The Southern Medical Journal (SMJ) is the official, peer-reviewed journal of the Southern Medical Association. It has a multidisciplinary and inter-professional focus that covers a broad range of topics relevant to physicians and other healthcare specialists.
SMJ // Article
Original Article
OPEN: Disaster Preparedness Training Needs of Healthcare Workers at the US Department of Veterans Affairs
Abstract
Objectives: Training healthcare workers in disaster preparedness has been shown to increase their willingness and ability to report to work during disasters. Little is known, however, about the relation between sociodemographic, household, and workforce characteristics and the desire for such training. Accordingly, this study aimed to assess healthcare workers’ desire for additional workforce preparedness training, and the determinants that influence the need for such training, for three types of disasters (natural, pandemic, manmade).Methods: The US Department of Veterans Affairs (VA) Preparedness Survey was a random, anonymous, Web-based questionnaire fielded nationwide (October–December 2018). Multivariate, logistic regression analyses were conducted.
Results: In total, 4026 VA employees, clinical and nonclinical, responded. A total of 61% of respondents wanted additional training for natural, 63% for pandemic, and 68% for manmade disasters. VA supervisors (natural: odds ratio [OR] 1.28, pandemic: OR 1.33, manmade: OR 1.25, P < 0.05) and clinicians (natural: OR 1.24, pandemic: OR 1.24, manmade: OR 1.24, P < 0.05) were more likely to report the need for additional training. Those who reported that they understood their role in disaster response were less likely to report the need for training (natural: OR 0.25, pandemic: OR 0.27, manmade: OR 0.28, P < 0.001), whereas those who perceived their role to be important during response (natural: OR 2.20, pandemic: OR 2.78, manmade: OR 3.13, P < 0.001), and those who reported not being prepared at home for major disasters (natural: OR 1.85, pandemic: OR 1.92, manmade: OR 1.94, P < 0.001), were more likely to indicate a need for training.
Conclusions: Identifying which factors encourage participation in disaster preparedness training can help hospitals and other healthcare providers create targeted training and educational materials to better prepare all hospital staff for future disasters.
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References
1. Goodhue CJ, Burke RV, Ferrer RR, et al. Willingness to respond in a disaster: a pediatric nurse practitioner national survey. J Pediatr Health Care 2012;26: e7–e20.
2. Toner E. Healthcare preparedness: saving lives. Health Secur 2017;15:8–11.
3. Dobalian A, Callis R, Davey VJ. Evolution of the Veterans Health Administration’s role in emergency management since September 11, 2001. Disaster Med Public Health Prep 2011;5(suppl 2):S182–S184.
4. Centers for Medicare & Medicaid Services. State Operations Manual: Appendix Z- Emergency Preparedness for All Provider and Certified Supplier Types Interpretive Guidance. https://www.cms.gov/Regulationsand-Guidance/Guidance/Manuals/downloads/som107ap_z_emergprep. pdf. Published February 2, 2020. Accessed June 2, 2020.
5. The Joint Commission. Revised Emergency Preparedness Standards for Federally Qualified Health Centers. https://www.jointcommission.org/-/ media/ff56866a5b7b4ca886f3c401ede0b103.ashx. Published March 2020. Accessed July 24, 2020.
6. Di Marco J. Hospital Accreditation Facts to Know. https://www.chthealthcare. com/blog/hospital-accreditation. Published March 9, 2017. Accessed July 24, 2020.
.
7. Bistaraki A, Waddington K, Galanis P. The effectiveness of a disaster training programme for healthcare workers in Greece. Int Nurs Rev 2011;58:341–346.
8. Hsu CE, Mas FS, Jacobson H, et al. Assessing the readiness and training needs of non-urban physicians in public health emergency and response. Disaster Manag Response 2005;3:106–111.
9. Williams J, Nocera M, Casteel C. The effectiveness of disaster training for health care workers: a systematic review. Ann Emerg Med 2008;52:211–222, 222.e1–222.e2.
10. Henning KJ, Brennan PJ, Hoegg C, et al. Health system preparedness for bioterrorism: bringing the tabletop to the hospital. Infect Control Hosp Epidemiol 2004;25:146–155.
11. Jacobs-Wingo JL, Schlegelmilch J, Berliner M, et al. Emergency preparedness training for hospital nursing staff, New York City, 2012–2016. J Nurs Scholarsh 2019;51:81–87.
12. Bell MA, Dake JA, Price JH, et al. A national survey of emergency nurses and avian influenza threat. J Emerg Nurs 2014;40:212–295.
13. Gershon RR, Magda LA, Qureshi KA, et al. Factors associated with the ability and willingness of essential workers to report to duty during a pandemic. J Occup Environ Med 2010;52:995–1003.
14. Hayanga HK, Barnett DJ, Shallow NR, et al. Anesthesiologists and disaster medicine: a needs assessment for education and training and reported willingness to respond. Anesth Analg 2017;124:1662–1669.
15. Labrague LJ, Hammad K, Gloe DS, et al. Disaster preparedness among nurses: a systematic review of literature. Int Nurs Rev 2018;65:41–53.
