NURS FPX 4060 Assessment 3 Disaster Recovery Plan  SC

NURS FPX 4060 Assessment 3 Disaster Recovery Plan SC

Disaster Recovery Plan- Speaker Notes

Hello, my name is Sarah Cintron, I am senior nurse at Valley City Regional Hospital. Today I will be sharing with you my Disaster Recovery Plan.

I would like to provide you some background information that helps explain the need for a disaster recovery plan. Valley City Regional Hospital is in Valley City, North Dakota. Valley City has a population of 8,295 not including unknown number of undocumented migrant workers. Our hospital, which is a 105-bed facility, serves as the primary source of health care for a wide area of North Dakota.  Two years ago, our town was faced with a disaster situation, that unfortunately exposed our cities vulnerability in handling such a catastrophic event.  An oil-tanker train derailed and subsequently caused an immediate explosion and fire then water contamination for the months that followed. Most residents were evacuated, 200 people needed hospitalization and six lives were lost. 

What is a disaster? The American College of Emergency Physicians defines disaster as “when the destructive effects of natural or man-made forces overwhelm the ability of a given area or community to meet the demand for health care.” Disasters are divided into 2 basic groups: natural and man-made. Among the natural disasters are earthquakes, volcanoes, hurricanes, floods, fires, and medical emergencies. Among the man-made disasters are war, pollution, nuclear explosions, fires, hazardous materials exposures, explosions, and transportation accidents.

Disasters often cause loss of life, human suffering, loss of income, and property loss and/or damage. Disasters are becoming more prevalent and complex. Therefore, having a disaster plan to optimize hospital resources at their most strained moments is an important skill for navigating disasters.

NURS FPX 4060 Assessment 3 Disaster Recovery Plan SC

In 1979, President Carter established the Federal Emergency Management Agency, FEMA. The agency’s primary purpose is to coordinate the response to a disaster that has occurred in the United States and that overwhelms the resources of local and state authorities. FEMA does not respond to disasters on its own, the governor of the state in which the disaster occurs must declare a state of emergency and formally request from the President that FEMA and the federal government respond to the disaster. 

FEMA Mission: Helping people before, during and after disasters.

The 2018-2022 strategic plan creates a shared vision for the field of emergency management and sets an ambitious, yet achievable, path forward to unify and further professionalize emergency management across the country. The strategic plan sets out three overarching strategic goals:

  • Build a Culture of Preparedness. Every segment of our society, from individual to government, industry to philanthropy, must be encouraged and empowered with the information it needs to prepare for the inevitable impacts of future disasters
  • Ready the Nation for Catastrophic Disasters. FEMA will work with its partners across all levels of government to strengthen partnerships and access new sources of scalable capabilities to quickly meet the needs of overwhelming incidents.
  • Reduce the Complexity of FEMAFEMA must continue to be responsible stewards of the resources we are entrusted to administer. We must also do everything we can to leverage data to drive decision-making and reduce the administrative and bureaucratic burdens that impede impacted individuals and communities from quickly receiving the assistance they need.

NURS FPX 4060 Assessment 3 Disaster Recovery Plan SC

In 1988, the Robert T. Stafford Disaster Relief and Emergency Assistance Act, which provides funds for states. The Stafford Act gives the president the power to make disaster declarations during an emergency When the president issues an emergency declaration, the Federal Emergency Management Agency (FEMA) will then coordinate relief resources to assist overwhelmed state and local governments.

The Stafford Act authorizes three types of assistance from the federal government. These are:

  • Individual assistance: Assistance directly given to individuals and businesses affected by an emergency/disaster
  • Public Assistance: Funding and expertise allocated to state and local governments.
  • Hazard mitigation assistance: Funding aimed at eliminating or reducing the long-term effects of the disaster.

In addition to funding other relief efforts include: the creation of emergency medical facilities, the provision of emergency medical treatment, and the provision of water, food, medicine, and other supplies to affected areas.

The Safford act is used approximately 56 times per year. It has been used a response to disasters like Hurricane Katrina and the Oklahoma City bombing. It has been used to respond to public health emergencies including the West Nile Virus outbreak in New York and New Jersey and most recently by President Trump as a response to the COVID-19 pandemic.

The context of people’s lives determines their health.

