Healthcare Professionals can take slight measures to aid their facilities in preparing for potential crises. Here’s how.
When it comes to providing safe and effective healthcare, the formality of following algorithms and protocols is perhaps more important than in any other industry. But while having processes in place may seem mostly reserved for situations that seem otherwise predictable, there is also a need for a certain level of consistency that should be practiced during times of unpredictable events if patients and staff members are going to have the best chances of being safe.
Millions of people are said to be affected by disasters and unforeseen events in this country. In 2017 alone (fiscal year dates), there were 260 “large-scale disasters” that occurred in 46 U.S. states and territories that required response from the American Red Cross. That number, which includes notable events such as the Louisiana flooding, Hurricane Matthew, the Tennessee wildfires and the California floods, represented a 50 percent increase from the prior fiscal year, according to Red Cross officials.
While the services of emergency staff are crucial in any of these scenarios, there’s also an inherent importance that nurses should exhibit in their day-to-day responsibilities, regardless of the setting in which they work, as it relates to disaster preparedness and response, said Mary Casey-Lockyer, MHS, BSN, RN, CCRN, senior associate for disaster health services with the Red Cross.
“The nurse is an integral team member in fostering and leading healthcare emergency planning, response and recovery [because they] have deep knowledge of how the healthcare infrastructure works and bring crucial clinical knowledge to the table that may be lacking by safety or facility personnel often tasked with healthcare emergency management,” she said.
Officials associated with VectorCare, a healthcare logistics company based in Sausalito, CA, have reportedly developed a way for hospitals to quickly evacuate patients during a crisis and is making the new technology available to California hospitals and transport providers in preparation for another dangerous fire season.
Key components of the platform include hospital personnel having the ability to broadcast a single alert to every transport provider in the area, rather than individually calling each company, and accessibility from any web browser.
When staff members at Kaiser Santa Rosa (CA) Medical Center used VectorCare’s platform to evacuate during the 2017 California Tubbs fire, an event that’s said to be the most destructive wildfire in California history, they were able to safely evacuate all 130 patients in less than two hours, according to officials.
Founded in 2011, Vectorcare (previously Medlert Inc.) is a fully customizable, comprehensive healthcare logistics platform that helps hospitals use an online marketplace to schedule everything from patient transport to in-home health visits, according to officials. A single entry point to manage the patient’s entire experience helps to enable healthcare providers to become change-makers in their industry through efficiency, improved patient care and reduced healthcare costs for everyone,” officials said.
This role can essentially begin with nurses assuming the responsibility of helping their administrators remain cognizant of the need for ongoing preparedness measures and advocating for appropriate planning on a continuous basis. Being aware of warning signs that could point to a facility’s disregard for safety measures is one important step. Clues to assess that could point to a subpar level of readiness include a lack of coordinated emergency drills and the lack of an emergency management committee (which should be comprised of individuals who are separate from any safety committee that should be in place). Similarly, common misconceptions about who should be trained in disaster preparedness methods are also responsible for inadequate disaster response potential.
“A common misconception is that only the emergency room setting needs to be prepared,” Casey-Lockyer said. “Actually, the needs of those individuals with chronic disease and substance abuse disorders were the most prevalent resource needs in the response to the hurricanes of 2017.”
Competent emergency planning also involves gathering information about possible emergencies that could impact any facility’s capabilities to respond to and recover from a disaster or other emergency, according to Red Cross officials. For instance, being knowledgeable about the region in which one’s facility is located and the types of disasters most likely to impact the area should be a priority. As an example, according to the U.S. Department of Homeland Security, coastal areas are at greater risk for flooding during hurricane season from June to November and the Midwest is more at risk in the spring and during heavy summer rains, although flooding can certainly occur during any season. The Red Cross also suggests that all facilities develop an emergency action plan, or a response strategy that describes the steps that an organization will take to protect people before, during and after an emergency. Components of a valid action plan include identifying personnel to be responsible for developing and implementing an emergency response plan, initiating a written plan to describe how the organization will respond during a disaster or medical emergency, training employees regularly about what to do during a disaster or emergency, and acquiring and maintaining needed safety equipment and emergency preparedness supplies. Beyond ensuring staff’s preparedness, an action plan should also make an additional commitment to impact overall community disaster preparations by conducting such tasks as hosting blood drives, contributing supplies and/or services to emergency response efforts, and/or adopting a local school or school district in an effort to support their disaster and emergency preparedness programs.
When Disaster Occurs
Of course, preparing for unexpected occurrences is only part of the equation. If and when the time comes to act onsite, Casey-Lockyer said that focus must be given to what may appear to be even the most simplistic of responsibilities. “Nurses should be personally prepared to report to their work location quickly, where they may not have all the monitors and bells and whistles of an acute care setting,” she continued. “If a healthcare setting is impacted, nurses need to know how to take a manual blood pressure and to chart with paper and pencil. Many of the machines we use in the healthcare setting [could] be impacted by a loss of power.”
Being prepared for an emergency also involves practicing good mental health strategies that can enhance one’s level of competency in the event of a crisis, Casey-Lockyer said.
“It is important to think about what one might have to do in a disaster response,” she continued. “Thinking and planning for your response over time alleviates anxiety. The No. 1 anti-anxiety promoting action is to make sure your [facility] has a disaster plan — that will go a long way in making nurses prepared for disaster.”
In 2009, the Institute of Medicine (IOM) formed a committee that developed guidance that healthcare officials can use to establish and implement standards of care during times of crises. Casey-Lockyer suggests that all nurses and healthcare facilities should consult to help alleviate additional anxiety that can add to the challenge of acting in an emergency. These “crisis standards of care” (CSCs) help to establish a state of being that indicates a substantial change in healthcare operations and the level of care that can be delivered in a public health emergency. In a 2012 report titled Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Response, IOM officials develop templates to guide the efforts of professionals and organizations responsible for CSC planning and implementations, which Casey-Lockyer said is also a valuable resource. Additionally, the Red Cross offers its Ready Rating™ program, a free, online program in which hospitals, schools and other organizations can complete a confidential assessment of their current readiness level for emergencies and receive immediate, customized feedback with tips and resources for improvement. Other resources include a listing of specific supplies to have available and what to do before, during and after a variety of emergencies.”
