Pandemic Management: Health Data and Public Health Surveillance.

The inefficiency of the healthcare system in addressing pandemics is highlighted after COVID-19 which is mostly rooted in data availability and accuracy. As it is believed we might witness more pandemics in future, our research's main objective is to propose an integrated health system to support healthcare preparedness for future infectious outbreaks and pandemics. The system could support managers and authorities in healthcare and disaster management, and policymakers through data collection, sharing, and analysis.

Development of disaster nursing in Nepal: Opportunities and challenges for advanced practice.

AIM: This article discusses the evolution of the field of disaster nursing in Nepal and its challenges and ways to protect the health and well-being of the community during disasters. It also discusses the alignment of field activities with the International Council of Nurses' (ICN) competencies in disaster nursing. BACKGROUND: Disaster nursing has become increasingly important due to the increasing frequency and impact of disasters on health. In Nepal, disaster nursing is a relatively new field, but it has grown over the years with nurses playing a vital role in providing holistic care during disasters, emergencies, and crises. SOURCES OF EVIDENCE: Literature review and experience from the field. DISCUSSION: Following the Nepal earthquake, the concept of the "epidemiology nurse" evolved in Nepal which trained local nurses with disaster nursing knowledge and skills using the digital information, communication, and technology (ICT) toolkit for collecting real-time information. Nurses monitored the environment, conducted physical and mental health assessments, identified the needs of vulnerable populations, provided basic aid, offered mental health support, and shared data with authorities. However, their competencies are not yet enough to fully align with those given by ICN nursing standards. CONCLUSION: Recognizing the valuable contributions of Nepalese nurses in the field, their initiatives can serve as a foundation for advancing their roles in disaster nursing. It is essential to implement national disaster plans and invest in specialized university courses for disaster nursing training. IMPLICATIONS FOR NURSING POLICY: The field experiences of disaster nursing reflected in this article can contribute to the development of policies and practices related to disaster management in adherence to the ICN' guidelines.

Hospital preparedness for COVID-19 in Indonesia.

Introduction: As a disaster-prone country, hospital preparedness in dealing with disasters in Indonesia is essential. This research, therefore, focuses specifically on hospital preparedness for COVID-19 in Indonesia, which is important given the indication that the pandemic will last for the foreseeable future. Methods: During March to September 2022, a cross-sectional approach and a quantitative study was conducted in accordance with the research objective to assess hospital preparedness for the COVID-19 pandemic. This research shows the level of readiness based on the 12 components of the rapid hospital readiness checklist for COVID-19 published by the World Health Organization (WHO). Evaluators from 11 hospitals in four provinces in Indonesia (Capital Special Region of Jakarta, West Java, Special Region of Yogyakarta, and North Sumatra) filled out the form in the COVID-19 Hospital Preparedness Information system, which was developed to assess the level of hospital readiness. Results: The results show that hospitals in Capital Special Region of Jakarta and Special Region of Yogyakarta have adequate level (≥ 80%). Meanwhile, the readiness level of hospitals in West Java and North Sumatra varies from adequate level (≥ 80%), moderate level (50% - 79%), to not ready level (≤ 50%). Conclusion: The findings and the methods adopted in this research are valuable for policymakers and health professionals to have a holistic view of hospital preparedness for COVID-19 in Indonesia so that resources can be allocated more effectively to improve readiness.

Climate disasters and oncology care: a systematic review of effects on patients, healthcare professionals, and health systems.

PURPOSE: Climate disasters have devastating effects on communities and society that encompass all aspects of daily life, including healthcare. Patients with cancer are particularly vulnerable when disaster strikes. As the number and intensity of disasters increases, it is important to understand the effects across the cancer care continuum. This systematic review investigates the effect of climate disasters on patients, the oncology healthcare workforce, and healthcare systems. METHODS: A medical librarian conducted a literature search in PubMed, Embase, CINAHL, and Web of Science from January 1, 2016, through May 11, 2022. Eligible studies included any published report on a climate disaster globally reporting on patient-, oncology healthcare workforce-, or healthcare systems-level outcomes. Study quality was assessed, and findings were narratively synthesized, given the diversity of reported evidence. RESULTS: The literature search identified 3618 records, of which 46 publications were eligible for inclusion. The most frequent climate disaster was hurricanes (N = 27) followed by tsunami (N = 10). Eighteen publications were from disasters that occurred in the mainland USA with 13 from Japan and 12 from Puerto Rico. Patient-level outcomes included treatment interruptions and inability to communicate with the healthcare team. At the workforce level, findings included distressed clinicians caring for others when their own lives have been affected by a disaster along with lack of disaster preparedness training. Health systems reported closures or shifting services post-disaster and a need to have improved emergency response plans. CONCLUSION: Response to climate disasters necessitates a holistic approach at the patient, workforce, and health systems levels. Specifically, interventions should focus on mitigating interruptions in care for patients, advanced coordination and planning for workforce and health systems, and contingency planning for allocation of resources by health systems.

