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1.
Niger J Clin Pract ; 25(1): 27-32, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35046191

RESUMO

Background: The disaster situations call upon the effective and speedy response from the nurses. The link to self-perceived competence in disaster preparedness remains unclear, although there is strong support for competence in nursing practice to ensure safe patient care. Aims: The study aims to evaluate the self-perceived competence and familiarity of nurses at personal and professional levels concerning disaster preparedness. Cross-sectional exploratory design was employed. A sample of 350 nurses from five government hospitals in Medina was surveyed using an emergency preparedness information questionnaire. Patients and Methods: IBM SPSS (Statistical Package for Social Sciences) for Windows, Version 21.0, was used for analyzing the data. Results: Nurses perceived inadequate preparation for emergencies. The unit area had no impact on their self-perceived competence and familiarity. Conclusions: Female nurses, non-Saudi staff, and years of work experience were perceived to increase nurse competence in disaster preparedness. The managers can create activities to enable nurses to learn and view their disaster preparedness concerns.


Assuntos
Defesa Civil , Planejamento em Desastres , Desastres , Enfermeiras e Enfermeiros , Estudos Transversais , Feminino , Hospitais Públicos , Humanos , Inquéritos e Questionários
2.
Surg Clin North Am ; 102(1): 169-180, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34800385

RESUMO

Mass casualty incidents are increasingly common. They are defined by large numbers of patients arriving nearly simultaneously, overwhelming available resources needed for optimal care. They require rapid mobilization of resources to provide optimal outcomes and limit disability and death. Because the mechanism of injury in a mass casualty incident is often traumatic in nature, surgeons should be aware of the critical role they play in planning and response. The coronavirus disease 2019 pandemic is a notable, resulting in a sustained surge of critically ill patients. Initial response requires local mobilization of resources; large-scale events potentially require a national response.


Assuntos
Defesa Civil , Serviços Médicos de Emergência , Recursos em Saúde , Incidentes com Feridos em Massa , COVID-19/epidemiologia , COVID-19/prevenção & controle , Árvores de Decisões , Humanos , Triagem
3.
Artigo em Inglês | MEDLINE | ID: mdl-34948550

RESUMO

BACKGROUND: Previous research has suggested many households are meeting the Federal Emergency Management Agency's 3-day emergency food and water storage recommendations. The impact of limited economic household resources on emergency preparedness practices related to food and water is uncertain. The purpose of this study was to compare emergency preparedness practices in households participating in United States' food assistance programs with households not participating in these programs. METHODS: A convenience sample of adults (n = 572) completed an online Qualtrics survey. Descriptive statistics, chi-square statistics, and independent t-tests were used to measure differences between households participating in food assistance programs vs. non-participating households. RESULTS: Most households participating in food assistance programs felt prepared to provide household members with food and water during an emergency, which did not significantly differ from non-participating households. Households using food assistance programs had less accessible cash but had similar foods on-hand for an emergency compared to non-participating households. However, they more frequently reported having baby formula/food and less frequently reported having vitamin/mineral supplements compared to non-participating households. CONCLUSIONS: Food assistance programs may be effective in providing enough food and water to help low-income families be prepared for an emergency.


Assuntos
Defesa Civil , Assistência Alimentar , Adulto , Características da Família , Alimentos , Abastecimento de Alimentos , Humanos , Pobreza , Estados Unidos
4.
Am J Disaster Med ; 16(3): 167-177, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34904701

RESUMO

OBJECTIVE: To capture organizational level information on the current state of public health emergency response leadership training. DESIGN: A web-based questionnaire. PARTICIPANTS: This multitiered assessment of health departments included two distinct respondent groups: (1) Public Health Emergency Preparedness (PHEP) Cooperative Agreement recipients (n = 34) and (2) local health departments (LHDs) (n = 169) representative of different agency sizes and populations served. RESULTS: Overall, PHEP and LHD respondents expressed a clear preference for participatory learning with practical drills/exercises and participatory workshops as the preferred training delivery modes. Compared with technical and role-specific training, leadership training was less available. For both PHEP and LHD respondents, staff availability for training is most notably limited due to lack of time. For PHEP respondents, a common factor limiting agency ability to offer training is lack of mentors/instructors, whereas for LHD respondents, it is limited funding. CONCLUSIONS: Efforts should focus on increasing accessibility and the continued development of rigorous and effective training based on practical experience in all aspects of multitiered public health emergency response leadership.


