Introduction
A hospital disaster plan helps minimize strain on healthcare resources and management in case of a casualty upsurge at the ED. The prompt activation of the plan is important to mobilize resources for efficient care delivery within the shortest time. Periodic emergency drills are essential to familiarize the medical team with the disaster plan (Duchene, 2011). Establishing a disaster committee, stocking sufficient supplies in the ER, and maintaining a disaster SOP are considered best practices in this area. This paper examines the disaster plan of KRMC and the role of the nurse manager within it.
The Professional who Activates the Plan
The on-duty Chief Medical Officer (CMO) at the ED activates KRMC’s disaster preparedness plan upon authenticating information about the nature of the disaster and the projected number of casualties (Kendallmed.com, 2016). The initial activation entails notifying the accident and emergency department and key professionals to prepare to attend to the victims.
How the Plan is Activated
The CMO first confirms the authenticity of the incident upon learning about the incident. He/she must confirm the nature of the disaster, e.g., hurricanes, place/time it occurred, and casualty profile. The CMO then alerts the available medical staff in the ED about the crisis to initiate preparation. The preparation follows normal disaster management steps, including increasing hospital beds, indoor decontamination, mobilization of staff, i.e., doctors, nurses, and other personnel, and stocking adequate supplies, e.g., antidotes (CMS, 2014). KRMC creates an initial treatment area for resuscitation and a disaster/ICU ward for stabilization and treatment. Other actions include creating a triage area, a control room, an information center, and relatives waiting area.
Who is Involved
The implementation of the disaster plan involves the KRMC’s disaster committee that includes the hospital director, HODs, nurse manager, and administration team. The first responders dispatched to the site upon activation of the plan include paramedics (ambulance), nurses, anesthetists, OT specialist, and drivers to give first aid and stabilize critical cases. At the hospital, a multidisciplinary team drawn from orthopedics, medical, radiology, and surgical departments are involved in the treatment.
Location of the Command Center
The magnitude of the disaster determines the location and number of medical control points (Duchene, 2011). KRMC runs a hospital operation center (HOC), a central medical command post from where the hospital director and the medical/ambulance commanders manage all emergency operations. KRMC’s seminar room is used as the operation center during disasters.
Communication of the Plan to the Staff
Upon notification, the CMO informs the hospital director who directs the implementation of the disaster plan to the HODs/coordinators. He/she relays the information to the administrative coordinator to provide communication facilities, extra supplies, and morgue facilities. The director also informs the clinical coordinators in the emergency care who communicate the plan to the ED and ambulance staff. The critical care services coordinator informs the medical staff in the surgery, pediatrics, and orthopedic units, among others. Clinical support personnel, including the pathologists, radiologists, and pharmacists, are informed through the same channel. The nurse manager informs the nursing staff through the ED department.
Calling off the Plan and Debriefing
After the hospital reverts to its usual operating rate, a performance evaluation is done before calling off the disaster plan. According to Pole, Marcozzi, and Hunt (2013), a performance evaluation helps determine if there is a “return to normal levels of operations” (p. 3). Departmental evaluations of the level of operations are communicated to the incident commanders and the hospital director who calls off the disaster plan.
Debriefing sessions are held during the recovery phase in the hospital’s conference room. The aim is to report the damage and determine supply replacement (Hegazy, Taha, Zeid, El-Taher, & Hassan, 2016). The debriefing involves the staff offering emergency care services.
Potential Threats to Quality Care Deliver in a Disaster
Inadequate inpatient capacity can hamper quality care delivery. It leads to ED overcrowding due to limited critical care beds to handle mass casualties during a disaster (VanVactor, 2012). This affects patient rounding and bedside care. Another threat relates to patient boarding due to ED overcrowding during disasters. Critical care patients are forced to wait for a bed, comprising the quality of care received. Also, a disaster can stretch the staff and equipment to the maximum, hampering the ED’s ability to take in more patients (VanVactor, 2012). This prolongs the patient waiting times to see a doctor. The quality of nursing care is also affected due to overworked nurses during ED surges.
Measures for Ensuring Quality
KRMC’s disaster plan has a triaging and treatment system for handling casualties. Critically injured victims are ferried immediately to the ED in an ambulance while those with intermediate injuries are treated later after first aid. Patients with slight injuries receive treatment after the first two categories of casualties. The dead are attended to later. This system ensures that hospital resources are used to offer quality care to those in urgent need.
Suggestions
KRMC should consider offering counseling and support services to the emergency care team after the disaster. The responsibility of providing such services should be left to the facility’s social services department.
Conclusion
The KRMC’s elaborate disaster plan ensures adequate preparation during an emergency. It provides for a system for mobilizing staff and resources to offer quality nursing care in a timely and efficient manner to minimize suffering and death toll.
References
Centers for Disease Control and Prevention. [CMS]. (2014). Emergency preparedness and response: Preparation & planning. Washington, DC: U.S. Department of Health and Human Services.
Duchene, M. (2011). Emergency management in action: Surviving a flood. Home Healthcare Nurse, 29(6), 383–387.
Hegazy, I., Taha, M., Zeid, A., El-Taher, E., & Hassan, N. (2016). Assessing the awareness regarding disaster management plan among an interprofessional team in a university hospital. International Journal of Medicine and Medical Sciences, 3(2), 32-39.
Kendallmed.com. (2016). Web.
Pole, T., Marcozzi, D., & Hunt, R. (2013). Interrupting my shift: Disaster preparedness and response. Annals of Emergency Medicine, 1, 1-5.
VanVactor, J. (2012). Strategic health care logistics planning in emergency management. Disaster Prevention and Management, 21(3), 299-309.