Ready or not: Does household preparedness prevent absenteeism among emergency department staff during a disaster?
DOI:
https://doi.org/10.5055/ajdm.2014.0174Keywords:
Emergency Department, disaster preparedness, absenteeism, physician, nurseAbstract
Introduction: During major disasters, hospitals experience varied levels of absenteeism among healthcare workers (HCWs) in the immediate response period. Loss of critical hospital personnel, including Emergency Department (ED) staff, during this time can negatively impact a facility's ability to effectively treat large numbers of ill and injured patients. Prior studies have examined factors contributing to HCW ability and willingness to report for duty during a disaster. The purpose of this study was to determine if the degree of readiness of ED personnel, as measured by household preparedness, is associated with predicted likelihood of reporting for duty. Additionally, the authors sought to elucidate other factors associated with absenteeism among ED staff during a disaster.
Methods: ED staff of five hospitals participated in this survey-based study, answering questions regarding demographic information, past disaster experience, household disaster preparedness (using a novel,15-point scale), and likelihood of reporting to work during various categories of disaster. The primary outcome was personal predicted likelihood of reporting for duty following a disaster.
Results: A total of 399 subjects participated in the study. ED staffs were most likely to report for duty in the setting of an earthquake (95 percent) or other natural disaster, followed by an epidemic (90 percent) and were less likely to report for work during a biological, chemical, or a nuclear event (63 percent). Degree of household preparedness was determined to have no association with an ED HCW's predicted likelihood of reporting for duty. Factors associated with predicted absenteeism varied based on type of disaster and included having dependents in the home, female gender, past disaster relief experience, having a spouse or domestic partner, and not owning pets. Having dependents in the home was associated with predicted absenteeism for all disaster types (OR 0.30-0.66). However, when stratified by gender, the presence of dependents at home was only a significantly associated with predicted absenteeism among women as opposed to men (OR 0.07-0.59 versus OR 0.41-1.02).
Discussion: Personal household preparedness, while an admirable goal, appears to have no effect on predicted absenteeism among ED staff following a disaster. Having responsibilities for dependents is the most consistent factor associated with predicted absenteeism among female staff. Hospital and ED disaster planners should consider focusing preparedness efforts less toward household preparedness for staff and instead concentrate on addressing dependent care needs in addition to professional preparedness.
References
Damery S, Draper H, Wilson S, et al.: Healthcare workers' perceptions of the duty to work during an influenza pandemic. J Med Ethics. 2010; 36(1): 12-18.
Anantham D, McHugh W, O'Neill S, et al.: Clinical review: Influenza pandemic—Physicians and their obligations. Crit Care. 2008; 12(3): 217.
Iserson KV, Heine CE, Larkin GL, et al.: Fight or flight: The ethics of emergency physician disaster response. Ann Emerg Med. 2008; 51(4): 345-353.
Ruderman C, Tracy CS, Bensimon CM, et al.: On pandemics and the duty to care: Whose duty?. Who cares? BMC Med Ethics. 2006; 20(7): E5.
Chaffee M: Willingness of health care personnel to work in a disaster: An integrative review of the literature. Disaster Med Public Health Prep. 2009; 3(1): 42-56.
Garrett AL, Park YS, Redlener I: Mitigating absenteeism in hospital workers during a pandemic. Disaster Med Public Health Prep. 2009; 3(2): S141-S147.
McCabe OL, Barnett DJ, Taylor HG, et al.: Ready, willing, and able: A framework for improving the public health emergency preparedness system. Disaster Med Public Health Prep. 2010; 4(2): 161-168.
Berggren R, Curiel TJ: After the storm—Health care infrastructure in post-Katrina New Orleans. N Engl J Med. 2006; 354: 1549-1552.
Leiby SL: Caring for the caregivers and patients left behind: Experiences of a volunteer nurse during Hurricane Katrina. Crit Care Nurs Clin North Am. 2008; 20(1): 83-90.
Madamala K, Campbell CR, Hsu EB, et al.: Characteristics of physician relocation following Hurricane Katrina. Disaster Med Public Health Prep. 2007; 1(1): 21-26.
Wong TY, Koh GC, Cheong SK, et al.: Concerns, perceived impact and preparedness in an avian influenza pandemic—A comparative study between healthcare workers in primary and tertiary care. Ann Acad Med Singapore. 2008; 37(2): 96-102.
Wong TY, Koh GC, Cheong SK, et al.: A cross-sectional study of primary-care physicians in Singapore on their concerns and preparedness for an avian influenza outbreak. Ann Acad Med Singapore. 2008; 37(6): 458-464.
Stangeland PA: Disaster nursing: A retrospective review. Crit Care Nurs Clin North Am. 2010; 22(4): 421-436.
Mareiniss DP, Hirshon JM, Thibodeau BC: Disaster planning: Potential effects of an influenza pandemic on community healthcare resources. Am J Disaster Med. 2009; 4(3): 163-171.
