Disaster Planning And Management Flashcards
Disasters
Events that occur when significant numbers of people are exposed to hazards to which they are vulnerable, with resulting injury and loss of life, often combined with damage to property and livelihoods
Paradigm change required in disaster management
Change from the application of unlimited resources for the greatest good of each individual client, to the allocation of limited resources for the greatest good to the greatest number of casualties
Main causes of disaster events
- Nature
- Technology
- Human conflict
- Combination
Examples of natural disaster potential hazards
- Firestorms
- Flood
- Landshift
- Tornado
- Epidemic
- Earthquake
- Volcano
- Hurricane
- High winds
- Blizzard
- Heat wave
Examples of technological disaster potential hazards
- Hazmat spills
- Explosions
- Utility failure
- Building collapse
- Transportation accident
- Power outage
- Nuclear accident
- Dam failure
- Fire
- Water loss
- Ruptured gas main
Examples of conflict disaster potential hazards
- Riots
- Strikes
- Suicide bombings
- Bomb threat
- Employee violence
- Mass shootings
- Equipment sabotage
- Hostage events
- Transportation disruption
- Weapons of mass destruction
- Computer viruses/worms
Parameters to classify disasters
- Number of fatalities
- Number of ill/injured
- Length of time for the impact
- Rescue time
- Radius of disaster area
Richter scale
Used to measure magnitude of earthquake
Modified Mercalli Intersity (MMI)
Subjective measurement used to describe the intensity, or nature and spatial extent of damage from an earthquake
Safffir-Simpson scale
Used to measure the strength of hurricanes
Fujiita scale
Used to measure the strength of tornados
Nat-tech disasters
Technological emergencies that result from natural disasters
Aka joint disasters
Examples of nat-tech disasters
- Earthquake causing ruptured natural gas lines and fires
2. Tornado causing chemical tank breach and chemical spill
Characteristics of nat-tech disasters
- Response for both events required simultaneously
- Likely to be more than one technologic event
- Major utilities may be disrupted
- Mitigation efforts may not work as anticipated because of natural disaster
Factors that contribute to the increased probability and severity of consequences of disasters
- Risk of disasters is greater
- People have become more vulnerable to nature
- Technologic disasters are more frequent and severe as result of increased complexity and dependency in these area
Reasons why risk of disaster is greater currently
- Growing population
- More technology
- Increased political turbulence resulting in threat of terrorism
Reasons people are currently more vulnerable to nature
- Mass migration
- Urbanization
- Building in high risk areas
- War
Dependency on the following areas causes technologic disasters to be more severe and frequent
- Telecommunications
- Computer systems
- High rise buildings
- Widespread power supply grids
- Global marketing
Disaster nursing
The systematic and flexible utilization of knowledge and skills specific to disaster related nursing, and the promotion of a wide range of activities to minimize the health hazards and life threatening damage caused by disasters in collaboration with other specialized fields
Emergencies defined
Any natural or man made situations that result in severe injury, harm or loss of humans, property and/or environment
Phases of Disaster Life Cycle Model
- Prodromal phase
- Impact phase
- Rescue or emergency phase
- Recovery or reconstruction phase
- Quiescent or interdisaster phase
Prodromal phase
- The warning period when signs or public announcements occur.
