Preparing for Terrorism and Disasters in the New Age of Health Care


In retrospect, healthcare has changed greatly over the past few years, both due to the legislation changes and the introduction of new technological opportunities. With the advent of the era of new technology, the necessity to reconsider the standards for healthcare emerged, and, though the changes have not been fully implemented yet, their effects are already quite tangible.

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Though the core alterations inspired by the technological breakthrough concern the Nursing Outcomes Classification, the Nursing Interventions Classification and the patient-doctor communication, the realm of TDM (Terrorism and Disaster Management) has also been shaped to a considerable degree. According to the recently published documents, the emphasis has been made on facilitating better communication between a patient and a nursing specialist.

The changes to the overall healthcare system, however, have also triggered a profound change in the TDM. As the emphasis has been shifted from providing timely services onto what actually defined timeliness and accuracy, i.e., efficient communication between a patient and a doctor, the PAT procedures have geared towards improved information acquisition, interpretation and transfer from a victim to a healthcare specialist, major improvements in the efficacy of TDM related healthcare facilities can be expected.


The research of the chances, which the age of new media has offered to the healthcare system in general and the TDM in particular, should be carried out by viewing new regulations and analyzing their impact onto the management of disasters and terrorist attacks and the role of healthcare services in this process.

To be more exact, a careful analysis of the existing sources on healthcare and the TDM process regulation, as well as the effects that new technologies and media have had on these rules and regulations, including the definition of healthcare specialists’ role, will be carried out.


Seeing how the research in question will be conducted to define the effects that the recently created forms of media have had onto the provision of healthcare services for the victims of terrorist attacks and disasters, as well as the process of preparation for the above-mentioned problems and the facilitation of a relatively safe environment for the victims.

Judging by the fact that the research is focused on changes in the efficacy of healthcare services for the victims of terrorism or disasters, the aforementioned changes can be considered the dependent variables.

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The existing definition of a dependent variable says that this is the element of research that needs to be altered in order to test the hypothesis. Even though it would be technically rather complicated to change the existing regulations regarding TDM, they can be shaped hypothetically in order to make sure that technology does affect healthcare services for the TDM regulations.

As for the dependent variables, the laws and regulations, as well as the new forms of media, can be seen as the key factors that shape the dependent ones. By comparing the effects that the implementation of new principles is going to have on the TDM, one will be able to evaluate the scale, to which the landscape of TDM has been altered and, therefore, provide an assessment of the effects, which these changes are going to have on the management of terrorism and disasters.

The healthcare principles are another important dependent variable, which will help research the changes in the TDM of the XXI century. Comparing the effect that the previous healthcare standards had on the TDM to the ones that have been introduced with the advent of new technology will help understand the alterations in the TDM in general.


Null hypothesis

Because of the active use of elements of new media and technology in the present-day healthcare, as well as major enhancement of patient-nurse communication in the new age healthcare, the field of TDM has been shaped towards establishing better communication between the TDM experts and the people who have or are under a threat of becoming disaster victims. Particularly, the process of raising awareness concerning disasters and the steps to be taken the increase of a disaster or a terrorist attack has become much easier once new forms of media, especially social networking, have been incorporated into the TDM strategies.

Alternative hypothesis

Due to improved standards for nursing specialists, which were introduced with the advent of a new age of healthcare, the quality of healthcare services for the victims of terrorism and disaster has been improved considerably, which means that the TDM field has it’s key updated together with the upgrade of the healthcare services quality.

Since the demands towards healthcare specialists have been raised to the point where only the candidates with higher education diploma are accepted for becoming nurses, the TDM field will benefit from creating new ways for the patients, who are victims of terrorism or disasters to recover faster, as well as prevent the instances of terrorism and disaster or, at the very least, drive the number of the related emergencies to a minimum.

Literature Review

When analyzing the effects that the new age of healthcare has had on the TDM, it is most reasonable to start with the analysis of the actual changes, which the former have had on the management of terrorism and disasters. American Nurses Association (2011) has provided a decent overview of the changes brought by the new age of healthcare, as well as outlined some of the major challenges. The redefinition of standards for nurses has made a huge difference in the healthcare services of the XXI century.

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It is important that the line has finally been drawn between expert nurses and advanced practice registered nurses (APRNs). The fact that APRNs have been split into several major categories (a Nurse Practitioner (NP), a Certified Nurse-Midwife (CNM), a Clinical Nurse Specialist (CNS), and a Certified Registered Nurse Anesthetist (CRNA)), with the roles and responsibilities of each outlined. Thus, a better distribution of roles and responsibilities for a TDM process, should the need arise, becomes possible.

Assessing the effects that the previous system of healthcare principles has had on TDM prevention is a crucial step towards understanding what the reconsideration of nursing strategies is going to have on the TDM. This is the point at which the paper by Redlener factors into the research.

