learning of student nurse volunteers in federal disaster exercise university of portland portland,...
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![Page 1: Learning of Student Nurse Volunteers in Federal Disaster Exercise University of Portland Portland, Oregon Diane Vines, R.N., Ph.D. and Lori Chorpenning,](https://reader037.vdocuments.us/reader037/viewer/2022110321/56649ce05503460f949a9bc3/html5/thumbnails/1.jpg)
Learning of Student Learning of Student Nurse Volunteers in Nurse Volunteers in
Federal Disaster Federal Disaster ExerciseExercise
University of Portland University of Portland Portland, OregonPortland, Oregon
Diane Vines, R.N., Ph.D.Diane Vines, R.N., Ph.D.andand
Lori Chorpenning, R.N., M.S.Lori Chorpenning, R.N., M.S.
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University of PortlandUniversity of Portland
Established in 1901Established in 1901 3200 students3200 students Teaching, Faith, Teaching, Faith,
ServiceService Faith-based Faith-based
institutioninstitution
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UP School of NursingUP School of Nursing
Large undergraduate Large undergraduate programprogram
Graduate programsGraduate programs
- Master’s entry program- Master’s entry program
- Clinical Nurse Leaders - Clinical Nurse Leaders Masters programMasters program
- Doctorate of Nursing - Doctorate of Nursing Practice program Practice program
beginning Summer 2008beginning Summer 2008
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TOPOFF 4 Disaster ExerciseTOPOFF 4 Disaster Exercise
15,000 participants15,000 participants
Scenario-Terrorists bring Scenario-Terrorists bring radioactive material into radioactive material into the U.S.the U.S.
Guam, Portland and Guam, Portland and PhoenixPhoenix
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TOPOFF 4 GoalsTOPOFF 4 Goals
Policy and strategic issues Policy and strategic issues Difficult decisionsDifficult decisions Essential functionsEssential functions Common operating picture Common operating picture
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University of Portland University of Portland ParticipationParticipation
The athletic center The athletic center as site of 50 bed as site of 50 bed stabilization area stabilization area (medical care (medical care point)point)
Student nurses, Student nurses, faculty, and staff faculty, and staff volunteersvolunteers
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UP ParticipationUP Participation
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Importance of Disaster Importance of Disaster PreparednessPreparedness
ACHNE White Paper on disaster ACHNE White Paper on disaster preparednesspreparedness
ANA White PaperANA White Paper Essentials of Baccalaureate NursingEssentials of Baccalaureate Nursing Homeland Security training fundsHomeland Security training funds
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Literature ReviewLiterature Review
Disaster exercisesDisaster exercises Stimulating training (Jasper et al, 2005)Stimulating training (Jasper et al, 2005) Importance of simulation (Smith, 2007)Importance of simulation (Smith, 2007) Multidisciplinary team in Israel (Waisman Multidisciplinary team in Israel (Waisman
et al (2006)et al (2006) Healthcare worker training in a rural Healthcare worker training in a rural
community hospital drill (Vinson, 2007)community hospital drill (Vinson, 2007)
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Literature ReviewLiterature Review
Student nurse involvement in Student nurse involvement in exercisesexercises
Physical injuries focus (Jennings-Physical injuries focus (Jennings-Sanders et al, 2005)Sanders et al, 2005)
Clayton State University students Clayton State University students increased confidence in caring for increased confidence in caring for patients (Eichelberger & Odom, patients (Eichelberger & Odom, 2006)2006)
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Literature ReviewLiterature Review
Provider reactions to disaster Provider reactions to disaster exercisesexercises
Communication (Behney et al, 2006)Communication (Behney et al, 2006) Responders experienced stress Responders experienced stress
reactions (Burkle, 1996)reactions (Burkle, 1996) Exercise reactions similar to actual Exercise reactions similar to actual
disaster (Sanner & Wolcott, 1983)disaster (Sanner & Wolcott, 1983)
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Literature Review Literature Review
Curricular implicationsCurricular implications Disaster preparedness -basic Disaster preparedness -basic
competency (Pattillo, 2003)competency (Pattillo, 2003) Competency for entry-level RN’s- Competency for entry-level RN’s-
International Coalition for Mass International Coalition for Mass Casualty Education (INCMCE) now Casualty Education (INCMCE) now called National Emergency called National Emergency Preparedness Education Coalition Preparedness Education Coalition (NEPEC) (NEPEC)
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Literature ReviewLiterature Review
No increase in teaching disaster No increase in teaching disaster preparedness (Weiner et al, 2005)preparedness (Weiner et al, 2005)
Lecture only (Weiner, 2005)Lecture only (Weiner, 2005) Barrier- time (Martin et al, 2006)Barrier- time (Martin et al, 2006)
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Study DesignStudy Design
Survey instrumentSurvey instrument
1. Category1. Category
2. Role2. Role
3. Experience during drill3. Experience during drill
4. Feelings during drill 4. Feelings during drill
5. Problems or challenges5. Problems or challenges
6. What worked well6. What worked well
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Study Design Study Design
Data CollectionData Collection After drillAfter drill Likert ScaleLikert Scale DebriefingDebriefing
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Study DesignStudy Design
Data analysisData analysis Quantitative and qualitative Quantitative and qualitative Compared responses of victims and Compared responses of victims and