Lautenbach E, Saint S, Henderson DK, et al.: Initial response of health care institutions to emergence of H1N1 influenza: Experiences, obstacles, and perceived future needs. Clin Infect Dis. 2010; 50(4): 523-527.
Scott LA, Carson DS, Greenwell IB: Disaster 101: A novel approach to disaster medicine training for health professionals. J Emerg Med. 2010; 39(2): 220-226.
Heinrichs WL, Youngblood P, Harter P, et al.: Training healthcare personnel for mass-casualty incidents in a virtual emergency department: VED II. Prehosp Disaster Med. 2010; 25(5): 424-432.
Jenckes MW, Catlett CL, Hsu EB, et al.: Development of evaluation modules for use in hospital disaster drills. Am J Disaster Med. 2007; 2(2): 87-95.
Chokshi NK, Behar S, Nager AL, et al.: Disaster management among pediatric surgeons: Preparedness, training and involvement. Am J Disaster Med. 2008; 3(1): 5-14.
Reilly M, Markenson DS: Education and training of hospital workers: Who are essential personnel during a disaster? Prehosp Disaster Med. 2009; 24(3): 239-245.
Kaji AH, Langford V, Lewis RJ: Assessing hospital disaster preparedness: A comparison of an on-site survey, directly observed drill performance, and video analysis of teamwork. Ann Emerg Med. 2008; 52(3): 195-201.
Hick JL, Hanfling D, Cantrill SV: Allocating scarce resources in disasters: Emergency Department principles. Ann Emerg Med. 2012; 59(3): 177-187.
Eisenman DP, Wold C, Fielding J, et al.: Differences in individual-level terrorism preparedness in Los Angeles County. Am J Prev Med. 2006; 30(1): 1-6.
Levac J, Toal-Sullivan D, O'Sullivan TL: Household emergency preparedness: A literature review. J Community Health. 2012; 37(3): 725-733.
Reissman DB, Howard J: Responder safety and health: Preparing for future disasters. Mt Sinai J Med. 2008; 75(2): 135-141.
Balicer RD, Omer SB, Barnett DJ, et al.: Local public health workers' perceptions toward responding to an influenza pandemic. BMC Public Health. 2006; 6: E99.
Barnett DJ, Balicer RD, Thompson CB, et al.: Assessment of local public health workers' willingness to respond to pandemic influenza through application of the extended parallel process model. PLoS ONE. 2009; 4(7): e6365.
Smith EC, Burkle FM Jr, Archer FL: Fear, familiarity, and the perception of risk: A quantitative analysis of disaster-specific concerns of paramedics. Disaster Med Public Health Prep. 2011; 5(1): 46-53.
Brahmbhatt D, Chan JL, Hsu EB, et al.: Public health preparedness of post-Katrina and Rita shelter health staff. Prehosp Disaster Med. 2009; 24(6): 500-505.
Qureshi K, Gershon RRM, Sherman MF, et al.: Health care workers' ability and willingness to report to duty during catastrophic disasters. J Urban Health. 2005; 82(3): 378-388.
Balicer RD, Catlett CL, Barnett DJ, et al.: Characterizing hospital workers' willingness to respond to a radiological event. PLoS ONE. 2011; 6(10): e25327.
Banks LL, Shah MB, Richards ME: Effective healthcare system response to consecutive Florida hurricanes. Am J Disaster Med. 2007; 2(6): 285-295.
Barnett DJ, Levine R, Thompson CB, et al.: Gauging U.S. Emergency Medical Services workers' willingness to respond to pandemic influenza using a threat- and efficacy-based assessment framework. PLoS ONE. 2010; 5(3): e9856.
Burke RV, Goodhue CJ, Chokshi NK, et al.: Factors associated with willingness to respond to a disaster: A study of healthcare workers in a tertiary setting. Prehosp Disaster Med. 2011; 26(4): 244-250.
Davidson,J, Sekayan A, Agan, D, et al.: Disaster dilemma: Factors affecting decision to come to work during a natural disaster. Adv Emerg Nurs J. 2009; 31(3): 248-257.
Hope K, Durrheim D, Barnett D, et al.: Willingness of frontline health care workers to work during a public health emergency. Aust J Emerg Manage. 2010; 25(3): 39-47.
Ives J, et al.: Healthcare workers' attitudes to working during pandemic influenza: A qualitative study. BMC Public Health. 2009; 9: 56.
Shapira Y, Marganitt B, Roziner I, et al.: Willingness of staff to report to their hospital duties following an unconventional missile attack: A state-wide survey. Isr J Med Sci. 1991; 27(11-12): 704-711.
Ten Eyck RP: Ability of regional hospitals to meet projected avian flu pandemic surge capacity requirements. Prehosp Disaster Med. 2008; 23(2): 103-112.
Watson CM, Barnett DJ, Thompson CB, et al.: Characterizing public health emergency perceptions and influential modifiers of willingness to respond among pediatric healthcare staff. Am J Disaster Med. 2011; 6(5): 299-308.
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