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El 31 de agosto de 2023, el Gobierno de Chile puso fin a la alerta sanitaria por COVID-19. Este hito invita a reflexionar sobre lecciones aprendidas respecto a la preparación y respuesta ante emergencias, que sean sensibles e informadas sobre la experiencia de la población migrante de nuestro país. En este marco, se presentan tres perspectivas. La primera se centra en evitar la responsabilización individual en el incumplimiento de las medidas de prevención del contagio, ya que este enfoque ignora las inequidades estructurales e históricas. Las recomendaciones de emergencia se deben construir bajo un abordaje colectivo y con la consideración de los diversos contextos socioculturales y políticos. La segunda perspectiva llama a tomar en cuenta y abordar la migración como determinante social de la salud de la población en la preparación y respuesta ante emergencias. Durante la pandemia, los cambios en la gobernanza de la migración en todo el mundo precarizaron los procesos migratorios, con riesgos para la salud física y mental de las personas que migran. Esto requiere una mejor planificación y decisiones informadas en evidencia científica para futuras pandemias. La tercera perspectiva se enfoca en promover la interculturalidad, dado que la comunicación de los riesgos de contagio y de las medidas preventivas se vio dificultada entre poblaciones migrantes con diversas cosmovisiones e interpretaciones de los procesos de salud y enfermedad. Asimismo, el responder a las necesidades de aquellas comunidades históricamente marginadas, requiere establecer modos de vida que respeten la diversidad en las narrativas y las prácticas cotidianas. Los gobiernos y sistemas sanitarios deben incorporar la migración a sus estrategias de preparación y respuesta ante emergencias, con la construcción de las condiciones para su cumplimiento óptimo.
On August 31, 2023, the Chilean government ended the health alert for COVID-19. This milestone invites us to reflect on lessons learned in emergency preparedness and response regarding migrant populations in the country. In this context, three perspectives are presented. The first focuses on avoiding pointing to individual responsibility for non-compliance with prevention measures, as this approach ignores structural and historical inequities. Emergency recommendations should be constructed considering a collective approach and diverse sociocultural and political contexts. The second perspective calls for considering and addressing migration as a social determinant of health. During the pandemic, changes in the governance of migration around the world made migration processes more precarious, with risks to the physical and mental health of migrants, which needs better planning and evidence-based decision-making in future pandemics. The third perspective focuses on promoting intercultural health, as effective communication of contagion risks and preventive measures were hampered among migrant populations with diverse worldviews and interpretations of health and disease processes. Responding to the needs of historically marginalized communities requires establishing ways of life that respect diversity in narratives and everyday practices. Governments and health systems must incorporate migration into their emergency preparedness and response strategies, creating the conditions for optimal compliance.
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Background The health and safety of people are often endangered during emergencies and disasters. Efficient emergency management systems ensure that mitigation, preparedness, response, and recovery actions exist to preserve the health, safety, and welfare of the public. Failure to carry out appropriate responses can have adverse consequences for both emergency responders and casualties; hence, the need for emergency preparedness. This study sought to assess the state of emergency preparedness capacity of the Kwame Nkrumah University of Science and Technology hospital in Ghana. Methods A facility-based cross-sectional study was conducted between December 2018 and February 2019 using three guidelines developed respectively by the World Health Organization, the Ministry of Health-Ghana, and the Ghana Health Service. The hospital's emergency preparedness was assessed regarding the emergency policies, plan, protocol, equipment, and medications. Results Overall, the hospital's emergency preparedness level was weak (57.36%). Findings revealed that the hospital had inadequate emergency equipment, and supplies for emergency care delivery, especially during upsurge. It also did not have an emergency planning committee. There were noticeable deficiencies in some emergency resources such as chest tubes, basic airway supplies, and many emergency drugs. Other vital emergency tools such as pulse oximeter, thermometer, and emergency medications were inadequate. The hospital had a strong emergency plan and policies on assessment (77.8% and 78%) respectively. Conclusion The Kwame Nkrumah University of Science and Technology hospital is not prepared sufficiently for an emergency surge, and this poses a major health challenge. Emergency items must be made available, and the organization and planning of emergency service provisions must be improved to avoid preventable deaths during an emergency surge.