Assuntos
Defesa Civil , Saúde Pública , Humanos , Liderança , Governo Local , Inquéritos e Questionários
5.
J Emerg Manag ; 18(7): 99-113, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34723351

RESUMO

Existing research on individual preparedness in the United States indicates that we are generally unprepared for disasters. While there is an abundance of research on emergency preparedness, there are gaps in our knowledge. For example, the results of extant research are unclear regarding what factors influence individual preparedness. The preparedness literature is also limited in the types of disasters examined and in understanding the timing of preparedness activities. The current COVID-19 global pandemic provides a tragic but albeit unique opportunity to address these limitations of previous research and examine emergency preparedness activities before and immediately following the onset of the COVID-19 outbreak in the United States. This research is further distinctive because it examines preparedness activities related to the global pandemic rather than other types of disasters. Policy and research implications of the findings are presented.


Assuntos
COVID-19 , Defesa Civil , Desastres , Humanos , Pandemias/prevenção & controle , SARS-CoV-2 , Estados Unidos
6.
J Emerg Manag ; 19(7): 39-48, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34723367

RESUMO

The COVID-19 pandemic exposed numerous challenges in the emergency management (EM) response system. The article contends that had EM deliberately and systematically engaged in systems thinking; it would have been better able to anticipate and respond to many of the challenges. Reasons for EM not fully embracing systems thinking are discussed, including the perception that it is complex and theoretical. This article attempts to dispel these beliefs by first demonstrating how many systems-thinking concepts are already embedded in the EM ethos and then by illustrating the application of system principles in the context of the COVID-19 response. This article concludes by recommending EM invest in training to encourage the systematic application of system principles in emergency preparedness and response.


Assuntos
COVID-19 , Defesa Civil , Humanos , Pandemias , SARS-CoV-2 , Análise de Sistemas
7.
J Emerg Manag ; 19(7): 99-107, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34723371

RESUMO

BACKGROUND: There is a paucity of research on college food pantry operations, especially in relation to emergency preparedness and disaster relief. However, there are multiple research studies confirming the efficacy of using social media to communicate with younger adults, especially Generation Z (Gen Z). METHODS: This study examines a college food pantry's social media posts and pantry utilization in a midsize, public university in Texas, prior to and during the COVID-19 pandemic. Collegiate food insecurity was analyzed through the lens of the socioecological model. Social media data during the spring 2019 semester were compared using a two-way ANOVA prior to and following the origination of the COVID-19 pandemic within the state, and pantry utilization over the spring 2019 and fall 2020 semesters was evaluated using a t-test. RESULTS: There were significantly more likes per post on Instagram than other social media outlets, and there were significantly more impressions per post on Twitter as opposed to Facebook, with a trend toward more impressions per posts, after COVID-19. There was no significant difference in food pantry utilization between the fall and spring semester aside from a spike after return following the spring recess, confirmed as Grubb's outlier. Application of the socioecological model emphasized the importance of interdisciplinary collaboration and multitiered interventions during an emergency, including the use of social media. CONCLUSION: This information can help collegiate organizations reach more students through targeted posting on select social media platforms used by their students. Interdisciplinary, inclusive approaches are recommended to reduce food insecurity for Gen Z students.


