE), which was tasked with exactly expounding what must be included in the nursing curriculum with the intention of assuring communities that both general and disaster nurses are competent to respond to disasters when they arise. According to Fung, Lai, and Loke (2009), the knowledge about disaster competencies as well as preparedness amongst nurses is by and large weak. For instance, in Hong King there is gap in research, education as well as training in the area of disaster nursing. Therefore, it is imperative to comprehend the perceived disaster care competencies before the development of the curriculum. As highlighted in Loke and Fung (2014) study, comprehending well the nurses’ competencies as well as their disaster nursing learning needs is the key step if healthcare administrators as well as nurse educators are seeking to introduce an education program for disaster nursing, which fulfils the nurses’ needs. In order to develop disaster nursing education competencies, a disaster nursing competencies framework was launches by ICN in 2009, specifically for general nurses. The framework intends to provide some set of disaster nursing competencies for an international nursing labour force as well as to offer illumination of the role played by nurses in disasters. Hamric, Hanson, Tracy, and O'Grady (2014) suggest that the nursing competencies’ framework must be utilised across the globe and its content may be revised so as to be culturally specific for diverse places and regions. So as to determine different disaster nursing competencies, O’Grady (2008) posits that more detailed examinations from wider perspectives are needed. Furthermore, understanding and controlling the borderline between the extreme as well as the day-to-day situation is crucial. That is to say, nurses must know, not just examine competencies for certain circumstances, but as well appreciate that such circumstance are associated with their everyday practice. This can only be achieved if all health professional can self-govern all disaster events with skills and competency their have learnt. Currently, as argued by Emergency Nurses Association (2008) competency may be learnt through different ways, such as successfully completing academic course, further education course completion as well as on-the-job instruction. In the future, Junglen, Pestka, Clawso, and Fisher (2008) thinks that advanced practice nurses will result in more credentialing opportunities, whereby nurses will be able to show their competencies in their areas of speciality. In this case, mechanisms for such certification consist of peer review, portfolio review, and examination. Greiner and Knebel (2003) argue that, the ongoing efforts have to stop by identifying core competencies that are foundational. The existing studies have failed to identify these foundational competencies; thus, more research is needed so as to identify the level to which such competencies form part of the present academic programs in the health sciences. Besides that, the existing studies have failed to exhibit the existing gaps exist in realising these core competencies in the present curricula as well as the existing mechanisms than can help fill the identified gaps. For this reason, collaborative efforts in the future for refining and generating training as well as educational curricula in public health and disaster management can be facilitated by utilising hierarchical learning framework. Studies such as Veenema (2012) and Gebbie et al. (2013) have proposed some core competencies that can be considered in developing disaster workforce. Expend scope Competencies for general nurses in managing disaster patient includes; identifying, collecting and preserving evidence such as forensic evidence; ordering as well as interpreting diagnostic tests; examining the therapeutic interventions response; and documents the whole process. Competencies for their professional role include; functioning as a direct service provider of disaster care; clinically performing their work during disaster response; taking part in external and internal disasters, emergencies as well as pandemics; being aware of the causes of incidents of mass casualty as well as the treatment modalities needed for disaster care; acting according to ethical and legal professional responsibilities such as managing patients (Emergency Nurses Association, 2008). During disasters, physically challenged persons are also affected and some of the competencies that general nurses must have include; managing and accessing patient; radio communicating with prehospital units; interpreting patient diagnostics; and removing foreign bodies. Core competencies for disaster nurses include demonstrating situational understanding of potential and/or actual health hazards afore, during, and subsequent to public health emergency or disaster (Ling, McBee, & Johnson, 2014). Besides that, disaster nurses must demonstrate