Exploring Medical and Public Health Preparedness for a Nuclear Incident Proceedings of a Workshop (2019) / Chapter Skim
Currently Skimming:
8 Capability-Building Challenges and Opportunities: Ensuring Workforce Readiness and Response Capacity
8 Capability-Building Challenges and Opportunities: Ensuring Workforce Readiness and Response Capacity
Pages 121-138
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 121... ...
• The National Disaster Medical System is a partnership among the U.S. Department of Defense, the U.S.
|
From page 122... ...
. HEALTH WORKERS' WILLINGNESS TO RESPOND TO NUCLEAR EVENTS Daniel Barnett, associate professor, environmental health and engineer ing, Johns Hopkins Bloomberg School of Public Health, described what he called the "ready, willing, and able" framework.
|
From page 123... ...
The training inter ention, which was intended to address the attitudinal and behavioral v gaps in willingness to respond, attempted to boost public health workers' sense of self-efficacy, which Barnett described as "confidence that one can perform one's role." In the model used, efficacy was given more weight than threat, so even in jurisdictions where the perceived threat of a dirty bomb scenario was low, improvement in self-efficacy increased willingness to respond. Barnett described PHIT as a "train the trainer" curriculum and said it involves several learning approaches: tabletop exercises, roleplaying exercises, debrief sessions, facilitated discussions, and recaps of prior events, among others.
|
From page 124... ...
A PENNSYLVANIA HEALTH CARE SYSTEM PERSPECTIVE Michael Consuelos, senior vice president, clinical integration, The H ospital + Healthsystem Association of Pennsylvania (HAP) , explained that nuclear preparedness in Pennsylvania largely ties back to the 1979 inci dent at Three Mile Island,1 during which a nuclear reactor partially melted down.
|
From page 125... ...
Further more, Consuelos highlighted nonacute care settings -- including ambulatory centers, nursing homes, and rehabilitation facilities -- as potential sites for screening, basic medical treatment, and decontamination during a nuclear event to lessen the burden on hospitals. Referring back to the Regional Disaster Health Response System, Consuelos said that HAP strongly sup ports ASPR's plan to build the system and is actively seeking out ways to incorporate telemedicine as a way to conduct just-in-time training connect ing regional centers to rural hospitals across the state.
|
From page 126... ...
126 Licensed 50 46.0 Staffed 44.6 45 43.4 42.2 40.8 39.6 39.4 38.9 40 38.3 37.9 37.6 37.6 37.6 37.3 37.5 37.2 37.2 36.4 36.1 35 36.9 36.6 35.3 35.1 35.0 34.9 35.5 35.0 35.0 35.0 35.2 35.1 35.4 34.9 34.8 34.1 33.7 33.3 30 25 20 15 10 Beds (thousands) 5 0 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 FIGURE 8-2 Number of licensed and staffed hospital beds in Pennsylvania, 2001–2017.
|
From page 127... ...
The five Response Deploy ent Teams are situated across the HHS regions and m provide mass care at federal medical shelters. Regional incident support teams are another HHS resource, with one team located in each region.
|
From page 128... ...
NDMS includes 72 total teams; among them are 50 disaster medical assistance teams, 10 disaster mortuary response teams, 1 victim identification center team, 1 national veterinary response team, and 1 trauma critical team (formerly known as the International Medical Surgi cal Response Team)
|
From page 129... ...
PROVIDER KNOWLEDGE OF DISASTER PREPAREDNESS Roberta Lavin, executive dean and professor, College of Nursing, Uni versity of Tennessee, described a study that assessed clinicians' knowledge about disaster preparedness. The multipronged study approach attempted to match core competencies in disaster preparedness -- the investigators chose to use competencies outlined by the National Center for Disaster Medicine and Public Health (NCDMPH)
|
From page 130... ...
Employ protective behaviors according to 3.88 4.44 3.84 3.32 changing conditions, personal limitations, and threats (10) Report unresolved threats to physical and mental 3.48 4.37 3.9 3 health through the chain of command (11)
|
From page 131... ...
