The Disaster Preparedness among the Emergency Nurses in the UK States - Research Paper Example

DISASTER MANAGEMENT Introduction A disaster management program is a recognized plan with actions enabling the registered nurses in an emergency department to offer the appropriate respond whenever faced up with a disaster. The word disaster is defined as an abrupt and unexpected event that its occurrence result into severe damage, the death of people, destruction of properties and physical features, and finally may cause injuries to the victims (Adams & Canclini 2012). Alternatively, a disaster can also be referred to as an occurrence that produces a widespread disruption of people’s infrastructures and their normal health status thus causing an instant threat to the public health and needs an external aid for the response (Baack & Alfred, 2013). A disaster can be divided into two; natural or man-made. According to Hassmiller, (2008), hospital involvement comprises of national disasters that normally occur within the health care and external disasters that involve those that occur without the healthcare capacity. For the disaster management program to be completed, four phases must be accomplished. These phases include; mitigation, response, recovery and preparedness (JCAHO, 2003). Mitigation involves the activities or actions are taken to thwart the appearance of the disaster especially in the emergency department whenever achievable (Maurer & Smith, 2005). On the other hand, preparedness is the activity and measure that is put into action in advance of the disaster to make sure an efficient response is taken to the effect of hazards (WHO 2007). Response phase is the situation whereby the mitigations applied have commenced saving the lives of the people, their property, and infrastructures as well as preventing the secondary effects (JCAFO, 2003). The recovery phase puts efforts to restore the effect into its normal state (Ciottone, 2006). In our study, we shall major on the disaster preparedness by the registered nurses in the emergency department. Research statement The problem of disaster management especially the phase of preparedness dates approximately 20 years ago in the United Kingdom. The rampant and constant occurring disasters have increased the magnitude of these disasters that in turn has prompted the WHO and other disaster-related organizations to strategize the most appropriate models for both healthcare disaster management (Traub et., 2007). For the past few decades, disaster management in the emergency department was a problem. The nurses lacked the competency in eradicating and reacting towards such emergencies of disaster. As the emergency nurses equip themselves with the emergency preparedness, resulted in the induction of significant developments. They include identification of fundamental competencies required for successful emergency response and complete attention to preparation for as well as practicing emergency response. Therefore, the research paper will evaluate the improvements that need to be implemented to improve the emergency nurse preparedness in the management of disasters that occurs in the emergency department. Purpose of the Research The objectives and aims of this research paper are to examine the disaster preparedness among the emergency nurses in the UK states. The main target of the study is to reduce the perception of emergency nurses' on familiarity with terrible conditions. This search paper will explore the emergency nurses' personal evaluation perceived through the ability to respond to the disastrous events effectively. The study will also embark on the analysis of factors impacting the preparedness and readiness of the nurses in the emergency department for disasters management. The research paper will help the hospitals, emergency nurses, organizations, as well as the communities to determine gaps and reinforce the appropriate disaster preparedness plans to make use of the nurses to the maximum potential. Research Design Jacobson, Soto Mas, et al., (2010) carried out an assessment in regard to the self-reported terrorist's vigilance and guidance requirements of the nursing workers in the United Kingdom. The research basically examined the Department of State Health Services Public Health region. Cross-sectional occurrence plan was applied as self-reported researches investigating the vigilance for disaster preparedness, as well as the reaction was gotten from 941 registered emergency nursing workers. These results showed the need for further scrutiny, education and evaluations purposing to increase the competency in emergency nurse disaster preparedness and response. Registered Emergency Nurses are obliged to apply their calamity vigilance competencies as their everyday activities and agree with the local, area and national leaders in a tragedy operation. Edification of such emergency nurse is supposed to incorporate appropriate training to enlighten the registered nurses on medical needs patients (Jakeway et al., 2008). Participants The research carried out by Fung et al (2008) amongst 164 UK master’s vigilant emergency nurses was employed in evaluating their readiness for the disaster. A 26-item research deliberated protocols, demography, readiness in workplace, and nursing experience question concerning the public services that were to react during catastrophic scenarios. This research found that ninety seven percent of emergency nurses asserted that they were not adequately vigilant to react to main tragedies. When asked how they would reply or react towards a disaster if it occurs while at work: one out of three of those who gave response stated that they were likely to adhere to the hospital protocols whereas one-third stated that they were likely to await for instructions generated by their seniors. A proportion of the respondents claimed that they could give a warning to other people and escape (24.4%), 15.2% claimed they could evacuate the patients, and finally another group said they could escape immediately (7.3%). the Fung et al. remarks show that ninety seven percent of nursing workers had a feeling of not being prepared in regard to handling critical catastrophes, and, therefore, it is assumed that were likely to have more benefits resulting from the more planned trainings regarding the tragedy preparedness. Research Instruments A research carried out by Yang & Luo (2010) investigated the assessment of the instrument of measuring calamity vigilance and to cope amongst emergency