Hospital disaster preparedness in Iranian province: A cross-sectional study using a standard tool.

OBJECTIVE: Hospitals are the first place to refer the victims of emergencies and disasters. Hamadan province, as one of the provinces in western Iran, like other parts of this country is exposed to various emergencies and disasters. This study was conducted to evaluate the level of hospital disaster preparedness in the Hamadan province of Iran using a standard tool. METHODS: This study was conducted in Hamadan province's hospitals in Iran. The Persian version of the World Health Organization Hospital Emergency Response Checklist was used as an evaluation tool. It consists of nine key components: command and control, triage, human resources, communications, surge capacity, logistics/supply management, safety and security, continuity of essential services, and post-disaster recovery. Data entry and analysis were performed using IBM® SPSS® software (version 18). RESULTS: Fifteen hospitals participated in this study (response rate 83 percent). Most hospitals (53.33 percent) were in moderate preparedness level, 26.66 percent are in good, and 13.33 percent are at a poor level. There was no significant relationship between "the hospital type" and "the hospital size" (number of beds) and preparedness score (p > 0.05). CONCLUSIONS: This study showed that most of the hospitals in the Hamadan province regarding the components of "logistics" and "essential services" are at a poor disaster preparedness level. Accordingly, the hospital authorities and managers must adopt a comprehensive strategy for strengthening the hospital disaster preparedness measures, especially in these components.

National Health-Oriented Hazard Assessment in Iran Based on the First Priority for Action in Sendai Framework for Disaster Risk Reduction 2015-2030.

BACKGROUND: Understanding disaster risk is the first priority for action based on the Sendai Framework for Disaster Risk Reduction 2015-2030 (SFDRR), and hazard assessment is the first step in the assessment of disaster risks. Therefore, assessing health-oriented hazards is the first measure in disaster risk assessment in the medical universities area in Iran. This article introduces a national experience and results obtained from designing a national tool for defining and assessment of health-oriented hazards in Iran. METHODS: In the present study, a National Health-Oriented Hazard Assessment tool (NHHAT) was developed by experts and implemented by the Iranian Ministry of Health for gathering data according to frequency, probability, magnitude, and vulnerability of the hazards to identify the first ten hazards of medical universities in the two decades ago (2000-2021). Finally, the top 20 health-oriented hazards were identified among the ten hazards reported by each university. RESULTS: According to the findings, the four most important hazards were road traffic accidents, earthquakes, drought, and seasonal floods. Nevertheless, the hazards such as desertification, tunnel events, soil liquefaction, mass population movement, and sea progression were among the rarest ones reported in the medical universities in Iran. CONCLUSION: Many functional aspects of disaster risk management depend on the realistic and accurate information related to the main elements of risk, especially the probable hazards in the communities. The comprehensive hazard assessment can only provide such information using context-bond tools. This is an applied study and a national implementation to fulfill the priority of the Sendai framework (i.e., understanding disasters risk) in Iran. It is suggested that other countries should also compile standard tools to explore the hazards for designing up-to-date hazard maps.

Disaster preparedness in emergency medical service agencies: A systematic review.

The Emergency Medical Services (EMSs) are in the frontline between the health-care systems and people in emergencies and disasters. With the increase in the frequency of natural or man-made disasters around the world, the need for prepared EMS services is increasing. This study aimed to evaluate the current disaster preparedness status of the EMS agencies in the literature and exploring the key preparedness elements and the strategies to improve the EMS disaster preparedness. The electronic database such as PubMed, Web of Science, Scopus, and Google Scholar was searched from 2000 to 2019. The searching keywords included: "EMS," "Disaster," "Preparedness," "Emergency" "Preparedness," "Disaster Preparedness," "Readiness," and the terms related to "disaster types" were used in combination with Boolean operators OR and AND. Out of 1412 articles, 7 articles were included in the review. The most important elements of the EMS disaster preparedness include the size and scope of the incident, surge capacity, planning, communication, training and education, policymaking, financial support, coordination, safety and security, early warning system, disaster response experience, and legal considerations. This systematic review showed that the EMS agencies in the world generally are inadequately prepared for an effective response to major emergencies and disasters. This study provides valuable information to EMS educators, EMS administrators to adopt and perform appropriate activities to improve the EMS disaster preparedness.

