DISASTER NURSING | NCM 120 | TOPIC 1

UNIT 1 (CHAPTER 1) DISASTER NURSING 4TH ED BY TENER GOODWIN

DEFINITIONS of war, civil strife, or other political

v Disaster conflict
 A serious disruption of the functioning of a community
Technological  Large numbers of people, property,
or a society at any scale due to hazardous events
disasters community, infrastructure, and
interacting with conditions of exposure, vulnerability economic welfare are directly and
and capacity, leading to one or more of the following: adversely affected by major industrial
accidents, unplanned release of nuclear
human, material, economic and environmental losses
energy, and fires or explosions from
and impacts hazardous substances such as fuel
v Health disaster chemical, or nuclear materials
 Is a catastrophic event that results in casualties that
Synergistic  Are commonly referred to as NA-TECHs
overwhelm the healthcare resources in that community disasters (natural and technological disasters)
and may result in a sudden unanticipated surge of  E.g. chemical plant explosion following
patients, a change in standards of care, and a need to an earthquake

allocate scarce resources

CATEGORIES ONSET, IMPACT AND, DURATION

v Rapid onset events
NATURAL DISASTER
v Those caused by natural or environmental forces  Short durations but with sudden impacts on
v Result of an ecological disruption or threat that exceeds the communities
adjustment capacity of the affected community  E.g. hurricane and volcanic eruptions, bioterrorism
v Includes earthquakes, floods, tornadoes, hurricanes, volcanic v Creeping disasters
eruptions, ice storms, tsunamis, and other geological or  Gradual onset or chronic genesis with prolonged
meteorological phenomena impacts
FACTORS THAT INFLUENCE THE IMPACT OF A
TYPES OF NATURAL DISASTER
DISASTER ON A COMMUNITY
Geological  Earthquakes, tsunamis, volcanic a) The nature of the event
eruptions and landslides b) Time of day or year
c) Health and age characteristics of the population affected
Hydrological  Extreme events associated with water
d) The availability of resources
occurrence, movement, and distribution,
hydrological hazards CLASSICIFCATION OF TERMS
 Includes droughts, flooding and related v Hazard (cause)
events (e.g. landslides, and river scour  Present the possibility of the occurrence of a disaster
and deposition)
caused by natural phenomena, failure of man-made
Meteorological  Floods, wildfires, heat waves and sources of energy or human activity
drought, were often combined and  Potential threat to humans and their welfare
interacted in physical processes over
v Risk
span multiple spatial and temporal
scales  Is the actual exposure of something of human value
and is often measured as the product of probability and
Fires  Wildfires are classified by the
loss.
environmental protection agency as
natural disasters. CATEGORIES BY LOCATION
 However only 10-15% of them happen v Defining an event as a disaster also depends on the location in
on their own nature. Most are caused which it occurs particularly the population density of that
by humans, and the most common
location.
causes are unattended camp and debris
fires, discarded cigarettes and arson EXTERNAL DISASTER
v Are those that do not affect the hospital infrastructure but ta
hospital resources due to numbers of patients or types of
ANTHROPOGENIC DISASTERS
v Are those in which principal direct causes are identifiable injuries

human actions, deliberate or otherwise INTERNAL DISASTERS

v Cause disruption of normal hospital function due to injuries ie
TYPE OF ANTHROPOGENIC DISASTERS deaths of hospital personnel or damage to the facility itself, as

Complex  Involve situations where populations with a hospital fire, power failure or chemical spill
human suffers significant casualties as a result
emergencies

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HEALTH EFFECTS OF DISASTERS DISASTER LIFE CYCLE
v May be extensive and broad in their distribution across v Or disaster continuum or emergency management cycle
populations
3 MAJOR PHASES OF DISASTER LIFE CYCLE
v Disasters disrupt access to primary, preventive services, and
exacerbate underlying psychiatric illness Preimpact  Before the disaster
 0 hour
v Epidemiology
 Planning/preparedness, prevention,
 Quantitative study of the distributions and determinants warning
of health related events in human population
Impact  During the disaster
v Disaster epidemiology
 0-24 to 24-72 hours
 Is the measurements of the adverse health effect of  Response, emergency management,
nature and human-generated disaster and the factor mitigation
thar contribute to those effects
Post impact  After the disaster
DISASTERS AFFECT THE HEALTH STATUS OF A  Greater than 72 hours
COMMUNITY IN THE FOLLOWING WAYS:  Recovery, rehabilitation, reconstruction,
1. Disasters may cause premature deaths, illnesses, and injuries in evaluation
the affected community.
2. Disasters may destroy the local healthcare infrastructure.

