The document discusses the role of nurses in disaster management. It begins with defining disasters and categorizing them into natural and man-made disasters. It then outlines the disaster cycle, which includes mitigation, preparedness, response and recovery. The nursing process, which involves assessment, nursing diagnosis, outcome identification, planning, implementation and evaluation, can guide the role of nurses across the different phases of the disaster cycle. Specifically, nurses are involved in planning, training, response and providing care during disasters.

1. THEME: MULTIDICIPLINARY APPROACH TO DISASTER MANAGEMENT
NATIONAL ORTHOPAEDIC HOSPITAL
IGBOBI LAGOS
3RD ANNUAL SCIENTIFIC
CONFERENCE

2. ROLE OF
NURSES IN
DISASTER
MANAGEMENT
BY MRS. BERNADINE OKORO

3. PRESENTATION OUTLINE
1. Introduction
2. What is Disaster
3. Types
4. Scope/Intensity
5. Differences between Major / Minor distater
6. Cycle of Disaster
7. Roles of Nurses in Each Cycle Using The Nursing Process
8. What is Nursing Process
9. Clinical Aspect Triage
10. sumary
11. Conclusion

4. ● The word “désastre” derives from French and from Old Italian “disastro,”
which, in turn, comes from the Greek pejorative
pre x dus =“bad” +aster =“star.”
● The root of the word disaster (“bad star” in Greek) comes from an astrological
theme in which the ancients used to refer to the destruction of a star as a
disaster. The ancient people believed that disaster is occurs due to the
unfavorable position of the “planets” or “Act of God”
INTRODUCTION

5. ● Disaster occurrence is a global phenomenon. It can occur anywhere and at
any time. Disaster occurrence in any country
affects its health and economic conditions. The impact of disasters is usually
more pronounced in developing nations due to a lack of funding for disaster
preparedness and functional disaster plan
● Further more deforestation, misuse of land we have every
reason to believe that frequency of disasters such as floods, droughts will be
on the increase in the coming decades.
INTRODUCTION CONT.

6. INTRODUCTION CONT.
For effective disaster management:
1. The availability of qualified individuals who are ready to respond and participate in
preparedness and disaster recovery activities is very crucial.
2. The role of nurses in disaster preparedness, response and recovery cannot be
over emphasized
In the words of World Health Organization’s assistant director general on health
action in crisis,

7. —WHO (2008)
““Nurses are often the first medical
responders onsite after disaster strikes. In
these situations, where resources are scarce,
nurses are called upon to take roles as first
responders, direct care provider, on-site
coordinator of care, information provider,
educator, mental health counselor and triage
officers”

8. WHAT IS
DISASTER?
02

9. Disaster has been defined in different ways, though there
is no universally acceptable definition.
Disaster means a catastrophe, calamity or mishap, a grave
occurrence which causes loss of life, human suffering,
damage to and destruction of property degradation of
environment and
disrupts the normal functioning of societies,
government and communities; which adversely
affects individual and families with severity and
it is beyond the coping capacity of the
community of the affected area.
What is Disaster?

10. According to WHO, disaster is any
occurrence that causes damage, economic
disruption, loss of human life and
deterioration in health.
The health services on a scale sufficient to
warrant an extra ordinary response from
outside to the affected community or area.
Meaning Of Disaster (2)

11. TYPES OF DISASTER
NATURAL
DISASTER
MAN MADE
DISASTER
S
Cannot be prevented, but
measures can be taken to eliminate
or reduce the possibility of trouble
Technological disasters

12. • Cyclones
• Tornadoes and hurricanes
• Hail Cloud burst
• Heat wave and cold wave
• Snow and volcanoes
• Drought
• Thunder and lightning
• Floods
• Earthquakes
NATURAL DISASTERS
Natural disasters cannot be prevented, but measures can be taken to eliminate or
reduce the possibility of the trouble. Examples are:
Floods in China in 2015

13. • Geological related disasters
• Biological related disasters
• Water and climate related disasters
• Chemical, industrial and nuclear
disasters
• Accident related disasters
.
CLASSIFICATION OF DISASTER

14. • Earthquakes
• Landslides and Mudflow
• Mine Fires
• Pest Attacks
GEOLOGICAL RELATED DISASTERS