Assuntos
COVID-19 , Defesa Civil , Mídias Sociais , Adulto , Comunicação , Humanos , Pandemias , SARS-CoV-2 , Universidades
8.
J Athl Train ; 56(11): 1224-1231, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34752627

RESUMO

CONTEXT: Secondary schools that offer school-sponsored athletic events should follow best-practice guidelines to provide policies that promote student health and safety. OBJECTIVE: To assess emergency preparedness from the perspective of athletic administrators (AAs) in Iowa secondary schools. DESIGN: Cross-sectional study. SETTING: Online survey. PATIENTS OR OTHER PARTICIPANTS: Ninety-eight AAs from Iowa completed the survey (age = 45.33 ± 10.22 years, years as an AA = 9.37 ± 8.14, years in current role = 7.72 ± 7.09). MAIN OUTCOME MEASURES(S): The 6-section survey contained with questions about access to athletic trainers (ATs), emergency action plans (EAPs), cardiopulmonary resuscitation (CPR), automated external defibrillators (AEDs), concussions, heat illness, and other general policies. Descriptive statistics (percentages and frequencies) were reported. Relative risk was calculated to compare schools with and those without access to ATs (P < .05). RESULTS: Most respondents (76.5%, n = 75/98) reported their school had access to a licensed AT. The majority had a written EAP (83.3%, n = 70/84), but fewer than half (39.2%, n = 31/79) reviewed it annually and fewer than 10% (n = 6/85) reported practicing it each year. All respondents (100%, N = 78/78) stated they had an AED on campus. All respondents (N = 77/77) indicated that they were familiar with the Iowa High School Athletic Association's (IHSAA's) concussion policy and had a concussion guideline in place. Many respondents (95.9%, n = 71/74) described being familiar with the IHSAA's heat illness policy, but more than half (62.1%, n = 41/66) noted they did not have a heat illness policy in place at their school. CONCLUSIONS: Most respondents indicated their school had access to ATs, followed the state-mandated concussion guidelines, and had an AED. Although participants reported having written EAPs in place, levels of annual EAP review and practice were low. These results suggest that schools would benefit from educational opportunities to improve safety policies.


Assuntos
Traumatismos em Atletas , Defesa Civil , Esportes , Adulto , Traumatismos em Atletas/terapia , Estudos Transversais , Humanos , Iowa , Pessoa de Meia-Idade , Políticas , Instituições Acadêmicas , Inquéritos e Questionários
9.
J Cardiovasc Med (Hagerstown) ; 22(9): 701-705, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34714259

RESUMO

The Coronavirus disease 2019 (COVID-19) pandemic has thoroughly and deeply affected the provision of healthcare services worldwide. In order to limit the in-hospital infections and to redistribute the healthcare professionals, cardiac percutaneous intervention in Pediatric and Adult Congenital Heart Disease (ACHD) patients were limited to urgent or emergency ones. The aim of this article is to describe the impact of the COVID-19 pandemic on Pediatric and ACHD cath laboratory activity during the so-called 'hard lockdown' in Italy. Eleven out of 12 Italian institutions with a dedicated Invasive Cardiology Unit in Congenital Heart Disease actively participated in the survey. The interventional cardiology activity was reduced by more than 50% in 6 out of 11 centers. Adolescent and ACHD patients suffered the highest rate of reduction. There was an evident discrepancy in the management of the hard lockdown, irrespective of the number of COVID-19 positive cases registered, with a higher reduction in Southern Italy compared with the most affected regions (Lombardy, Piedmont, Veneto and Emilia Romagna). Although the pandemic was brilliantly addressed in most cases, we recognize the necessity for planning new, and hopefully homogeneous, strategies in order to be prepared for an upcoming new outbreak.


