Disaster Nursing Competencies

• In 2009, the International Council of Nurses (ICN) and the World Health Organization (WHO) released the first edition of the ICN Framework of Disaster Nursing Competencies.
• The original competencies were divided into 4 areas and 10 domains.

Competency

• A competency measures applied skills and knowledge that enable people to perform work.
• Competency consists of an action verb, content, and context.
• Once developed, competencies can form the framework for an education program through sub-competencies or knowledge/skills.

Competency Levels

• LEVEL I: Nurses who have completed a basic nursing education program and are authorized to practice.
• LEVEL II: Nurses who have achieved Level I competencies and aspire to be disaster responders.
• LEVEL III: Nurses who have achieved Levels I and II competencies and are prepared to respond to a variety of disasters and emergencies and serve on a deployable team.

Prevention/Mitigation Competencies

• Focuses on risk reduction and disease prevention:
• Uses epidemiological data to assess disaster risks and effects on the community, determining nursing implications.
• Works with healthcare professionals, community groups, government, and leaders to develop risk reduction measures.
• Participate in planning for health care needs during a disaster.
• Identifies health system challenges and collaborates with teams to mitigate them.
• Identifies vulnerable populations and coordinates risk reduction activities.
• Understands isolation, quarantine, containment, and decontamination principles, helping create community implementation plans.
• Collaborates with organizations and governments to enhance community disaster preparedness and response capabilities.

Health Promotion

• Involves community education for disaster preparedness.
• Assess communities to identify health issues, disease prevalence, chronic illnesses, disabilities, and health care resources.
• Partners to implement risk-reduction measures related to disease transmission, sanitation, and foodborne illnesses.
• Participates in planning to address the community's health needs (mass immunization, medication administration programs).
• Works with the community to strengthen the health care system's ability to respond to and recover from a disaster.

Policy Development and Planning

• Demonstrate awareness of relevant disaster terminology.
• Describes the phases of disaster management: prevention/mitigation, preparedness, response, and recovery/rehabilitation.
• Describe the role of government and organizations in disaster planning and response.
• Understands the community disaster plan and how it relates to the national and international response plans.
• Recognizes the disaster plan in the workplace and one's role in the workplace at the time of a disaster.
• Participates in disaster planning and policy development.
• Contributes to community disaster plan development, evaluation, and modification.
• Ensures the needs of vulnerable populations are included in the community disaster plan (those with disabilities, women, older people etc.).
• Understands the roles of nurses within a team.
• Participates politically and legislatively in developing disaster preparedness and response policies.
• Describes the role of public health in a disaster and how it relates to nursing.

Preparedness Competencies

• Involves Ethical Practice, Legal Practice, and Accountability:

Ethical Practice

• Collaborates to identify and address ethical dilemmas.
• Applies the national ethical framework to support decision-making and prioritizing.
• Protect the rights, values, and dignity of individuals and communities.
• Practices respecting cultural, social, & spiritual beliefs.
• Maintains confidentiality in communication and documentation.
• Understands and recognizes any personal beliefs that impact on disaster response.
• Describes potential conflicts between security issues and ethics.

Legal Practice

• Practices according to local, state, national, and international laws.
• Understand how disaster laws impact nursing practices and disaster survivors.
• Recognizes public health's role in community protection.
• Understands disasters' legal implications (security, maintaining evidence, confidentiality).
• Describes legal/regulatory issues related to volunteering, responsibilities, patient abandonment, adaptation of standards, employer roles and delegation.

Accountability

• Accept responsibility for one's actions.
• Delegates as per professional standards, laws, regulations, and the disaster situation.
• Acknowledge the limits of one's skills and practices within them.
• Practices in accordance with the laws and regulations governing nurses and nursing practice.
• Advocates for safe, appropriate care.

