Opening Statement
Disaster preparedness is an essential aspect that should be observed by medical practitioners especially home nurses. Prior preparedness helps nursing homes develop and practice procedures to accommodate and offer accessibility to health services following any disaster. Over the years, nursing homes have been faced with challenges, especially exclusion from community planning. They have not been adequately equipped with supplies and medications that are appropriate for catering for disaster struck casualties. Many of the disasters that have occurred have brought about the deaths of people, as hailstones as huge as golf balls have beaten thunderously on the roofs of nursing homes. Vulnerable populations are mostly on the negative receiving end as significant risks of illnesses and injuries in natural and human generated disasters affect their livelihood since they are not able to access home nursing (Allen, 2007).
Background of the study
The competence of reaction via public health agencies as well as public safety officials that take place during and after disasters is brought about by the degree to which planning has addressed the needs of special populations such as vulnerable older people. Through the previous research conducted, it is clear that nursing homes have been given less support than hospitals from various levels of the government. For instance , in the United States many residents live in about 18000 nursing homes and due to the current trends of disasters that range from the Hurricane Katrina, the 9/11 attack just to mention but a few, the disaster management system does not respond to the needs of frail older people in nursing homes. These events have brought about severing effects were about. The public health system has neglected nursing homes as they are faced with challenges such as earthquakes, tornadoes, chemical spills from train accidents and widespread lasting power outages that cause ice storms.
The purpose of this study will be to evaluate whether nursing home staff are adequately prepared to handle facility disasters. It has become a crucial part in that most are the times when nursing home staff is faced with challenges and disasters but are not able to save or offer first aid to salvage the lives of those affected. This paper will focus on the present experiences and perspectives of administrators and staff at nursing homes that will help identify needs for preparedness training in nursing homes. It will also help in evaluating whether the staffs in nursing homes are properly prepared in case a disaster strikes (Beaulieu, 2012).
In the United States for instance, federal law requires that Medicare and Medicaid certified facilities to have written plans and procedures that adhere to potential emergencies as well as offer training services to their workforce with regard to procedures of emergency. This is accompanied by state surveys that assess whether facilities meet the requirements given. In the Gulf States available, four out of five have additionally included emergency preparedness requirements which are basically expected to be available in facility emergency plans. Similarly, studies have been conducted to review State survey data for emergency preparedness measures both at the national level and for Gulf States such as Louisiana, Mississippi, Texas, Florida and Alabama. These states have been visited where selected communities have been interviewed in terms of nursing home staff, local authorities and other stakeholders. In addition to this, emergency plans for a number of selected nursing homes have been compared in terms of those affected by hurricanes in the 5 Gulf State requirements and guidance.
Through these surveys and research, it was indicated that about 94% of nursing homes meet Federal standards for emergency plans and more than 80% of sufficient emergency training compliance rates were similar for the Gulf States. It was also evaluated that multiple factors that included community evacuation orders influenced the decision of selected nursing homes to evacuate or shelter. This means that administrators in nursing homes as well as the owners most often made the evacuation decision based on local authorities’ information and their own past experiences. Mandatory evacuation orders strongly influenced the decision to evacuate but administrators and owners considered other factors as well. These factors included the health of residents, risk of transporting and availability of host facilities (Castle, 2011).
Gaps and deficiencies in prior research
The research conducted in the previous cases had various deficiencies and gaps in that the selected nursing homes that were used in the study experienced problems whether they evacuated or sheltered in place. This occurred to lack of effective emergency planning or failure to properly execute the emergency plans. It would require impromptu decisions and actions. These problems were quite similar for evacuating facilities across various states and communities that included transportation contracts that were not honored, lengthy travel times, complicated medication needs as well as host facilities that were unavailable or inadequately prepared, similarly, inadequate staffing insufficient food and water, difficulty reentry to facilities were other problems identified.
Another indication of the deficiencies and gaps in prior research is that administrators in some nursing homes failed to adhere to emergency plans, which were als not constructed based on the required provisions. The 20 emergency plans reviewed met federal requirements of the most recent State survey. However, administrators from 5 out of the 20 facilities reported that they had deviated from or worked beyond their emergency plans during the recent disaster attacks. This occurred due to reasons that either, the plans were not updated or plans did not include instructions for particular circumstances (Claver, 2013).
