ICN Framework of Disaster Nursing Competencies PDF

## ICN Framework of Disaster Nursing Competencies ### Outline for Topic 2 **The International Council of Nurses (ICN)** - A federation of over 130 national nurses' associations (NNAs), representing the over 28 million nurses worldwide. - Founded in 1899, ICN is the world's first and widest reachi...

## ICN Framework of Disaster Nursing Competencies ### Outline for Topic 2 **The International Council of Nurses (ICN)** - A federation of over 130 national nurses' associations (NNAs), representing the over 28 million nurses worldwide. - Founded in 1899, ICN is the world's first and widest reaching international organization for health professionals. - It is headquartered in Geneva, Switzerland. - Works to ensure quality nursing care for all, sound health policies globally, the advancement of nursing knowledge, and the presence worldwide of a respected nursing profession and a competent and satisfied nursing workforce. Membership is limited to one nursing organization per nation. ### Overview - Developed in 2009 after an analysis of existing competency frameworks in the area of public health, mental health, health care workers, emergency managers, nursing and disaster nursing. - Important to the development of the competencies were two disaster nursing competency documents: - Educational Competencies for Registered Nurses Responding to Mass Casualty Incidents (Stanley, 2003), and - Core Competencies Required for Disaster Nursing (Yamamoto, 2004). - The focus is the generalist nurse and their competencies serve as the foundation. - The "disaster management continuum" was selected for several reasons: - It is a process recognized throughout the world; - Nursing roles are integrated throughout it; - It provides a consistent way to organize the competences; and - It enhances the ability to develop educational curriculum that integrates the disaster management continuum with the competencies. - The competencies were organized under four areas: - Mitigation/prevention competencies - Preparedness competencies - Response competencies - Recovery/rehabilitation competencies ### ICN Framework of Disaster Nursing Competencies | ICN Framework of Competencies of the Generalist Nurse | Framework of Disaster Nursing Competencies | NEPEC Competencies COE Competencies | |---|---|---|---| | Prevention/Mitigation Competencies | Preparedness Competencies | Response Competencies | Recovery/Rehabilitation Competencies | | Risk Reduction, Disease Prevention and Health Promotion | Ethical Practice, Legal Practice, and Accountability | Care of the Community | Long-term Individual, Family and Community Recovery | | Policy Development and Planning | Communication and Information Sharing | Care of Individuals and Families | | | Education and Preparedness | Care of Vulnerable Populations | *COE: Center of Excellence: ICN, International Council of Nurses: NEPEC, Nursing Emergency Preparedness Education Coalition. ### A. Prevention / Mitigation Competencies **1. Risk Reduction, Disease Prevention and Health Promotion** - Disaster risk reduction is the concept and practice of reducing disaster risks through systematic efforts to analyze and reduce the causal factors of disasters. Reducing exposure to hazards, lessening vulnerability of people and property, wise management of land and the environment, and improving preparedness and early warning for adverse events are all examples of disaster risk reduction. - Disease prevention is a procedure through which individuals, particularly those with risk factors for a disease, are treated in order to prevent a disease from occurring. Treatment normally begins either before signs and symptoms of the disease occur, or shortly thereafter. - Health promotion is the process of enabling people to increase control over, and to improve, their health. **1.1 Risk Reduction and Disease Prevention** - Using epidemiological data evaluates the risks and effects of specific disasters on the community and the population and determines the implications for nursing. - Collaborates with other health care professionals, community organizations, government and community leaders to develop risk reduction measures to reduce the vulnerability of the populations. - Participates in planning to meet health care needs in a disaster. - Identifies challenges to the health care system and works with the multidisciplinary team to mitigate the challenges. - Identifies vulnerable populations and coordinates activities to reduce risk. - Understands the principles and process of isolation, quarantine, containment and decontamination and assists in developing a plan for implementation in the community. - Collaborates with organizations and governments to build the capacity of the community to prepare for and respond to a disaster. **1.2 Health Promotion** - Participates in community education activities related to disaster preparedness. - Assesses the community to determine pre-existing health issues, prevalence of disease, chronic illness and disability and the health care resources in the community. - Partners with others to implement measures that will reduce risks related to person-to-person transmission of disease, sanitation and foodborne illness. - Participates in planning to meet the health care needs of the