Communication and Information Sharing

• Describes the chain of command and the nurse's role within the system.
• Communicates with sensitivity.
• Describes principles of crisis communication, intervention, and risk management.
• Shares necessary information immediately with authorities.
• Uses various communication tools to reduce language barriers.
• Coordinates info with other members of the disaster response team.
• Provides current info about health issues and resource needs to the disaster response team.
• Works with the team to define the nurse’s role with the media.
• Understands health information management during a disaster.
• Demonstrates the use of specialized communication equipment.
• Keeps records and documentation, providing reports when needed.
• Communicates suspected health/environmental risks to the authorities, (Public Health).

Education and Preparedness

• Maintain knowledge relevant to disaster nursing.
• Participate in drills in workplaces and the community.
• Acquire and maintain expertise in disaster nursing.
• Facilitate disaster research.
• Assess the need for training and complete it.
• Develop and maintain a personal and family preparedness plan.
• Describes nurse's roles in various disaster assignments.
• Maintain a personal disaster/emergency kit.
• Implements preparedness activities as part of a multidisciplinary team.
• Help develop systems to increase nursing and healthcare personnel capacity for disaster response.
• Takes a lead in training programs for nurses and other providers.
• Assesses community readiness and increases it where needed.

Response Competencies

• Involves immediate actions before, during, and after disasters for saving lives and essential care.
• Includes skills like triage, coordination, assessment, and managing limited resources.

Domains

• Care of the Community.
• Care of Individuals and Families.
• Psychological Care.
• Care of Vulnerable Populations.

Care of the Community

• Describes the community's disaster response phases for nursing interventions.
• Collects data on injuries and illnesses as required.
• Assesses health needs and resources in the affected area to meet basic needs.
• Collaborates to reduce hazards and risks.
• Understands how to prioritize care and manage multiple situations.
• Participates in preventive strategies like mass immunizations.
• Collaborates with relief organizations to address community needs (shelter, food, water, healthcare).
• Provides community education regarding health implications of the disaster.
• Evaluates nursing interventions' impact on different populations and uses results for evidence-based decisions.
• Manages resources and supplies for care in the community.
• Works effectively as part of a multidisciplinary team.

Care of Individuals and Families

• Performs a rapid assessment of the disaster and nursing needs.
• Conducts both a health history and assess responses to the disaster.
• Recognizes communicable disease symptoms and takes steps to reduce exposure.
• Describes signs and symptoms of various exposures (chemical, biological, radiological, nuclear, explosive).
• Identify unusual patterns that indicates exposure to biological or any substance.
• Determines the need for action to take (decontamination, isolation, or quarantine).
• Recognizes mental health needs of responders and makes referrals.
• Implements the actions regarding the disaster and helps care for the individuals affected

Implementation

• Implements specific nursing interventions, (emergency, trauma), with established scientific principles.
• Implement critical, adaptable, and innovative problem-solving approaches to meet identified patient care issues resulting from the disaster.
• Applies accepted triage practices.
• Adapts the standards of nursing practices.
• Sets up a safe care environment.
• Prepares people for transport and offers safety measures during it.
• Shows safe administration of medication, vaccines, or immunizations.
• Implements the principles of infection control and how to prevent it from spreading.
• Measures outcomes of the nursing process while revising care as needed.
• Provides care in a judgemental type of free setting or area.
• Maintains overall safety precautions for themselves and others who are at the scene of the disaster.
• Documents care in accordance with disaster procedures.

Psychological Care

• Describes stages of psychological response to disaster and the actions.
• Understands the impact of disasters on specific populations and communities.
• Provides psychological support.
• Uses the relationships the community have in disaster with it's effectiveness.
• Identifies how the individuals behaviour impact on the situation while helping.
• Differentiates the between the adaptive and maladaptive processes in disaster.
• Involves the best and most appropriate psychological actions for the survivors, families, and responders.
• Understand the strategies needed to copy along with all people affected or helping after.
• Recognizes all people needing extra help and provides the accurate sources that better assist.

Care of Vulnerable Populations

• Describes all those at risk for vulnerable status at all ages.
• Actions from various individuals and actions that have to be carried out.
• Advocates for the vulnerable and their needs along with it's concerns.
• Determines the available places and makes sure all locations meet needs.
• Implements needs meeting all those impacts during it.
• Discuss the healthcare team to help provide continuous care.

