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PubMedDate not supplied

The volunteer potential of inactive nurses for disaster preparedness.

OBJECTIVES: Inactive nurses' interest in volunteering for emergency preparedness was examined. METHODS: A mail survey was sent to the entire Vermont Board of Nursing list of in-state inactive and lapsed registered nurses (n = 3,682). A high rate of undeliverable surveys (60%) was found and 611 surveys were returned for a 20% response rate. RESULTS: Twenty-seven percent of the respondents were interested in volunteering. Those interested in participating in volunteer work as part of a national homeland security effort were significantly more likely to (a) be younger in age (p < 0.0001); (b) identify themselves as "being a nurse" (p = 0.001); (c) be employed versus retired (p = 0.002); and (d) be currently volunteers (p = 0.001). CONCLUSIONS: Because 33% of the nation's nurses are over age 50, inactive nurses offer a potentially large pool of volunteers for emergency preparedness training and response in the years to come.

Adult↗

PubMed1995

Cardiac nurses' preparedness to use self-help groups as a support strategy.

Self-help groups are lay, mutual support groups in which people who share some long-term existential problems in their lives meet regularly to support each other empathetically. These groups can be viewed as supplementary sources of support outside patients' existing social networks. As such, it is of importance to be aware of them when planning nursing care. The aim of this study was to examine cardiac nurses' preparedness to use self-help groups as a support strategy. A qualitative research method was used and 12 registered nurses from two coronary care units were interviewed. The findings showed that nurses knowledge of social support, self-help groups and of patients' social circumstances as well as their attitudes to their own roles as nurses were of importance in their preparedness to use self-help groups as a support strategy. Lack of knowledge of social support and self-help groups affected the nurses' attitudes towards lay care and was probably the reason for not using self-help groups as a support strategy. Most of the nurses were well informed about their patients' social circumstances, they had an explicit family nursing approach and were not at all against further expansion of their nursing role. However, there is a need for education in innovative ways of working that respond to and interact with informal support networks if nurses are to be able to contribute to empowerment of their patients.

Adult↗

PubMed1995

Fear conditioning, preparedness, and the contingent negative variation.

Psychophysiological research on preparedness has previously focused on autonomic nervous system parameters. The present study used electrocortical indices of fear conditioning. Subjects (n = 10) were tested under fear-relevant and fear-irrelevant conditions (1 week apart, order of conditions counterbalanced). Each condition comprised acquisition and extinction sessions. The contingent negative variation (CNV) was elicited in anticipation of forewarned slides (fear relevant: small animals; fear irrelevant: landscapes). In acquisition, reinforced conditioned stimulus (CS+) (but not nonreinforced conditioned stimulus [CS-]) slides were followed by white noise as an unconditioned stimulus (UCS). In extinction, the UCS was omitted. In the fear-relevant condition, CNV amplitude was significantly larger for CS+ than CS- in both acquisition and extinction. In the fear-relevant condition, CNV amplitude was significantly larger for CS+ than CS- in both acquisition and extinction. In the fear-irrelevant condition, CNV differentiation between CS+ and CS- was weak in both sessions. CNV was significantly larger in the fear-relevant than in the fear-irrelevant condition, for CS+ but not CS-. The findings are consistent with a preparedness interpretation and suggest that CNV under such circumstances may represent an automatic affective response to fear-relevant stimuli. Electrocortical measures could be particularly useful in examining information processing mechanisms in phobia and cognition-affect relationships generally.

Adolescent↗

PubMed1994

Preparedness for clinical nursing education.

The identification of individualized patient care planning as a core element in clinical nursing training showed the need to evaluate how nursing students perceive themselves to be prepared for implementing the concept into patient care. Ninety-five nursing students, with a mean age of 27 years, participated in this study at the end of their first theoretical block. Three questionnaires were used; 1) One questionnaire designed for the study concerning demographic data, attitudes and valuation of the theoretical education of the nursing process, 2) Rosenbaum's Self-Control Schedule, and 3) Antonowsky's Sense of Coherence test. The results showed that the students' pre-educational health care experience, which varied from one to twenty years, significantly (p < 0.05) influenced the evaluation of their preparedness for clinical training. Attitudes towards nursing research and development of nursing care were negatively correlated (p < 0.05) to their years of previous experience of health care and positively correlated to a more theoretical school background. The students' personal preparedness to develop independence varied greatly as measured by the Self-Control Schedule and the Sense of Coherence test independently of age, work experience and earlier education. It was concluded that students might be favoured by individualized study planning as a parallel model to individualized care planning.