community such as, mass immunization and medication administration programmes. - Works with the community to strengthen the health care system's ability to respond to and recover from a disaster. **2. Policy Development and Planning** - Demonstrates an understanding of relevant disaster terminology. - Describes the phases of disaster management continuum: prevention/mitigation, preparedness, response and recovery/rehabilitation. - Describes 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 the development, evaluation and modification of the community disaster plan. - Ensures that the needs of vulnerable populations are included in the community disaster plan (including children, women, pregnant women, individuals with mental or physical disabilities, older people and other vulnerable persons/households). - Interprets role(s) of nurses in relation to other members of the team. - Participates politically and legislatively in the development of policies related to disaster preparedness and response. - Describes the role of public health in disaster and how it relates to the nurse's role. ### B. Preparedness Competencies **3. Ethical Practice, Legal Practice and Accountability** **3.1 Ethical Practice** - Collaborates with others to identify and address ethical challenges. - Applies the national approved ethical framework to support decision-making and prioritizing. - Protects the rights, values and dignity of individuals and communities. - Practices in accordance with the cultural, social and spiritual beliefs of individuals and communities.. - Maintains confidentiality in communication and documentation. - Understands one's own personal beliefs and how those beliefs impact on disaster response. - Describes how security issues and ethics may conflict. **3.2 Legal Practice** - Practices in accordance with local, state, national and international applicable laws. - Understands how laws and regulations specific to disaster impact on nursing practices and disaster survivors. - Recognizes the legal role of public health to protect the community in a disaster. - Understands the legal implications of disasters and emergency events (e.g. security, maintaining evidence, confidentiality). - Describes the legal and regulatory issues related to issues such as: - Working as a volunteer; - Roles and responsibilities of volunteers; - Abandonment of patients; - Adaptation of standards of care; - Role and responsibility to an employer; and - Delegation. **3.3 Accountability** - Accepts accountability and responsibility for one's own actions. - Delegates to others in accordance with professional practice, applicable laws and regulations and the disaster situation. - Identifies the limits of one's own knowledge, skills and abilities in disaster and practices in accordance with them. - Practices in accordance with the laws and regulations governing nurses and nursing practice. - Advocates for the provision of safe and appropriate care. **4. Communication and Information Sharing** - Describes the chain of command and the nurse's role within the system. - Communicates in a manner that reflects sensitivity to the diversity of the population. - Describes the principles of crisis communication in crisis intervention and risk management. - Identifies and communicates important information immediately to appropriate authorities.. - Utilizes a variety of communication tools to reduce language barriers. - Coordinates information with other members of the disaster response team. - Provides up-to-date information to the disaster response team regarding the health care issues and resource needs.. - Works with the disaster response team to determine the nurse's role in working with the media and others interested in the disaster. - Understands the process of health information management in a disaster. - Demonstrates an ability to use specialized communication equipement. - Maintains records and documentation and provides reports as required. - Communicates identified or suspected health and/or environment risks to appropriate authorities (i.e. Public Health). **5. Education and Preparedness** - Maintains knowledge in areas relevant to disaster and disaster nursing. - Participates in drills in the workplace and community. - Seeks to acquire new knowledge and maintain expertise in disaster nursing. - Facilitates research in disaster. - Evaluates the need for additional training and obtains required training. - Develops and maintains a personal and family preparedness plan. - Describes the nurse's role in various disaster assignments (e.g., shelters, emergency care sites, temporary health care settings. - Maintains a personal disaster/emergency kit (e.g., identification card, appropriate clothing, insect repellent, water bottle) in the event of deployment to a disaster. - Implements preparedness activities as part of a multidisciplinary team. - Assists in developing systems to address nursing and health care personnel capacity-building for disaster response.. - Takes on a leadership role in the development and implementation of training programmes for nurses and other health care providers. - Evaluates community readiness and takes actions to increase readiness where needed. ### C. Response Competencies **6. Care of Communities** - Describes the phases of community response