disaster

1. Emergency and Disaster
Nursing in Hospital
Ronny Basirun Simatupang, S.Kep.Ns., M.Si (Han)
International Nursing Webinar
DPK Pendidikan
Sunday, 9 April 2023

2. LCDR Ronny Basirun Simatupang, RN., M.Sc (Def)
Rank : Liutenant Commander
Position : Relation Department Officer Surgeon General Armed Forces
Date of Birth : Porsea, 3 December 1983
Address : Cluster Taman Asri Blok F/5 Jatiranggon Bekasi City
Religion : Christian
Education : Bachelor of Nursing – North Sumatera University 2005
Law School UNSURYA (2020 – Now)
Disaster Management Master Degree – RIDU 2017
Military Ed : Basic officer Military Training, Health Specialized Mil Training
TOD/TOA : Navy Hospital DR. Gandhi AT Biak - Papua
Marine Hospital Cilandak Jakarta
Organization : EDNA, IDEA (Indonesian Disaster Expert Association)

3. Outline
Emergency Vs Disaster
Disaster Management
Disaster Nursing Competencies
Disaster Nursing in Hospital
Challenges for Nurses
Conclusion

4. Emergency vs Disaster ???

5. Emergency
Any extraordinary event or
situation that requires an
intense, rapid response that
can be addressed with
existing community resources
Disaster
An Event or situation that is of greater
magnitude than an emergency; disrupts
essential services such as housing,
transportation, communication,
sanitation, water, health care, and that
requires the response of people outside
the community affected
(Kristine M. Gebbie, 2002)

6. Disaster Management
Mitigation
Preparednes
s
Response
Recovery

7. Paradigm Shifts in Disaster Management
Response Risk Reduction
Interprofessional Multisectoral

8. Challenges for Nurses in Disaster
Management
1. Lack of disaster nursing training
2. Less training for nurses’ knowledge and skills in
leadership (coordinating) and psychological problems
(mostly physical problems)
3. Available training was often designed for improving
nurses’ knowledge and skills in the response phase

9. Disaster Nursing Care Plan Model
Assessment
Diagnosis
Intervention
Implementatio
n
Evaluation
Documentatio
n
Community
Family
Individual
Preparedness
Response
Recovery
Mitigation
Illustrated by Arcellia Farosyah Putri 2021
arcel_farosy@yahoo.com
Sourcer:
ICN Framework Disaster Nursing 2019 &
Fundamental of nursing

10. What do nurses do?
PEOPLE
Behaviour
Knowledg
e
Beliefs
Skills

11. Disaster Nursing Competencies

13. Competency Domains
(ICN, 2019)

14. Disaster Nursing Competencies
(ICN, 2019)
Level 1 Any nurse who completed basic programme, general
education and authorised to practice
Level 2 Any nurse who has achieved the level 1 competencies
and designated disaster responder within an
institution, organisation or system
Level 3 Any nurse who has achieved level I and II
competencies and prepared to respond to a wide
range of disasters and emergencies and to serve on a
deployable team

15. (ICN, 2019)

16. (ICN, 2019)

17. (ICN, 2019)

18. DISASTER NURSING IN HOSPITAL
Mitigation
Preparedness
Response
Recovery

19. Mitigation
Risk assessment: Hazard
Vurnerability Assesment
Advocating all Staff and Patients
in Hospital
Hospital Disaster Plan
(Bullock et al., 2012)

21. HAZARD MAPS

22. PEMETAAN KEPADATAN MASYARAKAT DI RS
(POPULATION DENSITY)
OFFICE
200 People
Emergency Unit
500 People
POLICLINIC
1000 People
IN PATIENT ROOM
300 People

23. PEMETAAN PERALATAN KESELAMATAN
(Fire Safety Equipment)

24. EVACUATION ROUTE

25. RESCUE MEANS
 Emergency Stairs
 “EXIT WAY”
 Assembly Point
 Emergency Exit
 Do not Use Elevators

26. Preparedness
(Bullock et al., 2012)
Training
Simulation

27. Delivering Direct Care
 Wound care
 Bandaging and splinting
 Control bleeding
 IV insertion and fluid resuscitation
 Airway – breathing management
 Basic Life Support
 Disaster triage
 Evacuation, Stabilization and Transportation
Response

