Ready, aye ready? Support mechanisms for healthcare workers in emergency planning: A critical gap analysis of three hospital emergency plans
DOI:
https://doi.org/10.5055/ajdm.2007.0029Keywords:
healthcare workers, occupational health and safety, infectious diseases, bioterrorism, organizational support, disaster management, hospital, pandemicAbstract
Background: In response to the 2003 global outbreak of severe acute respiratory syndrome (SARS), and the threat of pandemic influenza, Canadian hospitals have been actively developing and revising their emergency plans. Healthcare workers are a particularly vulnerable group at risk of occupational exposure during infectious disease outbreaks, as seen during SARS and as documented/reported in the recent National Survey of the Work and Health of Nurses (Statistics Canada, 2006). Approximately one third of Canadian nurses identified job strain and poor health, related to their work environment. Three years after SARS, this article presents a critical analysis of the gaps of three hospital pandemic influenza plans in the context of established organizational supports for healthcare workers.
Methods: Hospital pandemic influenza plans were obtained from institutional representatives in three Ontario cities. Qualitative gap analysis of these plans was conducted using a checklist of 11 support categories, developed from a review of existing literature and findings from a previous study of focus groups with emergency and critical care nurses.
Results: Support mechanisms were identified in the plans; however, gaps were evident in preparation for personal protective equipment, education and informational support, and support during quarantine. Hospital emergency planning could be more robust by including additional organizational supports such as emotional/psychological support services, delineating management responsibilities, human resources, vaccine/ anti-viral planning, recognition/compensation, media strategies, and professional development.
Conclusions: Since the 2003 SARS outbreak, hospitals have invested in pandemic planning, as evidenced by the comprehensive plans examined here. Organizational support mechanisms for healthcare workers were included in these hospital plans; however, the gaps identified here may have serious implications for employee health and safety, and overall response during a large scale infectious disease outbreak. The authors provide a number of recommendations for consideration in infectious disease pandemic plan development to better support the healthcare workers in their roles as first responders.
References
Naylor D, Basrur S, Bergeron M, et al.: Learning from SARS: Renewal of Public Health in Canada. Ottawa: Health Canada, 2003:344.Available at http://www.phac-aspc.gc.ca/publicat/sars-sras/ pdf/sars-e.pdf.
ONA/OPSEU: Final recommendations to Justice Campbell regarding occupational health and safety matters arising from SARS. 2004. Available at http://www.opseu.org/hands/finalsarsrec24.pdf. Accessed August 8, 2007.
Amaratunga CA, O’Sullivan TL: Double jeopardy of health professionals in crisis situations: Experiences for SARS and consequences for gender strategies. In Walter U, Neumann B. (eds.): Gender in Health Promotion and Prevention. Vienna: Springer (in press).
O’Sullivan TL, Amaratunga CA, Hardt J, et al.: Are we ready? Evidence of support mechanisms for Canadian health care workers in multi-jurisdictional emergency planning. Can J Public Health (in press).
Amaratunga CA, O’Sullivan T, Corneil W, et al.: Health care workers reflect on their roles in infectious disease outbreaks. 2006. CRTI 03-0009RD:1-37.
Amaratunga CA, O’Sullivan TL, Dow D, et al.: Survey report: Preliminary descriptive data. 2006. CRTI: 03-0009RD (Module 2.3): 1-206.
Conly JM.Personal protective equipment for preventing respiratory infections:What have we really learned? CMAJ. 2006; 175: 263-264.
World Health Organization: WHO Global Influenza Preparedness Plan. Available at http://www.who.int/csr/resources/publications/ influenza/WHO_CDS_CSR_GIP_2005_5/en/index.html. Accessed August 8, 2007.
Yassi A, Bryce E, Moore D: Protecting the Face of Health Care Workers: Knowledge Gaps and Research Priorities for Effective Protection Against Occupationally Acquired Respiratory Infectious Diseases. Vancouver: Occupational Health and Safety Agency for Healthcare, 2004.Available at www.changefoundation.com.
Brand M, Kerby D, Elledge B, et al.: A model for assessing public health emergency preparedness competencies and evaluating training based on the local preparedness plan. J Homeland Secur Emerg Manage. 2006; 3: 1-21.
