Disaster preparedness

AORN Journal, August, 2007 by Mary Jo W. Steiert

August marks the second anniversary of Hurricane Katrina, which was followed soon after by Hurricanes Rita and Wilma during the storm season of 2005. As these anniversaries approach, we remember the horrific experiences of our heroic colleagues in Louisiana, Mississippi, Alabama, Florida, and Texas that were shared with us through stories and photographs. Many perioperative nurses responded and contributed their time and energy to assist people in need in the affected areas and in their own home states as those who lost their homes evacuated to other areas of the country. Sadly, many of these individuals are still without homes.

We hope that the lessons that were learned and shared will help us to prepare for future disaster scenarios, while we also pray that a disaster of that intensity will not happen again. The reality, however, is that any of us can be struck by a tragedy with little or no warning. The only real question is not if, but when.

Are you prepared? Is disaster planning part of your orientation plan for nurses new to your department? We prepare our staff to operate with high-tech equipment, but would they also know how to function in a low-tech situation? Do you and your family have a personal disaster plan? Do you have additional resources available if you need to evacuate? Do you have an arrangement with a contact who can relay information that you and your family members are safe?

As I write this message, I have the honor of representing AORN at the American Nurses Association (ANA) meeting, "Nursing Care in Life, Death, and Disaster." A few weeks ago, I represented AORN at the International Council of Nurses meeting in Yokohama, Japan, where the theme, "Nurses at the Forefront: Dealing With the Unexpected," also dealt with emergency situations. Emergency preparedness is a common topic on the minds of many nurses as the world experiences natural disasters such as floods, tornados, hurricanes, droughts, heat waves, and blizzards; terrorist attacks and war; man-made disasters such as chemical spills, nuclear accidents, power outages, train wrecks, and plane crashes; and epidemic diseases such as malaria, HIV and AIDS, and influenza. As nurses, we are expected to respond to disasters by providing care for our patients, and as a larger part of society, we are expected to offer assistance to members of the community. Are we ready? Do we know what to expect, what to plan for?

DISASTER PLANNING

In 2002, The Joint Commission stressed the importance of developing scalable, sustainable, and community-integrated plans for emergency response. (1) A community disaster plan should involve the police, fire, and rescue departments; local governmental agencies; hospitals; and ambulatory surgery centers. Drills should be held to determine the plan's effectiveness. The Joint Commission requires that accredited health care facilities conduct at least two tests a year of emergency plans, which can be either a drill or an actual emergency. (2)

The Department of Homeland Security has published suggestions for preparations for our families and homes in the event of a disaster. (3) One suggestion is that each person should put together a kit that contains personal identification; medications; a blanket; clothing for three to five days; a washcloth and towel; food (eg, protein bars) and water; a cell phone; extra batteries; a solar charger; and a flashlight. (3)

The ANA has commissioned an expert panel to prepare a white paper, Guidance for Providing Care Under Altered Conditions: A Review of Standards, Guidelines and Competencies during Emergencies and Disasters. There was much discussion regarding the proposed white paper at the ANA meeting, and attendees provided their feedback. It was emphasized that it is a professional society's duty to drive the standards of care; but we must work together to plan, prepare, and implement policy in emergency situations.

HELP FROM AORN

I am proud to say that our professional association has been on the forefront of emergency preparedness, offering an emergency management seminar in the fall of 2005 in Washington, DC, as well as other tools to guide us in planning for unexpected events in our communities and in our workplace settings. In 2003, AORN published the Perioperative Disaster Preparedness Resource Manual, (4) which provides information on natural and man-made disasters and safety and preparedness for facilities and perioperative staff members. A second edition, published in 2007 and renamed Perioperative Emergency Management Resource Manual, (5) has expanded to include preparing for disaster situations that might involve West Nile virus, severe acute respiratory syndrome, and human and avian influenza. Also in 2007, AORN published the "Guidance statement: Mass casualty, triage, and evacuation," (6) which includes practice scenarios for mass casualty situations. As AORN members, we should be proud to belong to a professional association composed of highly motivated and qualified volunteers and staff members who are planning for our future needs.