The influence of training of nurses in disaster plans
Document Type:Dissertation
Subject Area:Health Care
Reference to quotations from other authors has also been correctly acknowledged and referenced within the work. I have read the University’s definition of unfair practice and the related regulations and am aware of the potential penalties which may be incurred for breaches of these regulations. I have read the School’s Maintaining Confidentiality & Anonymity in Academic Work policy and am aware of the potential penalties which may be incurred for breaches of these regulations. By submitting this assignment, you are confirming that it is your own work and does not involve plagiarism, collusion or breaches of confidentiality & anonymity The influence of training of nurses in disaster plans to improve disaster management Abstract Occurrences of disasters have increased in number, which has led to increased loss of life and destruction of property.
There is an urgent need to address this issue, in relation to how it can be effectively managed to reduce the outcome severity. Table of Contents Acknowledgement 2 Chapter 1: 4 1. Introduction 4 1. Dissertation aim 5 Chapter 2: Literature Review 6 2. Introduction to literature review 6 2. Search strategy 6 2. Recommendations 28 Reference List 29 Chapter 1: 1. Introduction Natural and human-caused disasters have been intensifying in pervasiveness and severity. On average, there are disasters happening somewhere in the world every day, which has led to significant loss of life and immense destruction to infrastructure. This is correlated with long-term social, physical and economic impacts for the affected country. Additionally, the health care system can become strained in its attempts to mitigate the effects of the disaster. The International Council of Nurses (ICN) Disaster Management Continuum Model upholds four components that are essential in disaster management, mitigation, watchfulness, response and regaining.
The chief objective of the model is to reduce the effects on lives and infrastructure, improve recovery and create public resilience to calamities (Al-Shaqsi, 2015, p. Disaster preparedness involves formulating plans and preparing effectively to be able to respond to any event. It also includes competent development and coordination, skilled individuals and volunteers and ensuring all personnel are ready to respond. Oman has a history of recurrent tropical storms, which are associated with distressing impacts on lives and infrastructure. Dissertation aim This dissertation strives to explore the effects of training nurses to manage the disasters that have increased in number in Oman. Moreover, the author will examine plans that can be formulated to ensure the impacts of disasters are effectively managed, so that the affected groups will not suffer long-term social, economic and health challenges.
The next section will cover the search criteria, a literature review of academic materials related to the impact of training nurses, as well as disaster plans that can improve disaster management. Chapter 2: Literature Review 2. Introduction to literature review The literature review is useful in providing proof of past studies completed in the field of disaster management and nurses (Pautasso, 2013, p. During the search, the year for the research articles were set and the most recent research articles were selected and used. This is mainly because healthcare is changing with the advancement in the technology and with the continuing research studies. The topic searched was also narrowed with the focus on the role of nurses on disaster management (Achora, Susan and Kamanyire p. The initial number of studies found were 40 while the study used 31 studies.
Table 1: Literature used in the study Types of literature used Number of articles Articles published after 2008 All Local papers (in Oman) 25 Meta-analysis 6 Multi-centre article 5 Survey 6 Quasi-experimental design 8 Career perspective study 9 Randomised controlled trial papers 6 Cross Section paper 4 Qualitative studies 7 Papers in English only All Total articles used 31 The main themes evident in most articles included: • Nurses preparedness in response to disasters • Improving nurse training to enhance disaster management Inclusion Selection Criteria Inclusion Criteria Time 2008 - 2018 Search databases Articles from Oman MoH e-library, OMJ, BMJ, SAGE, PubMed, Cardiff e-library, Google Scholar, PubMed, CINAHL and EBSCO-guide Context Articles about the clinical problem Exclusion Criteria Selection Criteria Exclusion Criteria Time Before 2008 Search databases Articles not from Oman MoH e-library, OMJ, BMJ, SAGE, PubMed, Cardiff e-library, Google Scholar, PubMed, CINAHL and EBSCO-guide Context Articles not about the clinical pro elm.