RECOVERY / REHABILITATION COMPETENCIES

• Concentrates on the community and the impacted population to recover from the disaster's effect.

Long-Term Individual, Family, and Community Recovery

• Can occur at any level that needs recovery.
• Can ensure the services are accessible for help.
• Can help rebuilding from the destruction of lives to the overall housing conditions.
• The stages are very long and takes a lot of action for things to improve.

Individual and Family Recovery

• Can develops actions for short and long term plans for people's well being, also includes physical or psychological aid to heal or help after the situation.
• Identifies all the changing requirements of helping and improves the actions and plans as requied.
• Refers to those requiring aid and refers to accurate experts and services to help improve the lives of others.
• Educates the victims how to assist and help make them healthy again.
• Helps the local facilities improve their health.
• Works with the existing people to help aid in their health.
• Functions as someone to make the well being of others to ensure they help achieve their health.

Community Recovery

• Accumulates data to get a better measure on the best way to combat disaster after evaluation.
• Measures the reactions and the practices done to improve them, from the time of the action with the helpers until the issue is dealt with and resolve the issues.
• Assists in investigating knowledge for improvement when reacting to a situation.
• Can help those to improve who are helping with the situation and contacts them appropriately.
• Assists in action from the situation of the event to having normal roles without the situation happening from having services that can help improve lives.
• Collaborating with groups and groups to maintain and re-establish everything, especially health services within.

ROLE OF NURSES

• Can help heal and make sure problems are treated that deal with physical and mental health problems.
• For people injured or sick, with all their diseases to monitor them to reduce issues
• With knowledge, they provide accurate services while ensuring all standards are met, which ensures all laws are followed.
• Recommendations are to assist in improving the accurate services and sources that need help like (housing, medications, equipment etc.).

VERSION 2.0 OF THE ICN FRAMEWORK OF DISASTER NURSING

• With studies showing a substantial amount of change from when it originally been put into place, there was a new one created in the year 2019 to make it better

Preparation and planning

• Steps to take from any disaster to helping increase being prepared in certain actions that are done during a emergency along with high confidence.

Communication

• How a person talks to others internally while making sure all the information gets around along with being recorded.

Incident management systems

• An event occurs and a structure is created to ensure the right countries and people react properly.

Safety and Security

• Security measures and knowledge in place to prevent an issue or unsafe accidents to the victim or victims.

Assessment

• Collect information and facts for all people in all states.

Intervention

• Actions taken when caring to improve the care given as treatment.

Recovery

• Actions that taken that help aid to re-establish stability for an event for the people involved.

Law and Ethics

• Actions that have to be followed to ensure all rules are followed and actions are ethical.

Preparation and Planning

• Makes a plan that suits each family member to know about all risks and dangers that one has to be aware about.
• Takes action to have each person and family involved with the roles they have to abide to.
• Maintains all information needed for an issue.
• With the many ways or techniques to treat the most weakest involved with the event.

Communication

• Ensures all statements and meanings are known by having information and making sure communication is open.
• Involves those around with a specific person to ensure needs are met during issues.

Incident Management

• Making sure there is a system to assist in all possible events or issues.
• Uses specific actions used in the the system planned, with all details and the chain of command for all cases.
• Adds observations when reacting while having the response also.
• Is proficient when reacting to a new and confusing situation.

Safety and Security

• Maintains security to those around and at risk while ensuring everything is running smoothly to its finest levels.
• Adjusting the ways and actions so every situation is accurate.

Assessment

• Reports any issues and possible event or danger and is able to give quick actions if needed.
• When possible, they help and provides what help is needed while giving what information is possible during their interactions.
• Sustains all that's happening during or prior to while providing the best details and ensuring all details are known.

Intervention

• If they can assist during their close presence, they provide all first aid to people under risks.
• Helps all those at risk and ensuring no additional issues occur.
• Participates in knowing when cleaning is needed in a specific situation.

Recovery

• When a reaction is needed, all those at risk the most are given information and options when their discharged.

Law and Ethics

• Every action must be lawful while all morals are meeting the expectations to make ethical behaviour.