Comparison of the Effects of Hugo's Point Massage and Play on IV-Line Placement Pain in Children: A Randomized Clinical Trial.

Reduction of intravenous line placement pain is one of the most important nursing priorities in the pediatric wards. The present study was aimed at comparing the effect of Hugo's point massage and play on the severity of IV-line placement pain in hospitalized children aged 3-6 years in the pediatric ward. 72 children were selected and assigned randomly to three groups, i.e., control, play, and Hugo point massage. In the massage group, the middle angle between the first and second bones of the palm of the opposite hand was massaged, and the playgroup encouraged bubble-making play. The one-way analysis of variance (ANOVA) did not show a statistically significant difference between the mean IV-line placement pain in play, Hugo's point, and control groups before interventions (p=0.838; p > 0.05). However, the ANOVA test revealed a significant difference between the mean IV-line placement pain in play, Hugo's point, and control groups after the interventions (p=0.006; p < 0.05). The result of the post hoc Scheffe test also showed a statistically significant difference between the mean intensity of IV-line placement pain in both play therapy and Hugo's point massage groups (p=0.028; p < 0.05). Moreover, this test showed that the playgroup children felt less pain than Hugo's point and control group children. This study showed that, in comparison with Hugo's point massage, the play was a more effective way for reducing pain caused by IV-line placement in children, and pediatric nurses can play a significant role in reducing and managing children's pain by using it.

Anxiety, stress and depression levels among nurses of educational hospitals in Iran: Time of performing nursing care for suspected and confirmed COVID-19 patients.

BACKGROUND: Following the global emergency of coronavirus disease 2019 (COVID-19), health-care workers, especially nurses were encountered with an increasing workload. Therefore, due to the importance of this issue, the present study aimed to examine stress, anxiety, and depression levels among nurses during the COVID-19 pandemic in Iran. MATERIALS AND METHODS: This cross-sectional study was conducted in four educational hospitals affiliated to Kerman University of Medical Sciences in 2020. The standard Depression, Anxiety and Stress Scale-21 questionnaire was applied to assess the levels of stress, anxiety, and depression in nurse personnel with a census method (n = 403). Data were analyzed using descriptive statistics and analytic statistics such as Kolmogorov-Smirnov, Mann-Whitney, Kruskal-Wallis, and multiple linear regression tests through the version 20, SPSS Inc., Chicago, IL, USA, Software at the level of P < 0.05. RESULTS: The results of the study showed that the mean scores of depressions (9.18 ± 4.45), stress (9.62 ± 4.94), and anxiety (10.32 ± 4.85) in nurses were at moderate level. A significant relationship was observed between stressed, anxious, and depressed participants in the gender, marital status, level of education, and working hours per month. No statistically significant relationship was found between other demographic variables including age, work experience, and employment status with anxiety, depression, and stress categories. CONCLUSION: The results of this study can increase the awareness of health system managers, especially hospitals, about the level of stress, anxiety, and depression and can help in order to provide psychological support programs for improving the mental health of nurses during the COVID-19 pandemic.

Disaster Preparedness among Emergency Medical Service Providers: A Systematic Review Protocol.

