Are You Ready? Understanding Disaster Preparedness
Suzan Miller-Hoover DNP, RN, CCNS, CCRN-K
The occurrence and severity of natural disasters is increasing across the globe (The Economist, 2017). The Department of Homeland Security (DHS) and the Federal Emergency Management Agency (FEMA) have determined that preparing healthcare facilities for disaster is a national security priority (DHS, 2018). Across the United States, disasters happen almost every day. These disasters include:
• Storms
• Wildfires
• Floods
• Earthquakes
• Mass shootings
• Bombings
• Chemical & industrial accidents
• Epidemics
• Terrorism
The outcome of these disasters is dependent on the healthcare system’s ability to respond and treat the injured or ill. The increased risk of a disaster occurring requires that communities nationwide have a well-prepared public health and healthcare disaster system. To mitigate the consequences of disasters, all communities need to have processes in place to treat the ill/injured and protect the healthy (Toner, 2017).
There are various preparedness programs already in place; however, funding for many of these programs has been drastically decreased over the years (Toner, 2017). In 2016, the Centers for Medicare and Medicaid Services (CMS) preparedness rule was finalized and established emergency preparedness requirements for facilities participating in Medicare and Medicaid and coordinates efforts with the federal, state, and local emergency preparedness systems (Toner, 2017).
In 2014 the Association of Public Health Nurses updated their position paper “The Role of the Public Health Nurse in Disaster Preparedness, Response and Recovery. This paper supplies guidance for the public health nurse’s role throughout the disaster cycle (Association of Public Health Nurses (APHN), 2014).
Nurses may be allowed by federal and/or state law or declarations to cross state boards to assist in disaster relief; however, it is important that the nurse knows and understands these laws prior to joining the disaster effort. Be sure to clarify the expectations for licensure with the organization you are volunteering with. Currently, there are no comprehensive, national legal protections for healthcare workers participating in the disaster cycle (Courtney, Priest, & Roost, 2012).
Public health nursing is “the practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences” (American Public Health Association, Public Health Nursing Section, 2013, p.1). Currently there are an estimated 34,521 public health nurses (PHN) working across the U.S. This number represents a significant, nationwide shortage of PHN.
Public health nurses bring critical expertise to each phase of the disaster cycle: preparedness (prevention, protection, and mitigation), response and recovery. “They have a unique skill set and an ability to link systems that are vital to the disaster continuum to include, but not limited to disease surveillance, disease and health investigation, case finding, rapid needs assessment, public health triage, mass prophylaxis and treatment, collaboration, health teaching and provider education, community organizing, outreach and referral, population advocacy and policy development” (APHN, 2014, p. 6).
To understand the role of the public health nurse and the nursing process during a disaster, review the APHN Position Statement at http://nacchopreparedness.org/wp-content/uploads/2014/01/APHN_Role-of-PHN-in-Disaster-PRR_FINALJan14.pdf. Specifically table 1 on page 7.
Disaster preparedness, response, and recovery are critical components of public safety. Public health nurses who understand the population-based nature of a disaster response and possess the knowledge and skills to respond in a timely and appropriate manner to any type of disaster are a vital component to this process (APHN, 2014).
Resources: Emergency Response Resource Requirements. FEMA https://www.fema.gov/media-library/assets/documents/89520
Emergency preparedness materials (families, pets, seniors, disabled, businesses https://www.fema.gov/media-library/resources-documents/collections/344
Disaster Relief Agencies http://www.disastercenter.com/agency.htm (lists over 60 agencies)
References
Association of Public Heath Nurses (APHN). (2014). The role of the public health nurse in disaster preparedness, response, and recovery. Retrieved from: http://nacchopreparedness.org/wp-content/uploads/2014/01/APHN_Role-of-PHN-in-Disaster-PRR_FINALJan14.pdf
Beck, A.J. & Boulton, M.L. (2012). The public health nurse workforce in U.S. state and local health departments. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4716482/
Courtney, B. A., Priest, C., & Root, P. (2012). “Legal Issues in Emergency Response,” in Couig, M.P., Kelley, P., and Kasper, C. Editors, 2012 Annual Review of Nursing Research: Disasters and Humanitarian Service. Springer Publishing Company: New York City, NY.
The Economist. (2017). Weather-Related Disasters are Increasing. The Economist. Retrieved from https://www.economist.com/graphic-detail/2017/08/29/weather-related-disasters-are-increasing
Toner, E. (2017). Healthcare preparedness: Saving lives. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5314965/
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