Navigating Through Disaster: Application of Oncology Nurse Navigator Competencies to Climate Disaster Preparation and Response.

OBJECTIVES: The role of the oncology nurse navigator (ONN) before, during, and after a climate disaster is critical to ensuring that individuals with cancer continue to receive the necessary care and support. The objective of this article is to provide an overview of the essential role of the ONN by highlighting the application of core competencies to climate disasters. METHODS: Competencies available for ONNs from the Oncology Nursing Society include coordination of care, communication, education, professional role, and expertise. International Council of Nurses (ICN) core competencies for disaster nursing include eight domains: preparation and planning, communication, incident management systems, safety and security, assessment, intervention, recovery, and law and ethics. These competencies are explored for application to climate disaster preparation, mitigation, and response. RESULTS: The ONN competencies and the domains of the ICN disaster nursing competencies were integrated to outline the role of the ONN in disaster preparedness and response. CONCLUSION: The ONN is pivotal in maintaining the continuity of cancer care. The ONN's expertise is critical for navigating the difficulties presented by hurricanes, floods, wildfires, and other extreme climate events as well as existing barriers to cancer care. The ONN's adeptness at coordinating care, communicating effectively, and tapping into community resources will transfer to a climate disaster, ensuring minimal treatment interruptions and access to necessary care. IMPLICATIONS FOR NURSING PRACTICE: The ONN is integral to the cancer care team in preparing and responding to climate disasters. The ONN ensures ongoing access to cancer care and advocates for the specialized care that people with cancer need. The ONS ONN Core Competencies and the ICN Disaster Competencies are applicable for developing processes and procedures to address climate disasters in clinical practice.

Longitudinal multiplexity and structural constraints of online emergency collaborative networks: A tale of two Chinese societies.

Drawing upon the concept of longitudinal multiplexity and the Institutional Collection Action (ICA) framework, this article conducts a longitudinal observation of online emergency collaborative networks (ECNs) built and sustained among organizational actors within Shenzhen and Hong Kong in response to Typhoon Mangkhut. In addition to investigating the multiplex relationships among three types of online ECNs (i.e., preparedness networks, response networks, recovery networks), this article takes a comparative approach to examining how the structural constraints imposed by distinct emergency management systems (EMSs) influence the network formation and evolution as the disaster evolves over time. Findings obtained from a series of inferential network analyses reveal that preexisting online collaborative ties formed at the disaster preparedness stage are important for increasing organizations' tendency to build and sustain online collaborations during disaster response and recovery. Moreover, the decentralized EMS in Hong Kong exhibits more effectiveness in facilitating online network changes during both transitional periods. These findings demonstrate a pressing need for emergency researchers and frontline communication managers to understand the dynamic relationships among online ECNs across different disaster phases and further explore potential opportunities to facilitate online emergency collaboration on a broader scale.

Learning From Simulating Mass Casualty Events: A Systematic Search and a Comprehensive Qualitative Review.

Mass casualty events (MCE) strain available health-care resources requiring extraordinary measures. Simulated exercises are used to improve preparedness. We sought to identify learning points and common themes arising from such exercises in literature. Reporting of action points to improve response plans were investigated. Type of exercises, environments, and departments were also explored. We systematically searched 3 databases and applied our eligibility criteria. Inclusion criteria were in-situ MCE simulations of clinical response to traumatic MCEs, including scene management, prehospital care, and in hospital care. Exclusion criteria were nonmedical response, infectious outbreaks, training courses with self-selecting participants, simulations assessing mechanical tools, and mathematical modeling. A total of 6883 titles were identified and screened. Eighty-three studies were read in full. Twenty-two articles were included. We identified numerous learning points, which were collated and categorized into 11 themes. Fifty-nine percent of the papers reported actions that would be or had been implemented. MCE simulation exercises have been found to improve familiarity and confidence among participants. The 11 themes identified from published exercises overlap with areas of improvement from real events. MCE simulations in the literature appear to focus on carrying out the exercise itself rather than learning points possibly missing opportunities to improve response plans.

Improving mass casualty planning in low resource settings: Médecins Sans Frontières and International Committee of the Red Cross perspective.

Mass casualty events occur on a regular although unpredictable basis within the contexts of both Mèdecins Sans Frontières (MSF) and the International Committee of the Red Cross (ICRC) activities. The frequency of both natural disasters and other mass casualty incidents is increasing with urbanisation and industrialisation, compounded by climate change and conflict. Both organisations have recognised that the historical training focus on full-scale mass casualty simulations has not always been followed through to the resolution of action points and dissemination of learning. Staff training for mass casualty management has been variable. This led MSF and ICRC to develop a multimodal approach to assist development of mass casualty plans and preparedness. Capitalising on our presence in these contexts we are incorporating our experience of quality improvement and change management to complement simulation to 'stress and test' systems. We examine the challenges and share our efforts to improve training of staff in field projects across both MSF and ICRC and discussing future innovations.