to disaster and the implications for nursing interventions. - Collects data regarding injuries and illnesses as required. - Evaluates health needs and available resources in the disaster affected area to meet basic needs of the population. - Collaborates with the disaster response team to reduce hazards and risks in the disaster-affected area. - Understands how to prioritize care and manage multiple situations. - Participates in preventive strategies such as mass immunization activities. - Collaborates with relief organizations to address basic needs of the community (e.g. shelter, food, water, health care). - Provides community-based education regarding health implications of the disaster. - Evaluates the impact of nursing interventions on different populations and cultures and uses evaluation results to make evidence-based decisions. - Manages resources and supplies required to provide care in the community. - Effectively participates as part of a multidisciplinary team. **7. Care of Individuals and Families** **7.1 Assessment** - Performs a rapid assessment of the disaster situation and nursing care needs. - Conducts a health history and age-appropriate assessment that includes physical and psychological responses to the disaster. - Recognizes symptoms of communicable disease and takes measures to reduce exposure to survivors. - Describes the signs and symptoms of exposure to chemical, biological, radiological, nuclear and explosive agents. - Identifies unusual patterns or clustering of illnesses and injuries that may indicate exposure to biological or other substances related to the disaster. - Determines need for decontamination, isolation or quarantine and takes appropriate action. - Recognizes health and mental health needs of responders and makes appropriate referrals. **7.2 Implementation** - Implements appropriate nursing interventions including emergency and trauma care in accordance with accepted scientific principles. - Applies critical, flexible and creative thinking to create solutions in providing nursing care to meet the identified and anticipated patient care needs resulting from the disaster. - Applies accepted triage principles when establishing care based on the disaster situation and available resources. - Adapts standards of nursing practice, as required, based on resources available and patient care needs. - Creates a safe patient care environment. - Prepares patients for transport and provides for patient safety during transport. - Demonstrates safe administration of medication, vaccines and immunizations. - Implements principles of infection control to prevent the spread of disease. - Evaluates outcomes of nursing actions and revises care as required. - Provides care in a non-judgmental manner. - Maintains personal safety and the safety of others at the scene of a disaster. - Documents care in accordance with disaster procedures. - Provides care in a manner that reflects cultural, social, spiritual and diverse background of the individual. - Manages the care of the deceased in a manner that respects the cultural, social and spiritual beliefs of the population as situation permits. - Manages health care activities provided by others. - Works with appropriate individuals and agencies to assist survivors in reconnecting with family members and loved ones. - Advocates for survivors and responders to assure access to care. - Refers survivors to other groups or agencies as needed. **8. Psychological Care** - Describes the phases of psychological response to disaster and expected behavioral responses. - Understands the psychological impact of disasters on adults, children, families, vulnerable populations and communities. - Provides appropriate psychological support for survivors and responders. - Uses therapeutic relationships effectively in a disaster situation. - Identifies an individual's behavioral responses to the disaster and provides appropriate interventions as required (e.g. psychological first aid). - Differentiates between adaptive responses to the disaster and maladaptive responses.. - Applies appropriate mental health interventions and initiates referrals as required. - Identifies appropriate coping strategies for survivors, families and responders. - Identifies survivors and responders requiring additional mental health nursing support and refers to appropriate resources. **9. Care of Vulnerable Populations (Special Needs Populations)** - Describes vulnerable populations at risk as a result of a disaster (e.g. older persons, pregnant women, children, and individuals with a disability or chronic conditions requiring continued care) and identifies implications for nursing, including: - Physical and psychological responses to the disaster of vulnerable populations; and - Unique needs and high risks of vulnerable populations associated with the disaster. - Creates living environments that allow vulnerable populations to function as independently as possible. - Advocates for the needs of the vulnerable populations. - Identifies available resources, makes appropriate referrals and collaborates with organizations serving vulnerable populations in meeting resource needs. - Implements nursing care that reflects the needs of vulnerable populations impacted by a disaster. - Consults with members of the health care team