[Management of COVID-19 mass casualty incidents in nursing and retirement homes]. / Managementstrategie für den Massenanfall von Erkrankten/Infizierten in Alten- und Pflegeheimen im Kontext der COVID-19-Pandemie.

BACKGROUND: During the coronavirus disease 2019 (COVID-19) pandemic, outbreaks in inpatient care facilities, which grow into a large-scale emergency scenario, are frequently observed. A standardized procedure analogous to algorithms for mass casualty incidents (MCI) is lacking. METHODS: Based on a case report and the literature, the authors present a management strategy for infectious MCI during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic and distinguish it from traumatic MCI deployment tactics. RESULTS: This management strategy can be divided into three phases, beginning with the acute emergency response including triage, stabilization of critical patients, and transport of patients requiring hospitalization. Phase 2 involves securing the facility's operational readiness, or housing residents elsewhere in case staff are infected or quarantined to a relevant degree. Phase 3 marks the return to regular operations. DISCUSSION: Phase 1 is based on usual MCI principles, phase 2 on hospital crisis management. Avoiding evacuation of residents to relieve hospitals is an important operational objective. The lack of mission and training experience with such situations, the limited applicability of established triage algorithms, and the need to coordinate a large number of participants pose challenges. CONCLUSION: This strategic model offers a practical, holistic approach to the management of infectious mass casualty scenarios in nursing facilities.

Assessing Hospital Adaptive Resource Allocation Strategies in Responding to Mass Casualty Incidents.

OBJECTIVES: Hospitals are expected to operate at a high-performance level even under exceptional conditions of peak demand and resource disruptions. This understanding is not mature yet, and there are wide areas of possible improvement. In particular, the fast mobilization and reconfiguration of resources frequently result into the severe disruption of elective activities, worsening the quality of care. More resilient resource allocation strategies, ie, which adapt to the dynamics of the prevailing circumstance, are needed to maximize the effectiveness of health-care delivery. In this study, a simulation approach was adopted to assess and compare different hospital's adaptive resource allocation strategies in responding to a mass casualty incident (MCI). METHODS: A specific set of performance metrics was developed to take into consideration multiple objectives and priorities and holistically assess the effectiveness of health-care delivery when coping with an MCI event. Discrete event simulation (DES) and system dynamics (SD) were used to model the key hospital processes and the MCI plan. RESULTS: In the daytime scenario, during the recovery phase of the emergency, a gradual disengagement of resources from the emergency department (ED) to restart ordinary activities in operating rooms and wards, returned the best performance. In the night scenario, the absorption capacity of the ED was evaluated by identifying the current bottleneck and assessment of the benefit of different resource mobilization strategies. CONCLUSIONS: The present study offers a robust approach, effective strategies, and new insights to design more resilient plans to cope with MCIs. Future research is needed to widen the scope of the analysis and take into consideration additional resilience capacities, such as operational coordination mechanisms, among multiple hospitals in the same geographic area.

Rethinking preparedness planning in disaster emergency care: lessons from a beyond-surge-capacity event.

BACKGROUND: Large-scale burn disasters can produce casualties that threaten medical care systems. This study proposes a new approach for developing hospital readiness and preparedness plan for these challenging beyond-surge-capacity events. METHODS: The Formosa Fun Coast Dust Explosion (FFCDE) was studied. Data collection consisted of in-depth interviews with clinicians from four initial receiving hospitals and their relevant hospital records. A detailed timeline of patient flow and emergency department (ED) workload changes of individual hospitals were examined to build the EDs' overload patterns. Data analysis of the multiple hospitals' responses involved chronological process-tracing analysis, synthesis, and comparison analysis in developing an integrated adaptations framework. RESULTS: A four-level ED overload pattern was constructed. It provided a synthesis of specifics on patient load changes and the process by which hospitals' surge capacity was overwhelmed over time. Correspondingly, an integrated 19 adaptations framework presenting holistic interrelations between adaptations was developed. Hospitals can utilize the overload patterns and overload metrics to design new scenarios with diverse demands for surge capacity. The framework can serve as an auxiliary tool for directive planning and cross-check to address the insufficiencies of preparedness plans. CONCLUSIONS: The study examined a wide-range spectrum of emergency care responses to the FFCDE. It indicated that solely depending on policies or guidelines for preparedness plans did not contribute real readiness to MCIs. Hospitals can use the study's findings and proposal to rethink preparedness planning for the future beyond surge capacity events.

