Culture of Safety and Preparedness: Benefits of Applying a Daily Mitigation Mindset in the Hospital Setting.

AIM: Utilizing the subjective experience of nurse executives who have supervised nurses during a major disaster in a hospital setting, this study aims to describe the subjective experience of nurse executives (NE) who have supervised nurses' responses to major disasters. This paper will focus on strategies to support nursing response to disasters, specifically to strengthen resiliency and the ability to maintain function despite the shock of a disaster, including those caused by climate change. METHODS: Semi-structured interviews were conducted with 11 hospital-based nurse executives who supervised nurses during some of the worst natural and human-made disasters in different regions of the United States. A phenomenological approach was used to analyze and describe emerging themes from the qualitative data. RESULTS: Three nurse executives demonstrated theme saturation for mitigation steps to augment traditional disaster readiness activities: (1) Assessment of human infrastructure: daily skills needed during disaster response; (2) Identification and study of failure points and metrics; (3) Strengthening human infrastructure: rectifying deficiencies; and (4) Monitoring metrics and making corrections during conventional periods. CONCLUSION: Mitigation steps may improve outcomes in hospital function during conventional times; therefore, these steps may improve resiliency and the ability to maintain functions during major disasters, including climate change.

Nurse Executive Experiences With COVID-19: Now We Know-We Are Not Going Back.

We conducted semistructured telephone interviews with 2 hospital-based nurse leaders who supervised nurses during the initial phases of the COVID-19 pandemic in northeastern region of the United States. These interviews are a subset of a larger study with 11 nurse executives who supervised nurses during both natural and human-made disasters in different regions of the United States. Qualitative data were analyzed using a grounded theory approach, followed by a content analysis of emerging themes. Participants shared several key concepts: deep commitment of nurses in an extensive range of roles and responsibilities during tragic events; an emphasis on educational needs to best prepare nurses for disaster response; the importance of organizational strategies and definitive policies for supporting nurses' response and recovery; and mental/emotional health support as essential for nurses to cope with the events. The nurse executive participants reported many opportunities to enhance nurses' knowledge and skill set to augment care in the hospital. A team-based approach that leverages the expertise of team members to strengthen the health care team is implemented and demonstrates positive patient outcomes.

Hospitals Providing Temporary Emergency Department Services in Alternative Care Settings After Hurricane Sandy.

This article reports findings of a qualitative study describing how the US Department of Veterans Affairs cared for vulnerable veterans after Hurricane Sandy while medical center was closed for an extended period. This experience highlights how vulnerable patients continued to need care. Hospital preparedness planning efforts focus primarily on sheltering in place and evacuation. Research is needed to identify how hospitals provided temporary emergency services in alternative settings to inform practical guidance. Hospital planners should anticipate that their most vulnerable patients will continue to need emergency care. Viable solutions should be considered to meet immediate and long-term patient needs.

From Brainstorming to Strategic Plan: The Framework for the Society for the Advancement of Disaster Nursing: A Work in Progress.

Professional health care societies play a critical role in promoting excellence in patient care, educating and certifying their members on evidence-based practices, and pursuing relevant research agendas to advance the science in the field. Disaster nursing is a subspecialty of professional nursing characterized by a unique knowledge base and set of skills and abilities not used in normal daily health care activities. A disaster or large-scale public health emergency creates a sudden, unanticipated surge of patients with health care needs that far exceeds the capacity of the health care system. This creates a significant burden and risk for the nurses participating in the response. Recognizing the critical need to define scope of practice and core standards for disaster nursing and to promote greater nursing leadership in disaster preparedness and response, a group of subject matter experts established a professional society to provide leadership and guidance. The strategic planning process as described by M. Kwestel et al was used as the overarching framework for describing the design, development, and implementation of the new society. Establishment of the Society for the Advancement of Disaster Nursing is a definitive step toward improving national nurse readiness in the United States.