Background. The emergency medical service (EMS) provides first-line medical care to people who require urgent medical care in emergency and disaster situations. Preparedness is the most effective approach for the management of disaster risks, and it is essential for the emergency medical service (EMS) providers, such as paramedics, emergency medical technicians (EMT), and other EMS personnel. This systematic review will explore evidence on the preparedness of emergency medical service providers in emergency and disaster situations by reviewing peer-reviewed journal articles. Methods/Design. This study will be conducted on peer-reviewed articles published between 2005 and 2019 to explore the preparedness of emergency medical service providers in emergencies and disasters. Scopus, Web of Science, PubMed, and Google Scholar will be thoroughly searched to identify published studies on emergency and disaster preparedness. The following keywords will be used for searching the databases: "Medical Technician," "Paramedic," "Emergency Paramedic," "Emergency Medicine Technician," "Emergency Medical Technician," "Emergency Prehospital Provider," "Emergency Preparedness," "Disaster Preparedness," "Hospital Preparedness," "Disaster management," "Disaster Competencies," "Disaster Readiness," "Disaster," "Disaster Role," "Readiness, Preparedness, Terrorist," "Mass Casualty Incident," "Major incidents," "Mass Casualty," "Mass Gathering," "CBRNE," "Weapons of Mass Destruction," and "Chemical, Biological, Radiological, Nuclear, and Explosive Event." Discussion. To the best of our knowledge, no comprehensive review study has been conducted on the preparedness of emergency medical service providers in disaster situations. This study is the first attempt to address this gap. It will also explore the key dimensions in disaster preparedness of EMS providers and the strategies to enhance their preparedness. Identifying the key dimensions of disaster preparedness is the first step in designing and developing valid instruments to evaluate EMS provider's disaster preparedness and as well as adopting appropriate strategies to improve the level of their preparedness (This systematic review is registred in PROSPERO with CRD42020149689).

Work-Family Conflict among Iranian Emergency Medical Technicians and Its Relationship with Time Management Skills: A Descriptive Study.

BACKGROUND: Work-Family Conflict (WFC) is a form of interrole conflict in which an active participation in occupational activities causes strain and interferes with family roles of workers and vice versa. It is a major source of occupational stress among workers and personnel. Emergency Medical Technicians (EMTs) are an important part of the healthcare system that respond to emergencies. The EMTs experience high level of job stress, which may affect their ability to perform their family roles, and, on the other hand, actively performing their family responsibilities may interfere with the effective delivery of the already stressful activities at workplace. OBJECTIVE: The aim of this study was to determine the prevalence of WFC among Emergency Medical Technicians in Iran and its relationship with time management skills. METHODS: This was a descriptive study. In this study, 271 EMTs from the western part of Iran completed the questionnaire for the assessment of WFC. The Carlson Family-Conflict Questionnaire and the "Time Management Behaviors Scale" developed by Macan were used as evaluation instruments. The data were analyzed by SPSS software version 16. Appropriate statistical analysis such as mean and standard deviation, Pearson correlation, and Spearman rank correlation was applied for analyzing the data in SPSS. RESULTS: The majority of the participants reported some degrees of WFC. Statistical analysis showed a significant inverse correlation between total WFC score and total "Time Management Behaviors scale" score (r = -0/381، p < 0/0001). In the present study, there was no significant correlation between total WFC score and demographic factors such as educational level, age, sex, marital status, number of family members, need for family member care, and work experience (p > 0.05). CONCLUSIONS: The findings of this study indicate that time management behaviors and skills can reduce WFC among Emergency Medical Technicians. Therefore, it is recommended that prehospital emergency authorities and policymakers plan and implement measures such as reducing the duration of shift-work schedules, decreasing shift-change restrictions, and organizing regular time management courses. Also, employment of local inhabitants is preferred to geographically distant individuals with similar qualification as this will reduce the distance between home and workplace.

Evaluating the disaster preparedness of emergency medical service agencies in the world: A systematic literature review protocol.