understanding of practices and principles for clinically managing all populations and ages impacted by disasters, in line with the certified scope of practice (NCDMPH, 2012). Another competency is demonstrating understanding of ethical practices so as to protect the safety and health of all communities, populations and ages impacted by a disaster. Furthermore, disaster nurses should demonstrate understanding of legal practices with the intention of protecting the safety and health of people affected by disasters. Other competencies include: facilitating deployment of nurses internationally; creating consistency in the offered care; facilitating unified and professional approach as well as communication; building confidence; and being able to work within health setting provided (ICN & WHO, 2009). Because of the increasing demands on curriculum, Cusack, Arbon, and Ranse (2010) argues that the existing competencies are not standard enough in supporting curriculum development. In many countries, disaster nursing has not been given much priority and this can be evidenced by lack of sufficient tools for teaching, poor budgeting, inadequate experience in disaster response as well as lack of motivation. In consequence, the confidence amongst institutions that feel ready to teach disaster nursing is inadequate. Failure to include disaster education in nursing programs has been attributed mainly by the above-mentioned factors. Some of the colleges in US teaching disasters include; College of Nursing and Health (CoNH), University of Massachusetts Boston, University of Tennessee-Knoxville, University of Wisconsin, California State University Maritime among others. In UK they include; King's College London, Kingston University, Northumbria University, University of South Wales among others. Without a doubt, a key role is played by nurses in disaster preparedness, response and recovery activities. As stated by Reiling, Hughes, and Murphy (2008), policy creation associated with response as well as recovery needs input from the nurses. Arguably, policies associated with utilisation of unlicensed workforces, which includes health care providers who are not associated with disaster management or revision of care standards are hard to achieve devoid of full participation of nursing. In view of this, nurses offer assessments of the resources and needs of the community associated with medical and health care, which as stated by Baack and Alfred (2013) result in planning activities. Besides that, disaster nurses provide as well as develop training for general nurses and the community in general. Nurses’ role has broadened to capacity-building by means of maintaining the existing disaster nursing personnel or recruiting others (Crisp, Swerissen, & Duckett, 2000). Besides that, nurses presently taking part in planning, leadership roles and in readiness exercises to make sure the nursing labour force itself as well as the community are prepared for disaster or emergency. In response phase, the role of nurses is offering both mental and physical health care in various settings. Competencies needed at this stage include, but not limited to, ability to coordinate care, manage scarce resources, and triage assessment. Nurses have continually provided support as well as care to individuals with mental and physical health needs. They monitor the ill or injured persons or those with disability, mental health ailment or chronic disease so as to reduce complications’ risks. They always follow up with disaster survivors so as to make sure all the patients’ needs have been met. Ethical practice Nurses volunteering to offer disaster services according to APHN (2007) must clarify the anticipations for liability as well as licensure protection with the company they are planning to volunteer. Before volunteering, Public health nurses (PHNs) have to be aware of the plans of the employer for employees desiring to volunteer as well as their obligation expectations. Besides that must PHNs must understand their roles in disaster response. In this regard, the written policy must guarantee protections and give details about the expectations of the government response systems, the employer and the registered nurse prior to the occurrence of the disaster occurs. Even though increased demands have been placed on the healthcare provided to an extent that the care turns out to be qualitatively distinct from that offered in normal situations, APHN (2007) posits that professional liability must be decided counter to the situation relevant facts. Certainly, the majority of the ethical conflicts can be prevent through familiarising with disaster plans as well as disaster training, so as to be able to make medical decisions that are ethical in nature. Furthermore, nurses must be able to make consistent decisions and judgments anchored on disaster policies and plans, at times regardless of their personal beliefs. Nursing