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Objective:To investigate the status quo of disaster preparedness of nursing organization among newly recruited nurses in tertiary grade A hospitals of Zhengzhou city and analyze the influencing factors in order to provide theoretical basis for further improving the standardized training program for newly recruited nurses.Methods:This study was a cross-sectional survey. From December 2021 to March 2022, 964 newly recruited nurses from 4 tertiary grade A hospitals of Zhengzhou city were selected as the survey objects by convenient sampling method. The general information questionnaire and Hospital Nursing Department Disaster Preparedness Scale were used to conduct the questionnaire survey. Disordered multiple classification Logistic regression was used to analyze the influencing factors of disaster preparedness of hospital nursing organization.Results:The disaster preparedness score of nursing organization of newly recruited nurses was (37.62 ± 7.57) points. The results of disordered multiple classification Logistic regression showed that the factors influencing the disaster preparedness level of nursing organization of newly recruited nurses were whether they had participated in disaster rescue work and the degree of attention paid by nursing organizations to disaster rescue training (both P<0.05). Conclusions:The disaster preparedness of the nursing organization of newly recruited nurses in tertiary grade A hospitals of Zhengzhou city was at a medium level. Nursing managers should pay attention to the disaster preparedness of newly recruited nurses, develop their core abilities for disaster rescue according to their influencing factors, and incorporate disaster preparedness related contents on the basis of standardized training programs.
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Objective@#To construct an evaluation index system of public health emergency preparedness capacity in county-level centers for disease control and prevention (CDC), so as to provide the evidence for improving the public health emergency preparedness capacity in county-level CDC.@*Methods@#An index system framework was created based on review of health emergency policies, laws and regulations released in China from 2003 to 2023. The importance, sensitivity and accessibility of indicators were scored and screened through two rounds of Delphi expert consultations, and the weights of indicators were calculated using precedence charts. The efficiency of Delphi expert consultations was evaluated using the active coefficient, authority coefficient and coordination coefficient. @*Results@#Eighteen experts participated in consultations, including 9 men, 15 with educational levels of master degree and higher, 12 with preventive medicine or public health as the specialty, and 12 with deputy senior professional titles and higher. The active coefficients of two rounds of consultations were 100.00% and 94.44%, and the authority coefficients were 0.83 and 0.84, respectively. The coordination coefficients of secondary and tertiary indicators during the second round consultation were 0.341 and 0.241, which were both higher than those during the first round (both P<0.05). The final evaluation index system included 8 primary indicators, 21 secondary indicators and 58 tertiary indicators. Among primary indicators, health emergency organization and management (0.203 1), health emergency team building (0.203 1) and financial support for health emergency (0.203 1) had the highest weights, and of secondary indicators, completion degree of health emergency administration regulations (initial weight/global weight: 0.750 0/0.152 3), health emergency team building (0.750 0/0.152 3) and financial support for emergency (0.750 0/0.152 3) had the highest weights, while among tertiary indicators, defining the duty of health emergency administration sectors had the highest weight (0.750 0/0.114 2). @*Conclusion@#The created evaluation index system is feasible for evaluation of the public health emergency preparedness capacity in county-level CDC.
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BACKGROUND@#Understanding bystander reactions to an emergency is an important component of effective training. Four stages of bystander intervention (BI) have been previously described: noticing the situation as a problem, interpreting when it is appropriate to intervene, recognizing personal responsibility to intervene, and knowing how to intervene. Using virtual reality (VR) to simulate emergencies such as sudden cardiac arrest (SCA) can be used to study these stages.@*METHODS@#In a secondary analysis of an observational cohort study, we analyzed bystander self-efficacy for stages of BI before and after simulated SCA. Each subject participated in a singleplayer, immersive, VR SCA scenario. Subjects interacted with simulated bystanders through voice commands (“call 911”, “get an AED”). Actions taken in scenario, like performing CPR, were documented. Scenario BI actions were compared based on dichotomized comfort/discomfort.@*RESULTS@#From June 2016 to June 2017, 119 subjects participated. Average age was 37±14 years, 44% were female and 46% reported CPR training within 2 years. During the scenario, 98% “noticed the event” and “interpreted it as a problem”, 78% “took responsibility”, and 54% “possessed the necessary skills”. Self-efficacy increased from pre- to post-scenario: noticing the event increased from 80% to 96%; interpreting as a problem increased from 86% to 97%; taking responsibility increased from 56% to 93%; possessing necessary skills increased from 47% to 63% (P<0.001).@*CONCLUSION@#Self-efficacy to respond to an SCA event increased pre- to post-scenario. Bystanders who reported feeling comfortable “taking responsibility to intervene” during an emergency were more likely to take action during a simulated emergency.