Assuntos
COVID-19 , Procedimentos Cirúrgicos Cardíacos , Serviços Médicos de Emergência , Cardiopatias Congênitas , Controle de Infecções , Gestão de Riscos/métodos , Adolescente , Adulto , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/transmissão , Procedimentos Cirúrgicos Cardíacos/métodos , Procedimentos Cirúrgicos Cardíacos/estatística & dados numéricos , Defesa Civil/métodos , Defesa Civil/tendências , Transmissão de Doença Infecciosa/prevenção & controle , Serviços Médicos de Emergência/métodos , Serviços Médicos de Emergência/estatística & dados numéricos , Feminino , Cardiopatias Congênitas/epidemiologia , Cardiopatias Congênitas/cirurgia , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Itália/epidemiologia , Masculino , Inovação Organizacional , SARS-CoV-2
10.
Acad Med ; 96(11): 1546-1552, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34705750

RESUMO

Racially and ethnically diverse and socioeconomically disadvantaged communities have historically been disproportionately affected by disasters and public health emergencies in the United States. The U.S. Department of Health and Human Services' Office of Minority Health established the National Consensus Panel on Emergency Preparedness and Cultural Diversity to provide guidance to agencies and organizations on developing effective strategies to advance emergency preparedness and eliminate disparities among racially and ethnically diverse communities during these crises. Adopting the National Consensus Panel recommendations, the Johns Hopkins Medicine Office of Diversity, Inclusion, and Health Equity; Language Services; and academic-community partnerships used existing health equity resources and expertise to develop an operational framework to support the organization's COVID-19 response and to provide a framework of health equity initiatives for other academic medical centers. This operational framework addressed policies to support health equity patient care and clinical operations, accessible COVID-19 communication, and staff and community support and engagement, which also supported the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care. Johns Hopkins Medicine identified expanded recommendations for addressing institutional policy making and capacity building, including unconscious bias training for resource allocation teams and staff training in accurate race, ethnicity, and language data collection, that should be considered in future updates to the National Consensus Panel's recommendations.


Assuntos
Centros Médicos Acadêmicos/organização & administração , COVID-19/etnologia , Desastres/prevenção & controle , Equidade em Saúde/normas , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/virologia , Defesa Civil/organização & administração , Consenso , Diversidade Cultural , Programas Governamentais/organização & administração , Programas Governamentais/normas , Disparidades em Assistência à Saúde/etnologia , Humanos , Grupos Minoritários/estatística & dados numéricos , Formulação de Políticas , Saúde Pública/normas , SARS-CoV-2/genética , Participação Social , Fatores Socioeconômicos , Estados Unidos/epidemiologia
11.
Health Secur ; 19(5): 508-520, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34597182

RESUMO

Federal investment in emergency preparedness has increased notably since the 9/11 attacks, yet it is unclear if and how US hospital readiness has changed in the 20 years since then. In particular, understanding effective aspects of hospital emergency management programs is essential to improve healthcare systems' readiness for future disasters. The authors of this article examined the state of US hospital emergency management, focusing on the following question: During the COVID-19 pandemic, what aspects of hospital emergency management, including program components and organizational characteristics, were most effective in supporting and improving emergency preparedness and response? We conducted semistructured interviews of emergency managers and leaders at 12 urban and rural hospitals across the country. Through qualitative analysis of content derived from examination of transcripts from our interviews, we identified 7 dimensions of effective healthcare emergency management: (1) identify capable leaders; (2) assure robust institutional support; (3) design effective, tiered communications systems; (4) embrace the hospital incident command system to delineate roles and responsibilities; (5) actively promote collaboration and team building; (6) appreciate the necessity of training and exercises; and (7) balance structure and flexibility. These dimensions represent the unique and critical intersection of organizational factors and emergency management program characteristics at the core of hospital emergency preparedness and response. Extending these findings, we provide several recommendations for hospitals to better develop and sustain what we call a response culture in supporting effective emergency management.


Assuntos
COVID-19 , Defesa Civil , Hospitais , Humanos , Pandemias , SARS-CoV-2
13.
Artigo em Inglês | MEDLINE | ID: mdl-34682602