Code of Ethics has been described by ICN, and they include the shared moral values as well as principles of conduct. Without a doubt, ethics is a crucial component of disaster nursing practice as well as decision-making. Therefore, the underlying competencies of disaster nursing are the moral values as well as principle of code of ethics as stipulated by ICN (Zahedi et al., 2013). From a professional point of view, respect is a foundational ethical principle as well as the basis of excellence in the practice. Rooted in moral obligations as well as nursing boundaries of practice and professionalism are the categorical concepts of moral courage, confidentiality, respect as well as being the world’s good citizen. Basically, practicing nursing ethics as well as applying the codes of ethics as guides assists nurses in developing moral foundation through which to function. Ability to respond For nurses to be able to respond effectively they must offer therapeutic nursing interventions, facilitation skills as well as educational support with the intention of optimising wellbeing and health. Besides that, they should be able promote management and self-care when possible and assisting disaster victims make choices concerning their healthcare needs. Comprehending fundamentals guarantees an effective foundation, but particulars like level of knowledge as well as geographic location adds depth to the ability of nurses to effectively respond in all disasters. Disaster nurses have reliably proved to be reliable disaster responders, and besides that, their kind-hearted nature characteristically coerces them to respond to people in problem, even if their own safety is put at risk. Nurses, especially non-disaster nurses often find themselves in a challenging situation while responding to catastrophic disasters since they are placed at risk. Basically, it is comforting to understand that due to their deep-rooted desire as well as kind-hearted nature for assisting others, disasters and general nurses are normally prepared to respond. This can be evidenced by Haiti earthquake in 2010 where nurse volunteered to help victims by responding swiftly (Lee & Chiang, 2010). Nurses should improve their abilities to respond to disasters as well as adopt concepts related to disaster-related and evacuation (person, situation, resource as well as time) so as to deliver holistic, spiritual, physical, social and psychological care to victims of disaster during, before and after the disaster. The ability to respond is driven by core competencies of disaster nursing; therefore, cultural and ethical sensitivities have to be taken into account. For this reason, nurses have to know response procedures and be able to communicate and negotiate effectively for them to consolidate group collaboration. Conclusion In conclusion, the paper has focused on the competencies scope of practice in disaster with emphasis on competencies, expanded scope, as well as ethical practices. As argued in the paper, nurses must be competent so as to handle disastrous situations. In view of this, competency has been defined as the person’s actual performance in certain role at a particular situation. Even though a lot of sets of competencies have been developed so as to prepare healthcare personnel in responding to disaster, some especially for general nurses are imprecise and inconsistent. Besides that, some efforts have been directed toward developing a competency framework that can be adapted and accepted for disaster nursing universal education. Undeniably, the complexities and scope of disasters as evidenced in the paper need nurses to have a set of disaster nursing competencies. In recommendation, it is important that healthcare facilities formulate plans so as to increase the number of nurses who have majored in disaster nursing. This will consequently create assurance that there are disaster nurses accessible during the disaster response. Besides that, workforce readiness as well as planning is crucial for assuring a successful workforce in responding to disasters. 7.0 References APHN. (2007). The Role of the Public Health Nurse In Disaster Preparedness, Response, and Recovery. Association of Public Health Nurses. Arbon, P., Bobrowski, C., Zeitz, K., Hooper, C., Williams, J., & Thitchener, J. (2006). Australian nurses volunteering for the Sumatra-Andaman earthquake and tsunami of 2004 : a review of experience and analysis of data collected by the Tsunami Volunteer Hotline. Australasian Emergency Nursing Journal, 9(4), 171-178. Baack, S. T., & Alfred, D. (2013). Nurses’ Preparedness and Perceived Competence in Managing Disasters. Journal of Nursing Scholarship, 45(3), 281–287. Brumfitt, S. (2008). Innovations in Professional Education for Speech and Language Therapy. New York: John Wiley & Son. Burke, L., Schlenk, E., Sereika, S., Cohen, S., Happ, M., & Dorman, J. (2005). Developing research competence to support