Review of the requirements for effective mass casualty preparedness for trauma systems. A disaster waiting to happen?

Mass casualty incidents (MCIs) are diverse, unpredictable, and increasing in frequency, but preparation is possible and necessary. The nature of MCIs requires a trauma response but also requires effective and tested disaster preparedness planning. From an international perspective, the aims of this narrative review are to describe the key components necessary for optimisation of trauma system preparedness for MCIs, whether trauma systems and centres meet these components and areas for improvement of trauma system response. Many of the principles necessary for response to MCIs are embedded in trauma system design and trauma centre function. These include robust communication networks, established triage systems, and capacity to secure centres from threats to safety and quality of care. However, evidence from the current literature indicates the need to strengthen trauma system preparedness for MCIs through greater trauma leader representation at all levels of disaster preparedness planning, enhanced training of staff and simulated disaster training, expanded surge capacity planning, improved staff management and support during the MCI and in the post-disaster recovery phase, clear provision for the treatment of paediatric patients in disaster plans, and diversified and pre-agreed systems for essential supplies and services continuity. Mass casualty preparedness is a complex, iterative process that requires an integrated, multidisciplinary, and tiered approach. Through effective preparedness planning, trauma systems should be well-placed to deliver an optimal response when faced with MCIs.

Transfusion support during mass casualty events.

Transfusion support is an essential element of modern emergency healthcare. Blood services together with hospital transfusion teams are required to prepare for, and respond to, mass casualty events as part of wider healthcare emergency planning. Preparedness is a constant collaborative process that actively identifies and manages potential risks, to prevent such events becoming a 'disaster'. The aim of transfusion support during incidents is to provide sufficient and timely supply of blood components and diagnostic services, whilst maintaining support to other patients not involved in the event.

The design of the arrangement of evacuation routes on a passenger ship using the method of genetic algorithms.

The article concerns the problem of evacuation from passenger ships. It is important because it has not yet been possible to eliminate all the hazards associated with sea travel. In this paper, a concept of a method allowing to determine the arrangement of evacuation routes, for which evacuation time would be minimal, was presented. The genetic algorithm method was used in the calculations, and an original method of coding the considered problem was proposed. Sample calculations were performed to verify the correctness of the proposed algorithm. The results of applying the developed method to calculate the evacuation time on a real passenger ship are presented.

Scientific research and product development in the United States to address injuries from a radiation public health emergency.

The USA has experienced one large-scale nuclear incident in its history. Lessons learned during the Three-Mile Island nuclear accident provided government planners with insight into property damage resulting from a low-level release of radiation, and an awareness concerning how to prepare for future occurrences. However, if there is an incident resulting from detonation of an improvised nuclear device or state-sponsored device/weapon, resulting casualties and the need for medical treatment could overwhelm the nation's public health system. After the Cold War ended, government investments in radiation preparedness declined; however, the attacks on 9/11 led to re-establishment of research programs to plan for the possibility of a nuclear incident. Funding began in earnest in 2004, to address unmet research needs for radiation biomarkers, devices and products to triage and treat potentially large numbers of injured civilians. There are many biodosimetry approaches and medical countermeasures (MCMs) under study and in advanced development, including those to address radiation-induced injuries to organ systems including bone marrow, the gastrointestinal (GI) tract, lungs, skin, vasculature and kidneys. Biomarkers of interest in determining level of radiation exposure and susceptibility of injury include cytogenetic changes, 'omics' technologies and other approaches. Four drugs have been approved by the US Food and Drug Administration (FDA) for the treatment of acute radiation syndrome (ARS), with other licensures being sought; however, there are still no cleared devices to identify radiation-exposed individuals in need of treatment. Although many breakthroughs have been made in the efforts to expand availability of medical products, there is still work to be done.

Health technology assessment applied to emergency preparedness: a new perspective.

Emergency preparedness is a continuous quality improvement process through which roles and responsibilities are defined to effectively anticipate, respond to, and recover from the impact of emergencies. This process results in documented plans that provide a backbone structure for developing the core capacities to address health threats. Nevertheless, several barriers can impair an effective preparedness planning, as it needs a 360° perspective to address each component according to the best evidence and practice. Preparedness planning shares common principles with health technology assessment (HTA) as both encompass a multidisciplinary and multistakeholder approach, follow an iterative cycle, adopt a 360° perspective on the impact of intervention measures, and conclude with decision-making support. Our "Perspective" illustrates how each HTA domain can address different component(s) of a preparedness plan that can indeed be seen as a container of multiple HTAs, which can then be used to populate the entire plan itself. This approach can allow one to overcome preparedness barriers, providing an independent, systematic, and robust tool to address the components and ensuring a comprehensive evaluation of their value in the mitigation of the impact of emergencies.