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Objective To explore the status and related influencing factors of disaster preparedness for ICU nurses and provide reference for carrying out learning and training of the knowledge of specialized disaster rescue. Methods With convenience sampling of network questionnaire, ICU nurses in two Fujian province hospitals attended the investigation. Results A total of 347 valid questionnaires were recovered. The score of ICU nurses disaster preparedness score was 146.32 ± 38.71. located in the middle level. Sex, working years, educational background, disaster relief experience, disaster knowledge and skill training were the main factors influencing the disaster preparedness of ICU nurses (t=-4.190-2.682, P＜0.01). Conclusions The level of disaster preparedness degree for ICU nurses was not optimistic. It was necessary to actively formulate and improve targeted training of disaster nursing theory knowledge and disaster nursing skills drills, so as to effectively promote the disaster preparedness of ICU nurses.
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According to WHO, one of these mass gatherings with critical risk is stampedes. Shanghai "12.31" stampede was a preventable tragedy that the government and event planner hold responsibility for. At the same time, it can be a legacy for improvement in the future. The government should draw experience on the implementation of an emergency preparedness system, in order to improve the rapid emergency response during mass gatherings in the future.
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BACKGROUND: Pharmacy curriculum change was made from a 4-year program to a 2+4 year program in year 2009 in Korea. The change has resulted in more educational exposures on patient-centered practice environments for about 1,400 hours in the last year of the professional pharmacy program. When the Middle East Respiratory Syndrome (MERS) outbreak hit Seoul and suburban areas and propagated to other provinces in Korea, emergency response to avoid student infection in the pharmacy practice sites became an urgent issue. While other health professional programs such as medicine and nursing had activated emergency preparedness manuals, timely and clear guidelines were not disseminated to all pharmacy programs and protective measures largely relied on individual pharmacy program. METHODS: A survey was developed by the Committee on Pharmacy Practice Experience Programs in the Korean College of Clinical Pharmacy to document the status of pharmacy programs during the Korea MERS outbreak in 2015. The 10-question survey was distributed to the pharmacy practice experience coordinators to 34 out of 35 pharmacy schools in Korea by emails. RESULTS: Our findings showed that 82.4% of the program coordinators (28/34) responded to the survey, 96.4% of the programs did not have emergency preparedness manuals, administrative meetings were held in 89.3% of the pharmacy programs, the rotation schedules were modified or withheld in 53.6% of schools, and the changes were mostly observed from the programs classified as MERS outbreak regions. CONCLUSION: Further needs in establishing the emergency preparedness manual should be explored for pharmacy education stakeholders.
Subject(s)
Humans , Appointments and Schedules , Civil Defense , Coronavirus Infections , Curriculum , Education , Education, Pharmacy , Electronic Mail , Emergencies , Health Occupations , Korea , Middle East , Nursing , Pharmacy , Schools, Pharmacy , SeoulABSTRACT
The role of air travel in rapid translocation of infectious disease is indisputable.1 The global health community has long been concerned about the movement across borders of vaccine-preventable diseases, tuberculosis and other diseases of public health concern. These concerns escalated following the September 2001 terrorist attack and the anthrax bioterrorism incident in the United States of America; the worldwide spread of severe acute respiratory syndrome (SARS) in 2003; and the reemergence of H5N1 avian influenza soon thereafter, which stoked fears about the possibility of a severe influenza pandemic. To better prepare and coordinate countries to respond to all-hazards health emergencies at their borders, in the past 10 years the global public health community has formed numerous domestic and international alliances.
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OBJECTIVE: To discuss the various factors contributory to the fatalities that resulted from the sinking of the MV Dona Paz. METHODS: Review of the pre-disaster, disaster and post-disaster events surrounding the sinking of the MV Dona Paz, as well as the subsequent response by the government and responsible agencies to the disaster. RESULTS: The Sinking of the MV Dona Paz, along with the loss of more than 4,000 precious lives, is but a footnote in the long litany of misfortunes plaguing the Philippine maritime industry. A closer look into the events and circumstances leading to this tragedy demonstrates a confluence of equipment and system inadequacy on one hand and human error and lack of preparedness on the other. CONCLUSION: Multiple factors account for the occurence of this tragedy, along with other maritime disaster incidents dotting the long maritime history of the Philippines. A cursory analysis of these factors may lead to recommendations that can prevent similar occurrences in the future and mitigate damage to property and loss of life. The policy implications of these findings are discussed in a subsequent paper.