nursing workers and provided systematic and logical assessment instruments for assessing tragedy coping ability of any nurse that dealt with urgent situation. Al Khalaileh et. al., (2009) carried out a research to understand how suitable the Disaster Preparedness assessment instrument was custom-made from its initial version mainly structured for the nursing workers. These authors made a translation on the instruments to the English version and oversaw it on 474 UK registered nursing practitioners. This research was undertaken to examine the questionnaire's psychometric aspects, dependability, strength, and factorial construction. The results unearthed that this research was suitable and dependable. The target of this research was steered to determine ideologies of nurses concerning tragedy vigilance and their strong capabilities for shelter activities, patients' enlightening, bio-terrorism, psychosomatic intervention, symptoms management, logistic, local emergency responses as well as different related queries. Garbutt et al., (2008) carried out an investigation on the tool in the research that was evaluating the understanding of nurses on emergency vigilance. They tested the Emergency Preparedness Information Questionnaire (EPIQ). The questionnaire was a tool made up of 44-item that interrogates emergency nurses' personal comprehension with eight ways of emergency preparedness. The tool was formed in 2003 and was applied on a big research by the Wisnieweski et al., (2004). They made a conclusion that this questionnaire had significance as well as a valid instrument. REVIEW OF LITERATURE State of Worldwide tragedies – The Macro View The global society possesses a mixed records of emergency reactions as well as an effectual disaster managerial tactics. The reason for the catastrophe vigilance and organization is minimizing the negative impacts of calamities (Barnes et al., 2008). Twedell (2009) reported that Emergency nurses from the United Kingdom exhibited some lack of hope, fearing unknown seventeen ailments, augmented levels of susceptibility, panic on their jobs being terminated and general stressful state. The main concern that face public registered emergency nurses is the increase in vector-borne ailments resulting from a climatic change. Medical intervention and catastrophe management of the vector-borne illness are of significance during the outcome of the calamities. Advanced planning and mitigation are crucial and imperative for emergency health care nurses to have a good comprehension on what is ahead while taking crucial actions in trainings as well as mock drills. The International Council of Nurses (ICN), in conjunction with WHO, made a publication of ICN Framework of Disaster Nursing Competencies and established the need for building capacities of emergency nurses. Such framework is used to guard the people, reduce damage and injuries as well as maintaining health system functioning (Dorsey, 2009, p. iv). The PAHO and WHO provided the UK countries with six core actions to make their registered emergency nurse Department facilities safe during emergencies: 1) adoption of nationwide strategies and programs for protected hospitals, 2) assess the safety of hospital, 3) protect equipment, medicines, and supplies, 4) design and build resilient hospitals, 5) plan for emergency response, and 6) protect and train health workers for emergencies, (Hareyan, 2009). Nursing practitioners will directly participate with all of these objectives. Emergency Nurses’ Preparedness and Response Issues – A Regional View Barlow (2008) is suggesting that a registered emergency nurse might be required to face catastrophes by being equipped with basic skills, such as interrogating the color and capillaries of a patient in refilling other than making use of pulses ox meters, and refinement of critical reasoning abilities. Emergency-preparedness education needs to be continued via a life-long learning and might be suitably delivered through the use of technological simulations (Polivka et al., 2008). The simulation provides the fundamental for the management of huge catastrophic scenarios has started to be applied more often during the preparation and planning activities. Morrison with Catanzaro (2010) carried out a catastrophe simulation task involving 83 senior registered emergency nurses. The simulation tasks have been used as a way of preparing emergency nurses (Morrison & Catanzaro, 2010). Academic Preparation and Scholarship Buyum et al. (2010) conducted a research involving 60 nursing practitioners that took part in a tragic vigilance summit in determining whether this program had significance in the integration of disaster vigilance into the emergency department. Douglas (2007) suggests combined efforts of the emergency nurses with the community commonly using the learning and adversity preparation procedures in the identification of any gap evident within the their system. The assessments on the gaps provide insight in regard to that which requires improvement and might can act as framework in the contingency plans. Adams and Canclini (2008) evaluated the impacts of the research thus promoting the active involvement of baccalaureate emergency nurse in reacting to the unexpected disaster. This project was a joint effort of the society and UK emergency nurses. The research concluded that there is a success and increased nurse readiness to manage disasters. Adams and Canclini are giving a suggestion that the healthcare institutions have a big part to play while preparing the society as well as its emergency nurses for disasters. A research carried out by Hammad et al., (2011) assessed the UK registered nursing workers' awareness and perception in regard to their duties on disaster reaction. Self-reported questionnaires were dispersed amongst 152 nursing workers within metropolitan public emergency department. This research identified three major themes from the data: The review conducted by Lavin, (2006) concluded that the nurses gets merits for appropriate disaster education and training, and recommended further researching on the suitability of education and trainings. Assessing Emergency Nurse Perception and Preparedness for calamities – A Micro View In the course of main disastrous scenarios, the demand for registered emergency nurses increases compared to the demand for different medical experts (Lavin, 2006). The duties of emergency nursing employees in the course of any disaster has developed from just taking care for the patients and injured