INTRODUCTION: Disasters occur almost everywhere in the world, and preparation is essential. Preparedness is an effective approach for disaster management, and it is crucial for the health systems, especially the Emergency Medical Service (EMS) agencies. This systematic review will be conducted to assess the preparedness levels of EMS agencies in the world for the response to disasters and explore the key dimensions and strategies to enhance it. METHODOLOGY: This systematic literature review will be conducted to search comprehensively the articles published between 2000 and 2019 to explore the disaster preparedness of EMS Agencies. To this end, PubMed, Scopus, Web of Science, and Google Scholar will be thoroughly assessed. The following terms and expression will be used for searching the databases: "EMS" and other keywords "Disaster Preparedness," "Mass Casualty Incident," "Mass Gathering," "Terrorist incident," "Weapons of Mass Destruction," and CBRNE, Disaster, included: 'Emergency Preparedness, Preparedness, Readiness. DISCUSSION: To the best of our knowledge, no systematic review study has been conducted on disaster preparedness of EMS agencies in the world. This is the first study to address this gape. It will also explore the key dimensions of disaster preparedness in EMS services and the strategies to enhance their preparedness. CONCLUSION: Identifying the key dimensions of disaster preparedness is the first step in designing valid assessment tools to evaluate disaster preparedness of EMS service. This study will provide valuable guides for EMS administrators and researchers in an attempt to enhance of preparedness of EMS systems in disasters.

The effect of education and implementation of "National Hospital Disaster Preparedness Plan" on an Iranian hospital preparedness: An interventional study.

INTRODUCTION: Hospitals as the first place for injuries have to keep up and increase activities in emergency and disasters. Therefore, any hospital necessarily requires disasters plan to improve its preparedness. The aim of this study is to investigate the effect of education and implementation of "National Hospital Disaster Preparedness Plan (NHDPP)" on Vali Asr Hospital preparedness in Iran. METHODOLOGY: In a pre- and post-intervention study, NHDPP educated in five sessions, and it was used as a guide in the promotion of Vali Asr Hospital preparedness in Iran. The Iranian version of "Hospital Disaster Preparedness (HDP) assessment tool" was used to measure the hospital preparedness score. Finally, the quantitative data analyzed by using IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp. RESULTS: Before intervention, the HDP score was measured in total and in the nine dimensions of preparedness. But after the intervention, it increased, 33% in command and control dimension, 33% in communication, 21% in safety and security, 26% in triage, 36% in surge capacity, 24% in the continuity of vital services, 27% in human resources, 13% in support and supplies management, and 7% in post disaster recovery dimension. Furthermore, the total HDP score increased about 24.5% after the intervention. CONCLUSION: This study demonstrates that the "Iranian HDP plan" leads to improve the Vali Asr HDP score. Therefore, by planning and implementation of effective educational programs, it is possible to improve the hospitals' preparedness in Iran.

Comparing the effects of two different educational methods on clinical skills of emergency intermediate technician: A quasi-experimental research.

BACKGROUND: Assessing the clinical skills of prehospital Intermediate technician is considered to be one of the priorities in dealing with diseases, which may provide an appropriate reflection of the training programs. The purpose of this study was to compare the two methods of clinical skills training of emergency intermediate technician. METHODS: This quasi-experiment was carried out on Kerman's emergency medical technicians in 2017. Operational and clinical skills, such as cardiopulmonary resuscitation (CPR), triage, familiarity with the equipment, and proper patient transportation methods, were taught in both electronic and traditional methods on two groups, each consisting of 30 intermediate technicians. Finally, the personnel's satisfaction level with the two teaching methods was compared and analyzed using IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp. RESULTS: There was no significant difference between the theoretical test scores in both the electronic and traditional methods in all the participants (triage, pulmonary resuscitation, familiarity with equipment, and patient transportation). Furthermore, there were significant differences between the practical test scores in both the electronic and traditional methods, in all the participants except triage. There was a significant difference between learners' satisfaction in both electronic and traditional methods in two areas of teaching and course difficulty in CPR, equipment usage, and methods of transportation. CONCLUSION: According to the results obtained by the present study, the electronic educational systems due to their inclusive and interactive nature are recommended to be employed in courses that have more theoretical aspects such as triage. The traditional method is suggested in teaching practical courses such as CPR that need more practical and clinical skills.