Employ protective behaviors according to 2.75 3.5 5.5 1.25 changing conditions, personal limitations, and threats (10) Report unresolved threats to physical and mental 2.75 3.51 5 1.5 health through the chain of command (11)
|
From page 132... ...
thoroughly 2.0 Demonstrate knowledge of one's Covered expected role(s) in organizational and 19 8 9 3 25 31 75 25 moderately to community response plans activated during thoroughly a disaster or PHE 3.0 Demonstrate situational awareness Covered of actual/potential health hazards before, 39 9 14 3 63 32 75 0 moderately to during, and after a disaster or PHE thoroughly Covered 4.0 Communicate effectively with others in 18 6 9 3 38 31 75 25 moderately to a disaster or PHE thoroughly 5.0 Demonstrate knowledge of personal safety measures that can be implemented in 3.88 4.44 3.84 3.32 2.75 3.5 5.5 1.25 Confidence a disaster or PHE 6.0 Demonstrate knowledge of surge capacity assets, consistent with one's role 3.22 4.56 3.87 3.32 2.63 3.63 5.75 2 Confidence in organization, agency, and/or community response plans 7.0 Demonstrate knowledge of principles and practices for the clinical management of Covered all ages and conditions affected by disasters 27 8 17 8 62 25 75 0 moderately to and PHEs, in accordance with professional thoroughly scope of practice 8.0 Demonstrate knowledge of public health Covered principles and practices for the management 30 10 14 3 63 31 75 0 moderately to of all ages and populations affected by thoroughly disasters and PHEs
|
From page 133... ...
n.d. of all ages, populations, and communities affected by a disaster or PHE 10.0 Demonstrate knowledge of legal Covered principles to protect the health and safety 17 9 21 3 63 35 75 0 moderately to of all ages, populations, and communities thoroughly affected by a disaster or PHE 11.0 Demonstrate knowledge of short- and Covered long-term considerations for recovery of all 12 7 13 3 25 23 75 0 moderately to ages, populations, and communities affected thoroughly by a disaster or PHE NOTE: DNP = Doctor of Nursing Practice; D.O.
|
From page 134... ...
National Nurse Readiness for Radiation Emergencies and Nuclear Events: A Systematic Review of the Literature Veenema's first study, a systematic review, was based on the belief that the nursing workforce is a critical component of a potential public health response to a large-scale radiation or nuclear event, but there is uncertainty about nurses' willingness or readiness to respond to such events (Veenema et al., 2019a)
|
From page 135... ...
are able and willing to serve in these roles," she said. National Assessment of Nursing Schools' and Nurse Educators' Readiness for Radiation Emergencies and Nuclear Events The second study Veenema presented used an online radiation nuclear survey, a questionnaire adapted from previous work by Veenema, Lavin, and Couig, updated after additional input from subject matter experts in radiation and nuclear emergency preparedness (Veenema et al., 2019b)
|
From page 136... ...
Among the data points plotted on the maps, Veenema listed the following: • The 99 active nuclear reactors licensed to operate in the United States; these include 60 total locations, with 23 one-reactor sites and 37 sites with two or more reactors • The top five research facilities based on their power levels: the Massachusetts Institute of Technology; the National Institute of Standards and Technology; the University of New Mexico; the University of California, Irvine; and the Atomic Energy Commis sion, Rhode Island • The 80 high-level nuclear waste sites (many overlap with existing nuclear reactors) • 50-mile emergency planning zones around nuclear sites, which is the typical distance used for radiation disaster plans • Schools of nursing, including schools affiliated with respondents • Geographic fault lines and affiliated slip rates • Federal Emergency Management Agency (FEMA)
|
From page 137... ...
She said that were a nuclear incident to unfold, there is concern among nursing leadership across the country that federal response planning is built on assumptions about the capabilities of the workforce that may not be accurate. Veenema explained that this study will systematically cross-check all relevant federal planning documents related to radiation and nuclear response needs to identify which capabilities and objects are nurse dependent and the roles and responsibilities delegated to and expected from nurses and present an analysis of the results.
|
From page 138... ...
What are gaps in readiness, and how do we address the root causes at a national level? Barnett responded that willingness to respond is scenario specific, so someone may have different feelings about a nuclear event compared to another potential threat.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.