Health Disparity, Natural Disaster, and COVID-19: Perspectives From a Bahamian American Nurse.

Trauma clusters are formed when 2 or more disasters occur simultaneously and/or consecutively. These disasters have the propensity to potentiate health disparities. The purpose of this article is to share thoughts about critical caring theory and how the theory can inform holistic nursing action when health disparity amplifies trauma clustering.

Revising "Nutritional Reference Values for Feeding at Evacuation Shelters" According to Nutrition Assistance by Public Health Dietitians Based on Past Major Natural Disasters in Japan: A Qualitative Study.

It is important to provide nutritionally adequate food in shelters to maintain the health of evacuees. Since the Great East Japan Earthquake in 2011, Japan's Ministry of Health, Labour and Welfare has released the "Nutritional Reference Values for Evacuation Shelters" (Reference Values) after every major natural disaster. There is clear evidence, however, that the Reference Values have only been used infrequently. This study aims to revise these guidelines to include the actual situation in the affected areas and the feasibility of the endeavor. This qualitative study uses group interviews with local government dietitians to propose revisions to Japan's Reference Values. These revisions include the following: issuing Reference Values within 1 week of a disaster, showing one type of values for meal planning for each age group, showing the minimum values of vitamins, upgrading salt to basic components, creating three phases of nutrition (Day 1, Days 1-3, and After Day 4), stipulating food amounts rather than nutrient values, and creating a manual. Local government officials could use the Reference Values as guidelines for choosing food reserves, and dietitians could use them while formulating supplementary nutrition strategies for a model menu in preparation for disasters.

COVID-19 Response in Thailand and Its Implications on Future Preparedness.

Thailand has been affected by COVID-19, like other countries in the Asian region at an early stage, and the first case was reported as early as mid-January 2020. Thailand's response to the COVID-19 pandemic has been guided by the "Integrated Plan for Multilateral Cooperation for Safety and Mitigation of COVID-19". This paper analyses the health resources in the country and focuses on the response through community-level public health system and legislative measures. The paper draws some lessons on future preparedness, especially with respect to the four priorities of Sendai Framework for Disaster Risk Reduction. At the end, the paper puts some key learning for future preparedness. While Thailand's response to COVID-19 has been effective in limiting the spread of the disease, it falls short at being able to address the multiple dimensions of the crisis such as the economic and social impacts. The socioeconomic sectors have been hardest hit, with significant impact on tourism sectors. Sociopolitical system also plays an important role in governance and decision-making for pandemic responses. The analysis suggests that one opportunity for enhancing resilience in Thailand is to strive for more multilevel governance that engages with various stakeholders and to support grassroots and community-level networks. The COVID-19 pandemic recovery is a chance to recover better while leaving no one behind. An inclusive long-term recovery plan for the various impacted countries needs to take a holistic approach to address existing gaps and work towards a sustainable society. Furthering the Health Emergency Disaster Risk Management (HEDRM) Framework may support a coordinated response across various linked sectors rather than straining one particular sector.

A New Paradigm for Addressing Health Disparities in Inner-City Environments: Adopting a Disaster Zone Approach.

Inner cities are characterized by intergenerational poverty, limited educational opportunities, poor health, and high levels of segregation. Human capital, defined as the intangible, yet integral economically productive aspects of individuals, is limited by factors influencing inner-city populations. Inner-city environments are consistent with definitions of disasters causing a level of suffering that exceeds the capacity of the affected community. This article presents a framework for improving health among inner-city populations using a multidisciplinary approach drawn from medicine, economics, and disaster response. Results from focus groups and photovoice conducted in Milwaukee, WI are used as a case study for a perspective on using this approach to address health disparities. A disaster approach provides a long-term focus on improving overall health and decreasing health disparities in the inner city, instead of a short-term focus on immediate relief of a single symptom. Adopting a disaster approach to inner-city environments is an innovative way to address the needs of those living in some of the most marginalized communities in the country.

A whole city approach to mass casualty planning.