The article not only provides a vast list of core competencies required for a healthcare specialist for TDM to have but also provides descriptions of the major TDM processes, thus, justifying the choice of healthcare methods prescribed by the American Nursing Association. The article has shown that healthcare and especially terrorism and disaster prevention has grown into one of the major issues in the USA, with healthcare staff being the second largest workforce in the United States (Markenson, DiMaggio, & Redlener, 2005).

Though the information provided in the article can be considered quite dated, it is priceless in terms of its further use in the comparison between the old and the new healthcare principles.

Redlener has shown that previously, spreading awareness concerning the actions to be taken in case of terrorism or disaster-related emergencies were restricted to lectures and training in disaster learning laboratories (Markenson, DiMaggio, & Redlener, 2005). The creation of new technology was the answer to the emergence of new threats, including nuclear and radiological events (Tsubokura et al., 2013).

The issue of new-age healthcare principles and their influence on disaster management should also be touched upon, and consideration of Knebel, Toomey and Libby’s research is a perfect way to analyze the success of the new age healthcare strategies in the TDM realm. Focusing on the leadership aspect of the TDM field, the researchers state that the traditional anecdotal lesson learned approach towards spreading awareness among the U.S. residents needs to be changed with the help of the new age healthcare strategies.

As it has been stressed above, the invention of new means of information transfer has opened new opportunities for enhancing awareness among the target audience and spread information concerning possible instances of terrorism or disasters faster. Knebel, Toomey, and Libby contemplate on these opportunities, coining new approaches for disaster management and prevention. According to the paper, it is necessary to keep the focus on the new age leadership models and use new tools, which enhance these models’ efficacy.

To be more exact, it will be necessary to change the roles and responsibilities of nurses in crafting disaster response plans and play the role of leaders at all levels and phases of a disaster. The efficacy of the model suggested by the researchers was proven by the analysis of the case of hurricane Katrina, during which this model was implemented (Knebel, Toomey & Libby, 2012).

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According to the standards listed by the Department of Health and Human Services in 2013, the location of the problem and the following investigation of the issue, including the measures of addressing the problem and providing the corresponding services to the victims, are carried out in accordance with the Medicare and Medicaid programs (Department of Health and Human Services, 2013).

The Department of Health and Human Services assures that, despite a sudden and rather impressive change in the regulations of TDM, the new strategies will allow for providing “generally consistent emergency preparedness requirements” (Department of Health and Human Services, 2013, p. 79082), enhancing “patient safety during emergencies for persons served by Medicare- and Medicaid-participating facilities” (Department of Health and Human Services, 2013, p. 79082), and establishing “a more coordinated and defined response to natural and man-made disasters” (Department of Health and Human Services, 2013, p. 79082).

The effects of the new age healthcare principles as the basis for preventing and addressing disasters and terrorist attacks must also be tested in the appropriate environment so that their efficacy could be proven.

The research carried out by FEMA (2012) has shown that the new principles of healthcare reduce the number of emergencies and victims to an impressive extent. For example, the assessment of a specific emergency situation, which used to take several days, can nowadays be completed within a few hours or two days at most (FEMA, 2012).

Eventually, the financial aspect of the issue must be considered. Technology updates, especially for healthcare and TDM, are far from cheap, which means that the financial policy must be well thought out.

The major problem is not that technology updates demand much money, but the fact that the actual amount of the required funds is hard to define. In the era of fiscal austerity, this is a major concern (Pines, Pilkington & Seabury, 2014). The problem can be solved by assessing the expected costs of public emergencies in question (e.g., tornadoes, floods, earthquakes, terrorist attacks, etc.).

Though the sources mentioned above give a very good idea of what the healthcare of the new age will look like, they still give few opportunities for integrating the principles of the new age healthcare services into the realm of the TDM. The book by McGlown (2004) allows focusing on the preventive measures, therefore, helping understand how the new healthcare concepts are going to factor into the disaster and terrorism management process.

Though the book does not review any of the new age healthcare standards or strategies, it outlines the current TDM principles, therefore, defining the environment into which the new age concepts are going to be planted into. According to McGlown, the communication aspect is at the top of TDM priorities, which corresponds to the new age healthcare ideas. In fact, McGlown stresses the necessity to facilitate cooperation among every single department of the TDM realm, including the nurses, the emergency squad, and the instructors.


Based on the new technology and new forms of media, the new age healthcare principles allow for better communication and cooperation between the members of the TDM staff, as well as between the TDM employees and the population that may be or has been affected by a disaster or an act of terror. Therefore, the new age healthcare principles help gather and analyze feedback from the population, acquire the data regarding the accidents that have or will occur, and address the aforementioned issues fast and efficiently.

Apart from the necessity to use new media tools efficiently, the integration of new-age healthcare principles into the TDM field suggests that the threats of the XXI century should be addressed properly as well, which is a very reasonable step to take. New media allows for enhancing the existing communication system and gather the information, which is required for addressing the emergency situations adequately.

