Disaster and Emergency Nursing: Strategies for Hospital Safety

This presentation addresses the critical topic of hospital safety in the face of increasing natural and man-made disasters. It emphasizes the need for hospitals to be resilient and prepared to provide essential healthcare services during emergencies. The presentation highlights the importance of disaster management plans, risk assessments, and the Hospital Safety Index developed by WHO. It delves into structural, non-structural, and functional components of a hospital, identifying hazards and proposing actions to improve safety, including strengthening structures, enhancing communication systems, and ensuring adequate staff training. The presentation also emphasizes the need for a resilient nursing workforce, addressing post-traumatic stress disorder and promoting mental health support. Furthermore, it covers frameworks for action, including risk management, early warning systems, education, risk factor reduction, and effective emergency response. The presentation concludes by stressing the importance of government support, resource allocation, and partnerships with other agencies to ensure a well-coordinated and effective emergency response system, ultimately safeguarding hospital operations and patient care during disasters. The presentation draws on research and emphasizes the use of IT tools and the importance of a collaborative approach involving various sectors and stakeholders.

DISASTER AND
EMERGENCY NURSING
WHAT MAKES A HOSPITAL SAFE IN DISASTER

INTRODUCTION
There has been a significant increase in the number of natural and man-made disasters
occurring worldwide.
Due to the rise of disasters, hospitals are high demand to provide health care services during
that time.
However, hospitals can also be hit hard during disasters and impair its services.
The structural, non-structural and functional components of the hospital are affected.
There is a growing need of ensuring hospitals are resilient to disasters and are able to provide
the critical emergency services required.

The hospitals administration is necessitated to develop a good disaster
management plan.
A risk assessment is first done. It determines the risks involved, existing
vulnerable areas and the capacity abilities of the hospitals.
This is one of the ways to ensures to ensure there is provision of adequate
health care and reduce the cases of fatalities to human life.

BACKGROUND INFORMATION
The significant rise in occurrences of man-made and natural disasters has
caught the attention of people worldwide
As a result of the disasters there is loss of human life, damage to
infrastructure and even the hospitals themselves are affected
Due to the unexpected nature of disasters, WHO provides a hospital
disaster risk assessment checklist
WHO considers to be very important that hospitals are prepared during
disasters

Hospitals are required to keep on providing essential health
services to injured patients when disaster strikes
There was also the need for medical administration and staff
to be familiar with disaster management procedures
The hospital safety index shows the resilience of a hospital to
disasters and ability for it continue functioning amid
disasters

THE HOSPITAL HEALTH INDEX
The hospital health index is an important tool in improving health care
provision in disasters
It has received tremendous support from WHO
It was developed in 2008 by WHO and PAHO
151 items are to be evaluated by experts. They fall under structural, non-
structural and disaster management modules.
The hospital health index in maintaining safety and operations of the
hospital is the most valued tool in use right now
the hospital health index is in constant revisions to cater for specific new
chances.

In assessing the safety of the hospital, there are two forms
which should be completed.
The first form focuses on general information about the
hospital.
The second form is the hospital checklist to evaluate the
safety of the hospital.

Hospital preparedness assessment tool. Structural,
non-structural and functional aspects evaluated
Heidaranlu et al( 2015)

IDENTIFICATION OF HAZARDS
In assessments of risks, three criteria's are observed; structural, non-structural and
functional.
Structural focuses on construction elements, structure of the hospital building and the
damage it can sustain during a disaster.
Non-structural focuses on the essential properties that ensure smooth running of the
hospital. They include the electrical systems, water systems and sewage disposal
systems.
The functional aspect refers to the hospital management and hospital staff who
provide essential services during disasters.

PROPOSED ACTIONS
Improving the structures of the hospital involves addition of
foundations. Additional support beams and walls will provide strength
to the overall structure of the hospital. This improves the resiliency of
the hospital in times of earthquakes, hurricanes and floods
Hospitals are mandated to uphold safety health standards
The hospital management is also mandated to hospital safety. In doing
so they reduce losses when disaster strikes

FRAMEWORK FOR ACTION
1.Priorities in risk management
Risk managements for emergencies are to be prioritized. This involves
setting up of policies to provide guidance during times of disasters.
In disaster managements, there is co-ordination of various sectors for
control of risk damage
Energy, supply lines and communication are important factors
contributing to continuation of health services