28. Response
 Activate Incident Command System
 Communication System
 Human Resources
 Logistics
 Essential Support Service
 Surge Capacity
 Infection and Prevention Control
(WHO, 2009)

29. (FEMA, 2016)

30. CILANDAK MARINE HOSPITAL
DISASTER MANAGEMENT TEAM

31. Human Resources
“Adapted human resource management is
required to ensure adequate staff capacity
and continuity of operations in response to
an increased demand for human resources”
 Human Resources Policy
 Minimum Essential Health Workers
 Recruitment and Training
 Nursing Staff Rotation
 Routine Medical Check Up for Staff
 Family services as long as disaster
Response
 Multisector collaboration and Coordination
 Assurance for Health Workers

32. Logistics & Suplay Chain Management
“The continuity of hospital services and
the availability of essential equipment and
supplies, including pharmaceuticals,
require a proactive approach to resource
 Logistics comprises such activities as procurement,
transport, warehousing and stock monitoring,
tracking and reporting.
 Coordination of logistics between the various
hospital departments and units is a core function of
the hospital’s Incident Command Group.
 Providing support for patient transport is an
essential logistic function for the transfer of
patients between hospitals, especially referral
hospitals.
 Ensuring the availability of back-up resources and
providing support for the maintenance of essential
equipment are important logistic functions.
 Logistics management can be facilitated by
procuring standard equipment and adopting
standard procedures.

33. Essential Support Services
To optimize patient care, it is
necessary to identify and maintain
essential support services (e.g.,
laundry, cleaning, waste
management, dietary services and
security).
 Food and nutritional Services
 Security
 Engineering and maintenance
 Laundry, cleaning, waste management
 Cleaning
 Mortuary services

34. Surge Capacity
“Surge capacity is the ability of a health
service to expand beyond its normal capacity
to meet this increased demand”.
 Total Number of Nurses
 Plan the action when the patients arise
 Standard of Procedure
 Triage Patients
 Posting Patients based on level of severity
 Recruit Health Worker Volunteer if needed

35. “An operational IPC policy is essential to
minimize the risk of transmission of
nosocomial infection to patients,
hospital staff, and visitors”
Infection and Prevention Control (IPC)
Adapt the infection prevention and control
component of the Hospital Emergency Response
Plan
Assess infection prevention and control staffing
needs for the emergency
Make sure that the hospital’s infection prevention
and control policies are consistent with the
presumed mode of transmission of the epidemic
infection and with locally available resources.
Reinforce standard infection control precautions
and establish additional precautions if required by
the specific nature of the epidemic.
 Establish patient flow based on transmission
risks and on patients' clinical status

36. Activities
 Preventing outbreaks
 Maintaining sanitation and clean environment
 Psychological first aid
 RE- Evaluation Hospital Disaster Plan
Recovery

37. Challenges for Nurses
Nurse’s Roles
Nurse’s Competencies

38. Next Challenges …………..

39. Conclusions
1. Good Preparedness will be a key of good Response
2. Nurses need to have knowledge and skills needed to
carried out their roles in disaster management in
Hospital
3. Continues professional development for disaster
nurses needs to be established
4. Urgently needs comprehensive disaster nursing
training that addressing each level of disaster nurse’s
competency

40. Disaster Nurses
https://www.sheffield.ac.uk/rs/ecr/training/cpd

41. References
1. Bullock, J. A., Haddow, G. D., & Coppola, D. P. (2013). Mitigation, Prevention, and
Preparedness. Introduction to Homeland Security, 435–494.
https://doi.org/10.1016/B978-0-12-415802-3.00010-5
2. Efendi, F., Indarwati, R., Aurizki, G. E., Susanti, I. A., & Maulana, A. E. F. (2021).
Policymakers’ perspectives on responding to the elderly’s mental health needs in
post-disaster situations. Journal of Public Health Research, 11(1).
https://doi.org/10.4081/jphr.2021.2386
3. UNDRR https://www.preventionweb.net/
4. ICN. (2019) Core competencies in disaster nursing version 2.0.
https://www.icn.ch/sites/default/files/inline-files/ICN_Disaster-Comp-Report_WEB.pdf
5. Infection prevention and control of epidemic-and pandemic prone acute respiratory
infections in health care - WHO guidelines. World Health Organization, 2014.

42. THANK YOU