Design and validation of a preparedness evaluation tool of pre-hospital emergency medical services for terrorist attacks: a mixed method study

Abstract

Introduction Terrorist attacks are one of the human problems that affect many countries, leaving behind a huge toll of disabilities and deaths. The aim of this study was to use a mixed-method analysis to design and validate an evaluation tool for pre-hospital emergency medical services for terrorist attacks. Methods The present study is a mixed-method (qualitative and quantitative) study that was conducted in two phases. In the qualitative phase (item generation), semi-structured interviews were conducted with 34 Iranian emergency medical technicians who were selected through a purposive sampling method and a scoping literature review was conducted to generate an item pool for the preparedness evaluation of Emergency Medical Services (EMS) in terrorist attacks. In the quantitative phase (item reduction), for validity of tool face, content and construct validity, were performed; for tool reliability, the test and retest and intra-class correlation coefficient were evaluated. Results At the first stage, 7 main categories and 16 subcategories were extracted from the data, the main categories including “Policy and Planning”, “Education and Exercise “,“ Surge Capacity”, “Safety and Security”, “Command, Control and Coordination”, “Information and Communication Management “and “Response Operations Management”. The initial item pool included 160 items that were reduced to 110 after assessment of validity (face, content and construct). intra-class correlation coefficient (ICC = 0.71) examination and Pearson correlation test (r = 0.81) indicated that the tool was also reliable. Conclusion The research findings provide a new perspective to understand the preparedness of pre-hospital emergency medical services for terrorist attacks. The existing 110-item tool can evaluate preparedness of pre-hospital emergency medical services for terrorist attacks through collecting data with appropriate validity and reliability.

Assessing hospital disaster preparedness: A scoping review of available tools

“…The flow of the processes of selecting the articles is provided in Figure 1 . Out of ten studies included in the present scoping review, they were from Turkey [ 14 ], Iran [ 15 ], Lebanon [ 16 ], Indonesia [ 17 ], India [ 18 ], Ethiopia [ 19 ], Saudi Arabia [ 20 ], Pakistan [ 7 ], Philippines [ 21 ], and Saudi Arabia [ 20 ], which implemented the tools of disaster preparedness in the hospital. The characteristics of the data included studies are presented in Table 1 .…”

“…Although studies used the HSI tool, it was modified and therefore the results are still in line with the aim of the studies [ 7 , 17 - 20 ]. Two studies used the modified hospital preparedness tool by the expert with 34 sub-criteria and 110 sub-criteria [ 14 , 15 ]. Three studies used the WHO Hospital Emergency Checklist [ 16 , 21 , 22 ], and one study used modified Public Health Emergency Preparedness [ 18 ] to measure public hospital preparedness and resilience to health emergencies.…”

“…The data of the included studies reveal that it is important to have hospital buildings designed with high safety standards, including earthquake resistance, fire-resistant building materials, and protection against disaster damage [ 14 , 15 ].…”

“…The availability of human resources is needed during a disaster [ 19 ]. This aspect is a strength for hospitals so that the hospitals are ready to respond to disasters during emergencies and increase mitigation efforts that have an impact on the humanitarian crisis in Lebanon [ 15 ]. For this reason, hospitals need to increase staff knowledge and skills through training activities to ensure that they are ready to deal with disasters in the future [ 22 ].…”