RESUMO

Resilience is an important issue in urban development, and community resilience (CR) is the most typical representative in building urban resilience, which has become the forefront of international resilience research. This paper presents a bibliometric and visual analysis of community resilience research collected from the WoS Core Collection database over the past two decades. H-index, citation frequency, centrality and starting year were adopted to analyze the research objects by bibliometric tools including CiteSpace, VOSviewer, and Gephi. The national and institutional characteristics of macro-geographical distribution and the characteristics of disciplines, journals, authors, and author cooperation of micro-knowledge network distribution were revealed. Finally, the potential research directions of community resilience in the future were discussed. The results show that there are three stages in community resilience research. Seven intellectual bases constitute the research background for community resilience, including social capital mechanism, the evolution of resilience knowledge, earthquake resistance and disaster mitigation, substance abuse, resilient development in rural communities, resilience-building in the least-developed countries, and emergency preparedness. Our analysis shows that the hottest community resilience research topics are the concept of resilience, climate resilience, the social capital mechanism, macro-environment and disaster-reduction policies, and an evaluation index system for community resilience.


Assuntos
Defesa Civil , Desastres , Terremotos , Bibliometria , Bases de Dados Factuais
14.
Best Pract Res Clin Anaesthesiol ; 35(3): 369-376, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34511225

RESUMO

Hospitals face catastrophic financial challenges in light of the coronavirus disease 2019 (COVID-19) pandemic. Acute shortages in materials such as masks, ventilators, intensive care unit capacity, and personal protective equipment (PPE) are a significant concern. The future success of supply chain management involves increasing the transparency of where our raw materials are sourced, diversifying of our product resources, and improving our technology that is able to predict potential shortages. It is also important to develop a proactive budgeting strategy to meet supply demands through early designation of dependable roles to support organizations and through the education of healthcare staff. In this paper, we discuss supply chain management, governance and financing, emergency protocols, including emergency procurement and supply chain, supply chain gaps and how to address them, and the importance of communication in the times of crisis.


Assuntos
COVID-19/terapia , Gestão de Recursos da Equipe de Assistência à Saúde/métodos , Equipamentos e Provisões Hospitalares/provisão & distribuição , Equipamento de Proteção Individual/provisão & distribuição , COVID-19/economia , COVID-19/epidemiologia , Defesa Civil/economia , Defesa Civil/métodos , Gestão de Recursos da Equipe de Assistência à Saúde/economia , Equipamentos e Provisões Hospitalares/economia , Humanos , Equipamento de Proteção Individual/economia
15.
J Am Geriatr Soc ; 69(10): 2766-2777, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34549415

RESUMO

BACKGROUND/OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has taken a disproportionate toll on long-term care facility residents and staff. Our objective was to review the empirical evidence on facility characteristics associated with COVID-19 cases and deaths. DESIGN: Systematic review. SETTING: Long-term care facilities (nursing homes and assisted living communities). PARTICIPANTS: Thirty-six empirical studies of factors associated with COVID-19 cases and deaths in long-term care facilities published between January 1, 2020 and June 15, 2021. MEASUREMENTS: Outcomes included the probability of at least one case or death (or other defined threshold); numbers of cases and deaths, measured variably. RESULTS: Larger, more rigorous studies were fairly consistent in their assessment of risk factors for COVID-19 outcomes in long-term care facilities. Larger bed size and location in an area with high COVID-19 prevalence were the strongest and most consistent predictors of facilities having more COVID-19 cases and deaths. Outcomes varied by facility racial composition, differences that were partially explained by facility size and community COVID-19 prevalence. More staff members were associated with a higher probability of any outbreak; however, in facilities with known cases, higher staffing was associated with fewer deaths. Other characteristics, such as Nursing Home Compare 5-star ratings, ownership, and prior infection control citations, did not have consistent associations with COVID-19 outcomes. CONCLUSION: Given the importance of community COVID-19 prevalence and facility size, studies that failed to control for these factors were likely confounded. Better control of community COVID-19 spread would have been critical for mitigating much of the morbidity and mortality long-term care residents and staff experienced during the pandemic. Traditional quality measures such as Nursing Home Compare 5-Star ratings and past deficiencies were not consistent indicators of pandemic preparedness, likely because COVID-19 presented a novel problem requiring extensive adaptation by both long-term care providers and policymakers.