Adolescent↗

PubMed2002

Emergency medical preparedness and response to a Singapore airliner crash.

A Singapore airline crash in 2000 was the first documented mass casualty incident (MCI) caused by an aircraft disaster in Taiwan. This report reviews the emergency medical preparedness of the airport and examines its effects on the medical response during this incident. The anticipated benefits from the new MCI plan and prior medical preparedness were not achieved during this disaster. Poor compliance with the new MCI plan by the airport authority was noted. Victims were not triaged and did not receive adequate field medical care. Structural problems with the MCI plan were also noted. Site medical teams responding from hospitals could not function as the plan had been designed. This article discusses factors causing the poor compliance, various problems, and related issues in medical response to the incident. As learned from this experience, a properly and practically designed MCI plan, good compliance of responders, and a strong support system of responding agencies are the most important factors for successful emergency response to any MCI.

Accidents, Aviation↗

PubMed1981

'Preparedness' and the development of aversive associations.

The paper presents two studies investigating the role of the preparedness value of stimulus content in an aversive compound signal conditioning procedure. It was predicted that greater compound to component transfer would occur to 'potentially phobic' compared to 'neutral' stimulus components, and that responses to potentially phobic components would show a relatively greater resistance to extinction. Results from both studies failed to support these hypotheses thus questioning the generality of the previously demonstrated role of 'preparedness' in average associative processes.

Adult↗

PubMed2005

The south central center for public health preparedness training system model: a comprehensive approach.

The South Central Center for Public Health Preparedness (SCCPHP) is a collaboration among the schools of public health at Tulane University and the University of Alabama at Birmingham and the state health departments in Alabama, Arkansas, Louisiana, and Mississippi. The SCCPHP provides competency-based training via distant delivery methods to prepare public health workers to plan for and rapidly respond to public health threats and emergency events. This article presents the training system model used by the SCCPHP to assess, design, develop, implement, and evaluate training that is both competency driven and practice based. The SCCPHP training system model ensures a standardized process is used across public health occupations and geographic regions, while allowing for tailoring of the content to meet the specific training needs of the workforce in the respective state and local health departments. Further, the SCCPHP training system model provides evidence of the reciprocal nature between research and practice needed to advance the area of emergency preparedness training and workforce development initiatives in public health.

Competency-Based Education↗

PubMed2005

Partnering for preparedness: the project public health ready experience.

Effective partnerships between local and state public health agencies and schools of public health have tremendous potential to improve the health of communities nationwide. This article highlights successful collaboration between local public health agencies (LPHA), state health departments, and Academic Centers for Public Health Preparedness (ACPHP) in schools of public health developed through participation in Project Public Health Ready, a program to recognize LPHA emergency preparedness. The project's pilot phase illustrated that LPHAs, state health departments, and ACPHP can effectively work together to improve individual public health worker competency and organizational response capacity in local public health agencies nationwide.

Community Health Centers↗

PubMed2005

The practice community meets the ivory tower: a health department/academic partnership to improve public health preparedness.

When the local health department of Montgomery County, Maryland, was chosen to participate in Project Public Health Ready and was charged with the daunting task of providing a comprehensive emergency preparedness plan, training all 600 employees to carry out that plan, and conducting exercises to demonstrate the department's competency, it realized it couldn't do it alone. The department sought the assistance of the Johns Hopkins Bloomberg School of Public Health. The first challenge for these unlikely partners, one a bastion of research and the other firmly immersed in the practice world of public health, was to figure out how to work together. This article describes the development of their partnership; outlines the preparedness plan, training, and exercises that resulted from the partnership; summarizes the challenges and benefits for each entity; and enumerates lessons learned that could be useful to other public health entities planning to undertake similar partnerships.