NURS FPX 4060 Assessment 3 Disaster Recovery Plan SC

  • Income and social status – higher income and social status are linked to better health. The greater the gap between the richest and poorest people, the greater the differences in health.
  • Education – low education levels are linked with poor health, more stress and lower self-confidence.
  • Social support networks – greater support from families, friends and communities are linked to better health.
  • Physical environment – safe water and clean air, healthy workplaces, safe houses, communities, and roads all contribute to good health.
  • Employment and working conditions – people in employment are healthier, particularly those who have more control over their working conditions
  • Culture – customs and traditions, and the beliefs of the family and community all affect health.
  • Genetics – inheritance plays a part in determining lifespan, healthiness and the likelihood of developing certain illnesses.
  • Personal behavior and coping skills – balanced eating, keeping active, smoking, drinking, and how we deal with life’s stresses and challenges all affect health.
  • Health services – access and use of services that prevent and treat disease influences health 
  • Gender – Men and women suffer from different types of diseases at different ages.

You can see how all these variables may affect an individual or community when faced with disaster recovery efforts.  They may be less prepared. Have less knowledge about or limited access to resources.  And may be in an already compromised state of health, which would make recovery even more of a challenge.

Every 10 years, The U.S. Department of Health and Human Services and the Office of Disease Prevention and Health Promotion release information on health indicators, public health issues, and current trends. This is known as Healthy People. The vision of Health People is a society in which all people live long, healthy lives. Since the 2000 launch of Healthy People 2010, the United States suffered several emergency situations:  the attacks of September 11, 2001, the subsequent anthrax attacks, the devastating effects of natural disasters such as hurricanes Katrina and Ike, and concerns about an influenza pandemic. These have added urgency to the importance of preparedness as a public health issue. For Healthy People 2020, Preparedness was added to its list of 42 national objectives.  The goal of the preparedness objective was to strengthen and sustain communities’ abilities to prevent, protect against, mitigate the effects of, respond to, and recover from incidents with negative health effects. Why Is Preparedness Important? A public health emergency can happen at any time and being prepared can save lives. Communities can prepare for emergencies like natural disasters and disease outbreaks through planning and by training individuals in emergency response. In addition, making sure people are prepared for disease outbreaks and have evacuation plans for natural disasters is key to helping them stay safe. And providing accurate, complete information can help people take steps to protect themselves during emergencies. The negative health consequences of deliberate attacks, accidents, and natural disasters impact communities across the Nation.

The Healthy People 2020 MAP-IT framework is designed to help communities develop local health initiatives.  Its phases of Mobilize-Assess-Plan-Implement-Track provide a logical structure for communities to address and resolve local health problems and to build healthy communities.

MAP-IT (Mobilize, Assess, Plan, Implement, Track:

  • Mobilize individuals and organizations that care about the health of your community into a coalition.
  • Assess the areas of greatest need in your community, as well as the resources and other strengths that you can tap into to address those areas.
  • Plan your approach: start with a vision of where you want to be as a community; then add strategies and action steps to help you achieve that vision.
  • Implement your plan using concrete action steps that can be monitored and will make a difference.
  • Track your progress over time.

This framework can be adopted by any community such as Valley City, to come together and work as s coalition to ensure the disaster recovery plan is a success.

Disaster management is a comprehensive approach in dealing with all four phases of disasters: Response is defined as the actions taken to decrease mortality and morbidity, and to prevent further property damage when the hazard occurs. Response is putting preparedness plans into action.

  • Response activities may include search and rescue, triage, acute medical care, firefighting, sheltering victims, relocating medical records
  • Recovery is defined as the actions taken to return to normal following an event.: Repairing buildings, Replacing homes
  • Prevention/Mitigation is defined as “sustained actions that decrease the risk of a hazard (probability of occurrence) of a hazard, or to reduce the potential negative consequences suffered by people and/or property.” It can involve such actions as: Laws and regulations restricting deforestation to prevent mudslides. Relocating or elevating structures to minimize the effects of floods. Securing shelves and hot water heaters to walls in earthquake zones. Developing, adopting and enforcing building codes and standards. Engineering roads and bridges to withstand earthquakes. Using fire-retardant materials in new construction to reduce the risk of fire.
  • Preparedness takes the form of plans or procedures designed to minimize physical and property damage when an event occurs. These activities ensure that when a disaster strikes, disaster (emergency) managers will provide the best response possible. The essential elements include Planning, Training personnel, Disaster drills. 

Triage is a standard procedure in medical care, however, but it may shift during a disaster or mass casualty incident (MCI). The goal of triage in a disaster situation becomes providing the best chances of survival for the greatest number of people, rather than providing immediate treatment. During disaster triage first responders assign a score or code, often color-coded, to the patient. START (Simple Triage and Rapid Treatment) is the most commonly used triage system in the United States. It helps responders rapidly assess victims’ ability to walk and their mental status, blood flow, and respiration. The evaluation is designed to work within 60 seconds.