to the improvement of the capacity of reacting to a calamity in regard to readiness, alleviation, responses, recovery and assessment (Gebbie & Qureshi, 2006). The registered emergency nurses in the UK must be ready to step up to take part in the event of a disaster whereby their responsibility is supplementing the deliverance of emergency services by the legitimate workers. The four central themes in emergency nurse preparedness for the disaster management include; concern, attitude and perceived vigilance for disasters reaction; catastrophic plans in acute setup; and surge capabilities of acute setup. Some of the variables that influence emergency nurses are the psychological effects, for example, post-traumatic stress disorders, risk of being exposed to disastrous agents, and environment of fear. Secor-Turner and O’Boyle made a conclusion that little data is accessible in regard to the concern and fear on emergency nursing workers in regard to their disaster management roles and working environments in disastrous events. Secor-Turner and O’Boyle state that sufficient trainings and preparedness are vital in the preparation of health workers to safely operate and reduce emotional and psychological distress. Limitations of the Research The nurses' duty during disaster moments cannot be understated. Physical needs and fundamental delivery of clean clothing, foodstuff, rest, respite and better accommodation have to be put into consideration. Besides, nurses within disastrous reactions face psychosocial needs, consideration for personal accountabilities (families), security matters, and growing nervousness from the sick that has to be all put into consideration within the plans and alleviation stages of preparations (Qureshi et al., 2005). Good (2007) noted after-hours matters of accessing information and supply as a requirement for the preparation for nurses' reaction to disastrous scenarios. Different challenges encountered by nursing workers were the poor communication and inadequate preparedness. Nursing workers did express their concerns on the sense that calamity plans anticipations weren't explicitly conveyed, and a comprehensible link between the planning itself and the ones anticipated to implement it was not communicated (Good, 2007). Theoretical Framework The Ecological Theory Theoretical frameworks offered guidance to the improvement of important content and efficient teaching methods for the pilot registered emergency nurse preparedness program. First, the Ecological theory, which is a proposal by Bronfenbrenner (1977), is stating that the individual development results from related systems that are autonomous while still affecting each other. Explicitly, the setting has to be considered to be an influencing aspect. The ecological method has given an information of the development of different models. For instance, the Center for Disease Control and Prevention (CDC) made use of the ecological theory in creating a social-ecological models on violence avoidance. Within the model, four systems were assessed for violence impediment: societies, communities, relations and individuals (Dahlberg & Krug, 2002). In a different case, Beaton et al. (2008) came up with a model on catastrophe management in relation to the ecological theory. The model exhibited the manner in which aspects at the individuals, working place, communities, and state levels required evaluation by the emergency nurses for calamity preparedness. The ecological model of the calamity was used in the pilot emergency nurse preparedness program reflecting various degrees of catastrophe readiness, their interconnections, and interrelation. These levels include; personal, workplace and state or federal preparedness levels of disaster response. These levels of vigilance are crucial to the whole planning, and that one ill-prepared degree could considerably affect the incapability of the whole system to successfully react to a calamity, demonstrating the interlinking of the model. Constructivist Learning Theory The second framework used in the pilot crisis nurses' readiness program was the constructivist learning theory, grounded the work of Piaget. The theory offered guidance to the progress of the course content and application method, in that nursing workers on crisis were motivated to use their experience and earlier knowhow in helping the construction of a newer knowledge (Hoover, 1996; McEwen & Wills, 2011). The constructivist theory is implying that crisis and disasters readiness requires being active to enhance the progress of critical thinking abilities (Brandon & All, 2010; (Chikotas, 2008). The theory applies to case studies and the emergency nurse’s former knowhow to have a discussion and form solution to actual disasters occurrences. Case studies discussion and experience were applied within the pilot program in helping crisis nurses to have explorations on personal readiness, communal partnership and moral dilemmas faced by a crisis. Summary and conclusions Disastrous scenarios have significant demands on nurses dealing with crisis. Significant obstacles exist in providing adequately for disaster planning and readiness among emergency department nurses all over the UK regions. The emergency nurses should be active partakers in decision-making concerning crucial healthcare services offered in emergency preparedness either in the pandemic or huge casualty events (Hynes, 2006). This research paper brought about a general idea of a recent study in regard to disaster preparedness amongst the emergency nursing employees. It concentrated on difficulties hindering the emergency nurses from acquiring the proper preparedness skills and identified criteria for improving the disaster response in the United Kingdom. Nurses are the main reinforcers of any disaster response. A research of the perceived readiness of hospital-based nursing workers is an essential starting stage while examining the capacity of emergency department nurses of UK in reacting to crisis. The lives and safety of various UK nations will be dependent on the nurses should a disaster strike. REFERENCE Adams, L., & Canclini, S. (2012). Disaster readiness: A community-university partnership. Online Journal of Issues in Nursing, 13(3). Retrieved from Baack, S., & Alfred, D. (2013). Nurses’ preparedness and perceived competence in managing disasters. Journal Of Nursing Scholarship, 45(3), 281-287. http://dx.doi.org/10.1111/jnu.12029 Bradt D.A., and Drummond C.M. 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