Disaster Planning↗

PubMed2005

Cross-sector leadership development for preparedness.

After fall 2001, scientists and professionals recognized the importance of integrating public health with traditional first-response professions in planning and training for disasters. However, operationalizing this approach among professionals in the field confronted barriers that were both inter-cultural and jurisdictional. The Pennsylvania Preparedness Leadership Institute (PPLI) is a collaboration of the Pennsylvania Department of Health and the University of Pittsburgh Center for Public Health Preparedness. Team members are recruited from public health, emergency medicine, emergency management, hospitals, and public safety agencies from each of nine multi-county regions in Pennsylvania. Each team takes on a year-long project that addresses a strategic problem as a focus for capacity-building within its region. Unexpectedly during PPLI's first year in operation, a hepatitis-A outbreak tested whether one regional team could successfully mount the necessary integrated response. This experience, as well as the planned evaluation for PPLI, demonstrated both the successful processes and the positive impact of this integrated leadership training initiative.

Curriculum↗

PubMed2004

Methodological issues in the measurement of birth preparedness in support of safe motherhood.

Behavior change interventions focusing on birth preparedness for pregnant women, their husbands, and adults in the community are common components of community-oriented Safe Motherhood programs in developing countries. Few studies have examined the effectiveness of these interventions, and existing studies are flawed due to study and sample design. This article highlights methodological issues that are often overlooked when measuring indicators of birth preparedness among multiple audiences for program evaluation purposes in household-based surveys. Solutions are proposed to address each of these problems in an effort to improve future research.

Birth Rate↗

PubMedDate not supplied

A conceptual framework for evaluating information technologies and decision support systems for bioterrorism preparedness and response.

OBJECTIVES: The authors sought to develop a conceptual framework for evaluating whether existing information technologies and decision support systems (IT/DSSs) would assist the key decisions faced by clinicians and public health officials preparing for and responding to bioterrorism. METHODS: They reviewed reports of natural and bioterrorism related infectious outbreaks, bioterrorism preparedness exercises, and advice from experts to identify the key decisions, tasks, and information needs of clinicians and public health officials during a bioterrorism response. The authors used task decomposition to identify the subtasks and data requirements of IT/DSSs designed to facilitate a bioterrorism response. They used the results of the task decomposition to develop evaluation criteria for IT/DSSs for bioterrorism preparedness. They then applied these evaluation criteria to 341 reports of 217 existing IT/DSSs that could be used to support a bioterrorism response. MAIN RESULTS: In response to bioterrorism, clinicians must make decisions in 4 critical domains (diagnosis, management, prevention, and reporting to public health), and public health officials must make decisions in 4 other domains (interpretation of bioterrorism surveillance data, outbreak investigation, outbreak control, and communication). The time horizons and utility functions for these decisions differ. From the task decomposition, the authors identified critical subtasks for each of the 8 decisions. For example, interpretation of diagnostic tests is an important subtask of diagnostic decision making that requires an understanding of the tests' sensitivity and specificity. Therefore, an evaluation criterion applied to reports of diagnostic IT/DSSs for bioterrorism asked whether the reports described the systems' sensitivity and specificity. Of the 217 existing IT/DSSs that could be used to respond to bioterrorism, 79 studies evaluated 58 systems for at least 1 performance metric. CONCLUSIONS: The authors identified 8 key decisions that clinicians and public health officials must make in response to bioterrorism. When applying the evaluation system to 217 currently available IT/DSSs that could potentially support the decisions of clinicians and public health officials, the authors found that the literature provides little information about the accuracy of these systems.

Bioterrorism↗

PubMed2005

The New Mexico school nurse and emergency medical services emergency preparedness course: program description and evaluation.

