Learning of Student Nurse Volunteers in Federal Disaster Exercise University of Portland Portland, Oregon

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Learning of Student Nurse Volunteers in Federal
Disaster ExerciseUniversity of Portland
Portland, Oregon

• Diane Vines, R.N., Ph.D.
• and
• Lori Chorpenning, R.N., M.S.

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University of Portland

• Established in 1901
• 3200 students
• Teaching, Faith, Service
• Faith-based institution

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UP School of Nursing

• Large undergraduate program
• Graduate programs
• - Masters entry program
• - Clinical Nurse Leaders Masters program
• - Doctorate of Nursing Practice program
• beginning Summer 2008

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TOPOFF 4 Disaster Exercise

• 15,000 participants
• Scenario-Terrorists bring radioactive material
  into the U.S.
• Guam, Portland and Phoenix

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TOPOFF 4 Goals

• Policy and strategic issues
• Difficult decisions
• Essential functions
• Common operating picture

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University of Portland Participation

• The athletic center as site of 50 bed
  stabilization area (medical care point)
• Student nurses, faculty, and staff volunteers

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UP Participation
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Importance of Disaster Preparedness

• ACHNE White Paper on disaster preparedness
• ANA White Paper
• Essentials of Baccalaureate Nursing
• Homeland Security training funds

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Literature Review

• Disaster exercises
• Stimulating training (Jasper et al, 2005)
• Importance of simulation (Smith, 2007)
• Multidisciplinary team in Israel (Waisman et al
  (2006)
• Healthcare worker training in a rural community
  hospital drill (Vinson, 2007)

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Literature Review

• Student nurse involvement in exercises
• Physical injuries focus (Jennings-Sanders et al,
  2005)
• Clayton State University students increased
  confidence in caring for patients (Eichelberger
  Odom, 2006)

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Literature Review

• Provider reactions to disaster exercises
• Communication (Behney et al, 2006)
• Responders experienced stress reactions (Burkle,
  1996)
• Exercise reactions similar to actual disaster
  (Sanner Wolcott, 1983)

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Literature Review

• Curricular implications
• Disaster preparedness -basic competency
  (Pattillo, 2003)
• Competency for entry-level RNs- International
  Coalition for Mass Casualty Education (INCMCE)
  now called National Emergency Preparedness
  Education Coalition (NEPEC)

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Literature Review

• No increase in teaching disaster preparedness
  (Weiner et al, 2005)
• Lecture only (Weiner, 2005)
• Barrier- time (Martin et al, 2006)

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Study Design

• Survey instrument
• 1. Category
• 2. Role
• 3. Experience during drill
• 4. Feelings during drill
• 5. Problems or challenges
• 6. What worked well

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Study Design

• Data Collection
• After drill
• Likert Scale
• Debriefing

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Study Design

• Data analysis
• Quantitative and qualitative
• Compared responses of victims and caregivers
• Emotions experienced and suggestions for
  improvement

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Findings Demographics and Roles

• 45 total participants
• 32 served as victims
• 13 served as caregivers

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Nursing Student Responses This will enhance my
nursing student abilities
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Nursing Student Responses This will enhance my
future skills as a practicing nurse
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Preparation for Exercise

• Was the training sufficient
• Was the info received sufficient
• Prepared for real disaster

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Preparation for Exercise

• Experience felt realistic

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Preparation for Exercise

• Would participate in future drills

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I was Anxious

• Caregivers
• Victims

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Emotions Experienced during drill
Boredom 27
Confusion 22
Competence 19
Compassion 13
Helplessness 7
Empathy 5
Frustration 1
Anxiety 1
Curious 1
Supported 1
Comfortable 1
Cared For 1
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Suggestions for Improvement

• Role performance
• Caregiver
• Act more like victims
• Wanted child victims
• Severely affected victims
• Wanted more preparation
• Better definition of caregiver role

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Suggestions for Improvement

• Curriculum improvement
• More disaster preparedness
• More preparation beforehand

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Suggestions for Improvement

• Information
• Underclassmen- more simulations
• More information
• Wanted handout

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Suggestions for Improvement

• Operational
• Too slow
• Better clock placement
• Better data collection
• Better preparation on use of students

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Discussion of Findings

• Caregivers more negative in assessment of value
  of exercise
• Anxiety for all
• Not sufficiently realistic

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Discussion of Findings

• Encourage assertiveness
• More preparation is needed
• Agreement- participation in future drills

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Need for Further Study

• Simulation should be realistic
• Students should participate more

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Conclusions

• Valuable learning experience
• Suggestions shared

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Questions ?

• Diane Vines vines_at_up.edu
• Lori Chorpenning chorpenn_at_up.edu

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References

• Behney, A., Briet, M., Phillips, C. (2006).
  Pediatric Mass Casualty Are You Ready. Journal
  of Emergency Medicine, 32(3), 241-245.
• Burkle, F. (1996). Acute Phase Mental Health
  Consequences of Disasters Implications for
  Triage and Emergency Medical Services. Annals of
  Emergency Medicine, 28(2), 119-128.
• Eichelberger, L., Odom, S. (2006). Disaster
  response a clinical experience students and
  faculty reflecting on Hurricane Katrina. American
  Journal of Nursing, 106(9), 72AAA-72DDD.
• International Coalition For Mass Casualty
  Education. (2003, July). Educational competencies
  for registered nurses responding to mass casualty
  incidents. Retrieved November 27, 2007, from
  http//www.incmce.org/competenciespage.html

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References

• Jasper, E., Miller, M., Sweeney, B., Berg, D.,
  Feuer, E., Reganato, D. (2005). Preparedness of
  hospitalas to respond to a radiological terrorism
  event as assessed by a full-scale exercise.
  Journal of Public Health Management and Practice,
  11(6), S11-S16.
• Jennings-Sanders, A., Frisch, N., Wing, S.
  (2005). Nursing students' perceptions about
  disaster nursing. Disaster Management and
  Response, 3(3), 80-85.
• Martin, S., Bush, A., Lynch, J. (2006). A
  National Survey of Terrorism Preparedness
  Training Among Pediatric, Family Practice, and
  EmergencyMedicine Programs. Pediatrics, 118 (3),
  620-626.
• Pattillo, M. M. (2003). Mass casualty disaster
  nursing course. Nurse Educator, 28(6), 271-275.
• Sanner, P., Wolcott, B. (1983). Stress
  Reactions among Participants in Mass Casualty
  Simulations. Annals of Emergency Medicine, 12(7),
  426-428.

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References

• Smith, R. (2007). Making a Case for Integration
  of Disaster Preparedness Content in Associate
  Degree Nursing Programs. Thinking Learning in
  Nursing, 2 (4), 100-104.
• Vinson, E. (2007). Managing Bioterrorism Mass
  Casualties in an Emergency Department Lesson
  Learned From a Rural Community Hospital Disaster
  Drill. Disaster Management and Response, 5 (1),
  18-21
• Waisman, Y., Amir, L., Mor, M., Figenberg, Z.,
  Aharonson, L., Peleg, K., et al. (2006).
  Prehospital Response Field Triage in Pediatric
  Mass Casualty Incidents  The Israeli Experience.
  Clinical Pediatric Emergency Medicine, 7(1),
  52-58.
• Weiner, E. F. (2005). A national curriculum for
  nurses in emergency preparedness and response.
  Nursing Clinics of North America, 40, 469-479.
• Weiner, E., Irwin, M., Trangenstein, P.,
  Gordon, J. (2005). Emergency preparedness
  curriculum in nursing schools in the United
  States. Nursing Education Perspectives, 26(6),
  334-339.