Disaster-related injuries and illnesses treated by American Red Cross disaster health services during Hurricanes Gustav and Ike.

OBJECTIVE: To describe the injuries and illnesses treated by the American Red Cross (Red Cross) during Hurricanes Gustav and Ike disaster relief operations reported on a new Aggregate Morbidity Report Form. METHODS: From August 28 to October 18, 2008, 119 Red Cross field service locations in Louisiana, Mississippi, Tennessee, and Texas addressed the healthcare needs of people affected by the hurricanes. From these locations, individual client visit data were retrospectively collated per site onto new 24-hour Aggregate Morbidity Report Forms. RESULTS: A total of 3863 clients were treated. Of the clients, 48% were girls and women and 44% were boys and men; 61% were 19 to 64 years old. Ninety-eight percent of the visits occurred in shelters. The reasons for half of the visits were acute illness and symptoms (eg, pain) and 16% were for routine follow-up care. The majority (65%) of the 2516 visits required treatment at a field location, although 34%, or 1296 visits, required a referral, including 543 healthcare facility transfers. CONCLUSIONS: During the hurricanes, a substantial number of displaced evacuees sought care for acute and routine healthcare needs. The capacity of the Red Cross to address the immediate and ongoing health needs of sheltered clients for an extended period of time is a critical resource for local public health agencies, which are often overwhelmed during a disaster. This article highlights the important role that this humanitarian organization fills, to decrease surge to local healthcare systems and to monitor health effects following a disaster. The Aggregate Morbidity Report Form has the potential to assist greatly in this role, and thus its utility for real-time reporting should be evaluated further.

Evaluation of a disaster-surge training for public health nurses.

OBJECTIVE: To examine the effect of a blended educational intervention (in-class and independent learning modules) developed to enhance Ohio PHN confidence in 25 disaster surge competencies that address the PHN role and skills in Preparedness, Response, and Recovery. DESIGN AND SAMPLE: This was a quasi-experimental one group pre and post design. Participants (N = 54) completed pre- and postintervention surveys to evaluate intervention impact on self-perceived confidence and need for further training in the 25 competencies. MEASURES: Parallel pre and post surveys assessed participant evaluation of confidence and need for further competency training. Paired t tests and repeated measures ANOVA compared pre- and postsurvey results. RESULTS: Confidence in Preparedness, Response, and Recovery PHN disaster surge competencies significantly increased, whereas self-perceived need for further competency training correspondingly significantly decreased. CONCLUSIONS: A blended learning approach to disaster surge training effectively improved PHNs confidence in competency achievement and reduced perceived need for further training.

Psychological impact of disasters on communities.

Disaster mental health is defined as "community and individual mental and behavioral health preparedness and response as well as other psychosocial and cultural factors" (Hoffman et al., 2005, p. S141). The research included in this review was published between 2000 and 2011, capturing a snapshot of the last decade of relevant research on the psychological impact of disaster. The conceptual framework used to examine the research involves a population-based approach based on primary, secondary, and tertiary prevention levels. Aspects of conducting mental health research, to include evidence-based approaches and disaster mental health outcome measurements postdisaster, are also included. The authors conclude the review by presenting implications and future recommendations for nursing practice and research related to the psychological impact of disasters on communities.

Public health nursing competencies for public health surge events.

OBJECTIVE: To develop consensus regarding public health nursing competencies in the event of a public health surge event related to disaster. DESIGN AND METHODS: Using a 3-round Delphi approach, public health nurses (PHNs) and directors of nursing from local health departments, state nursing leaders, and national nursing preparedness experts reviewed and commented on 49 draft competencies derived from existing documents. RESULTS: The final 25 competencies were categorized into Preparedness (n=9), Response (n=8), and Recovery (n=7). The Preparedness competencies focus on personal preparedness; comprehending disaster preparedness terms, concepts, and roles; becoming familiar with the health department's disaster plan, communication equipment suitable for disaster situations; and the role of the PHN in a surge event. Conducting a rapid needs assessment, outbreak investigation and surveillance, public health triage, risk communication, and technical skills such as mass dispensing are Response phase competencies. Recovery competencies include participating in the debriefing process, contributing to disaster plan modifications, and coordinating efforts to address the psychosocial and public health impact of the event. CONCLUSIONS: Identification of competencies for surge events that are specific to public health nursing is critical to assure that PHNs are able to respond to these events in an effective and efficient manner.

The ExploreSurge Trail Guide and Hiking Workshop: discipline-specific education for public health nurses.

Generic preparedness education and training for the public health workforce has increased in availability over the past 5 years. Registered Nurses also have more opportunities available for participation in emergency and disaster preparedness curricula. Discipline- and specialty-specific training and education for public health nurses (PHNs) incorporating their population-based practice, however, remains a largely unexplored area that is not accessible except for sporadic local venues. The Public Health Nursing Surge Curriculum provides 50 hr of nursing continuing education and activity-based aggregate focused learning experiences that are completed within a 12-month period, including an in-classroom seminar. The Public Health Nursing Surge Curriculum was developed on a foundation of 25 competencies linking PHNs and their population-based practice to surge capability. The curriculum was built in partnership with statewide public health directors of nursing over a 12-month period and is evaluated by a 3-level process to include self-rated confidence in performance. The curriculum's use of a blended learning methodology enables staff-level PHNs to master individual competencies toward surge capability within the public health response system.

Critical issues in bioterrorism preparedness: before and after September 2001.

The Bioterrorism Preparedness and Response Survey (BPRS) was a survey of Ohio local health departments' capacity to respond to bioterrorism. Soon after completion of the BPRS, the events of September 11 occurred, followed by the human cases of anthrax. The Ohio Response to Bioterrorism 2001 Survey (ORB) identified bioterrorism preparedness issues related to the suspected anthrax incidents. The BPRS measured capacity before September 11, 2001, and the ORB measured Ohio communities' response to white powder incidents. The BPRS and ORB provided independent and outcome measures related to the 2001-bioterrorism events. The significant bioterrorism response issues were: monitoring critical or unexplained deaths and clusters or symptoms; training on bioterrorism agents; integration of medical and criminal investigations of bioterrorism incidents; development of bioterrorism emergency response plans to include agencies to be contacted, management strategies for implementing mass vaccination, prophylaxis, treatment distribution and administration; and participation in a bioterrorism field or tabletop exercise. These results are confirmed and extended by studies by the US General Accounting Office, the Rand Corporation, Trust in the Future of America's Health foundation, and a follow-up survey of issues during a simulated covert smallpox attack.