3. Disasters may create environmental imbalances, increasing the

risk of communicable diseases and environmental air, soil, and
water hazards.
4. Disasters may affect the psychological, emotional, and social
well-being of the population in the affected community.
5. Disasters may cause shortages of food and cause severe
nutritional deficiencies.
6. Disasters may cause large population movements (refugees)
creating a burden on other healthcare systems and
communities.
7. Disaster frameworks for response are increasingly shaped by
globalization, changing world dynamics, social in- equality, and
sociodemographic trends

5 PHASES OF DISASTER

PREAPREDNESS
v Proactive planning efforts
v Risk assessment
v Warning/forecasting (monitoring events to look for indicators
that predict the location, timing and magnitude of future
disasters)
MITIGATION
v Reduce harmful effects

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v Limit disaster impact
v Prevention measures COMMON PROBLEMS TO ADDRESS
v Requires significant amount of forethought, planning and PROACTIVELY
1. Communication
implementation of measure before occurrence
2. Information management
RESPONSE
3. Coordination
v Actual implementation
4. Advanced warning system and the use of evacuation
v Emergency management and activity organization
5. Surge management (triage and distribution)
v Emergency relief
v Successful if its clear, specific, simple to understand, use an DISASTER PREVENTION MEASURES
incident common system (ICS), are routinely practiced &
updated
RECOVERY
v Stabilizing the community to normal
v Rebuilding and repairing infrastructure
v Build back better
v Resilient and sustainable community
v Rehab and reconstruction to counter long-term effects of
disaster
EVALUATION
v Determine what worked, did not work
v Specific problems, issues and challenges identification
v Empirical evidenced based from previous disaster
v Prevention or removal of hazard (e.g. closing old factories)
DISASTER PLANNING
v Addresses the problems posed by various potential events, v Containment of the hazard or implementation of mitigation

ranging in scale from mass casualty incidents strategies (E.g. strict building regulations)

v Address collaboration across agencies and organizations, v Removal of at risk populations from the hazards

advanced preparations, as well as needs assessments, event v Provision of public information and education

management, and recovery efforts v Establishment of early warning systems

v Critical to ensure that nurses are aware of and prepared to deal v Mitigation of vulnerabilities (E.g. sensor to detect contamination

with whatever these numerous other factors may turn out to be in water)

2 TYPES OF DISASTER PLANNING v Reduction of risk posed by some hazards (E.g. relocate
AGENT SPECIFIC chemical depot from school)
v Focused their preparedness activities on the most likely threats v Enhancement of local community’s capacity to respond
to occur based on their geographic location
CORE PREPARENESS ACTIVITES
ALL HAZARDS APPROACH v Prepare a theoretical foundation for disaster planning
v Incorporates disaster management components that are v Disaster planning is only as effective as the assumptions which
consistent across all major types of disaster events to maximize it is based (Review existing literature)
resources, expenditures, and planning efforts v Core preparedness activities must go beyond the routine

DISASTER PLANNING AND PUBLIC v Have a community need assessment

HEALTH AWARENESS v Identify leadership and command post

v Design a local response for the first 72 hours
v Identify and accommodate vulnerable populations
v Know about the state and federal assistance
v Identify training and educational needs, resources, and PPE
v Plan for the early conduction of damage assessment

SITUATION SUGGESTIVE OF AN INCREASED

NEED FOR PLANNING
v Megacities
v Disasters within hospitals and healthcare setting (internal and
external)
v Pandemics
v Hazardous material

PROFESSIONAL NURSING MANDATE

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Disaster Nursing NCM 120
v Provision of a caring relationship that facilitates health and VERSION 2.0 HAS 8 DOMAINS
healing
v Attention to the range of human experiences and responses to
health and illness with in the physical and social environment’s
v Integration of objective data with knowledge gained from an
appreciation of the patient of group’s subjective experience
v Application of scientific knowledge to the processes of diagnosis
and treatment through the use of judgment and critical thinking
v Advancement of professional nursing knowledge through
scholarly inquiry
v Influence on social and public policy to promote social justice

ICN CORE COMPETENCIES IN DISASTER

NURSING
v To whom do these competencies apply?
v Any nurse who has completed a program of basic, generalized
nursing education and is authorized to practice by the
regulatory agency of his/her country.
v

TO WHOM DO THESE COMPETENSIES APPLY

LEVEL 1  Any nurse who has completed a program of

basic, generalized nursing education and is
authorized to practice by the regulatory
agency of his/her country.

LEVEL 2  Any nurse who has achieved the Level I

competencies and is/aspires to be a
designated disaster responder within an
institution, organisation or system.

LEVEL 3  Any nurse who has achieved Level I and II

competencies and is prepared to respond to a
wide range of disasters and emergencies and
to serve on a deployable team

ORIGINAL DISASTER PLANNING COMPETENCIES

(4 AREAS & 10 DOMAINS)

MITIGATION/ 1. Policy development and planning

PREVENTION 2. Risk reduction, disease prevention
and health promotion

PREPAREDNESS 3. Ethical practice, legal practice and

accountability
4. Communication and information
sharing
5. Education and preparedness

RESPONSE 6. Care of the community

7. Care of individuals and families
8. Psychological care
9. Care of vulnerable populations

RECOVERY/ 10. Long-term recovery of individuals,

REHABILITATION families and communities.

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PSYCHOLOFICAL CARE COMPETENCIES

v P-phases of response description
v S-support for survivors and responders
v Y-you understand the psychological impact
v C-counsel psychological needs & intervene as needed
v H-humanistic relationships in disaster situations
v O-offer appropriate interventions as required
v L-levels of adaptive response is differentiated
v O-offer mental health assessment & intervene
v G-give age-appropriate interventions as needed
v I-identify appropriate coping strategies
v C-comfort survivors and responders

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