- Evacuation or taking shelter may occur in this hose if there is sufficient time
Impact phase
- When the disaster causing event occurs
- May be short (tornado) or prolonged (hurricane)
Rescue or emergency phase
The period when immediate assistance is provided by bystanders and first responders
Recovery or reconstruction phase
- The period when all the necessary services and resources are applied to return to predisaster conditions
- May last for days, months, years
Quiescent or interdisaster phase
The period between disaster events
Stages of model for disaster chronology defined by use of a timeline
- Preimpact phase
- Impact phase
- Postimpact phase
Preimpact phase
Includes planning/preparedness and disaster warning
Impact phase
- Divided into 0-24 hours and 24-72 hours
- Includes response and emergency management
Postimpact phase
- Begins after 72hours
- Efforts aimed at recovery, rehabilitation, reconstruction and evaluation
Jennings Disaster Nursing Management Model
- Developed to assist educators to add disaster nursing to community health nursing courses
- Enables community nurses to plan for and manage disasters in conjunction with other personnel in each of the segments of ech phase of the model
Jennings Disaster Nursing Management Model Phase I
- Predisaster
- Includes assessment, planning, primary prevention, education and plan practice activities
Jennings Disaster Nursing Management Model Phase II
- Disaster
- Includes direct nursing care provision, case management, and secondary prevention education activities
Jennings Disaster Nursing Management Model Phase III
- Post disaster
- Client needs reassessment
- Tertiary prevention level education
- Reevaluation and revision of disaster plan
- Communication of the experiences and findings
Jennings Disaster Nursing Management Model Phase IV
- Positive client/population outcomes
- Defines outcome expectations
- Impacted by phases I-III
Examples of outcome expectations from Jennings Disaster Nursing Management Model Phase IV
- Decreased mortality rates
- Decreased costs
- Improved knowledge and health status
- Improvement in disaster plan effectiveness and collaboration
Phase I Predisaster assessment activities
- Identification of resources and risks in a work setting
2. Education: primary levels of prevention
Phase I Predisaster planning activities
- Allocation of resources
- Planning cooperative agreements
- Defining roles
- Development/activation of disaster assessment tools
- Development of education programs
- Development of volunteer opportunities
Phase I Predisaster implementation activities
- Practice the disaster plan
Phase II Disaster roles of the nurse
- Caregiver
- Educator
- Case manager
Phase II Disaster caregiver role activities
- Triage
2. Provide holistic care
Phase II Disaster educator role activities
- Secondary levels of prevention
Phase II Disaster case manager role activities
- Liaison
- Provide referrals
- Coordination of services
- Tracking system
Phase III Post Disaster assessment activities
- Reevaluate healthcare needs of client
- Education: tertiary levels of prevention
- Reevaluate current disaster plan
Phase III Post Disaster planning activities
- Revise existing plan
2. Plan for next potential disaster
Phase III Post Disaster implementation activities
- Practice new/revised disaster plan
2. Disseminate findings
Phase IV Client/Population outcomes
- Decreased mortality rates
- Decreased healthcare costs
- Decreased disaster related costs
- Improved health status
- Increased knowledge
- Increased effectiveness of disaster plan
- Increase collaborative relationships
Disaster planning and preparedness occur during…
The pre-disaster phase
Planning includes…
The determinations made by others on how to respond and manage resources if a disaster event occurs
Preparedness includes….
Measures taken and policies formed before an event occurs that allow for prevention, mitigation and readiness
Regardless of the cause or phase of a disaster, disaster planning and preparedness share common overall problems:
- Conventional wisdom and routine emergency response don’t work
- Disaster problems cross interdisciplinary boundaries, triggering the mobilization of resources not ordinarily used in local emergencies
- Actual human attitudes differ from what one might expect
- There are multiple organizational barriers to preparing for and responding to a disaster
- Groups and organizations can contribute in various ways to ineffective disaster response
- Because companies, local agencies and organizations experience the fewest exposures to disaster loss compared to a state or nation, they are the least apt to perceive disaster planning and resources as important issues
Disasters often pose unique problems rarely faced in daily emergencies such as:
- Blocked access
- Inadequate resources
- Unfamiliar tasks and procedures
- Unfamiliar faces and roles
- Overload of communications
- Need for inter organizational coordination
Human attitudes experienced in a disaster that can cause problems
- Underestimating risk and overestimating ability to survive an event
- Overestimation of an entity’s capability to deal with a disaster
- Fatalism and denial
- Lulled into a false sense of security when precautionary measures are in place
- Responders having a need to be identified as heroes by their peers and others
One explanation for why people mistakenly underestimate risk and overestimate ability to survive an event
They have experienced the periphery of disaster events previously
Overestimation of an entity’s capability to deal with a disaster is called…
Robinson Crusoe syndrome
We’re the only ones on the island
Result of Robinson Crusoe syndrome
Neither collaboration nor a coherent overall strategy
Examples of comments that manifest fatalism and denial
