1. Copyright © 2008 Delmar. All rights reserved. Part V Public Health Nursing in the 21 st Century

2. Copyright © 2008 Delmar. All rights reserved. Chapter 29 Disaster Preparedness and Public Health Nursing

3. Copyright © 2008 Delmar. All rights reserved. 3 Disasters Occur with little to no warning: –Avalanches –Fires –Explosions –Tsunamis –Hurricanes, floods –Winter storms, droughts

4. Copyright © 2008 Delmar. All rights reserved. 4 Two Disaster Classifications Natural disasters (Table 29-1) –Hurricanes –Emerging diseases Avian influenza Man-made disasters (Table 29-2) –Accidental –Deliberate

5. Copyright © 2008 Delmar. All rights reserved. 5 Terrorism Purpose: –Injure –Kill –Instill fear

6. Copyright © 2008 Delmar. All rights reserved. 6 Terrorism Targeted sites: –Critical infrastructure systems –Public buildings or assembly areas –Symbolic or historic sites –Controversial facilities or businesses

7. Copyright © 2008 Delmar. All rights reserved. 7 Terrorism Code of Federal Regulations Federal Bureau of Investigation (FBI) –Domestic –International Emerging threat –Cyber terrorism

8. Copyright © 2008 Delmar. All rights reserved. 8 Weapons of Mass Destruction Categories of weapons of mass destruction: –Biological –Nuclear –Chemical –Incendiary/explosive

9. Copyright © 2008 Delmar. All rights reserved. 9 Weapons of Mass Destruction Public health nurses should be: –Aware of guidelines for prophylaxis and treatment of incidents –Prepared to develop and present information to EMS, those on the front line, and the public

10. Copyright © 2008 Delmar. All rights reserved. 10 Biological Weapons Categorized into three groups (Table 29-4) –Bacterial agents –Viral agents –Biological toxins

11. Copyright © 2008 Delmar. All rights reserved. 11 Biological Weapons Three routes of exposure: 1.Inhalation 2.Contact 3.Gastrointestinal

12. Copyright © 2008 Delmar. All rights reserved. 12 Smallpox –Isolation –Quarantine

13. Copyright © 2008 Delmar. All rights reserved. 13 Smallpox Smallpox Vaccine Guidelines by CDC –Assess for contraindications –Choose site Deltoid –Prepare skin Do not use alcohol to prep skin

14. Copyright © 2008 Delmar. All rights reserved. 14 Smallpox Administer vaccine with a bifurcated needle: –Absorb excess vaccine –Cover site until scab forms –Record vaccination –Educate the client

15. Copyright © 2008 Delmar. All rights reserved. 15 Nuclear/Radiological Weapons Two types: 1.Radiological dispersal device Dirty bomb 2. Radiation hidden in public place

16. Copyright © 2008 Delmar. All rights reserved. 16 Nuclear/Radiological Weapons Most effective way to protect the public from exposure: –Time, distance, shielding Acute Radiation Syndrome

17. Copyright © 2008 Delmar. All rights reserved. 17 Chemical Weapons Four categories: 1.Nerve agents 2.Vesicant or blistering agents 3.Choking agents 4.Blood agents

18. Copyright © 2008 Delmar. All rights reserved. 18 Incendiary/Explosive Devices Acts carried out by using: –Small arms –Explosives –Incendiaries Hazards are same as from fires: –Smoke inhalation, burns –High temperatures, dangerous fumes

19. Copyright © 2008 Delmar. All rights reserved. 19 Effects of Disasters Affects individuals, communities, economic and productivity abilities Physical health effects –Preimpact, impact, post-impact May include bone, muscle, joint injuries, lacerations, rashes, burns, puncture wounds, death

20. Copyright © 2008 Delmar. All rights reserved. 20 Effects of Disasters Mental health effects: –Depression –Post-traumatic stress disorder –Emotional disorders

21. Copyright © 2008 Delmar. All rights reserved. 21 Effects on Responders Post-traumatic stress disorder Responders should have: –Limited on-duty work hours –Rotate from high to low stress functions –Adequate breaks and plenty of water –Nutritious meals –Debriefing

22. Copyright © 2008 Delmar. All rights reserved. 22 Coping with Disasters Guidebook of Psychological Intervention, Coping with Disasters –Four phases: 1.Rescue 2.Honeymoon 3.Disillusionment 4.Reconstruction

23. Copyright © 2008 Delmar. All rights reserved. 23 Public Health Role Community assessment Diagnosing and reporting Providing preventative measure Preventing spread of disease Assisting with outbreak investigation Discouraging inappropriate responses

24. Copyright © 2008 Delmar. All rights reserved. 24 Public Health Role Disease surveillance –Public Health Information Network –National Electronic Disease Surveillance System Strategic national stockpile –Technical Advisory Response Unit

25. Copyright © 2008 Delmar. All rights reserved. 25 Public Health Role Disaster life cycle –Preparedness stage –Response stage –Recovery stage –Mitigation stage –Risk reduction –Prevention stage

26. Copyright © 2008 Delmar. All rights reserved. 26 Disaster Response and Management National Response Plan National Incident Management System –Incident command structure

27. Copyright © 2008 Delmar. All rights reserved. 27 Public Health Preparedness Eight domains of core competencies: 1.Analytic/assessment 2.Policy development/program planning 3.Communication 4.Cultural competency

28. Copyright © 2008 Delmar. All rights reserved. 28 Public Health Preparedness Eight domains of core competencies: 5. Community dimensions of practice 6. Basic public health sciences 7. Financial planning and management 8. Leadership and systems thinking

29. Copyright © 2008 Delmar. All rights reserved. 29 Public Health Nurse Practice Model Framework for developing a disaster plan: –Assessment –Diagnosis –Outcome identification –Planning –Assurance –Evaluation