Emergency and Disaster Preparedness in Nurses: a Concept Analysis

Journal of Holistic Nursing and Midwifery. Spring2017;27(1) Pages: 35- 43 Published online 2017March Review Article Emergency and Disaster Preparedness in Nurses: A Concept Analysis Seyedeh Negar Pourvakhshoori1, Hamid Reza Khankeh2*, Farahnaz Mohammadi3 1Research Center in Emergency & Disaster Health, Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran 2Research Center in Emergency & Disaster Health, Professor, Department of Nursing, University of Social Welfare and Sciences, Tehran, Iran 3Social Determinants of Health Research Center (SDHRC), Assistant Professor, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran *Corresponding author: Research Center in Emergency & Disaster Health, Professor, Department of Nursing, University of Social Welfare and Sciences, Tehran, Iran E-mail: [email protected] Received: 2014August13; Accepted: 2015December02 Abstract Introduction: Given the growing rate of accidents and disasters in the world, preparing nurses as the main group responding to these events is crucial; however, a review of literature suggests no comprehensive and theoretical or practical definitions for this concept in nursing, which has been often misunderstood and used as an alternative to other similar concepts. Objective: The present study was conducted to analyze the concept and provide a practical definition for emergency and disaster preparedness in nurses. Materials and Methods: The eight-step Walker and Avant’s approach was used to clarify the concept of disaster preparedness in nurses. A total of 40 articles selected on the subject through an extensive review of literature up to 2013 were analyzed and the relevant definitions, applications, attributes, antecedents, consequences and empirical referents were extracted. Results: According to the analysis conducted, the concept attributes include gaining the disaster knowledge and management capability, response planning strategies, response behavior exercises and the evaluation of the knowledge level and the response program content. Improved knowledge and skills, professional accountability, more comprehensive programs and more accurate response behaviors were found to be the outcomes of disaster preparedness in nurses. Conclusion: According to the present study, disaster preparedness in nurses refers to the knowledge, skills, abilities and comprehensive functions required for responding to natural or man-made events and disasters. Nurses’ preparedness in disasters refers to a process in which nurses involve to properly prepare and effectively respond to emergencies and disasters. Given the wide range of the concept, further studies are recommended. Keywords: Disasters, Nurses, Qualitative Research Pourvakhshoori N et al. Emergency and Disaster Preparedness… Introduction model cases, borderline cases, related Given the growing number of incidents cases and contrary cases as well as and disasters, health service providers play defining empirical referents [18] and a key role before, during and after these ultimately presenting a practical definition events and their preparedness is crucial [1- for the concept of disaster preparedness in 3]. The professional preparedness of nurses. In order to obtain the articles and nurses is undoubtedly crucial [4] in resources relevant to the concept, an providing health services for the injured, extensive review was first conducted on as they are often considered to be in the databases including EBSCO, front line of healthcare provision [3-6, 7]. SCIENCEDIRECT, MEDLINE, CINAHL, Given the negative impacts of disasters on IRANDOC, SID, IRANMEDEX, OVID public health and welfare, providing and PROQUEST using keywords such as proper health services is the main factor emergency and disaster preparedness in contributing to the survival, reduced nurses, emergencies and disasters, mortality and well-being in people affected preparedness, prepared and emergencies. by the events [8]. The World Health All English and Persian articles published Organization emphasizes the activities that between 1980 and 2013 were searched and are essential for achieving preparedness included in the study. A total of 34 papers [9] as part of the process of sustainable were also obtained using Google search development in communities and the most engine. The papers found to be irrelevant effective method for responding to the to nurses’ preparedness were excluded. A emerging needs [10].Research suggests no total of 40 articles selected on the subject definition for nurses’ preparedness despite finally. All these articles were thoroughly the emphasis placed mainly on their reviewed and unanimously decided on problems and the nursing position upon the their relevance to the subject by all the emergence of disasters [11-17]. three members of the research team and The services and their effectiveness cannot the relevant papers were analyzed using be investigated as long as there is no the Walker and Avant method. A pre- definition for disaster preparedness in developed checklist was used to resolve nurses. The first step in this regard is to the possible conflicts among the team conduct a concept analysis, specify the members. The concept applications were attributes and present a practical definition. thus extracted and the defining attributes The present study was therefore conducted of the concept were determined. The to practically define and analyze the antecedents and consequences were then concept of disaster preparedness in nurses identified, the model, borderline, related using the systematic approach proposed by and contrary cases were constructed and Walker and Avant. empirical referents were ultimately specified. After conducting a literature Methods and Materials review and following the steps cited, a The present study was conducted to practical definition was proposed for the specify and define the attributes of concept of emergency and disaster emergency and disaster preparedness in preparedness in nurses. nurses using the eight-step Walker-Avant’s approach to concept analysis. These eight Results steps include selecting a concept, Applications of the emergency and disaster determining the purpose of analysis, concept identifying all uses of the concept, Walker and Avant argue that illustrating an determining all the defining attributes of overall perspective of the applications of the concept, identifying antecedents, the study concept causes a more enriched identifying consequences, constructing understanding of the concept and 36 J Holist Nurs Midwifery. 2017;27(1) Pourvakhshoori N et al. Emergency and Disaster Preparedness… validation of the defined attributes [19]. improves the knowledge and skills. In The so-called health preparedness for addition, there are different types of emergencies and disasters was found to be trainings and exercise programs [21]. used in literature as a foundation of A review of literature suggests the need for individual, local and national preparedness nurses to participate in disaster programs for enabling responses to mass preparedness training programs and casualties through hospital capacity practical exercises at least once a year, enhancement and for improving responses irrespective of their level of education, to terrorist attacks and other emergencies expertise and work place. These programs and disasters. This preparedness involves a should be multidisciplinary to enable the process of planning, training and skill nurses to cooperate with a variety of improvement through exercises and supply responding experts during emergencies of proper equipment [11, 20]. The only and disasters. Researchers identified that definition proposed in literature with an the lack of training programs as the most emphasis on the role of mayors was found common obstacle to gaining knowledge to be ‘A well-prepared political power for about responding to emergencies and structurally responding to potential threats disasters [22-24]. from the surroundings while minimizing Disaster and emergency preparedness is a the negative consequences of the incident continuous rather than a static process, in for people’s health and security as well as which nurses gain knowledge through for the integrity and function of physical training activities and response planning structures and systems”[20]. strategies. The response strategies and The literature review suggested no behaviors are practiced through emergency theoretical or practical definitions of the drills. The nurses’ knowledge and planning term emergency and disaster preparedness level is then evaluated and the based on developing its specific attributes. shortcomings in the process of knowledge The US Federal Emergency Management acquisition and planning are determined Agency defined preparedness as ‘being and addressed [11]. The present study aware of existing dangers and what to be emphasizes the process nature of the done in emergencies as well as pre- preparedness program and the need for emergency programs designed to save gaining knowledge and presenting better people’ life and help with the response and skills and responses. rescue operation’ [15]. Preparedness is therefore defined as readiness for The concept attributes immediate responses. With the need for involvement in the A review and investigation of the process of emergency and disaster applications of nurses’ preparedness in preparedness divided into two parts, the emergencies and disasters suggests some actual level of nurses’ involvement ranges attributes

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