Based on the assessment, patients are placed in 1 of 4 color-coded categories:

  • Red: severely injured patients who will receive the most care and fastest transportation.
  • Yellow: stable patients who do not need to be treated or transported immediately.
  • Green: patients with minor injuries, or the “walking wounded.”
  • Black: victims who have been killed during the incident or are so severely injured they cannot be resuscitated with the resources available. 

Communication plays an important part disaster recovery before, during, and after an event. I have broken communication into 3 sections: Internal, External and Public. It is important that a communication plan for each of these is established. According to statics, it takes effective communication in order to coordinate response efforts and limit secondary morbidity and disease. Organizations must communicate early and frequently with multiple stakeholders to prevent panic and implement an orderly response plan.

Internal: It is important to have and organized and accurate list of all employees with and emergency phone number and email in order to disseminate information. The location of a command center should be pre-established. This will serve as the center of communication. All staff should know to check in here to report availability and receive assignments. The command center will distribute a backup method of communication (such as walkie-talkie radios with a pre-established internal channel) should phone line and internet fail.

External: Establishing communication with local and federal agencies in order to communicate the hospital/community needs, this will help facilitate and expedite resources. Establish radio communications with Fire and Police departments in order to prepare for potential victims/patents. Coordinate care with other healthcare facilities. Establish a Media Liaison to facilitate real time updates.

Public: The public wants to know how to obtain assistance, what personal risks they face, and how they can protect themselves and their families? They need real-time updates in order to prevent chaos and confusion, but also allay fear.  Platforms for this communication include press releases and media interviews, Internet articles and social media, and town hall forums.

Villa Health Leadership is committed to always being prepared should a disaster strike…Now that we have all this important information laid out, how are we going to remain prepared….

  • Hold semi-annual mock disaster drills with staff and physicians to ensure awareness and comfort the disaster recovery. At the end of the mock drills a competency skill check will be done, this will help identify additional training needed.
  • We will encourage the staff feedback. Frontline staff offer an insight that leadership may not see, this will only help improve upon our plan.
  • The disaster Recovery Plan will be included in all new staff onboarding training. New staff will not be exempt from being prepared for a disaster. Disasters can happen at any time; therefore, it is crucial that all team members are prepared.
  • Leadership will be responsible for having a disaster recovery kit made for each department. This way should a disaster strike, all information will readily accessible. The kit is to include communication plan, a list of roles and responsibilities, and location of access to emergency equipment (radios/generators/flashlights). 

We will be ready for the next disaster!

References

ASSOCIATION OF STATE AND TERRITORIAL HEALTH OFFICIALS. (n.d.). EMERGENCY AUTHORITY AND IMMUNITY TOOLKIT. Retrieved September 29, 2021, from http://www.astho.org/Programs/Preparedness/Public-Health-Emergency-Law/Emergency-Authority-and-Immunity-Toolkit/Robert-T–Stafford-Disaster-Relief-and-Emergency-Assistance-Act-Fact-Sheet/

Bazyar, J., Farrokhi, M., & Khankeh, H. (2019). Triage Systems in Mass Casualty Incidents and Disasters: A Review Study with A Worldwide Approach. Open access Macedonian journal of medical sciences, 7(3), 482–494. https://doi.org/10.3889/oamjms.2019.119

Community Tool Box. (n.d.). Section 14. MAP-IT: A Model for Implementing Healthy People 2020. Retrieved September 29, 2021, from https://ctb.ku.edu/en/table-of-contents/overview/models-for-community-health-and-development/map-it/main

Federal Emergency Management Agency. (n.d.). Mission & Strategic Plan. Retrieved September 20, 2021, from http://www.fema.gov/about/mission

Hart, A., Hertelendy, A., & Ciottone, G. R. (2020). Why every US hospital needs a disaster medicine physician now. Disaster Medicine and Public Health Preparedness. https://doi.org/10.1017/dmp.2020.302

NURS FPX 4060 Assessment 3 Disaster Recovery Plan SC

Medford-davis, L., & Kapur, G. B. (2014). Preparing for effective communications during disasters: lessons from a World Health Organization quality improvement project:[doc 177]. International journal of emergency medicine (online), 7(15). https://doi.org/10.1186/1865-1380-7-15

World Health Organization. (2017, February 3). Determinants of health. Retrieved September 25, 2021, from http://.who.int/news-room/q-a-detail/determinants-of-health

Zibulewsky, J. (2001). Defining disaster: the emergency department perspective. Proceedings (Baylor University. Medical Center), 14(2), 144–149. https://doi.org/10.1080/08998280.2001.11927751

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