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Philippines , Glucosamine , Disasters , Government , Policy , OrganizationsABSTRACT
OBJECTIVE: To discuss the various factors contributory to maritime disaster preparedness in the Philippines, in the context of the sinking of the MV Dona Paz and formulate recommendations to address these factors. METHOD: Review of the state of maritime preparedness in the pre-disaster setting and the post-disaster response following the sinking of the MV Dona Paz by the government and responsible agencies. A scrutiny of the state of preparedness of concerned agencies and subsequent response to the disaster was conducted with the objective of formulating recommendations which may lead to prevention and mitigate loss of lives. RESULTS: Multiple factors accounted for the occurrence of this tragedy. These factors include an inherent risk due to the geography of shipping industry and its labor force. Economic conditions prevent both the industry and government agencies from upgrading vessels and communications equipment. Lack of enforcement of existing regulations allows vessels to sail overloaded and at times manned by less-than-qualified crew. Delayed response and deficient post-disaster medical response may have led to a disproportionately high mortality. CONCLUSIONS: The systems inadequacies of the Philippine maritime disaster response mechanism are highlighted by the Dona Paz tragedy. Many of the factors contributing to the disproportionately high incidence of maritime disasters in the Philippines and the resulting loss of limb may be preventable. Recommendations on regulation and enforcement, disaster preparedness, search and rescue, and medical response are discussed.
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Incidence , Philippines , Glucosamine , Disasters , Government Agencies , Government , Men , Geography , EmploymentABSTRACT
Medical preparedness and response to radiation emergency are challenged by the fast development of nuclear energy and nuclear technology, the rapid use of radiological source and devices,and terrorist threats involving radiological material. Against this background, hospitals play a vital role in medical response to radiation emergency. In this article, we discussed the hospital's responsibility in medical response to radiation emergency, and raised a series of requirements to the medical bases engaged in radiation emergency, which cover the planning, personnel, facilities, equipments and drugs stockpiling, and medical management technique of such bases. Adequate preparedness in advance makes the best guard for such bases, to effectively handle nuclear and radiological emergency, minimizing casualties and health damage and protecting people's health and safety.
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OBJECTIVES: Bioterrorism (BT) preparedness and response plans are particularly important among healthcare workers who will be among the first involved in the outbreak situations. This study was conducted to evaluate the current status of education for BT preparedness and response in healthcare-related colleges/junior colleges and to develop learning objectives for use in their regular curricula. METHODS: We surveyed all medical colleges/schools, colleges/junior colleges that train nurses, emergency medical technicians or clinical pathologists, and 10% (randomly selected) of them that train general hygienists in Korea. The survey was conducted via mail from March to July of 2007. We surveyed 35 experts to determine if there was a consensus of learning objectives among healthcare workers. RESULTS: Only 31.3% of medical colleges/schools and 13.3% of nursing colleges/junior colleges had education programs that included BT preparedness and responses in their curricula. The most common reason given for the lack of BT educational programs was 'There is not much need for education regarding BT preparedness and response in Korea'. None of the colleges/junior colleges that train clinical pathologists, or general hygienists had an education program for BT response. After evaluating the expert opinions, we developed individual learning objectives designed specifically for educational institutions. CONCLUSIONS: There were only a few colleges/junior colleges that enforce the requirement to provide education for BT preparedness and response in curricula. It is necessary to raise the perception of BT preparedness and response to induce the schools to provide such programs.
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Humans , Bioterrorism , Curriculum , Disaster Planning/organization & administration , Korea , Schools, Health Occupations/organization & administrationABSTRACT
PURPOSE: To investigate different emergency medical centers' (EMCs) preparedness for a biological disaster in Korea. METHODS: A survey of 120 EMCs in Korea was done through questionnaire. We examined facilities, equipments and supplies, and emergency personnel training and drill. RESULTS: Ninety (75%) EMCs participated in the survey. Sixteen were from regional/specialized EMCs and 74 were from local EMCs. The median for the number of staffed beds were 680(range, 200~2200) and the median for patient visits were 73(range, 24~210) per day. Ten(11%) of the 90 participating EMCs had personal protective equipments (PPEs); 7(8%) had wet decontamination units; 11(12%) had independent ventilation systems; 15(17%) had mechanical ventilator; 9(10%) had life lines; 39(43%) had alternative care sites and none (0%) had triage tag with presence of contamination. At least one drill was conducted annually in 11(12%). When the availability of resources needed in a biological disaster between regional/specialized EMCs and local EMCs were compared, the regional/specialized EMCs had PPEs(38% vs. 5%, p<0.01), wet decontamination unit(44% vs. 0%, p<0.01), independent ventilation systems (31% vs. 8%, p<0.05), and drills (38% vs. 7%, p<0.01) more frequently than local EMCs. Approximately 70% of the respondents attributed the above passive preparedness results from a lack of budget and the notion that only the minimum preparedness is necessary for the possibility of a biological disaster. Also, half of the respondents agreed that new infectious diseases will occur with a possibility of more than 50% in the future. CONCLUSION: Our data indicated that preparedness of EMCs for a biological disaster in Korea was low. Therefore, we should develop comprehensive plans to remedy the identified deficiencies.