caregiverscaregivers Emotions experienced and Emotions experienced and
suggestions for improvement suggestions for improvement
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Findings – Demographics and Findings – Demographics and RolesRoles
7
17
11
2 2
4
2
0
2
4
6
8
10
12
14
16
18
AEMUP Senior Junior Freshman Faculty
Total respondants
Victim
Caregiver
45 total 45 total participantsparticipants– 32 served 32 served
as victimsas victims– 13 served 13 served
as as caregiverscaregivers
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Nursing Student Responses: Nursing Student Responses: This will enhance my nursing This will enhance my nursing
student abilitiesstudent abilities
6
2
12
5 5
2
0
1
4
1
0
2
4
6
8
10
12
StronglyAgree
Agree Disagree StronglyDisagree
No Opinion
This w ill enhance my nursing student abilities
Victim
Caregiver
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Nursing Student Responses: Nursing Student Responses: This will enhance my future skills This will enhance my future skills
as a as a practicing nursepracticing nurse
5
3
14
2
5
2
0 0
4 4
0
2
4
6
8
10
12
14
StronglyAgree
Agree Disagree StronglyDisagree
No Opinion
This will enhance my future skills as a practicing nurse
Victim
Caregiver
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Preparation for ExercisePreparation for Exercise
Was the training sufficient:Was the training sufficient:
Was the info received sufficient:Was the info received sufficient:
Prepared for real disaster:Prepared for real disaster:
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Preparation for ExercisePreparation for Exercise
Experience felt realistic:Experience felt realistic:
0
1
2
3
4
5
6
7
8
9
10
Strongly Agree Agree Disagree Strongly Disagree No Opinion
The drill felt realistic
AEMUP
Senior
Junior
Freshman
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Preparation for ExercisePreparation for Exercise
Would participate in future drills:Would participate in future drills:
0
2
4
6
8
10
12
14
16
18
Strongly Agree Agree Disagree Strongly Disagree No Opinion
I would participate in a future disaster drill
AEMUP
Senior
Junior
Freshman
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I was Anxious…I was Anxious…
Caregivers Caregivers
Victims Victims
0
1
2
3
4
5
6
7
8
9
Strongly Agree Agree Disagree Strongly Disagree No Opinion
Caregiver anxiety
Before drill
During drill
0
2
4
6
8
10
12
14
16
Strongly Agree Agree Disagree Strongly Disagree No Opinion
Victim anxiety
Before drill
During drill
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Emotions Experienced during drillEmotions Experienced during drill BoredomBoredom 2727
ConfusionConfusion 2222
CompetenceCompetence 1919
CompassionCompassion 1313
HelplessnessHelplessness 77
EmpathyEmpathy 55
FrustrationFrustration 11
AnxietyAnxiety 11
CuriousCurious 11
SupportedSupported 11
ComfortableComfortable 11
Cared ForCared For 11
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Suggestions for Suggestions for ImprovementImprovement
Role performanceRole performance CaregiverCaregiver Act more like victimsAct more like victims Wanted child victims Wanted child victims Severely affected victimsSeverely affected victims Wanted more preparation Wanted more preparation Better definition of caregiver roleBetter definition of caregiver role
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Suggestions for Suggestions for ImprovementImprovement
Curriculum improvementCurriculum improvement More disaster preparedness More disaster preparedness More preparation beforehandMore preparation beforehand
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Suggestions for ImprovementSuggestions for Improvement
InformationInformation Underclassmen- more simulations Underclassmen- more simulations More informationMore information Wanted handoutWanted handout
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Suggestions for ImprovementSuggestions for Improvement
Operational Operational Too slow Too slow Better clock placement Better clock placement Better data collectionBetter data collection Better preparation on use of studentsBetter preparation on use of students
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Discussion of FindingsDiscussion of Findings
Caregivers more negative in Caregivers more negative in assessment of value of exerciseassessment of value of exercise
Anxiety for allAnxiety for all
Not sufficiently realisticNot sufficiently realistic
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Discussion of FindingsDiscussion of Findings Encourage assertivenessEncourage assertiveness
More preparation is neededMore preparation is needed
Agreement- participation in future drillsAgreement- participation in future drills
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Need for Further StudyNeed for Further Study
Simulation should be realisticSimulation should be realistic
Students should participate moreStudents should participate more
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ConclusionsConclusions
Valuable learning experienceValuable learning experience
Suggestions sharedSuggestions shared
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Questions ?Questions ?
Diane Vines: [email protected] Vines: [email protected] Lori Chorpenning: [email protected] Chorpenning: [email protected]
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ReferencesReferences Behney, A., Briet, M., & Phillips, C. (2006). Pediatric Mass Casualty: Behney, A., Briet, M., & Phillips, C. (2006). Pediatric Mass Casualty:
Are You Ready. Are You Ready. Journal of Emergency Medicine, Journal of Emergency Medicine, 32(3), 241-245.32(3), 241-245. Burkle, F. (1996). Acute Phase Mental Health Consequences of Burkle, F. (1996). Acute Phase Mental Health Consequences of
Disasters: Implications for Triage and Emergency Medical Disasters: Implications for Triage and Emergency Medical Services. Services. Annals of Emergency Medicine, Annals of Emergency Medicine, 28(2), 119-128. 28(2), 119-128.
