Assessing Levels of Hospital Emergency Preparedness

Abstract

Abbreviations: ASR = acute stress reaction CAR = Capabilities Assessment for Readiness MCI = mass-casualty incident PPE = personal protective equipment Abstract Introduction: Emergency preparedness can be defined by the preparedness pyramid, which identifies planning, infrastructure, knowledge and capabilities, and training as the major components of maintaining a high level of preparedness. The aim of this article is to review the characteristics of contingency plans for mass-casualty incidents (MCIs) and models for assessing the emergency preparedness of hospitals. Characteristics of Contingency Plans: Emergency preparedness should focus on community preparedness, a personnel augmentation plan, and communications and public policies for funding the emergency preparedness. The capability to cope with a MCI serves as a basis for preparedness for non-conventional events. Coping with chemical casualties necessitates decontamination of casualties, treating victims with acute stress reactions, expanding surge capacities of hospitals, and integrating knowledge through drills. Risk communication also is important. Assessment of Emergency Preparedness: An annual assessment of the emergency plan is required in order to assure emergency preparedness. Preparedness assessments should include: (1) elements of disaster planning; (2) emergency coordination; (3) communication; (4) training; (5) expansion of hospital surge capacity; (6) personnel; (7) availability of equipment; (8) stockpiles of medical supplies; and (9) expansion of laboratory capacities. The assessment program must be based on valid criteria that are measurable, reliable, and enable conclusions to be drawn. There are several assessment tools that can be used, including surveys, parameters, capabilities evaluation, and self-assessment tools. Summary: Healthcare systems are required to prepare an effective response model to cope with MCIs. Planning should be envisioned as a process rather than a production of a tangible product. Assuring emergency preparedness requires a structured methodology that will enable an objective assessment of the level of readiness. Adini B, Goldberg A, Laor D, Cohen R, Zadok R, Bar-Dayan Y: Assessing levels of hospital emergency preparedness. Prehosp Disast Mec/2006;21(6):451-457. November -December 2006 http://pdm.medicine.wisc.edu Prehospital and Disaster Medicine 452 Assessing Levels of Hospital Preparedness Adini

Assessing Healthcare Facilities Preparedness for Mass Fatalities Incident

“…Healthcare facilities are complex institutions and their resources are limited [23,24]. Therefore, it is extremely important to strengthen hospital preparedness for mass fatalities.…”

Are emergency care nurses prepared for chemical, biological, radiological, nuclear or explosive incidents?

“…However research has shown that, in previous major incidents, minimal decontamination has occurred at the scene and that Emergency Departments need to be prepared to carry out the majority of decontamination at their hospital site (Okumura et al, 1998;Vogt and Sorensen, 2002;Auf der Heide, 2006). A variety of studies recommend providing ED staff with opportunities for simulated CBRNe incidents as a means through which staff confidence and awareness can be increased (Adini et al, 2006;Chapman and Arbon, 2008). Training, exercising and testing of major incident plans is an important part of emergency preparedness and guidelines suggest table top exercises every year and simulations once every 3 years (DoH, 2005).…”

“…It is important to note that in relation to PODs, only nurses involved in various levels of management or those who have attended a MIMMS course are likely to know the correct answers, so the number of incorrect responses was expected (Carley and Mackway-Jones, 2005). Studies have however highlighted pharmaceutical stockpiles as a major component to preparedness, going hand in hand with the need for staff awareness and knowledge on this topic (Adini et al, 2006). Training that included the release and use of PODs would therefore be beneficial to all staff regardless of their nursing band or position and should form a part of any preparedness training program.…”

The identification of competencies for an NHS response to chemical, biological, radiological, nuclear and explosive (CBRNe) emergencies

“…. .developing a comprehensive methodology for assessing emergency preparedness that will be integrated into the contingency plans of medical organizations (p. 6) (Adini et al, 2006).…”