to assure continued care in meeting special care needs. ### D. Recovery / Rehabilitation Competencies **10. Long-term Care Needs** **10.1 Individual and Family Recovery** - Develops plans to meet short- and long-term physical and psychological nursing needs of survivors. - Identifies the changing needs of survivors and revises plan of care as required. - Refers survivors with additional needs to appropriate organizations or specialists. - Teaches survivors strategies for prevention of disease and injury. - Assists local health care facilities in recovery. - Collaborates with the existing health care community for health maintenance and health care. - Serves as an advocate for survivors in meeting long-term needs. **10.2 Community Recovery** - Collects data related to the disaster response for evaluation. - Evaluates nursing response and practices during the disaster and collaborates with nursing organizations to resolve issues and improve response. - Participates in analysis of data focusing on improvement of response. - Identifies areas of needed improvement and communicates those areas to appropriate personnel. - Assists the community in transitioning from the response phase of the disaster/emergency through recovery and rehabilitation to normal functions. - Shares information about referral sources and resources used in the disaster. - Assists in developing recovery strategies that improve the quality of life for the community. - Collaborates with appropriate groups and agencies to re-establish health care services within the community. ### ICN Framework of Disaster Nursing Competencies: Version 2.0 * To address the skills required of advanced practice or specialized nurses in disaster nursing who assume leadership roles, the ICN published an updated version of disaster nursing competencies - the Core Competencies in Disaster Nursing Version 2.0 (ICN CCDN V2.0) in 2019 (ICN, 2019). * The newly released ICN CCDN V2.0 is organized under eight different parallel domains at two levels to be attained by general nurses and advanced/specialized nurses: (1) preparation and planning; (2) communication; (3) incident management systems; (4) safety and security; (5) assessment; (6) intervention; (7) recovery; and (8) law and ethics (ICN, 2019). * The emphases in the domains are on competencies such as up-to-date knowledge, professional readiness and responsibilities; priorities and essential communication and documentation; incident response and actions; infection control and personal protection; triage and reporting, the identification of vulnerable groups; first aid and clinical actions with available resources; resumption of the functioning of individuals and communities; and adherence to relevant laws and ethical norms according to utilitarian principles. * The three levels of nurses defined for use in Version 2.0 are: * Level 1: - Any nurse who has completed a program of basic, generalized nursing education and is authorized to practice by the regulatory agency of his/her country. - Examples: staff nurse in a hospital, clinic, public health center; all nurse educators. * Level II: - Any nurse who has achieved the Level I competencies and is/aspires to be a designated disaster responder within an institution, organization or system. - Examples: supervising or head nurse; a nurse designated for leadership within an organization's emergency plan; a nurse representing the profession on a hospital/agency emergency planning committee; preparedness/response nurse educators. * Level III: - Any nurse who has achieved Level I and II competencies and is prepared to respond to a wide range of disasters and emergencies and to serve on a deployable team. - Examples: frequent responders to either national or international disasters, military nurses, nurses conducting comprehensive disaster nursing research. **Version 2.0 Eight Domains** | Domain | Description | |---|---| | Domain 1 | Preparation and planning (actions taken apart from any specific emergency to increase readiness and confidence in actions to be taken during an event) | | Domain 2 | Communication (approaches to conveying essential information within one's place of work emergency assignment and documenting decisions made) | | Domain 3 | Incident management systems (the structure of disaster/emergency response required by countries/organisations/institutions and actions to make them effective) | | Domain 4 | Safety and Security (assuring that nurses, their colleagues and patients do not add to the burden of response by unsafe practices) | | Domain 5 | Assessment (gathering data about assigned patients/families/communities on which to base subsequent nursing actions) | | Domain 6 | Intervention (clinical or other actions taken in response to assessment of patients/families/communities within the incident management of the disaster event) | | Domain 7 | Recovery (any steps taken to facilitate resumption of pre-event individual/family/community/organisation functioning or moving it to a higher level) | | Domain 8 | Law and Ethics (the legal and ethical framework for disaster/emergency nursing) | **References:** - https://www.sciencedirect.com - http://www.apednn.org - https://www.icn.ch - https://en.wikipedia.org - https://nursingtv.wordpress.com Prepared by: KARMINA I. CAUTI, RN, MN, LPT CN Faculty