Beruflich Dokumente
Kultur Dokumente
Key words
Calamity, disaster, disaster preparedness,
Philippine nurses
Correspondence
Leodoro J. Labrague, Sultan Qaboos University,
College of Nursing, Department of
Fundamentals and Administration, Al Khoudh,
Muscat, Oman. E-mail: leodoroj@squ.edu.om
Accepted: November 2, 2015
doi: 10.1111/jnu.12186
Abstract
Purpose: This study examined the perceived level of disaster preparedness in
Philippine nurses.
Design: A descriptive, cross-sectional research design was used in this study.
Methods: Two hundred nurses were invited to participate in the study, with
170 responses (105 hospital nurses and 65 community nurses) or an 85% response rate, during the months of April 2014 through July 2014. Data collection was based on interviews using a standardized instrument, the Disaster
Preparedness Questionnaire. Descriptive statistics such as frequencies, means,
percentages, and standard deviations were utilized to quantify the responses.
Results: Three fourths of the respondents (n = 136, 80%) indicated that
they were not fully prepared to respond to disasters, while only 20% (n = 34)
acknowledged that they felt they were adequately prepared. Respondents believed that they could function in the primary roles of educator (n = 107,
62.94%), caregiver (n = 104, 61.17%), and counselor (n = 82, 48.24%). More
than half of the respondents (n = 98, 57.7%) were not aware of existing protocols of disaster management in the workplace. Courses taken in such areas
as first aid (n = 79, 46.4%), field triage (n = 43, 25.29%), and basic cardiac life
support (n = 57, 33.53%) were cited as important in preparing for disasters.
Conclusions: Nurses in the study revealed that they were not sufficiently
prepared for disasters nor were they aware of disaster management protocols
in the workplace.
Clinical Relevance: Hospital administrators should consider the development and formulation of disaster management protocols and provide
appropriate disaster nursing education and training. Nursing curricula should
incorporate basic principles of disaster management into nursing courses as a
framework for addressing this critical deficit.
Labrague et al.
Background
Disaster preparedness is essential for reducing the
damaging effects of emergencies and disasters, since
it is vital to meet the needs to deliver effective and
immediate responses reflecting the health needs of
affected people (Baack & Alfred, 2013; Fung, Loke, & Lai,
2008). It is critical for nurses and other health workers
to be ready to assume their roles and help maintain the
stability of the communities. Disaster-related roles of
nurses may include responding to emergencies, detecting
threats, giving direct nursing care to patients, managing
healthcare teams and facilities, reducing or eliminating
injuries and deaths, developing healthcare policies,
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Ibrahim (2014) examined nurses knowledge, attitudes, practices, and familiarity regarding disaster and
emergency preparedness in Saudi Arabia. Findings
revealed that the level of knowledge and practice in
disaster scenarios was below average, with acceptable
levels of attitudes regarding disaster preparedness.
However, the nurses level of awareness on emergency
preparedness was found to be moderate. Ibrahim recommended conducting hospital disaster preparedness
with hospital-based employees. In another study among
hospital-based nurses in the United States, nurses had
a somewhat low perceived competence regarding their
familiarity with disasters, and the majority indicated
unpreparedness and lack of confidence in their capacities
to effectively respond in a disaster situation (Baack &
Alfred, 2013). In another study, Duong (2009) examined
Australian nurses knowledge and their understanding
of disaster response in the healthcare setting. A significant proportion of nurses (45%) expressed a limited
preparedness to respond to disaster situations, and more
than half reported they had never been involved in
any disaster response in their professional career as a
nurse.
Undoubtedly, the typhoon in November 2013 in the
Central Philippines aroused a great number of concerns
among nursing professionals and other organizations in
the Philippines regarding disaster preparedness. However, to date there is limited research on nurses understanding of disaster preparedness and other related
concepts in this country. Exploring and understanding
nurses perceptions on disaster preparedness and their
roles during disasters will provide sound and valuable information, providing for direction in the areas of healthcare education and research development for disaster
preparedness in the Philippines.
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Labrague et al.