16. US Department of Veterans Affairs. Office of Nursing Services (ONS). http://www.va.gov/nursing/workforce/workforce.asp. Published March 25, 2020. Accessed June 5, 2020.
17. Bossert WH, Dobalian A. VA’s involvement in the aftermath of the 9/11 attacks. Disaster Med Public Health Prep 2011;5(suppl 2):S167.
18. Claver M, Friedman D, Dobalian A, et al. The role of Veterans Affairs in emergency management: a systematic literature review. PLoS Curr 2012;4: e198d344bc40a75f927c9bc5024279815.
19. US Department of Veterans Affairs. VA fourth mission summary. https:// www.va.gov/health/coronavirus/statesupport.asp. Published June 5, 2020. Accessed June 6, 2020.
20. Dobalian A, Balut MD, Der-Martirosian C. Workforce preparedness for disasters: perceptions of clinical and non-clinical staff at the U.S. Department of Veterans Affairs. BMC Public Health 2020;20:1501.
21. Balut MD, Der-Martirosian C, Dobalian A. Determinants of workforce preparedness during pandemics among healthcare workers at the U.S. Department of Veterans Affairs. J Prim Care Community Health 2021;12: 21501327211004738.
22. Der-Martirosian C, Balut MD, Dobalian A. Household preparedness and perceptions of workforce preparedness during pandemics: a healthcare employee survey at the U.S. Department of Veterans Affairs. Disaster Med Public Health Prep 2021. DOI: 10.1017/dmp.2021.198.
23. Naser WN, Saleem HB. Emergency and disaster management training; knowledge and attitude of Yemeni health professionals—a cross-sectional study. BMC Emerg Med 2018;18:23.
24. Ma X, He Z, Wang Y, et al. Knowledge and attitudes of healthcare workers in Chinese intensive care units regarding 2009 H1N1 influenza pandemic. BMC Infect Dis 2011;11:24.
25. Baack S, Alfred D. Nurses’ preparedness and perceived competence in managing disasters. J Nurs Scholarsh 2013;45:281–287.
26. Stergachis A, Garberson L, Lien O, et al. Health care workers’ ability and willingness to report to work during public health emergencies. Disaster Med Public Health Prep 2011;5:300–308.
27. Der-Martirosian C, Strine T, Atia M, et al. General household emergency preparedness: a comparison between veterans and nonveterans. Prehosp Disaster Med 2014;29:134–140.
28. Der-Martirosian C, Schmitz S, Wyte-Lake T, et al. US military veterans: an untapped resource as disaster volunteers. Am J Public Health 2019;109(S4): S263–S264.
29. Qureshi KA, Merrill JA, Gershon RR, et al. Emergency preparedness training for public health nurses: a pilot study. J Urban Health 2002;79:413–416.
30. Blessman J, Skupski J, Jamil M, et al. Barriers to at-home-preparedness in public health employees: implications for disaster preparedness training. J Occup Environ Med 2007;49:318–326.
31. US Department of Health and Human Services, Office of the Inspector General. Hospital emergency preparedness and response during Superstorm Sandy. https://www.hsdl.org/?view&did=757768. Published September 16, 2014. Accessed June 6, 2020.
32. Niska RW, Shimizu IM. Hospital preparedness for emergency response: United States, 2008. Natl Health Stat Rep 2011;(37):1–14.
33. Ragazzoni L, Barco A, Echeverri L, et al. Just-in-time training in a tertiary referral hospital during the COVID-19 pandemic in Italy. Acad Med 2021; 96:336–339.
34. Stoler GB, Johnston JR, Stevenson JA, et al. Preparing emergency personnel in dialysis: a just-in-time training program for additional staffing during disasters. Disaster Med Public Health Prep 2013;7:272–277.
35. Becker SM, Middleton SA. Improving hospital preparedness for radiological terrorism: perspectives from emergency department physicians and nurses. Disaster Med Public Health Prep. 2008;2:174–184.
36. Whetzel E, Walker-Cillo G, Chan GK, et al. Emergency nurse perceptions of individual and facility emergency preparedness. J Emerg Nurs 2013;39: 46–52.
37. Joint Commission International. Joint Commission International Accreditation Standards for Hospitals: including standards for academic medical center hospitals, 6th edition. https://www.jointcommissioninternational.org/-/media/ jci/jci-documents/accreditation/hospital-and-amc/learn/jci_standards_only_ 6th_ed_hospital.pdf?db=web&hash=E2D36799998C7EE27C59CFF3 131EE0A7&hash=E2D36799998C7EE27C59CFF3131EE0A7. Published July 1, 2017. Accessed June 5, 2020.
38. World Health Organization. Hospital preparedness for epidemics. https:// www.who.int/publications/i/item/hospital-preparedness-for-epidemics. Published April 4, 2014. Accessed June 10, 2020.
39. Der-Martirosian C, Radcliff TA, Gable AR, et al. Assessing hospital disaster readiness over time at the US Department of Veterans Affairs. Prehosp Disaster Med 2017;32:46–57.
40. Dobalian A, Stein JA, Radcliff TA, et al. Developing valid measures of emergency management capabilities within US Department of Veterans Affairs hospitals. Prehosp Disaster Med 2016;31:475–84.