On the same note, the challenges of State and local emergency entities to work together with the nursing homes impeded emergency planning and management. This was another form of deficiency where local emergency managers often provided guidance regarding the decision to evaluate the preparedness of staff members in nursing homes. The prior research indicated that most of the respondents or rather nursing home staff members did not collaborate with the authority in terms of emergency planning and management (Frahm, 2011).
Problem Statement
A clear evaluation of the preparedness of nursing home staff to handle facility disasters are a vital aspects as it brings out the issues that need to be addressed. Nursing home staff need to evaluate in terms of their preparedness to handle facility disaster. This study is important as it will help identify the areas that are mostly affected by the disasters. It will also give the staff’s insights on their experiences and areas that have brought more challenges in their line of work. This will be coupled with the issues that they feel should be improved in order to facilitate better preparedness. The study should be pursued as it will help improve nursing home emergency preparedness and ensure effective execution of plans. It will also encourage communication and collaboration between State and local emergency entities and nursing homes (Landesman, 2006).
This will come about by providing guidance and technical assistance to the facilities as well as better management between nursing homes and local emergency management. The study is important for local authorities as it will help them manage their resources in order to facilitate the nursing homes to be better prepared in case of disasters. It would also supplement the broad Federal requirements that nursing homes develop detailed emergency plans and procedures. These would include: plans for evacuation that include actionable details on travel, provision of supplies, transport records, medications and belongings, plans for adequate staffing levels that include clear expectations for relocation, plans for collaboration with emergency managers and other community entities to better assure success of emergency plans and plans for addressing specific needs of residents that include residents in hospice care as well as plans for sheltering in places that have adequate supply of electricity and sufficient supplies of food (Hauserman, 2012).
Research Design
In order to evaluate the level of preparedness in nursing home staff to handle facility disasters a mock survey should be conducted that should check the procedure, systems, as well as the processes of care and realize possible survey risk areas. It should be performed on a scheduled basis and shared with nursing home staff and the results implemented. The mock survey will also help in revealing how the staff will function under stressful circumstances. The research design would include a series of steps that can facilitate objectivity. These steps include: assigning department heads to survey departments other than their own. This would enable them to identify the faults and risks involved in other departments. Secondly, ensure that internal surveyors or the staff members are not aware that the study is being conducted in order to maximize the surprise and stress factor and thirdly the study should be an impromptu one that gets the staff members unawares. This will give them a real life condition and the evaluation will involve their response to the real life situation (Laditka, 2008).
The theory being tested in the study will be whether the staff in nursing homes is adequately prepared to handle facility disaster. The intentions of the study will focus on describing the extent to which their preparedness can salvage the lives of people. The variables will be dependent as the study will involve all members of every department in order to evaluate their preparedness and collaboration.
References
Allen, J. E. (2007). Nursing home federal requirements: Guidelines to surveyors and survey protocols, 2006 : a user-friendly rendering of the Centers for Medicare and Medicaid's (CMS) nursing home inspection and requirement forms. New York: Springer Pub. Co.
Beaulieu, E. (2012). A Guide for Nursing Home Social Workers. New York: Springer Publishing Company.
Castle, Nicholas G.; Engberg, John B (2011). The Health Consequences of Relocation for Nursing Home Residents Following Hurricane Katrina. Research on Aging, 33(6), 661-686.
Claver, Maria; Dobalian, Aram; Fickel, Jacqueline J.; Ricci, Karen A.; Mallers, Melanie Horn. (2013). Comprehensive care for vulnerable elderly veterans during disasters. Archives of Gerontology & Geriatrics, 56(1), 205-213.
Frahm, Kathryn A.; Brown, Lisa M.; Gibson, Maggie. (2011). The Importance of End-of-Life Care in Nursing Home Settings is Not Diminished by a Disaster. Omega: Journal of Death & Dying, 64(2), 143-155.
Hauserman, Becky. (2012). Be Prepared Now for When Disaster Strikes: How Can Psychiatric Nurses Help? Journal of Child & Adolescent Psychiatric Nursing, 25(2), 57-58.
Laditka, Sarah B.; Laditka, James N.; Xirasagar, Sudha; Comman, Carol B.; Davis, Courtney B.; Richter, Jane V.E. (2008). Providing Shelter to Nursing Home Evacuees in Disasters: Lessons From Hurricane Katrina. American Journal of Public Health, 98(7), 1288-1293.
Landesman, L. Y. (2006). Public health management of disasters: The pocket guide. Washington, D.C: American Public Health Association.