Aim
This study determined the perceived level of disaster preparedness in Philippine nurses. Further, their
perceived roles during disasters were ascertained.
Methods
Research Design
This study employed a descriptive, cross-sectional
research approach. The research design was deemed
appropriate for this study since the study goal was to
describe Philippine nurses knowledge with respect to
disaster planning and management at this time.
Instruments
Self-report questionnaires consisted of two parts:
(a) demographic information and (b) the Disaster Preparedness Questionnaire.
Demographic Information
General information included age, sex, marital status,
years of experience in the healthcare profession, highest
level of qualification, and current area employed.
Labrague et al.
Variable
Age (years)
1825
2635
3645
4660
Gender
Female
Male
Marital status
Not married
Married
Years of experience in healthcare profession
<1
15
610
1115
>15
Highest qualification
Bachelors degree
Masters degree
Current profession
Hospital nurse
Community nurse
52
46
39
33
30.6
27.1
22.9
19.4
122
48
71.8
28.8
88
82
51.8
48.2
30
66
13
43
18
17.6
38.8
7.6
25.3
10.6
156
14
91.7
8.3
105
65
61.8
38.2
Ethical Clearance
The study protocol was reviewed and approved by
the Health Ethics Committee of Samar State University.
Nurses rights were maintained through disclosure of the
nature, benefits, and lack of known risk of the study.
After the informed consent form was signed, the researchers dispersed the questionnaires at the respective
sites and collected them in a sealed envelope upon com-
Participants Characteristics
Table 1 identifies the demographic characteristics of
the respondents. During the 4-month period, a total of
170 nurses were recruited to participate in the study. The
majority of the participants were hospital nurses (n =
105, 61.8%), and the remaining participants were community nurses (n = 65, 38.2%). A majority of the respondents were female (n = 122, 71.8%) and not married
(n = 88, 51.8%). More than half of the respondents (n =
98, 57.7%) were 18 to 35 years of age. More than half of
the respondents had been in the healthcare profession for
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Labrague et al.
13.5
18.8
47.6
20.0
62.94
61.17
48.24
41.76
34.12
28.82
Study Limitations
While the results of this study are important, since it
is the first study of its kind conducted in the country,
it nevertheless has some limitations that need to be addressed. First, although the response rate in this study
is worthy, the use of convenience sampling may have
weakened the generalization of the study. Second, the
study could be duplicated in other healthcare settings to
recruit more representative samples, so as to represent
worthy generalizations. Third, data were collected from
only one country (the Philippines); thus, caution should
be observed when interpreting or comparing the results
with other countries.
Journal of Nursing Scholarship, 2016; 48:1, 98105.
C 2015 Sigma Theta Tau International
Labrague et al.
Discussion
Currently there is an international call for all nurses to
be ready and prepared in the areas of disaster preparedness and management so they can better respond to the
health needs of the victims. In this study, the perceptions
reflect the perceived role in only Philippine nurses.
Healthcare institutions such as hospitals and health
units are among the first institutions to be affected after
a disaster occurs, and nurses are among the first individuals to manage these consequences (Arbon et al., 2006).
Thus, it is imperative that hospitals and healthcare facilities be prepared to handle such unusual work demands
because of the unanticipated, emotional, and substantial
loads placed on their services at the time of a disaster. It
is therefore necessary that a well-documented and tested
disaster management plan or protocol be in place (Mehta,
2006). In one study among nurses in Hong Kong, the
majority of the participants knew of the existing protocol in their workplace, but when asked if they had read
the protocol, only 61% reported to have read it. About
15.2% of nurses did not know if there was such a protocol (Fung et al., 2008). In one study, 58% of Jordanian nurses were not familiar with the disaster protocol in
their workplace. The majority of those who were aware
of disaster plans reported having no confidence in carrying out the plan (Al Khalaileh, Bond, & Alasad, 2012). In
Australia, 87% of nurses knew that a disaster plan existed
in their institution, but 42% reported they had not read it
at all (Duong, 2009). In the current study, more than half
Journal of Nursing Scholarship, 2016; 48:1, 98105.