The study concluded that there was great need on the amount of information the nurses needed to know on skills, knowledge and disaster preparedness. Although these are generally understood, they are lacking for various reasons. There is need for in-house programs that would be used by the nurses to learn more regarding disaster whole the graduate and undergraduate nursing programs will help the future nurses to gain more information on the disaster preparedness (Öztekin et al. Melnikov, Itzhaki & Kagan, (2014), conducted a study to investigate the effects of organizational factors and personal characteristics on the intention of nurses to report to work during a national emergency. The study used a convenient sample of 243 registered Israeli nurses (Melnikov, Itzhaki & Kagan, 2014). The study was conducted in a military hospital located in Taiwan (Tzeng et al.
The sample size was 311 consisting of registered nurses all of which participated in the study. The data on readiness of the nurses for a disasters ere collected with the use of a 40-item self-administered, researcher-designed questionnaire that had satisfactory validity and reliability. The questionnaire had four domains: clinical management (7), emergency response (6 items), self-protection (11 items), and personal preparation (16 items). Data analysis was done using generalized linear models, independent t-tests, and descriptive statistics (Tzeng et al. The findings of the study demonstrated that ¾ of the respondents (80%, n=136) were not fully trained and prepared to respond to disaster whereas 20% (n=34) admitted were adequately prepared and trained for cases of disasters (Labrague, et al. of the respondents were not aware of the existence of the protocols of disaster preparedness and management in their workplaces. The courses taken like basic cardiac life support (n=33.
field triage (n=43), and first aid (46. were shown to be important in disaster preparedness and response (Labrague, et al. Therefore, they lack confidence while handling and managing disaster cases. The findings of this review contributed to the increasing body of knowledge concerning disaster preparedness and the role of nursing educators, hospital administration and academia and provided evidences that may be used by the nurse administrators and nurse educators in preparing nurses for disasters better (Labrague, et al. The findings of the review have various implications in nursing. Labrague, et al. place more emphasis on hospitals to increase the training relevant for the nurse to handle disasters. All the phases of a disaster are designed in a way that significantly reduces the likely harm that the disaster may cause in a society.
Besides, the training of the nurses should be designed to become conversant with the approaches applied in each of the phases of a disaster. Recommendations for improvements in training According to Jakeway, et al. p. nurses should undergo intensive training to understand the scope of disaster. Nurses also need personal experience that will help them to effectively deal with various disaster events (Al-Shaqsi, 2011). Nurses should, therefore, interact with the disaster world on a continual basis to actively yearning to better understand ethical practices that are key to disaster management. Nurse’s previous experience increases their confidence to act in the case of a severe disaster. As per Veenema (2013) drills often feature a restricted part of the general crisis administration design. They ought to be intended to elucidate the roles and obligations of the individuals who are relied upon to react to a disaster and to enhance coordination among those reacting.
After imparting nurses with the right skills and knowledge, subsequent outcomes are expected to be very impressive, and for that reason, the following are service improvements that would be of great value to the residents of Oman (Pautasso, 2013, p. Heath centres should prepare their workers to take after each kind of fiasco design. They ought to likewise have a routine "taunt calamity preparing" with different divisions comprehending what to do in a crisis (Langan, 2009, p. Adelman and Legg (2009, p. add to this by saying that disaster preparation ought to be incorporated into all staff introduction sessions and yearly competency refreshers, rehearsed under genuine conditions and assessed for changes. There is emphasised improvement for nursing competency to promote effective management of disasters. Consequently, the Council of Nurses is challenged to ensure that nurses are provided with the appropriate knowledge and skills to meet the set principles of practice in disaster management.
For the country to improve in disaster management, nurses are perceived as the change agents that will facilitate a positive change in disaster management, through the adoption of the best practice grounded on proven research outcomes (Powers and Daily, 2010, p. Improvement in disaster management can only be achieved through continuous training of nurses on the relevant competencies that are vital during service delivery (Raes, et al. p. It is important to note that the transactional leadership style is concerned with the current situation. Its salient weakness is that it lacks the vision to improve the organisational management of emerging issues and the strategic planning for long-term objectives. For that reason, we can conclude that transactional leadership does not advocate for, or support, change or innovation in an organisation. Conversely, the transformational leadership style is highly recommended for healthcare specialists, with the objective of ushering innovative reforms in the health sector.