Assuntos
COVID-19 , Instituição de Longa Permanência para Idosos/organização & administração , Assistência de Longa Duração , Casas de Saúde/organização & administração , Risco Ajustado , Instituições de Cuidados Especializados de Enfermagem/organização & administração , Idoso , COVID-19/mortalidade , COVID-19/prevenção & controle , Defesa Civil/organização & administração , Humanos , Controle de Infecções/métodos , Controle de Infecções/normas , Assistência de Longa Duração/métodos , Assistência de Longa Duração/tendências , Avaliação de Resultados em Cuidados de Saúde , SARS-CoV-2
19.
Infect Dis Clin North Am ; 35(3): 697-716, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34362539

RESUMO

The built environment has been integral to response to the global pandemic of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). In particular, engineering controls to mitigate risk of exposure to SARS-CoV-2 and other newly emergent respiratory pathogens in the future will be important. Anticipating emergence from this pandemic, or at least adaptation given increasing administration of effective vaccines, and the safety of patients, personnel, and others in health care facilities remain the core goals. This article summarizes known risks and highlights prevention strategies for daily care as well as response to emergent infectious diseases and this parapandemic phase.


Assuntos
COVID-19 , Defesa Civil , Instalações de Saúde/tendências , Controle de Infecções , Gestão da Segurança/organização & administração , COVID-19/epidemiologia , COVID-19/prevenção & controle , Defesa Civil/métodos , Defesa Civil/organização & administração , Ambiente Controlado , Arquitetura Hospitalar/métodos , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , SARS-CoV-2
20.
Am J Med ; 134(11): 1380-1388.e3, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34343515

RESUMO

BACKGROUND: Whether the volume of coronavirus disease 2019 (COVID-19) hospitalizations is associated with outcomes has important implications for the organization of hospital care both during this pandemic and future novel and rapidly evolving high-volume conditions. METHODS: We identified COVID-19 hospitalizations at US hospitals in the American Heart Association COVID-19 Cardiovascular Disease Registry with ≥10 cases between January and August 2020. We evaluated the association of COVID-19 hospitalization volume and weekly case growth indexed to hospital bed capacity, with hospital risk-standardized in-hospital case-fatality rate (rsCFR). RESULTS: There were 85 hospitals with 15,329 COVID-19 hospitalizations, with a median hospital case volume was 118 (interquartile range, 57, 252) and median growth rate of 2 cases per 100 beds per week but varied widely (interquartile range: 0.9 to 4.5). There was no significant association between overall hospital COVID-19 case volume and rsCFR (rho, 0.18, P = .09). However, hospitals with more rapid COVID-19 case-growth had higher rsCFR (rho, 0.22, P = 0.047), increasing across case growth quartiles (P trend = .03). Although there were no differences in medical treatments or intensive care unit therapies (mechanical ventilation, vasopressors), the highest case growth quartile had 4-fold higher odds of above median rsCFR, compared with the lowest quartile (odds ratio, 4.00; 1.15 to 13.8, P = .03). CONCLUSIONS: An accelerated case growth trajectory is a marker of hospitals at risk of poor COVID-19 outcomes, identifying sites that may be targets for influx of additional resources or triage strategies. Early identification of such hospital signatures is essential as our health system prepares for future health challenges.


Assuntos
Ocupação de Leitos/estatística & dados numéricos , COVID-19 , Número de Leitos em Hospital/estatística & dados numéricos , Unidades de Terapia Intensiva/estatística & dados numéricos , Mortalidade , Melhoria de Qualidade/organização & administração , COVID-19/mortalidade , COVID-19/terapia , Defesa Civil , Alocação de Recursos para a Atenção à Saúde/organização & administração , Alocação de Recursos para a Atenção à Saúde/normas , Mortalidade Hospitalar , Hospitalização/estatística & dados numéricos , Humanos , Avaliação de Resultados em Cuidados de Saúde , Sistema de Registros , Medição de Risco , SARS-CoV-2 , Triagem/organização & administração , Estados Unidos/epidemiologia
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