Disaster Nursing: Philippine Disaster Profile

Disaster Nursing

• Bryan G. Bejer, RN, LPT, MAN is credited as the author.

The Philippine Disaster and Risk Profile

Disaster

• A disaster is a disruption of a community or society's functioning at any scale.
• This occurs due to hazardous events interacting with exposure, vulnerability, and capacity conditions.
• It leads to human, material, economic, and environmental losses and impacts.
• The United Nations International Strategy for Disaster Reduction defines disaster.

Types of Disaster

Natural Disasters

• Result from ecological disruptions or threats exceeding an affected community's adjustment capacity
• The World Health Organization defines natural disasters.

Geophysical Disaster

• This is brought about by tectonic and seismic activity below the Earth's surface.
• Any kind of geological disturbance can cause this event.
• Similar geophysical disasters have signs that they are about to occur like shaking & unstable ground.
• These may also trigger other geophysical disasters or disasters from different categories.

Meteorological Disaster

• A catastrophic event caused by atmospheric conditions, including severe weather phenomena
• Hurricanes, tornadoes, floods, and blizzards are types of these disasters.
• They result from natural processes in the Earth's atmosphere and can lead to significant loss of life, property damage, and disruption of communities.

Hydrological Disaster

• Events caused by deviations in the normal water cycle and/or water body overflow due to wind set-up.
• Examples include river floods, flash floods, and storm surge/coastal floods.

Climatological Disaster

• Events refer to immediate and violent changes in the earth's environment
• They're related to or caused by the earth's atmosphere
• A hazard mainly caused by long-lived/meso to macro-scale processes in the spectrum from intra-seasonal to multi-decadal climate variability.

Biological Disaster

• Natural and unfortunate events that can cause diseases, disabilities, or even deaths at an average to a larger rate of various species, including humans and plants
• Catastrophic scenarios caused by living or non-living organisms
• They cause large-scale severe diseases, viruses, or infections in plants, humans, and other species.

Man-made Disaster

• Have elements of human intent, negligence, or error involved in the human-made system's failure
• Disturbances in natural resources also sometimes lead to human-made disasters.

Anthropogenic Disaster

• Disasters in which the causes are identifiable human actions, deliberate or otherwise
• Includes biological/biochemical terrorism, chemical spills, nuclear events, fire, explosions, transportation accidents, armed conflicts and acts of war.

Terrorism

• Defined as incidents in which terrorists use force or violence against people or property, violating criminal laws for purposes such as threats, rebellion, or ransom
• Aims to create unrest within a country and spread panic among people.
• Acts typically include intimidation, murder, bombing, kidnapping, hijacking, and cyber-attacks.

Technological Disaster

• A catastrophic event that occurs due to the breakdown or failure of technological systems.
• Results in intense and sudden damage, such as bridge collapses, dam failures, or industrial accidents
• Potentially involves the release of highly toxic substances or radiation, causing prolonged distress and loss of control over affected systems.

Disaster for Hospitals and other Healthcare Facilities

External Disaster

• Events that don't affect a hospital's infrastructure.
• They tax hospital resources due to the numbers of patients or types of injuries.

Internal Disaster

• Disrupt normal hospital function due to injuries and deaths of hospital personnel or damage facility itself
• Examples include hospital fires, power failure, or chemical spills.

Disaster Continuum

• The life cycle of a disaster is generally referred to as disaster continuum or emergency management cycle.
• This cycle is characterized in three major phases.

Three Phases of Disaster Continuum

• Pre-impact (Before)
• Impact (During)
• Post-impact (After)

Basic Phases or "Life Cycle" of Disaster Management Program

• Preparedness
• Mitigation
• Response
• Recovery
• Evaluation

Preparedness

• Productive planning efforts designed to structure the disaster response prior to its occurrence
• Disaster planning encompasses evaluating potential vulnerabilities (assessment of risk) and the propensity for a disaster to occur.

Mitigation

• Includes measures taken to reduce the harmful effects of a disaster
• Attempting to limit the impact on human health, community function, and economic infrastructure
• These are all steps to lessen the impact of a disaster should one occur and can be considered preventative measures.

Prevention

• Refers to a broad range of activities, such as attempts to prevent disasters from occurring
• Any actions taken to prevent further disease, disability or loss of life.

Recovery

• Actions focus on stabilizing and returning the community (or an organization) to normal (its preimpact or improved status)
• Range from rebuilding damaged buildings and repairing infrastructure to relocating populations and instituting physical, behavioral and mental health interventions.

Evaluation

• Disaster planning and response phase that often receives the least attention
• FEMA (Federal Emergency Management Agency) recognizes the previously mentioned phases of disaster life cycle
• The importance of response and recovery evaluation cannot be underestimated.

Disaster Phases: Nursing Actions

Pre-impact

• Participate in developing community disaster plans.
• Participate in community risk assessment.
• Initiate disaster prevention measures (prevention/removal of hazard, movement/relocation of at-risk populations, public awareness campaigns, establishment of early warning systems).
• Perform disaster drills and table-top exercises.
• Identify educational and training needs for all nurses.
• Develop disaster nursing databases for notification, mobilization, and triage of emergency staffing resources.
• Develop evaluation plans for all components of nursing response.

Impact

• Activate disaster response plan (notification and initial response, leadership assumes control, command post established, establish communications, conduct damage and needs assessment, search/rescue/extricate, establish field hospital/shelters, triage/transport patients).
• Mitigate all ongoing hazards.
• Activate agency disaster plans.
• Establish need for mutual aid relationships.
• Integrate state and federal resources.
• Ongoing triage and provision of nursing care.
• Evaluate public health needs of the affected population.
• Establish safe shelter and deliver adequate food and water.
• Provide sanitation and waste removal.
• Establish disease surveillance/vector control.
• Evaluate need for/activate additional nursing staff.

Post-impact

• Continue provision of nursing/medical care and disease surveillance.
• Monitor safety of food/water supply.
• Withdraw from disaster scene.
• Restore public health infrastructure.
• Re-triage/transport patients to appropriate level care facilities.
• Reunite family members.
• Monitor long-term physical and mental health outcomes for survivors.
• Debrief staff and provide adequate time off for rest.
• Evaluate actions and revise preparedness plan

ICN Framework of Disaster Nursing Competencies

• In 2009, the International Council of Nurses (ICN) and World Health Organization (WHO) published the first edition of the ICN Framework of Disaster Nursing Competencies.
• Stated at that time that nurses are key players in the disasters.
• Rapid action and assistance are also key.
• Nurses need effective and rapid skills in order to provide these services

Global Disaster Mitigation and Preparedness

• The United Nations and WHO began to address disaster mitigation and preparedness issues.
• In January 2005, 168 governments adopted the Hyogo Framework for Action, a 10-year disaster risk reduction blueprint.
• Goals are to reduce lives lost and damage to economic, social and environmental community resources.
• Strengthening disaster preparedness for effective response is a top priority.
• Effective response includes well-trained personnel with required skills who understand their roles and the roles of others.

World Health Assembly Resolution

• In 2005, the World Health Assembly passed a resolution calling on the Organization to intensify technical guidance and support.
• Support should go to countries building their emergency response capacities.
• The resolution stressed a multisectoral and comprehensive approach focused on the following WHO functions in emergencies:
• Measure ill-health and promptly assess health needs of populations.
• Support Member States in coordinating action for health.
• That the critical gaps in health response are rapidly identified and filled.
• Revitalize and build the capacity of health systems for preparedness and response.

The Role of Nurses

• Key players in disaster and crisis situations given their broad care-giving skills.
• Nurses are also effective in variety of disaster settings and situations