C 2015 Sigma Theta Tau International
of the respondents were not aware of disaster management protocols in the workplace, although most of them
agreed that disaster management protocols and disaster
management courses should be developed, implemented,
and practiced. This identified the need for the development of a disaster management plan that would incorporate various issues relevant to disasters, such as the
establishment of care sites, clinician training in the management of exposure to chemicals and nuclear materials,
drills on various aspects of the response plans, and knowledge of special disaster equipment and supplies. This
also should include collaboration activities with external
agencies such as national and local health institutions,
emergency medical services, fire departments, and law
enforcement agencies (Natan et al., 2014; Mehta, 2006).
The United Nations (2004) posts that nurses should
also assist and participate in the development of disaster
preparedness programs and explore their role in raising
community awareness with regard to disaster management. This study explored nurses perceptions of disaster
preparedness, and they agreed that their role as educators
is seen as a primary role. Apart from their role as educators, nurses in this study believed that they also have
the role of caregivers. When disasters happen, nurses actively participate in giving immediate care to the victims
and others who are affected, assign on-site triage, and
support and protect others from potential health hazards.
In one study, apart from giving direct care to victims,
nurses performed other roles, such as educating, solving
a problem, and even coordinating activities (Yang,
Xiao, Cheng, Zhu, & Arbon, 2010). In another study
conducted in Australia, nurses performed various roles
during disasters, such as clinician, commander, logistical
coordinator, and administrator (Ranse et al., 2010). In
a more recent study, in addition to their clinical care
role, nurses performed psychosocial support, coordinated
care and resources, and were problem solvers (Ranse
& Lenson, 2012). However, this finding differs from
that of a study conducted in Israel. Nurses in that study
were found to have little knowledge of their roles during
emergencies and disasters (Melnikov, Itzhaki, & Kagan,
2014).
It is worth noting that 80% of the nurses in the present
study were not fully prepared for disasters. This finding
agrees with previous study findings (Al Khalaileh et al.,
2012; Fung et al., 2008; Jiang et al., 2015). For example,
in the study by Fung et al. (2008), the vast majority
of the respondents (94%) reported that they were not
adequately prepared for disasters and that they lacked
confidence in responding appropriately. In another study
conducted among Jordanian nurses, 65% of respondents
felt that they were unprepared for disasters. Specifically,
Jordanian nurses considered themselves deficient in
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other educational opportunities and training that are relevant to disaster preparedness. In one study, self-efficacy
enhancing activities were recommended to be integrated
in disaster training for nurses (Melnikov et al., 2014).
Conclusions
This study showed that nurses perceived that they
are not fully prepared for disasters and were not aware
of disaster management protocols in the workplace. In
agreement with previous study findings, both the areas
of nursing academia and hospital administration play
a major role in assuring that nurses and future nurses
are equipped with the necessary knowledge and skills to
handle such unexpected situations. For instance, hospital
administrators should support the development and
formulation of disaster protocols and provide essential
disaster training for nurses. They also should require
nurses to engage in disaster planning and mock drills in
order to enhance their competence in disaster situations
and be oriented with disaster preparedness. At the academic level, nursing curricula should incorporate basic
principles of disaster management into nursing courses
as a framework for addressing this critical deficit.
Acknowledgments
The authors would like to express their gratitude to all
nursing students who participated in the study.
Clinical Resources
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References
Al Khalaileh, M. A., Bond, E., & Alasad, J. A. (2012).
Jordanian nurses perceptions of their preparedness for
disaster management. International Emergency Nursing, 20,
1423.
Arbon, P., Bobrowski, C., Zeitz, K., Hooper, C., Williams, J., &
Thitchener, J. (2006). Australian nurses volunteering for
the Sumatra-Andaman earthquake and tsunami of 2004: A
review of experience and analysis of data collected by the
Tsunami Volunteer Hotline. Australasian Emergency Nursing
Journal, 9, 171178.
Journal of Nursing Scholarship, 2016; 48:1, 98105.
C 2015 Sigma Theta Tau International
Labrague et al.
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