Traditionally, the response to mass casualty incidents has focused on the front line. However, effective management of these incidents relies on the seamless coordination of emergency, municipal and community services activities. The coordinated, complex planning required for response and recovery requires a holistic planning perspective, extensive engagement and collaborative problem-solving approach. This case study looks at the challenges, opportunities and solutions encountered by the Calgary Emergency Management and Calgary Police Service in its collective planning process for mass casualty incidents. The intent of Calgary's mass casualty incident plan is to provide an overarching framework to outline how all of the individual organisational plans come into effect to provide comprehensive response and recovery efforts. It does not provide an in-depth look at the frontline emergency services response, but rather looks at how these critical efforts can work in conjunction with a range of additional municipal, private and non-governmental agencies to provide for the full spectrum of needs victims, families and the community will have during and following a mass casualty incident.

Disaster Nursing: Taking Your Faith to the Field.

National and global disasters require immense resources, including nurses. Personal, professional, and spiritual preparation is strongly recommended for healthcare workers who desire to serve in disaster settings. Most nurses are underprepared for this role; options for preparation are described along with the ministry of nursing and spiritual care that expresses God's heart of mercy and care for hurting and desperate people.

Long-Term Impact of Disasters on the Public Health System: A Multi-Case Analysis.

As past events have shown, disasters can have a tremendous impact on the affected population's health. However, research regarding the long-term impact on a systems level perspective is still scarce. In this multi-case study, we analyzed and compared the long-term impacts on the public health system of five disasters which took place in Europe: avalanche (Austria), terror attack (Spain), airplane crash (Luxembourg), cable-car tunnel fire (Austria), and a flood in Central Europe. We used a mixed-methods approach consisting of a document analysis and interviews with key stakeholders, to examine the various long-term impacts each of the disasters had on health-system performance, as well as on security and health protection. The results show manifold changes undertaken in the fields of psychosocial support, infrastructure, and contingency and preparedness planning. The holistic approach of this study shows the importance of analyzing long-term impacts from the perspective of the type (e.g., disasters associated with natural hazards) and characteristic (e.g., duration and extent) of a disaster, as well as the regional context where a disaster took place. However, the identified recurring themes demonstrate the opportunity of learning from case studies in order to customize the lessons and apply them to the own-disaster-management setting.

Muddling through troubled water: resilient performance of incident management teams during Hurricane Harvey.

Modern communities face escalating threats from natural disasters. Thus, the resilience of incident management teams (IMTs) during adverse events becomes crucial to protect lives and physical systems. However, prior studies have only partially highlighted factors related to IMT resilience. To provide a holistic understanding of the resilience of the IMTs, this study conducted semi-structured interviews with 10 experienced IMT personnel during Hurricane Harvey. Thematic analysis revealed six characteristics of resilient IMTs during a hurricane event: (i) establishing a common operating picture, (ii) adopting and adapting plans and protocols, (iii) proactive, re-prioritizing, and unconventional decision-making, (iv) enhancing resourcefulness and redundancy, (v) learning for improved anticipation and response readiness, and (vi) inter-organisational relationship to promote IMT functions. As an empirical investigation of the resilience of the IMTs, the findings inform future endeavours for developing incident information technologies and strategies to harmonise pre-established plans with adaptive actions in the field and fostering capabilities to learn from incidents. Practitioner summary: Resilient incident management teams establish a common operating picture; effectively adopt and adapt plans and protocols; make decisions in an unconventional and anticipatory fashion; constantly re-prioritize goals and tasks; enhance resourcefulness and redundancy; continuously learn skills for improved anticipation and response readiness; and exhibit good inter-organisational coordination and planning skills.

A mindfulness toolkit to optimise incident management and business continuity exercises.

Mindfulness is the daily practice of noticing our present moment experiences (thoughts, emotions and physical sensations) with curiosity, non-judgment and equanimity (accepting what is). Scientific research shows that the regular practice of mindfulness can help lower stress, boost the immune system and increase productivity. Recognising these benefits, companies such as Google, Nike and Goldman Sachs have incorporated mindfulness programmes into the workplace. Among the positive results reported, these companies have observed a reduction in sick leave, improved collaboration between employees, and projects being completed more effectively. But these are only some of the benefits that mindfulness can offer. Other advantages include improved emotional regulation and better decision-making during a crisis. This suggests that those C-level executives and recovery teams who play key roles in restoring mission-critical processes following business-disruptive events would benefit from mindfulness training. This paper will explore how and why mindfulness can help optimise incident management, the training tools required, and how to build mindfulness into a business continuity management training and exercise programme.