When Disaster Strikes

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Beckman, Taylor; Lew, Sarah; Ostrem, Catherine; Belz, Alanna
emergency room; nursing preparedness; emergency nursing; mass casualty incidents
lecture / presentation description
Purpose/AimThe purpose of this project is to determine if providing mass casualty education in undergraduate nursing programs would better prepare nurses for mass casualty incidents. The PICOT format was used (P= emergency care nurses, patients; I= mass casualty education course; C= no educational course; O= improved patient outcomes and nursing preparedness; T= no time specified)Does implementing a mass casualty education course during the baccalaureate nursing degree program improve patient outcomes and nursing preparedness in the event of a mass casualty incident?BackgroundAccording to P. Minemyer of Fiercehealthcare.com, “Half of doctors don't think the facilities they work for are prepared for emergencies.” Mass casualty events (bombings, shootings, etc.), as well as catastrophic natural disasters (Hurricane Harvey, the California fires), are on the rise in the US, and many emergency department nurses may not have the educational means by which to deal with the large influx of trauma patients that result in these situations. Hospital protocols regarding mass casualties require quick action and critical thinking to maximize the number of lives saved and improve overall patient outcomes. Prioritizing and precise use of skills are two major components that can change patient outcomes in a mass trauma event and can be taught effectively in an undergraduate nursing program. This research investigates whether the implementation of a course in mass casualty nursing in the baccalaureate nursing program would be beneficial to both nurses and patients in the event of a mass casualty incident.MethodsThe database Medline-EBSCO was searched (2005 to present) using the following keywords: emergency room, nursing preparedness, emergency nursing, mass casualty incidents. We searched “(MH ""Emergency Nursing"") AND (MH ""Mass Casualty Incidents/MO"") AND Education” Medline-EBSCO 2000-current. Of 48 articles that came up, we found 15 relevant using the Melnyk and Fineout-Overholt Levels of Evidence. We found the remaining 33 articles irrelevant because they were focusing on one of the following: radiology or emergency response professions such as firefighters or paramedics, different aspects of nursing, were based in different countries, or were not focused on emergency nursing with mass casualties.ResultsThe level of evidence in the 15 articles found relevant was level VI and VII, 11 of the articles at level VII. The overall evidence concluded a need for nursing preparedness for mass casualty events either regarding more training, confirming lack of preparedness, and encouraging more studies and research to be done regarding better outcomes.In the article Be prepared - The Boston Marathon and Mass-Casualty Events, Paul Biddinger M.D. and several other medical professionals review the trauma centers responses to this mass casualty event. Biddinger, P. et al., states “We believe that the speed and coordination of the response is partially attributable to reviewing other cities’ experiences, adjusting our plans, and repeatedly training staff in imple­menting those plans.” The trauma centers in this event were relatively prepared because of well-implemented training programs based off lessons from other hospitals that had dealt with mass casualty events.ConclusionMass casualty events are prevalent in today’s society and need to be addressed in the healthcare setting. We do not know when or where the next one will occur but we do know through our research the importance of being properly prepared. Through our research, we have concluded it is imperative to continue researching the need for preparedness for mass casualty events in order to provide evidence for medical and educational institutions to implement educational courses. Implementing additional training or a course would benefit the hospitals and patients by equipping the nursing staff with the essential tools they may need when a crisis occurs.