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

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

“…who would be the Gold, Silver and Bronze commander in a mass incident has been identified as an essential competency by various authors who have attempted to define competencies for healthcare workers involved in major incidents (NEPEC, 2003;Hsu et al, 2006;Linney et al, 2010). Questions prompted participants to give an example of each and this showed a high degree of uncertainty (Table 1).…”

“…This method enabled the necessary range of information to be gathered whilst ensuring autonomy and confidentiality (Frankfort-Nachmias and Nachmias, 2008). The content was guided by a range of educational competencies previously mentioned by NEPEC (2003), Hsu et al (2006) and Linney et al (2010) as well as Heptonstall andGent (2008) CBRN manual andMackway-Jones (2005) Major Incident Medical Management and Support (MIMMS) manual. The competencies covered a range of essential topics including; awareness of CBRNe materials, hospital protocol and management, patient flow, triaging principles, decontamination skills including Personal Protective Equipment (PPE), command and control, waste management and health and safety.…”

“…This has also been found to be the case internationally where lack of training and educational standardisation in the United States has led to uneven and inconsistent approaches between states (Murray et al, 2006;Waeckerle, 2004). However, attempts have been made to specify competencies for mass incidents: three examples are: (1) general competencies for response to mass incidents for all American healthcare workers (Hsu et al, 2006); (2) specific nurse competencies for response to CBRNe incidents in America (Nursing Emergency Preparedness Education Coalition, 2003); and (3) competencies for response to CBRNe incidents for all first line NHS responders in the UK (Linney et al, 2010).…”

Exploring the non-technical competencies for on-scene public health responders in chemical, biological, radiological, and nuclear emergencies: a qualitative study

“…5e10 It has been established that interpersonal, social, and cognitive skills play an important role in response performance. 11 Those non-technical competencies broadly involve a range of knowledge, attitude, and skills in communication, 12e14 collaboration, 15,16 leadership, 17e19 situation awareness, 12 and other individual personal attributes. 20 However, the literature search revealed relatively few studies specifically focusing on public health staff working at a CBRN incident site.…”

“…21 CBRN emergencies cause trauma on a large scale and demand complex responses including triage, monitoring, diagnosis, decontamination, and self-protection for public health workers. 11,22 CBRN mass casualty situations are normally chaotic. Casualties may have single or multiple injuries or may have conventional injuries that are complicated by CBRN exposure (such as in a toxic spill or nuclear power plant accident).…”