- There’s nothing to worry about because nothing can be done about it anyhow
- It can’t happen here
Organizational barriers to preparing for and responding to a disaster
- No institution, person or government agency is seen as responsible or accountable for disaster preparedness
- Competing demands for resources needed to prepare for disasters at the bottom of priority lists
- Over-response from untrained volunteers, miscommunication in resource allocations, lack of incident command and sightseers
- Persons in authority at an agency or organization may assume command because they are the boss despite lack of expertise or training
Examples of how groups and organizations can contribute to ineffective disaster response
Vested interest groups can create the setup for disasters, such as the rights of property owners to build in flood prone areas
Actual and potential benefits to a workplace plan to prepare for disaster events
- Helps companies meet moral responsibilities of protection of workers, citizens and the environment
- Helps avoid risks of criminal charges for responsibility in industrial disasters
- Reduces disaster impacts and potentially civil liability
- Regulatory programs require planning
- Cost of addressing effects of disaster after it has happened will be greater than costs of preparedness
- Local, state and federal aid is usually insufficient to cover extent of damages
- Planning and preparedness can lessen impacts of disaster and speed recovery phase
- Disaster preparedness and planning enhance a company’s image a credibility
- Disaster preparedness and planning may reduce insurance premiums
- All organizations are vulnerable disaster: not a question of if it will happen but when
- Integration of occupational and environmental health into public health should lead to an all-hazards approach with better overall disaster preparedness
Moral responsibilities of companies
- Protection of workers, citizens and the environment
2. Western values of goodness, truth and justice
Several regulatory programs require planning under such names as:
- Emergency response plans
- Emergency action plans
- Contingency plans
- Emergency and fire prevention plans
- Risk management plans
OSHA regulations requiring emergency plans
- 29 CFR 1910.35, 36, 37
- 29 CFR 1910.38
- 29 CFR 1910.119
- 29 CFR 1910.120
- 29 CFR 1910.146
- 29 CFR 1910.151
- 29 CFR 1910.156
- 29 CFR 1910.158
- 29 CFR 1910.159
- 29 CFR 1910.160
- 29 CFR 1910.165
29 CFR 1910.35, 36, 37
Means of egress
29 CFR 1910.38
Emergency plans and fire prevention plans
29 CFR 1910.119
Process safety management of highly hazardous chemicals
29 CFR 1910.120
Hazardous waste operations and emergency response
29 CFR 1910.146
Permit-required confined spaces for general industry
29 CFR 1910.151
Medical services and first aid
29 CFR 1910.156
Fire brigades
29 CFR 1910.158
Portable fire extinguishers
29 CFR 1910.159
Automatic sprinkler system
29 CFR 1910.160
Fixed extinguishing systems
29 CFR 1910.165
Employee alarm systems
Increase in speed of response and recovery can enhance the company’s ability to recover from
- Financial losses
- Regulatory fines
- Loss of market share
- Damages to equipment or products
- Business interruption
—- of businesses that experience a fire or major theft go out of business within two years
47%
—- of companies that lose records in a disaster never resume business
44%
—– of business that experience a significant data loss are out of business within five years
93%
The majority of businesses spend less than —- of their total budget on business recovery planning
3%
Why is there increasing importance that nurses should be able to function effectively in disaster situations?
Disaster preparedness has reached a new level if urgency
Why are occupational and environmental health nurses able to assess and respond holistically in disaster events?
- Have regular interaction with workers, the workplace and the community
- Likely to be aware of strengths and needs of clients
Why are occupational health nurses well positioned to serve on the frontlines of terrorist affront to workers?
They have a long history of protecting workers from the adverse effects of a multitude of workplace exposures
Basic types of disaster response plans:
- Ones with specifically defined functions for particular agents
- Ones which are broader in scope to cover all potential hazards
Priority in all disaster response plans
Life safety
Major types of disaster response plans
- Emergency Action Plan
- Business Continuity Plan
- Risk Management Plan
- Emergency Response Plan (ERP)
- Contingency Plan
- Federal Response Plan
- Spill Prevention, Control and Countermeasures Plan
- Mutual Aid Plan
- Recovery Plans
- Emergency Management Plan
- All-Hazard Disaster Management Plan (DMP)
Emergency Action Plan
- Required by OSHA
- Ensures that worker evacuation plans and drills have been developed
- Particularly focuses on response to facility fires
Business Continuity Plan
Requires that all operations performed by a particular unit or component be listed, prioritized, and identified as to their importance to continued business operations
Business Continuity Plan focuses on:
- Policies
- Practices
- Activities
That reduce business losses and enhance actions to resume operations
Why is there increasing importance that nurses should be able to function effectively in disaster situations?
Disaster preparedness has reached a new level if urgency
Why are occupational and environmental health nurses able to assess and respond holistically in disaster events?
- Have regular interaction with workers, the workplace and the community
- Likely to be aware of strengths and needs of clients
Why are occupational health nurses well positioned to serve on the frontlines of terrorist affront to workers?
