Emergency Preparedness Training for Social Workers

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Emergency Preparedness Training for Social Workers

• New Jersey Preparedness Consortium (NJ-PTC)
• UMDNJ US Department of HHS
• Grant No. T01HP01407

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Goals Objectives

• List 12 categories of items in an Emergency
  Preparation Kit
  
• Identify 3 ethical issues dealing with an
  emergency
  
• Name 2 laws dealing with legal issues in an
  emergency
  
• Identify the role of NIMS ICS during a crisis

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HSPD 5 Executive Order 50Executive Order 5

• Homeland Security Presidential Directive 5
• Purpose Develop administer a National
  Incident Management System (NIMS)
  
• Executive Order 50 (Codey)
• Purpose Mandates NIMS as state emergency
  response standard for NJ
  
• Executive Order 5 (Corzine)
• Purpose Creates cabinet level Homeland Security
  Director to oversee state emergency response
  efforts
  

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National Incident Management System (NIMS)

• Provides a national structure to prepare for,
  prevent, respond recover from disasters
  
• Training at www.fema.gov/emiweb/is

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NIMS Components

• Command Management Incident Command System
  (ICS)
  
• Preparedness Emergency Operations Plan (EOP),
  training
  
• Resource Management Personnel, facilities,
  equipment, supplies
  
• Communications Information Management Public
  Information Officer (PIO)
  
• Supporting Technologies Computers
• Ongoing Management Maintenance Changes,
  demobilization

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Emergency Operations Planning 4 Components

• Preparedness evaluate risks/probabilities
• Response how to deal with risks/probabilities
• Mitigation how to minimize the effects or
  prevent reoccurrence of disaster
  
• Recovery What would be needed to restore
  unmet needs/how to do this
  

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Incident Command System(ICS)

• System for organizing a response (based on the
  Emergency Operations Plan) to an emergency after
  it occurs
  
• Common goal of stabilizing the incident -
  protecting life, property the environment
  
• Directed by an Incident Commander (IC)
• Has 4 Basic Functions

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4 Basic Functions of ICS

• Planning Determine what specifically needs to
  be done to handle incident
  
• Operations Directs all resources to carry out
  the plan
  
• Logistics Provides the resources all other
  services needed to support the plan
  
• Finance/Administration Monitors costs related
  to managing the incident
  

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Laws Pertaining to Incidents

• Homeland Security Presidential Directive 5
• Established NIMS on national level
• Executive Order 50
• Established NIMS on state level
• Executive Order 5
• Established Cabinet Level Homeland Security
  Director
  
• NJ Emergency Health Powers Act - N.J.S.A. 2613
• Established powers of Commissioner of DHSS
  during incident
  
• Health Insurance Portability Accountability Act
  - HIPAA
  
• Established permitted disclosures of
  identifiable health information
  

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NJ Emergency Health Powers Act N.J.S.A. 26.13

• Report Suspected Disease - DHSS
• Track Disease Process - Commissioner
• Emergency Health Care Providers Registry
• Transfer management of health care facility to
  DHSS
  
• Control of Health Care Supplies
• Vaccination mandate
• Require Health Care Providers to Assist
• Immunity from Liability
• Reasonable Reimbursement for Services

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HIPAA

• Personal Health Information (PHI)
• Persons exposed to reportable communicable
  diseases
  
• Persons who refuse treatment

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Principles of Ethics

• Autonomy Respect self-determination choice of
  action
  
• Beneficence Enhance welfare of others avoid
  harm (nonmaleficence)
  
• Paternalism Protect against self-harm or harming
  others (compromised autonomy)
  
• Justice Equitable treatment

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Biological Agents of Highest Concern

• Smallpox
• Anthrax
• Plague
• Tularemia
• Botulism
• Viral Hemorrhagic Fevers

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Types of Illnesses These Agents Can Cause

• Flu-like illness (fever, sweats, nausea)
• Cough and/or pneumonia
• Headache, confusion
• Skin ulcers (anthrax, tularemia, plague)
• Rashes (smallpox, viral hemorrhagic fevers)
• Paralysis (botulism)

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Contagious Agents

• Person-to-Person Transmission Smallpox
• Plague Pneumonia
• Some Viral Hemorrhagic Fevers (Ebola)

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Antibiotics, Antitoxin, or Immunization

• Antibiotics Anthrax, Plague, Tularemia
• Antitoxin Botulism
• Immunization Smallpox, Anthrax, Some Viral
  Hemorrhagic Fevers

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Infection Control Category A Critical Agents

• Standard precautions all cases
• Airborne contact precautions - smallpox, viral
  hemorrhagic fevers
  
• Droplet precautions pneumonic plague

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Infection ControlStandard Precautions

• Disposable, non-sterile gloves
• Handwashing after glove removal
• Disposable gown/apron, face-shield if splashing
  anticipated
  
• Change protective gear between cases

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Infection ControlContact Precautions

• Standard precautions plus
• Wear gloves gown, change after contact with
  infectious material
  
• Dedicate non-critical patient care items to
  single patient or disinfect between patients

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Infection ControlAirborne Precautions

• Airborne Precautions
• Standard precautions plus
• Patient in negative air pressure room
• Wear respiratory protection (HEPA filter mask)

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Infection ControlDroplet Precautions

• Standard precautions plus
• Wear mask when within 6 feet of patient

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Quarantine vs. Isolation

• Isolation separation of a contagious
  person/group from other people to prevent spread
  of infection
  
• Quarantine restrictions of activities or
  limitations of freedom of movement of those
  presumed exposed to communicable disease to
  prevent contact with those who have not been
  exposed

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Severity of Response Dependent Upon

• Proximity to event (injured/bereaved)
• Intensely exposed (first responders)
• Displaced from home/work
• Loss of property
• Age (child/elderly)
• Special Needs (developmentally disabled/blind/cogn
  itively impaired/etc)
  
• Culture

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Severity of Response Dependent Upon Continued

• History of
• Previous trauma
• Mental illness
• Substance Abuse
• Chronic Illness

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Early Intervention Goal 1

• Safety
• Protect from further physical harm (remove from
  traumatic scene)
  
• See to basic needs (food, shelter, clothing,
  sanitation, sleep, medical care)
  
• Information dissemination

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Early Intervention Goal 2

• Function
• Support to return to normal function (reduce
  stressors/reminders)
  
• Link to critical resources
• Reunite and keep families together
• Educate about responses to stressful or traumatic
  events

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Early Intervention Goal 3

• Action
• Support to return to productive activity
• Redirect to constructive/helping tasks

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CommunicationGeneral Guidelines

• Tell the truth as it is known, when it is known
• Explain what is being done to deal with the
  situation
  
• Avoid withholding bad news or disturbing
  information
  
• Be forthright about what is not known
• Provide practical guidance
• Messages should be simple straightforward

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Self-Care

• Healthy lifestyle
• Self-regulation
• Positive coping skills (resilience)
• Stress management
• Education
• Emergency Preparedness Practice