15. • Epidemics
• Pest Attacks
• Cattle Epidemics
• Food Poisoning
BIOLOGICAL RELATED DISASTERS

16. • CHEMICAL SPILL
• NUCLEAR DISASTERS
• INDUSTRIAL DISASTERS
CHEMICAL, INDUSTRIAL & NUCLEAR RELATED
DISASTERS
A RIVER IN NIGER DELTA CONTAMINATED BY OIL

17. • Forest fire
• Urban fire
• Mine flooding
• Oil spill And pipeline vandalization
• Major building collapse
• Village fire
• Serial bomb blasts
• Festival related disasters
• Electrical disasters and fires
• Air, road and rail accidents
• Boat capsizing
ACCIDENT RELATED DISASTERS
MILITARY PLANE CRASH
IN NIGERIA MAY 2021

18. • Population explosion
• Wars and conflicts/ Communal Clash
• Stampede
• Deforestation
• Wide spread pollution to environment
• Wide spread use of fossil fuel
• Accident: Road, sea wreck
• Chemical explosion
• Domestic accident
• Collapsed building
• constructional failure)
• Fire outbreak (wild fire)
• Terrorism
MAN MADE DISASTERS

19. • Radiation exposure
• Civil disturbance and riot
• Conventional wars
MAN MADE DISASTERS
Riot in Honduras

20. ● Floods
● Destructive Storms
● Drought
● Desertification
● Catastrophic gully and coastal erosion
● Disease epidemic
● Insurgency
● Fire disasters
● Building collapse
● Explosions. ETC
● End sars protest
DISASTER TYPES IN NIGERIA

21. 21 STORY BUILDING COLLAPSE IN IKOYI
Source: Guardian

22. ● Loss of life and disposal of dead
bodies
● Outbreaks of communicable
diseases (water-borne)
● Vector-borne diseases
● Problems of malnutirtion
● Problems of psychological trauma
● Problem of orphans and shelther
HEALTH EFFECTS OF DISASTER
REFUGEE CAMP FOR DISPLACED

23. Disaster can be classified according to:
● Number of patients involved
● Place of occurence.
CLASSIFICATION OF DISASTER

24. ● Multiple patients disaster: results in less than 10 casualties at a time.
● Multiple casualty disaster: Casualty that result in 100 of patient or less;
occurs in the air, rain, flood, tornados.
● Mass casualty disaster: results over a hundred casualty ; earthquake,
structural collapse, fire incident
CLASSIFICATION OF DISASTER: NUMBER OF
PATIENTS INVOLVED

25. Internal disaster: within the hospital emergency department, can result
from terrorist activity, chemical spill, radiation etc.
External disaster: This occurs outside the hospital or outside the ED but
may impair Normal ED operation.
CLASSIFICATION OF DISASTER: ACCORDING
TO PLACE OF OCCURENCE

26. IMPACT OF MINOR & MAJOR DISASTERS
MINOR DISASTER MAJOR DISASTER
Resources sufficient Not Sufficient
Personnel May not be overstreched Always overstreched
External aids Not required Required
Number of victims Small number of victims Large number of victims
Level of Destruction
Minimal number of
destruction to life and
properties 10 to 25
Mass destruction of
properties >100

27. IMPACT OF MINOR & MAJOR DISASTERS
MINOR DISASTER MAJOR DISASTER
Duration
Short period and of temporary effect Long term and Permanent
effect
Death
There may be few about 25 people.
or no loss of life
About 50% may require
hospitalization.
There is usually loss of life at
least 1000, of which 250 will
require hospitalization.

28. SCOPE & INTENSITY OF DISASTER
• This expiains the extent or measure of the breadth of damage caused by a disaster. It
describes how extensively the larger community is impacted, including the rescue and support
infrastructure, which in turn predicts how much help is available and how quickly recovery can
proceed.
• In an event with a large scope, survivors may be unable to turn to their normal support systems
of friends, family, and neighbours as they would after a smaller scale traumatic event, since
those people may be dealing with their own recovery needs. Very large scope events, like
Hurricanes Katrina and Sandy, or the 2010 earthquakes in Haiti and Chile, may leave survivors
without a shelter, work, go to school, or place of worship.
• Many may be forced to relocate in order to find housing, work, and schools, which will add to
the emotional stress of resettling and losing one’s community on top of the direct disaster
losses.
SCOPE