evidence-based practice. Journal of Professional Nursing, 21(6), 358-363. Crisp, B. R., Swerissen, H., & Duckett, S. J. (2000). Four approaches to capacity building in health: consequences for measurement and accountability. Health Promotion International: Oxford Journals, 15(2), 99-107. Cusack, L., Arbon, P., & Ranse, J. (2010). What is the rote of nursing students and schools of nursing during disaster? A discussion paper. Collegian Journal of the Royal College of Nursing Australia, 17(4), 193-197. Daily, E., & Williams, J. (2013). White paper on identifying and assessing competencies in disaster health. White Paper, World Association for Disaster and Emergency Medicine. Daily, E., Padjen, P., & Birnbaum, M. (2010). A Review of Competencies Developed for Disaster Healthcare Providers: Limitations of Current Processes and Applicability. Prehospital and Disaster Medicine, 25(5), 387-395. Emergency Nurses Association. (2008). Competencies for Nurse Practitioners in Emergency Care. Des Plaines, IL: Emergency Nurses Association. Fung, W. M., Lai, K. Y., & Loke, A. Y. (2009). Nurses' perception of disaster: Implications for disaster nursing curriculum. Journal of Clinical Nursing, 18(22), 3165-3171. Gebbie, K. M., Weist, E. M., McElligott, J. E., Laura A. Biesiadecki, M. C., Gotsch, A. R., Keck, C. W., & Ablah, E. (2013). Implications of Preparedness and Response Core Competencies for Public Health. J Public Health Management Practice, 19(3), 224–230. Greiner, A., & Knebel, E. (2003). Health Professions Education: A Bridge to Quality. Washington (DC): National Academies Press (US). Gursky, E. A., & Hrečkovski, B. (2012). Handbook for Pandemic and Mass-casualty Planning and Response. Fairfax, VA : IOS Press. Hamric, A. B., Hanson, C. M., Tracy, M. F., & O'Grady, E. T. (2014). Advanced Practice Nursing: An Integrative Approach (5th ed.). Melbourne: Elsevier Health Sciences. Hoyt, K. S., & Proehl, J. (2011). Competencies and Certification for Advanced Practice Nurses in Emergency Care . Advanced Emergency Nursing Journal, 31(2), 91- 93 . ICN, & WHO. (2009). ICN Framework of Disaster Nursing Competencies. World Health Organization. Geneva: International Council of Nurses. Junglen, L. M., Pestka, E. L., Clawso, M. L., & Fisher, S. D. (2008). Incorporating Genetics and Genomics into Nursing Practice: A Demonstration. OJIN: The Online Journal of Issues in Nursing , 13(3), 1-11. Kako, M., & Mitani, S. (2010). A literature review of disaster nursing competencies in Japanese nursing journals. Collegian, 17, 161 - 173. Ledlow, G. (., Hsu, J.-P., Ledlow, G., & Coppola, M. N. (2010). Leadership for Health Professionals. Burlington, MA : Jones & Bartlett Publishers. Lee, C., & Chiang, L. (2010). Disaster response: essential competence for nurses. Hu li za zhi The journal of nursing, 57(3), 5-10. Lester, S. (2014). Professional competence standards and frameworks in the United Kingdom. Assessment and Evaluation in Higher Education, 39(1), 38-52. Ling, C. G., McBee, E. C., & Johnson, H. L. (2014). Curriculum Recommendations for Disaster Health Professionals The Geriatric Population. Rockville, MD: https://ncdmph.usuhs.edu/. Loke, A. Y., & Fung, O. W. (2014). Nurses’ Competencies in Disaster Nursing: Implications for Curriculum Development and Public Health. International Journal of Environmental Research and Public Health, 11, 3289-3303. NCDMPH. (2012). Resources for Core Competencies in Disaster Health. Retrieved from NCDMPH: https://ncdmph.usuhs.edu/KnowledgeLearning/2013-CompetenciesResources.htm O’Grady, E. T. (2008). Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville, MD: Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Reiling, J., Hughes, R. G., & Murphy, M. R. (2008). Chapter 28The Impact of Facility Design on Patient Safety. Rockville, MD: Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Vathanophas, V., & Thai-ngam, J. (2007). Competency Requirements for Effective Job Performance in The Thai Public Sector. Contemporary Management Research, 3(1), 45-70. Veenema, T. G. (2012). Disaster Nursing and Emergency Preparedness: For Chemical, Biological, and Radiological Terrorism and Other Hazards, for Chemical, Biological, and Radiological Terrorism and Other Hazards (3rd ed.). New York: Springer Publishing Company. Walsh, L., Subbarao, I., Gebbie, K., Schor, K. W., Lyznicki, J., Strauss-Riggs, K., . . . Zukowski, R. (2012). Core Competencies for Disaster Medicine and Public Health. Disaster Medicine and Public Health Preparedness, 6(1), 44-52. Warn, E., & Adamo, S. B. (2014). The Impact of Climate Change: Migration and Cities in South America. Retrieved from Bulletin of the World Health Organization: http://www.wmo.int/bulletin/en/content/impact-climate-change-migration-and-cities-south-america Zahedi, F., Sanjari, M., Aala, M., Peymani, M., Aramesh, K., Parsapour, A., . . . Dastgerdi, M. V. (2013). The Code of Ethics for Nurses. Iran J Public Health, 42(1), 1–8. Read More