The reconsideration of the existing principles of healthcare has led to the restatement of the demands towards healthcare and TDM applicants. As recent papers issued by the American Nurses Association state, it is required now that the nursing specialists should have a higher education diploma.

Results Discussion

Speaking of the legitimacy of the alterations made to the TDM, some of the changes are quite a welcome change of pace, while others seem to make very little sense. For instance, the fact that spreading the awareness of a nuclear disaster is included in the new age TDM is a very important update of the previous instructions. However, one must admit that some of the expectations set by the new TDM principles stemming from the new age healthcare rules are rather unrealistic.

For example, the idea of creating preparedness for nuclear attacks and radiation caused by a nuclear explosion is rather good, seeing how the threat is quite tangible, which the notorious Fukushima case has proven (Tsubokura et al., 2013).

Buying the equipment required for providing every single member of every community with the appropriate healthcare services is hardly possible, though. Granted that some of the financial issues can be resolved by reconsidering the state budget, it will be still rather problematic to keep the equipment updated and at the same time spend the minimum costs on the upgrades.

Speaking of using new technology and modern media as the means for enhancing the security of and spreading awareness among the population, one must admit that there are a few dents in the overall good principles of e wage terrorism and disaster management. On the one hand, creating a database, which will allow for the organization and storage of the key data is quite attainable, though rather expensive.

Providing complete security from hacking attempts, however, is impossible; no matter how good the passwords are and how thorough the security strategy has been thought out, there still is a chance for a security breach. The consequences may be dire; with the access to complete information on the state TDM, the alleged criminals, such as terrorists, may plan the strategies for fighting the obstacles set by the local TDM effectively.

The null hypothesis, therefore, has been proven. The introduction of new healthcare principles does affect the speed and quality of healthcare services delivery. With the use of modern technology, spreading awareness, and delivering the required resources have become much faster. The inclusion of more stringent demands towards healthcare specialists also seems to have changed the modern TDM field for the better.

The alternative hypothesis can also be considered affirmed since the new healthcare regulations allow only people with a Master or Bachelor degree to apply for the position of a TDM specialist. While the effects of the given step are yet to be seen, it can be assumed that qualified staff is going to be of much use in the TDM department.

It should be noted, though, that, apart from updating standards, the means for the staff to evolve professionally should have been provided. Creating courses and providing access to the latest information concerning TDM should be the next step towards the TDM system improvement.


Because of the opportunities that the modern technologies have opened for nursing specialists in terms of communication and better cooperation between the units of the TDM, as well as the communication process between the disaster or terrorism victims and the healthcare specialists, the new age health care has clearly reinvented the field of TDM completely.

After the latest communication technologies are integrated into the TDM specialists’ interaction and strategies, a rapid improvement in the provision of healthcare facilities can be expected. In addition, terrorism and disaster prevention will be carried out more efficiently with the application of the technological advances of the new age healthcare.

Though the process of new healthcare and communication tools introduced into the TDM realm can be viewed as rather smooth, it still requires that certain compromises should be made between the current standards and the demands that modern technology makes.

For instance, it will be necessary to make sure that the staff has undergone training in order to make efficient use of the new technology at their disposal. In addition, enhancing awareness concerning new methods of communicating with the healthcare staff should be carried out among the target audience.

Reference List

American Nurses Association (2011). Advanced practice nursing: A new age in healthcare. Silver Spring, MD: American Nurses Association.

Department of Health and Human Services (2013). Medicare and Medicaid programs; emergency preparedness requirements for Medicare and Medicaid participating Providers and suppliers. Federal Register, 78(249), 79082–79184.

FEMA (2012). Primer to design safe school projects in case of terrorist attacks and school shootings. Washington, DC: Homeland Security.

Knebel, A., Toomey, L. & Libby, M. (2012). Nursing leadership in disaster preparedness and response. Annual Review of Nursing Research, 30(1), 21–45.

McGlown, J. (2004). Terrorism and disaster management: Preparing healthcare leaders for new reality. Chicago, IL: ACHE Management Series.

Markenson, D., DiMaggio, C. & Redlener, I. (2005). Preparing health professions students for terrorism, disaster, and public health emergencies: Core competencies. Academic Medicine, 80(6), 517–526.

Pines, J. M., Pilkington, W. F. & Seabury, S. A. (2014). Value-based models for sustaining emergency preparedness capacity and capability in the United States. Washington, DC: Institute of Medicine, Forum on Medical and Public Health Preparedness for Catastrophic Events.

Tsubokura, M., Nihei, S., Sakuma, N., Furutani, Y., Uehara, T., Sugimoto, K.… & Endo, Y. (2013). Limited internal radiation exposure associated with resettlements to a radiation-contaminated homeland after the Fukushima Daiichi nuclear disaster. PLOS One, 8(12), e81909. Web.

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