29. SCOPE & INTENSITY OF DISASTER
• As a result, people who experienced
multiple losses are at the highest risk
of a difficult bereavement process and
readjustment and should be a focus of
early mental health
INTENSITY

30. DIAGRAM OF DISASTER CYCLE

31. Mitigation: Disaster mitigation work involves
directly preventing future emergencies and
minimizing their negative effects. It requires
hazard risk analysis and the application of
strategies to reduce the likelihood that hazards
will become disasters, such as flood-proofing
homes or buying insurance.
DISASTER MITIGATION

32. Disaster mitigation measures are specifically
designed to reduce or minimize the impact of
disasters whenever they occur. The measures
are often, but not always, in the form of laws
and regulations.
Such as:
DISASTER MITIGATION CONT.

33. Such as:
● Building codes;
● Development control measures;
● Safety regulations relating to high rise building and the
handling of explosives and other hazardous
substances;
● Safety codes for land, water and air transportation;
● Irrigation projects to counter drought and
● The establishment of shelterbelts to mitigate the
effects of drought and desertification.
Mitigation activities take place before and after
emergencies
DISASTER MITIGATION CONT.

34. Disaster preparedness efforts include plans or
preparations made in advance of an emergency
that help individuals and communities get ready.
Such preparations might include the stocking of
food and water or the gathering and screening of
willing volunteers, ready to mobilize post-disaster.
DISASTER PREPARDNESS

35. Disaster response work includes any actions taken
during or immediately following an emergency, including
efforts to save lives and to prevent further property
damage. Ideally, disaster response involves putting
already established disaster preparedness plans into
action.
Typically, this phase of the disaster life cycle draws the
most attention. It is also known as “disaster relief.”
DISASTER RESPONSE

36. Disaster recovery happens after damages have been assessed
and involves actions to return the affected community to its
pre-disaster state or better – and ideally, to make it less
vulnerable to future risk.
Risk identification includes understanding the nature of hazards
and understanding the nature of vulnerabilities.
Subsequent efforts may range from physical upgrades to
education, training and public awareness campaigns. Most
people give financially immediately after a crisis, in response to
clear emotional appeals. Yet donors who allocate funds
across the disaster life cycle have an opportunity to help
ensure that each money given reaches its full potential.
Investing in mitigation saves money.
DISASTER RECOVERY

37. ● Injury
● Damage of Property
● Damage of Cash
● Loss of Life
● Lost of lively hood
● Disruption of lifestyle
● Disruption of essential
services
● Loss/disruption of
infrastructure
● State economic loss
● Socilogical/psychological
after effects
GENERAL EFFECTS OF DISASTER
DESTRUCTION IN UKRAINE

38. THE ROLE OF
NURSES
The role of nurses in different
cycles of Disaster
07:

39. During a disaster, nurses can contribute from the
beginning to the last minute, preparation and
planning. "The role of a disaster nurse begins long
before catastrophic events even occur. Nurses
must first align with disaster planning agencies, for
example, the Red Cross, fire services ,emergency
medical services ,rescuer team etc.
In Developed Countries, this allows the agencies
to assess nurses' skills and interests and assign
them to response teams accordingly.
ROLE OF NURSES IN DISASTER CYCLES

40. The nursing process is defined as a
systematic, rational method of planning
that guides all nursing actions in
delivering holistic and patient-focused
care. The nursing process is a form of
scientific reasoning and requires the nurse's
critical thinking to provide the best care
possible to the client. Using the six stages.
ANOPIE
THE NURSING PROCESS

41. STAGES OF NURSING PROCESS
ANOPIE
 Assesment
 Nursing Diagnoses
 Outcome of Identification
 Planning
 Implementation
 Evaluation

42. ASSESMENT:
Assess the areas likely to experience
disaster. Nurses should be part of decision
makers. Government should set aside funds.
Nurses should be part of disaster planning
committee. Training school set aside for
training of experts
ASSESMENT STAGE | ROLE OF NURSING
MITIGATION STAGE

43. NURSING DIAGNOSIS:
This is the clinical judgement about
individuals family or community responses
to actual or potential health problems/, life
processes. it can be subjective or objective’
NURSING DIAGNOSIS | ROLE OF NURSING
MITIGATION STAGE

