Disaster Nursing Competencies

Disaster Nursing Learning Outcomes

• Understand the role of nurses in disaster situations
• Identify levels of nursing competencies in disaster situations
• Familiarize with core competencies and domains in disaster nursing
• Apply ethical principles in disaster nursing

Disaster Nursing Definition

• World Health Organization: A serious disruption of community or society functioning, causing widespread human, material, economic, or environmental losses exceeding the community's ability to cope using its own resources.
• International Federation of Red Cross and Red Crescent Societies: A sudden, calamitous event that seriously disrupts community or society functioning, causing human, material, and economic or environmental losses exceeding the community's or society's ability to cope using its own resources.
• United Nations: The occurrence of sudden or major misfortune which disrupts the basic fabric and normal functioning of society or community.
• Food and Agriculture Organization of the United Nations: A serious disruption to the functioning of a community or society, where disasters are producing unprecedented levels of damage and loss in agriculture around the world.

Disaster Nursing Goals

• Address urgent fundamental survival requirements of communities impacted by catastrophes
• Ascertain likelihood of subsequent calamity
• Evaluate dangers and resources within environment
• Rectify disparities in access to healthcare or suitable resources
• Enable survivors to engage in and advocate for their own health and well-being
• Respect cultural, linguistic, and religious diversity among people and families
• Enhance optimal quality of life for survivors

Principles of Disaster Nursing

• Prompt assessment of the situation and nursing care need
• Prioritize triage and start lifesaving interventions immediately
• Deliberate use of important nursing interventions and reduced nonessential nursing responsibilities
• Modification of essential nursing competencies for disaster and emergency scenarios
• Assess environment and reduce/eliminate health risks
• Prevent further harm or disease
• Lead coordination of patient triage, treatment, and transport during crises
• Train, deploy, and oversee auxiliary medical staff and volunteers
• Provide compassion, empathy and emotional support to victims and their families

ICN Framework of Disaster Nursing (Version 2.0 of 2019)

• Aims to enhance disaster preparedness, mitigate risks, and improve overall response and recovery efforts in the face of disasters, contributing to the safety and well-being of communities
• Effective disaster nursing requires clinical competency and the application of utilitarian principles (doing the greatest good for the greatest number with the least amount of harm).

Three Levels of Nursing Competencies in Disaster Situations

• General Professional Nurse (Level I): Completed a basic, generalized nursing education program, authorized to practice by the regulatory agency of their country
• Advanced or Specialized Nurse (Level II): Achieved Level I competencies, designated disaster responder within an institution, organization, or system.
• Advanced Nursing Practice - Specialist in Disasters (Level III): Achieved Level I and II competencies, prepared to respond to a wide range of disasters, and serve on a deployable team.

Eight Domains of Disaster Nursing Competencies

• Preparation and planning: Actions taken to increase readiness and confidence for disaster response.
• Communication: Approaches to conveying essential information and documenting decisions.
• Incident management systems: The structure for disaster/emergency response.
• Safety and Security: Ensuring nurses, colleagues, and patients do not add to the response burden through unsafe practices.
• Assessment: Gathering data on patients, families, and communities for actions.
• Intervention: Clinical or other actions taken in response to assessment.
• Recovery: Steps taken to resume pre-event functioning.
• Law and Ethics: Legal and ethical framework for disaster nursing.

Domains 1-5 Detailed Information

• This section provides further details on the first five domains in a table-like format (without using tables)*
• Domain 1: Preparation and planning involves maintaining preparedness plans, engaging in drills, and possessing up-to-date knowledge of available emergency resources, plans, policies, and procedures ensuring continuity.
• Domain 2: Communication in disaster settings requires accurate use of disaster terminology and timely transmission of priority information. It entails use of multi-lingual resources and adapting communication to the needs of vulnerable populations.
• Domain 3: Incident management systems involve understanding the organisational structure of disaster response, contributing to observations and experiences that help improve the system in future events.
• Domain 4: Safety and Security must prioritise the safety of patients, family members, colleagues, and oneself during disaster actions.
• Domain 5: Assessment involves rapidly evaluating the physical and mental well-being of patients and families, while continually monitoring their needs during disasters and documenting crucial information.

Further Reference Information

• Core Competencies in Disaster Nursing Version 2.0, International Council of Nurses, 2019
• Core Competencies in Disaster Nurses: Competencies for Nurses Involved in Emergency Medical Teams (Level III), 2022