The pre-hospital and emergency department interface during disasters: workforce, education and other contemporary issues
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presentation to the ACT Ambulance Service Continuing Medical Education, 25th November 2010.
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The pre-hospital and emergency department interface during disasters: workforce, education and other contemporary issues
- 1. THE PRE-HOSPITAL AND EMERGENCY DEPARTMENT INTERFACE DURING DISASTERS: workforce, education and other contemporary issues Jamie Ranse Lecturer, University of Canberra Chief Nurse, St John Ambulance Australia Research Associate, Flinders University Email: jamie.ranse@canberra.edu.au Blog: www.jamieranse.com Twitter: jamieranse
- 2. overview • Background to health care disasters • Surge capacity • Triage • Workforce • Education
- 3. background • Defining disasters • Australian experience of disasters • Natural (bushfires) • Off-shore
- 4. background • Lessons learnt • Mostly in organisational reports (not public) • Resources • SARS • Bali 1 • Granville • H1N1 • Notification to the ED
- 6. surge capacity? • What is surge capacity? • Do we have ability to surge?
- 9. surge capacity? 0 20 40 60 80 100 120 140 160 180 Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Day PresentationFrequency Total Influenza Presentations Mean Influenza Presentations Mean Total Presentations Mean Total Presentations - Excluding Influenza
- 10. surge capacity? • Strategies to enhance the surge capacity of the health system
- 12. triage: principles • Greatest good for the greatest number • Life over limb
- 13. triage: in-hospital • Various triage systems in the world
- 15. triage: process
- 16. triage: process
- 18. education • Where do we teach disaster education • Are we teaching the right stuff • Who do we teach with? • Mock scenarios • Disaster content varied in all programs • National framework and consistency
- 19. education Elements of disaster content in courses: Community and public health response Pre-hospital response Hospital response Disaster triage Sustainability Disaster exercises Incident systems Nursing role in disaster Communications Techniques Management of the dead and dying Disaster plans Role of other organisations in disaster response Mental health in relation to disasters Populations with specific needs Types of disasters Examples of disasters Health effects of disasters
- 21. workforce • Preparedness • Roles • Willingness • Responding to disasters
- 22. Preparedness 0 50 100 150 200 250 family preparedness employer's preparedness colleagues' preparedness staff's preparedness medical-allied staff preparedness manager's preparedness 1 2 3 4 5 workforce: preparedness
- 23. workforce: roles • Minor injury / illness • Primary health • Health problem-solving
- 24. workforce: willingness • Varies depending on culture • Perceived responsibilities to profession • Out-of-work responsibilities • Personal beliefs and confidence, and • Availability of social and organisational support
- 25. Willingness to particpate 0 50 100 150 200 250 300 350 400 transport incident natural disaster pandemic outbreak CBR terrorist attack Disaster types Counts 1 2 3 4 5 Results: Willingness
- 26. Improvements 0 50 100 150 200 250 care provisions w orking conditions PPE education/training course Other type of improvements workforce: willingness
- 27. workforce: responding to disasters • Who do we send • What is the process • Cross boarder issues • Civilian corps • Individual deployments • Disaster tourism
- 28. THE PRE-HOSPITAL AND EMERGENCY DEPARTMENT INTERFACE DURING DISASTERS: workforce, education and other contemporary issues Jamie Ranse Lecturer, University of Canberra Chief Nurse, St John Ambulance Australia Research Associate, Flinders University Email: jamie.ranse@canberra.edu.au Blog: www.jamieranse.com Twitter: jamieranse
Editor's Notes
- Identify other facilities / institutions that can ‘take’ patients University Off-site processing of minor casualties Tell everyone to go home!
- 1=completely unprepared to attend 2=somewhat unprepared to attend 3=neither prepared nor unprepared to attend 4=somewhat prepared to attend 5=completely prepared to attend.
- Q5. Is there anything that would need to occur to improve your willingness to attend work when there is a health-disaster? There were 271 responses (61%) to ‘yes’ and 172 (38%) to ‘no’. The detail of improvements were as follows.