Eichelberger, L., & Odom, S. (2006). Disaster response: a clinical Eichelberger, L., & Odom, S. (2006). Disaster response: a clinical experience: students and faculty reflecting on Hurricane Katrina. experience: students and faculty reflecting on Hurricane Katrina. American Journal of Nursing, 106American Journal of Nursing, 106(9), 72AAA-72DDD. (9), 72AAA-72DDD.
International Coalition For Mass Casualty Education. (2003, July). International Coalition For Mass Casualty Education. (2003, July). Educational competencies for registered nurses responding to Educational competencies for registered nurses responding to mass casualty incidentsmass casualty incidents. Retrieved November 27, 2007, from . Retrieved November 27, 2007, from http://www.incmce.org/competenciespage.htmlhttp://www.incmce.org/competenciespage.html
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ReferencesReferences Jasper, E., Miller, M., Sweeney, B., Berg, D., Feuer, E., & Reganato, Jasper, E., Miller, M., Sweeney, B., Berg, D., Feuer, E., & Reganato,
D. (2005). Preparedness of hospitalas to respond to a radiological D. (2005). Preparedness of hospitalas to respond to a radiological terrorism event as assessed by a full-scale exercise. terrorism event as assessed by a full-scale exercise. Journal of Journal of Public Health Management and Practice, 11Public Health Management and Practice, 11(6), S11-S16. (6), S11-S16.
Jennings-Sanders, A., Frisch, N., & Wing, S. (2005). Nursing Jennings-Sanders, A., Frisch, N., & Wing, S. (2005). Nursing students' perceptions about disaster nursing. students' perceptions about disaster nursing. Disaster Disaster Management and Response, 3Management and Response, 3(3), 80-85.(3), 80-85.
Martin, S., Bush, A., & Lynch, J. (2006). A National Survey of Martin, S., Bush, A., & Lynch, J. (2006). A National Survey of Terrorism Preparedness Training Among Pediatric, Family Practice, Terrorism Preparedness Training Among Pediatric, Family Practice, and EmergencyMedicine Programs. and EmergencyMedicine Programs. Pediatrics, Pediatrics, 118 (3), 620-626.118 (3), 620-626.
Pattillo, M. M. (2003). Mass casualty disaster nursing course. Pattillo, M. M. (2003). Mass casualty disaster nursing course. Nurse Nurse Educator, 28Educator, 28(6), 271-275.(6), 271-275.
Sanner, P., & Wolcott, B. (1983). Stress Reactions among Sanner, P., & Wolcott, B. (1983). Stress Reactions among Participants in Mass Casualty Simulations. Participants in Mass Casualty Simulations. Annals Annals of of Emergency Emergency Medicine, Medicine, 12(7), 426-428.12(7), 426-428.
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ReferencesReferences Smith, R. (2007). Making a Case for Integration of DisasterSmith, R. (2007). Making a Case for Integration of Disaster
Preparedness Content in Associate Degree Nursing Programs. Preparedness Content in Associate Degree Nursing Programs. Thinking Thinking & Learning in Nursing, & Learning in Nursing, 2 (4), 100-104.2 (4), 100-104.
Vinson, E. (2007). Managing Bioterrorism Mass Casualties in an Vinson, E. (2007). Managing Bioterrorism Mass Casualties in an Emergency Department: Emergency Department: Lesson Learned From a Rural Lesson Learned From a Rural Community Hospital Disaster Drill. Community Hospital Disaster Drill. Disaster Disaster Management and Management and Response, Response, 5 (1), 18-215 (1), 18-21
Waisman, Y., Amir, L., Mor, M., Figenberg, Z., Aharonson, L., Peleg, K., Waisman, Y., Amir, L., Mor, M., Figenberg, Z., Aharonson, L., Peleg, K., et al. et al. (2006). Prehospital Response & Field Triage in Pediatric Mass (2006). Prehospital Response & Field Triage in Pediatric Mass Casualty Incidents : The Israeli Experience. Casualty Incidents : The Israeli Experience. Clinical Pediatric Clinical Pediatric
Emergency Medicine, Emergency Medicine, 7(1), 52-58.7(1), 52-58. Weiner, E. F. (2005). A national curriculum for nurses in emergency Weiner, E. F. (2005). A national curriculum for nurses in emergency
preparedness and response. preparedness and response. Nursing Clinics of North America, 40,Nursing Clinics of North America, 40, 469- 469-479.479.
Weiner, E., Irwin, M., Trangenstein, P., & Gordon, J. (2005). Emergency Weiner, E., Irwin, M., Trangenstein, P., & Gordon, J. (2005). Emergency preparedness curriculum in nursing schools in the United States. preparedness curriculum in nursing schools in the United States.
Nursing Education Perspectives, 26Nursing Education Perspectives, 26(6), 334-339.(6), 334-339.