2. Early warning assessment
Identification of the hazard is the first step. The magnitude and effects of the
hazard to the hospital have to be determined.
The risk to the hospital and health systems is calculated using a risk
assessment.
Potential Natural disasters are monitored continuously . The monitors to
enables the hazards to be detected early. This prompts early warnings to the
hospitals.
An analysis is also done on the vulnerability of the infrastructure. This is to
assess if they can withstand the disaster

3. Education on hospital safety
Hospital management and staff need should be adequately
trained and given the skills to utilize in times of emergency
It helps the staff to be adequately prepared in case of a
disaster. This reduces the risks incurred

4. Reduction of risk factor
Strengthening hospital structures to increase the resilience of hospitals
and to ensure they still function and deliver services during and after
disasters. This is also inclusive of new hospitals being constructed.
Business continuity is important it hospitals and all other healthcare
facilities. This can be achieved through effective insurance, adherence
to building standards and developing health infrastructure
Communication system, water lines and supply lines should be protected
as they are important to ensure smooth functioning of hospitals.

5. effective emergency response
It is important for hospitals to be adequately prepared for
emergencies
This includes training of the hospital staff, having a response
plan in place and having adequate health supplies
It is critical for hospitals to perform well during emergency
response

Resilience of nursing workforce
There has been the need to have a resilient workforce.
With the increase of the number of both natural and man-
made disasters more hospital staff are at high risks of post
traumatic stress disorder.
It is important for the nursing workforce to be able to
cope up with trauma that is associated with their line of
work.

Adequate training of hospital staff increases the resiliency of the staff to
mental health illness.
Receiving support from family members and the society at large is helpful
in protecting the staff from depression.
Research supports coming up with strategies to cope with disasters and
traumatic events. It provides that this is beneficial to the mental health of
workers.
It has been found out that participation in disaster response can be a
fulfilling experience at a personal level. They believe themselves to have
had a positive contribution towards the greater good

Enhancing the resiliency of the workforce
Greater partnerships among the various sectors has shown
to be able to foster resilience among the workforce.
Proper programs of inter professional training to nurses
support resilience in the workforce.
Research has shown that teamwork improves resiliency.
Having a common goal improves the resilience among the
team members .

DISASTER MANAGEMENT
Proper utilization of available resources is crucial in responding to
emergency during disasters.
In the UK a workshop participation discussion, emergency services have
two priorities; short term and long terms.
Ensuring Resilience of hospitals is an important aspect which requires to
be addressed.
The use of IT tools were suggested. The IT tools were to be used to test
and simulate emergency operations.

Equipping the staff the necessary skills, knowledge, and
experience to enable to handle emergencies in times of
disasters competently
They should be able to understand the procedures put into place
and their roles to play
It is important for the hospital’s human resource to ensure there
is adequate staff to provide services during emergencies
This will ensure there is effective emergency response

Partnership with other sectors e.g. the police, fire department will provide a
long term solution to the slow response to emergencies .
This can be achieved through having proper systems in place. a disaster can
occur at any moment and it is important for all sectors to be prepared.
IT services for emergency services will help in monitoring emergency
operation services.
Hospitals can check their preparedness and the systems set up to be utilized
during emergencies in real time.
The resilience of infrastructure is another long-term solutions to be
prioritized.

DISCUSSION
a proper plan in case of a disaster is dependant on the hospital
management knowing the risk involved.
An understanding on the probability of the disaster, vulnerable areas
which can be affected and the ability of the hospital to withstand the
disaster is important.
Achour et al.(2009) suggests that official committees can be applied
during disasters.
The committee will identify, evaluate and come up with plans to
follow during emergencies .

 This presentation provides a broad coverage of how
hospital safety can be ensured during disasters
 It covers structural, non-structural and functional aspects
of an hospital

CONCLUSION
 The government does have an important role to play
 It can allocate its resources to develop infrastructure which
will help in emergency operations
 Communication systems should be developed to reduce risks
 There should be a risk assessment tool that effectively
analyses the risks.
 The human resource should ensure there is adequate staff to
handle the emergency cases during disasters

 The need for appropriate policies to provide guidance
should be satisfied.
 There should be creation of partnerships with other
agencies like the military, police and the fire brigade.
 Utilization of IT tools will ensure a well co-ordinated
emergency response system. They can be used to evaluate
risk, preparedness of hospitals to emergencies and ensure
quick responses to emergencies

references
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