Illness and injuries are common among students and school staff. Therefore, school nurses must be prepared. In this study, a 16-hour scenario-based emergency preparedness course for school nurses was evaluated for its effectiveness. Effectiveness was measured by (a) traditional methods (written exams and confidence surveys) and (b) skills and performance evaluations in simulated emergencies called On-site Mock Emergency Scenarios. School nurses who completed the emergency preparedness course showed significant improvement in knowledge, confidence, and On-site Mock Emergency Scenarios scores that measured each nurse's ability to apply knowledge in simulated emergencies.

Child↗

PubMed2002

Bioterrorism preparedness for local health departments.

Bioterrorism preparedness has not traditionally been an everyday concern of local public health departments. The likely first responders to a biological bioterrorism event will be local public health personnel. The events of September 11, 2001, and the anthrax crisis that followed tested the capabilities of the public health system and demonstrated its fragility. Little federal funding has trickled down to local health departments, and they have not been included in planning or training for bioterrorism preparedness. Now local health departments must develop detailed bioterrorism response plans. Effective plans will involve internal assessment of strengths and weaknesses and strategizing with other local community agencies. Our health department is a suburban county agency that serves a population of over 250,000. We have started this self-assessment and planning process. This bioterrorism guide has provided some structure for us and may be helpful for other local health departments as they begin this process.

Bioterrorism↗

PubMed2003

Investigating the factor structure of an instrument to measure attitudes and preparedness to work with elders with Alzheimer's disease.

This study investigated the factor structure of an instrument to measure attitudes and preparedness of social work students to work with memory-impaired elders. Exploratory statistical procedures to reduce data through principle component analysis identified three factors with eigenvalues greater than 1.0 and a cumulative variance of 65.520%. These factors include general belief in the efficacy of psychotherapeutic services for elders with memory impairment; self-perceived adequacy to provide services to elders with memory impairment; and belief in the efficacy of other ancillary services to elders with memory impairment. Recommendations are made for utilizing this brief self-report instrument in training and assessing students and other practitioners for their attitudes toward and greater preparedness to work with memory- impaired elders.

Aged↗

PubMed2006

Bioterrorism and Emergency Preparedness in Aging (BTEPA): HRSA-funded GEC collaboration for curricula and training.

Frail elders living alone or in long-term care settings are particularly vulnerable to bioterrorism and other emergencies due to their complex physical, social and psychological needs. This paper provides an overview of the recent literature on bioterrorism and emergency preparedness in aging (BTEPA); discusses federal initiatives by the health resources and services administration (HRSA) to address BTEPA; describes the collaborative efforts of six HRSA-funded geriatric education centers (GECS) to develop BTEPA geriatric curricula and training; and offers recommendations for BTEPA education and training, clinical practices, policy, and research. The GEC/BTEPA collaboration has produced model curricula, including emergency planning for diverse groups of older persons; enhanced networking among stakeholders in a fast paced environment of information sharing and changing policies; and developed interdisciplinary educational resources and approaches to address emergency preparedness for various settings in the elder care continuum.

Aged↗

PubMedDate not supplied

Preparing for the unknown, responding to the known: communities and public health preparedness.

More than four years after September 11, 2001, bioterrorism preparedness remains a high priority for federal, state, and local governments. With reasonably flexible federal funding, communities have strengthened their ability to respond to public health emergencies, according to assessments by stakeholders and market observers. Collaborative relationships developed for bioterrorism preparedness have proved useful in addressing other threats, such as natural disasters and infectious disease outbreaks. Major ongoing challenges include funding constraints, inadequate surge capacity, public health workforce shortages, competing priorities, and jurisdictional issues.

Bioterrorism↗

PubMedDate not supplied

Local variation in public health preparedness: lessons from California.

Since September 2001 Congress has allocated approximately dollars 3 billion to strengthen the public health infrastructure. To achieve this goal, the U.S. Centers for Disease Control and Prevention (CDC) allocates funding to states, which distribute funds to local jurisdictions. Evidence-based measures to assess public health preparedness are lacking. We used an expert-panel process to develop performance measures, based on the ten essential public health services. We developed and conducted tabletop exercises in California to evaluate preparedness to detect and respond to a hypothetical smallpox outbreak based on those measures. There was wide variation of readiness in California. While the sources of variation are often different, common infrastructure gaps need to be addressed.

California↗