44. OUTCOME INDETIFICATION
Here you itemize your findings both
objectives and subjective data according to
their hazard level.
OUTCOME INDENTIFICATION | ROLE OF NURSING
MITIGATION STAGE

45. PLANNING
Creating schools to train experts in Rescuing
of victims, Training fire fighters ,red cross
Training of students on BLS, CPR use of
AED.
PLANNING | ROLE OF NURSING MITIGATION
STAGE

46. IMPLEMENTATION
Enacting laws that would help to prevent the
disaster from occurring
Liase with Ngos. Collaborate with other
countries who had experience similar
mishap Create awareness
Training drills ,
EVALUATION
IMPLEMENTATION | ROLE OF NURSING
MITIGATION STAGE

47. 1. ASSESMENT
○ Detecting early warning signs,
■ Emergency communication system,
■ How strong is our awareness,
■ How many Trained responders
○ Survellance
■ Areas of likely hazard
■ Our boarders how porous
2. NURSING DIAGNOSIS
3. OUTCOME OF IDENTIFICATION
ROLE OF NURSES DURING PREPAREDNESS PHASE

48. 5. PLANNING
○ formation of contingency disaster plans,
■ Stocking of relief materials
■ Training of personels
■ PLANNINGBuilding more health falcilities
■ Meet NGOS/AIDS
■ STOCKING OF FUNDS
■ Communication
■
6. EVALUATION
ROLE OF NURSES DURING PREPAREDNESS PHASE

49. 1. ASSESMENT
○ Asses for safety of the area, your self, other rescurers and the victim.
○ Know the types of the injury
○ AT THE SCENE
○ The Scope and The Intensity
2. NURSING DIAGNOSIS
○ The number of casualty
○ What types of injuries
○ Who are the vulnerable
○ Get your objective and subjective data
ROLE OF NURSES DURING RESPONSE PHASE
This is the phase immediately the mishap has occurred the nurses role start
from the scene of disaster to the hospital

50. 3. OUTCOME OF IDENTIFICATION
○ Prioritize your data using Triage
4. PLANNING
○ Identify the team to work with police’, FRSC,
○ call medical emergency rescue team
○ Call various facility to get ready, call ambulance service
○ Be prepared to resuscitate
5. IMPLEMENTATION
○ Triage using your emergency serverity index red, yellow, green, blue,
white and black.
○ Rescue and extract victims,protect the vulnerable once
6, Resuscitate, give first aid ,send to right falcility on ambulance
EVALUATION: Evaluate situation time to time
ROLE OF NURSES DURING RESPONSE PHASE

51. HOSPITAL SCENARIO
THE ROLE OF NURSE IN
RESPONSE PHASE

52. SCENARIO: You are in the hospital a call came that there is a collapsed school
building
This requires a multidisciplinary approach.
ASSESMENT:
- Asses your unit for equipments; resusitative measures, space, manpower.
Know your strength and weaknesses
NURSING DIAGNOSIS
Make your diagnosis based on your subjective information. Get your own
objective data. As patient arrives, triage using the colour code.
ROLE OF NURSES IN RESPONSE PHASE: HOSPITAL
SCENARIO

53. ROLE OF NURSES DURING RESPONSE PHASECONTD
OUTCOME OF IDENTIFICATION
Priotize your diagnosis as you triage the patient
or as you triage individual
PLANNING’
Inform your unit head, hod, pharmacy, radiology,lab wards and create space in the ward get your resuscitative
aquipment ready test them .get emergency drugs ready.
IMPLEMENTATION
Reception wheel patient in
Rapid assessment
Triaging
Resuscitation/stabilization
Communication/documentation
Psychology support
Control of grief
Care of valuables
Disposition .