Transformational leaders are known to impact others by adjusting their performance, regardless of being a position of influence or not (Markova, et al. Consequently, Labrague, et al. p. noted that inadequate training of nurses prevents them from having the exposure they need to handle disasters. In addition, insignificant research has occurred in relation to the issue of disaster planning and management by nurses (Boote, 2014, p. Effective training of nurses can improve the performance of nurses by 79%. Relevance of paradigms and approaches for service improvement Achieving positive reform in the healthcare sector is essential and should be carried out based on the best accessible approaches. Using a properly planned approach would result in the desired outcomes relating to the improvement of disaster management. The reviewed literature stresses the need to have a training programme for nurses that will result in an improvement in disaster management in Oman.
Huber (p. asserted that through the transformational leadership style, the health sector stands a high chance of obtaining more knowledge and formulating more solutions to the problems initiated by disaster events, as well as reducing the costs of managing disasters. The National Institute for Health and Clinical Excellence (NICE) has made tremendous efforts in enhancing awareness and dissemination of knowledge to targeted team members (nurses), to cooperate in the acceptance for the targeted reform. Since team members will have personality differences, it is vital for the team leader to have the ability to work with people who have different personalities and thus reduce the resistance that they are likely to face from team members. This is one of the codes that is stressed by ONMC in the professional conduct of nurses.
The success of implementing the change relating to training nurses for disaster management is influenced by several factors. The executive management must support a succinct set of policies that outline the mission of the project. p. A leader can use pre-tested questionnaires to obtain the anticipated outcomes from implementing nurse training aimed at improving disaster management skills and knowledge. To ensure a high questionnaire response rate, it is prudent to observe ethical standards, such as maintaining the anonymity of the participants. With this, the respondents will be more likely to provide accurate and reliable responses (Boone and Moore, 2011, p. Autonomy and confidentiality is highly stressed for nurses in Oman. Moreover, the leader of the team should develop a trusting relationship with the team members, as this is one of the results that are correlated with leadership activities (Chapman, 2011, p.
Trust can be achieved with the team members with clear and transparent channels of communication, to facilitate the flow of ideas and opinions within the project members. Presence of transparent communication channels within the project’s participants enables the team members to understand the requirements of the project. Any deviation from the set goals and objectives can be easily identified, and the appropriate corrective measures can be undertaken. In addition, the team leader should encourage active participation in the proposed change, and all members should be given opportunities to participate in the implementation of the plan. Consequently, this makes the team members reluctant to be involved in areas that have undefined interpersonal relations. Team conflicts are a common issue during development exercises and can be painful (Natvig and Stark, 2016, p 681). However, they assist the team members to clearly understand their responsibilities and the formulated rules, which enables the team members to undertake their task-related responsibilities and interactions amongst themselves.
Team conflicts mostly occur due to personality differences, based on ideas, feelings and social beliefs. With disagreement among members, there is decreased collaboration, which makes the achievement of the project’s goals and objectives impossible. Use of a tool such as SBAR is recommended, as it will enable the members to understand the message as it has been conveyed. Members’ active participation in discussions will enhance clarification of issues that are not clear to them, as well as sharing of innovative ideas for implementing the change (Natvig and Stark, 2016, p. Active participation in discussions held by the team leader enhances the motivation of the members towards the tasks that are assigned to them. Another factor that predisposes the presence of conflict among team members is a lack of awareness and inadequate knowledge and skills needed to make changes or improvements in the delivery of services.