Bartley BH, Stella JB,Walsh LD: What a disaster?! Assessing utility of simulated disaster exercise and educational process for improving hospital preparedness. Prehospital Disaster Med. 2006; 21: 249-255.
Moore D, Gamage B, Bryce E, et al., and members of the BC Interdisciplinary Respiratory Protection Study Group: Protecting health care workers from SARS and other respiratory pathogens: Organizational and individual factors that affect adherence to infection control guidelines. Am J Infect Control [serial online]. 2005; 33. Available at http://scholarsportal.info/pdflinks/ 06111308543514653.pdf.
Cannon CM: Are you prepared for a disaster? Chicago. 2005; 20: 20-24.
Kane-Urrabazo C: Said another way.Nurs Forum. 2006; 41: 95-101.
Reissman DB,Watson PJ, Klomp RW, et al: Pandemic influenza preparedness: Adaptive responses to an evolving challenge. J Homeland Secur Emerg Manage. 2006; 3: 1-26.
Leiss W: Effective risk communication practice. Toxicol Lett. 2004; 149: 399-404.
Lemyre L, Turner MC, Lee JC, et al.: Public perception of terrorism threats and related information sources in Canada: Implications for the management of terrorism risks. J Risk Res. 2006; 9: 755-774.
Department of Justice Canada: The Quarantine Act.Available at http://lois.justice.gc.ca/en/Q-1/258445.html. Accessed December 19, 2006.
Cava MA, Fay KE, Beanlands HJ, et al.: Risk perception and compliance with quarantine during SARS outbreak. J Nurs Scholarsh. 2005; 37: 343-347.
Cava M, Fay K, Beanlands H, et al.: The experience of quarantine for individuals affected by SARS in Toronto. Public Health Nurs. 2005; 22: 398-406.
Armagan E, Engindeniz Z, Devay AO, et al.: Frequency of posttraumatic stress disorder among relief force workers after the tsunami in Asia: Do rescuers become victims? Prehospital Disaster Med. 2006; 21: 168-172.
Maunder R: The experience of the 2003 SARS outbreak as a traumatic stress among frontline healthcare workers in Toronto: Lessons learned. Philos Trans R Soc Lond B Biol Sci. 2004; 359: 1117-1125.
Amaratunga CA, O’Sullivan TL, Phillips K, et al.: Dual-role conflict for health care workers as first responders in infectious disease outbreaks (in press).
Blanchard JC, Haywood Y, Stein BD, et al.: In their own words: Lessons from those exposed to anthrax. Am J Public Health. 2005; 95: 489-495.
Wilen SB: Crisis leadership versus leadership in crisis. J Emerg Manage. 2006; 4: 15-20.
Krewski D, Lemyre L, Turner MC, et al.: Public perception of population health risks in Canada: Health hazards and sources of information. Hum Ecol Risk Assess. 2006; 12(4): 626-644.
Fothergill A,Palumbo MV, Rambur B, et al.: The volunteer potential of inactive nurses for disaster preparedness. Public Health Nurs. 2005; 22: 414-421.
Schwartz D, Goldery A, Ashkenasi I, et al.: Prehospital care of tsunami victims in Thailand: Description and analysis. Prehospital Disaster Med. 2006; 21: 204-210.
Public Health Agency of Canada: Canadian Pandemic Influenza Plan. Ottawa: Public Health Agency of Canada, 2004.
Rhodes L, Eisenberger R: Perceived organizational support: A review of the literature. J Appl Psychol. 2002; 87: 698-714.
O’Boyle C, Robertson C, Secor-Turner M: Public health emergencies: Nurses’ recommendations for effective actions. AAOHN J. 2006; 54: 347-353.
Statistics Canada: National survey of the work and health of nurses. The Daily [serial online]. Accessed December 19, 2006.
Chan SS, Leung GM, Tiwari AF, et al.: The impact of work-related risk on nurses during the SARS outbreak in Hong Kong. Fam Community Health. 2005; 28: 274-287.
Downloads
Published
How to Cite
Issue
Section
License
Copyright 2007-2023, Weston Medical Publishing, LLC
All Rights Reserved
