Emergency preparedness involves having the skills, knowledge, and plans to respond to threats both natural and man-made. It is important for healthcare systems and nurses. Nurses play a key role in disaster response through caring for victims, infection control, triage, and more. However, nurses often feel unprepared for disasters due to lack of education and unclear plans. Healthcare systems also struggle with issues like limited funding and surge capacity. It is important for nurses and facilities to engage in preparedness activities like developing emergency plans and conducting trainings.

1. Preparing for
Emergencies
Kristin Botzer

2. Emergency Preparedness
Emergency preparedness is the “comprehensive skills, abilities, knowledge, and
actions that are needed to respond and prepare for a threat, actual or suspected,
chemical, radiological, nuclear, biological, or explosive in nature” (Slepski as
cited in Baack & Alfred, 2013, p. 282).

3. Types of Emergencies
• Natural Disasters – any disaster not man-made, including health disasters
Floods, hurricanes, earthquakes, wildfires
Health disasters: AIDS, Ebola virus, epidemics, pandemics
• Man-made disasters – accidental or intentional
Accidental: industrial accidents, structural collapse, power outages
Intentional: terrorist attacks, mass shootings, anthrax
(Sullivan, 2013)

4. Levels of Disaster
• Level I – Local response
• Level II – Regional response
• Level III – Statewide or National response
(Sullivan, 2013)
Where does healthcare fit in?
“The healthcare system is now viewed as a foundation of national security
that must provide care anytime, anywhere, without fail and in an ever-
expanding role” (Cagliuso, 2014/2015, p. 160).

5. Popular Disasters
• September 11, 2001
• Indian Ocean Earthquake and Tsunami 2004
• Hurricane Katrina 2005
• Haiti Earthquake 2010
• Sandy Hook Elementary School 2012
• Ebola 2014

6. The Role of Nursing During Disaster
• Caring for the sick and injured
• Infection control
• Planning to prevent further damage
• Triage
• Mass immunizations
• Mass evacuations
• Treatment for mass casualties
( Baack & Alfred, 2013, p. 282)

7. Challenges for Nurses
• Lack of preparation
• Lack of education in school
• Lack of understanding disaster communication methods
• Lack of understanding the formal disaster plan
• Perception of what constitutes disaster preparedness
( Baack & Alfred, 2013, p. 282)
Disasters can affect nurses in all areas of care: Community Health
Centers, Schools, Hospitals, Nursing Homes, Home Care, Management
and Administration

8. Challenges to Institutions
• Lack of performance metrics
• Lack of funding
• Limited surge capacity
• Unclear federal guidelines and requirements for accreditation
• Lack of Coordination
(Cagliuso, 2014/2015, p. 156)

9. Ways to Prepare
• Develop and maintain a current disaster plan
(American College of Healthcare Executives,
2014).
• Focus the plan to address “likely” events (ACHE,
2014).
• Develop a command system (ACHE, 2014).
• Assess available resources (ACHE, 2014).
• Plan for operations (ACHE, 2014).
• Develop resource protocols (ACHE, 2014).
• Assess safety of employees, patients, and families
(ACHE, 2014).
• Enhance communication protocols (ACHE,
2014).
• Control and report disease (ACHE, 2014).
• Staff education and training (Sullivan, 2013).
• Practice EOP biannually (Sullivan, 2013).

10. Emergency Operations Plan Components
• Activation response
• Communication plan
• Patient care and coordination plan
• Security plan
• Traffic flow plan
• Data management strategy
• Resource availability
(Sullivan, 2013)

11. National Preparedness Goal
• Prevention.
• Protection.
• Mitigation.
• Response.
• Recovery.
(Federal Emergency Management Agency [FEMA], 2015, para. 7)

12. Factors Affecting Nurses
• Exhaustion and fatigue
• Personal safety concerns
• Illness
• Leaving families to care for others
• Professional accountability
• Grief counseling
(Sullivan, 2013)

13. Disaster Nursing Video

14. Additional Resources
• American Nurses Association Disaster Preparedness and Response: http://www.nursingworld.org/
MainMenuCategories/WorkplaceSafety/DPR
• Federal Emergency Management Agency, U.S. Government: http://www.fema.gov/ International Council
of Nurses Disaster Response Network: http://www.icn.ch/networks/disaster-response-network/
• International Nursing Coalition for Mass Casualty Education Educational Competencies for Registered
Nurses Responding to Mass Casualty Incidents: http://www.aacn.nche.edu/ leading-initiatives/education-
resources/INCMCECompetencies.pdf
• The Joint Commission: www.jointcommission.org/ standards
• National Center for Emergency Preparedness: http://www.ncep.vanderbilt.edu/index.html
• World Association for Disaster and Emergency Medicine Nursing Section:
http://www.wadem.org/nursing.html

15. References
• American College of Healthcare Executives. (2014). Healthcare executives’ role in emergency
preparedness. Healthcare Executive, 29(4), 90-91. Retrieved from http://www.ebscohost.com/
• Baack, S., & Alfred, D. (2013). Nurses’ preparedness and perceived competence in managing disasters.
Journal of Nursing Scholarship, 45(3), 281-287. http://dx.doi.org/10.1111/jnu.12029
• Cagliuso, N. (2014/2015). Stakeholders’ experiences with US hospital emergency preparedness: Part 1.
Journal of Business Continuity & Emergency Planning, 8(2), 156-168. Retrieved from
http://www.ebscohost.com/
• Federal Emergency Management Agency. (2015). National preparedness goal. Retrieved from
http://www.fema.gov/
• Feuerstein, C. (2012, November 6). Disaster nursing [Video file]. Retrieved from https://youtu.be/W-
S2BXTPKHs
• Sullivan, E. J. (2013). Effective leadership and management in nursing (8th ed.). Boston, MA: Pearson.