Creating awareness of the entire change improvement plan is very important. Therefore, the leader of the nurses’ training programme should employ the PDSA cycle among a small number of nurses, to pilot the targeted improvement service plan. Plan “Plan” refers to a strategy in which the service improvement among nurses and disaster management would be implemented by splitting it into several steps. In this stage, the problem will be identified using the data collected from the analysed literature review. Maruta and Rikio, 2014, p. Provision of team training among the nurses can be effectively administered by use of simulation and the involvement of other multi-professional teams, to enhance the effectiveness of the training exercise. This stage involves executing the change, observing and recording challenges encountered during the implementation, and commencing the data analysis (Sokovic, 2010, p.
For this reason, training should be scheduled to commence at an identified time and place. At the time of implementation, the leader must ensure the identified challenges and strengths are recorded, and be ready to analyse the data collected during the study. Study As time elapses during change implementation, new challenges and threats are expected to come to the forefront (Sokovic, 2010, p. This stage of data analysis compares the actual results to the proposed outcomes and summarises the reflections on the learning experiences. The leader normally relies on the SWOT analysis completed in the previous stage, and the pre-test questionnaire, to evaluate the need for any change (Sokovic, 2010, p. The modifications made at this stage enable the team leader to prepare for the next stage of the action plan. In this stage, the leader can develop the next set of actions, which will aid in evaluating the change plan.
Performing This final stage is marked by the ability of the team members to become interdependent and effective in solving the challenges confronting the change (Raes, 2015, p. Most of the activities that are carried out by the team members are in harmony with the goal of improving training for nurses. Additionally, the PDSA cycle was employed to experiment training exercise using a small number of nurses. Chapter 4: 4. Conclusion The high prevalence of disaster occurrences around the world has led to the need to formulate intervention measures that will improve the management of the effects that are brought about by these tragic events. Nurses are key personnel, who play a significant role in providing healthcare services to patients affected by disasters. As such, they should be imparted with the right skills, knowledge and positive attitude to improve service delivery in the management of the welfare of those that have been affected by disasters in Oman (Raes, 2015, p.
There are several challenges that tend to confront the implementation of a change plan. Some of the major challenges that hampered the implementation were financial limitations and this challenge was properly catered for in the change plan. Secondly, conflicts among group members are another challenge that remained a limiting factor for the implementation. Conflict management strategies and negotiation were used to ensure the conflicts among the members were properly solved. Recommendations It is an established fact that training enhances skills and knowledge, and leads to improvement in the duty performance of the trainees. Reference List Achora, S. and Kamanyire, J. K. Disaster preparedness: Need for inclusion in undergraduate nursing education. Sultan Qaboos University Medical Journal, 16(1), e15. Boone, J. and Moore, D. Nursing education for disaster management: Pre-hospital and disaster medicine. Cambridge Journals, 26(S1), pp.
Boote, D. Assessing Writing, 17(4), pp. Holleran, S. R. Pre-hospital nursing: A collaborative approach. th ed. Public Health Nursing, 25(July/August), pp. Labrague, L. J. et al. Disaster preparedness in Philippine nurses. Maruta, R. The creation and management of organizational knowledge. Knowledge-Based Systems, 67, pp. Mere, M. O. Israeli nurses’ intention to report for work in an emergency or disaster. Journal of nursing scholarship, 46(2), 134-142. Moabi, M. R. Knowledge, attitudes and practices of health care workers regarding disaster preparedness at Johannesburg Hospital in Gauteng Province, South Africa. Japanese nurses' perception of their preparedness for disasters: Quantitative survey research on one prefecture in Japan. Japan journal of nursing science, 13(3), 391-401. Pautasso, M. Ten simple rules for writing a literature review. PloS Computational Biology, 9(7). Trauma monthly 20(4). Sokovic, M. Pavletic, D. Pipan, K. K. Chiang, L.
C. Pai, L. Lee, C. L. and Williams, J. Factors affecting hospital-based nurses’ willingness to respond to a radiation Yamamoto, A. and Watanabe, T. Disaster nursing competencies. Japan: The University of Hyogo, Graduate School of Nursing.
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