54. ● Red (Immediate)
● Yellow (Delayed)
● Green (Walking Wounded)
● White (Minor)
● Black (Deceased Expectant)
TRIAGE LABEL (CONVENTIONAL) EMERGENCY 1: 1ST
PRIORITY URGENT
URGENT 2nd Priority:
Few minutes less
than 30 minutes
NON URGENT: Can
be delayed for 1 - 2
hours
HOPELESS:
Deceased/expectant
MINOR

55. TRIAGE LABEL[CONVETIONAL]
Red (Immediate): life threatening emergency, those who cannot survive without immediate
treatment but who have a chance of survival e.g. severe hemorrhage, cardiac arrest, severe
shock, it can wait for about 30minutes. These victims will still need hospital care and would be
treated immediately under normal circumstances
Yellow (Delayed): Their condition is stable for the moment and, they are not in immediate danger
of death; it’s a serious injury but can deteriorate I if not treated.
Green (Walking wounded): non-urgent. Those who will need medical care at some point, after
more critical injuries have been treated.
White (Minor): those with minor injuries for whom a doctor's care is not required can be seen by
health care provider, known as cold cases.
Black (Desceased/Expectant): used for the deceased and for those whose injuries are so
extensive that they will not be able to survive given the care that is available.

56. ● Age of patient
● Skill and resources available at the centre
● Severity of injury
● Distance between site and skill facility
● possibility of survival
CONSIDERATION FOR TRIAGE

57.  To make best possible use of available resources ( human and
material)
 It ensures that patients who need immediate care receive it
 It ensures that patients with high survival rate are first attended to
 It ensures making proper patient assessment and closely observing
unstable patients.
PURPOSE of triage

58. ● Reliable five-leveled ED triage system used to enhance patient safety
when resources are limited. It was first developed in 1999
● Based on acuity of patient’s health care problems and the number of
resources (type of complex interventions or diagnostic tools) their care is
anticipated to require. Such resources include:
● Suturing, cardiac compression. Intravenous therapy, medications, blood
tests etc
EMMERGENCY SEVERITY INDEX[ ESI LEVELS]

59. ESI LEVELS EMMERGENCY SEVERITY INDEX

60. The aim at this phase is to restore the
affected areas/person to previous state. This
includes
● Rebuilding destroyed property
● Re-employement’
● Rehabilitation of vulnerables
● Assesment Phase
● Nursing Diagnosis
● Outcome of Identification
● Planning
● Implimentation
● Evaluation
ROLE OF NURSES IN RECOVERY PHASE

61. CHALLENGES OF DISASTER
1. Lack of effective coordination
2. Inadequate training.
3. Lack of equipment
4. Lack of relief materials
5. Absence of adequate early warning systems
6. Bad government
7. Convetiousness
8. Ignorance
9. Poverty

62. SUMMARY
Disaster occurs almost everyday, somewhere all over the world
It is usually with dramatic and devastating impacts on individuals, families and
community, Usually the quality of life is threatened ’Availability of qualified
individuals who are ready to respond and participate in preparedness and recovery
disaster activities is very crucial ’as the largest group of health care providers
nurses need to develop competencies in performing these vital roles Nurses who
possess adequate knowledge and skills have contributed positively in the time past
’NO wonder throughout history Nurses have been called upon to respond to the
needs of individuals, groups and communities in times of crises because of their
care given skill’

63. ● We cannot always prevent disaster. With careful planning however, the effects of
Organizations, communities and societies disaster can be minimized. The rate of
occurrence of man-made disasters and level of fatalities in our country remains
unacceptably high. All hands must be on deck to have an effective disaster management
plan
● The role of Nurses during disaster management cannot be over emphasized. They
determine the magnitude of the event, define and understand the health needs of the
affected groups, prepare the priorities and objectives, and estimate resources needed to
respond to the needs identified.
● Therefore, nurses should be involved in all stages concerning disaster management’
CONCLUSION

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65. REFERENCES ● First Aid Pre-Course Workbook (2014)
Queensland Ambulance Service –
Community Education Unit – Edition
2.0
● ICN &WHO (2009) ICN framework for
disaster nursing competencies.
● Livescience.
https://www.livescience.com/63223-
carrre photos.html.O
● Onwochei D.A.(2016). Lecture notes
on disaster preparedness and
management (Unpublished)

66. REFERENCES
● Oseni M O DISASTER
NURSING/DISASTER NURSING
COMPETENCIES
● Return to Disaster Management Hari
Srinivas - hsrinivas@gdrc.org
● The Disaster Handbook (1998)
National Edition. Institute of Food and
Agricultural Sciences. University of
Florida
● WHO.
http://www.who.int/hac/techguidance/
ems/natproles/en.