They have a long history of protecting workers from the adverse effects of a multitude of workplace exposures
Basic types of disaster response plans:
- Ones with specifically defined functions for particular agents
- Ones which are broader in scope to cover all potential hazards
Priority in all disaster response plans
Life safety
Major types of disaster response plans
- Emergency Action Plan
- Business Continuity Plan
- Risk Management Plan
- Emergency Response Plan (ERP)
- Contingency Plan
- Federal Response Plan
- Spill Prevention, Control and Countermeasures Plan
- Mutual Aid Plan
- Recovery Plans
- Emergency Management Plan
- All-Hazard Disaster Management Plan (DMP)
Emergency Action Plan
- Required by OSHA
- Ensures that worker evacuation plans and drills have been developed
- Particularly focuses on response to facility fires
Business Continuity Plan
Requires that all operations performed by a particular unit or component be listed, prioritized, and identified as to their importance to continued business operations
Business Continuity Plan focuses on:
- Policies
- Practices
- Activities
That reduce business losses and enhance actions to resume operations
Critical operations in a Business Continuity Plan
Those operations a business cannot do without or that have a role that is vital to the operation and/ or may pose a life safety risk
What should be done for each critical activity?
- Mitigation strategies should be implemented
2. Recovery process developed
Essential operations in a Business Continuity Plan
Are not critical, but are difficult to operate without, although the facility could run for a while without them
Nonessential operations in a Business Continuity Plan
Interruption would merely be an inconvenience
Types of business operations in a Business Continuity Plan
- Critical operations
- Essential operations
- Nonessential operations
Risk Management Plan
Evaluates potential off site consequences of chemical release
Risk Management Plan requires….
Identification of “worst case” scenarios and how they would be managed
EPA mandated Risk Management Plan
40 CFR Part 68 Risk Management programs for Chemical Accidental Release Prevention
Emergency Response Plan
- ERP
- governs the immediate response to a disaster to provide life safety, rescue, damage control, evacuation and/or sheltering-in-place
OSHA requires and ERP for:
- Hazardous waste sites
2. Hazardous materials spill response
OSHA standard that required ERP for certain facilities
29 CFR 1910.1209
Contingency Plan
A generalized emergency plan to handle unforeseen events not identified in a hazard and risk assessment
Federal Response Plan
Coordinates federal resources in any disaster or emergency situation in which there is a need for federal assistance
Legislation that identifies disasters or emergency situations that require federal assistance
Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5121 et seq.)
Spill Prevention, Control and Countermeasures Plan
- SPCC
- describes measures to prevent, contain and clean up oil spills
- intent is to protect waterways from oil contamination
A facility is required to have an SPCC plan if it meets the following criteria:
- It is non transportation related
- It has an above ground capacity greater than 1,320 gallons or buried capacity greater than 42,000 gallons
- There is reasonable expectation that a spill could occur to navigable US waters
SPCC plans are required by federal regulation….
40 CFR 112
Federal regulation 40 CFR 112 is implemented by…
The EPA
SPCC plans include:
- Procedures to be followed to prevent oil spills from occurring
- Procedures for responding to and controlling oil spills at the facility
Mutual Aid Plan
Calls for participating firms to share resources to help each other during an emergency
Mural Aid Plan is helpful for:
- Small facilities with limited resources
2. Larger facilities with significant hazards
Mutual aid agreements are also instituted among…
Community first responder agencies
Recovery Plans
Govern the repair and rebuilding, including prioritization of facilities and communities after a disaster
Emergency Management Plan is required by:
Joint Commission for Accreditation of Healthcare Organizations
Emergency Management Plan is required for the following facilities:
- Hospital
- Ambulatory care
- Behavioral Health
- Home care
- Long-term care facilities
Emergency Management Plan is required by the following standards:
Environment of Care (EC)
- EC.1.4
- EC.2.4
- EC.2.9.1
EC.1.4
Requires development of plan using four phases of mitigation, preparedness, response and recovery
EC.2.4
Standard to implement plan
EC.2.9.1
Standard to execute the plan by conducting drills
Emergency Management Plan must include the following emergencies
- Within the organization or facility
2. Handling of patient care demands from emergencies occurring in the community
Hospital Emergency Incident Command System
- HEICS
- component if Emergency Management Plan
- incident command structure
- links to the community structure
All-Hazard Disaster Management Plan
- DMP
- most broad in scope
- ultimate goal is to predict and prepare for the unpredictable
DMP covers:
- Natural disasters
2. Man made disasters
Man made disasters in a DMP are subdivided into:
- Technologic disasters
2. Conflict induced disasters
DMP incorporates all of the other more specific plans including:
- Emergency response plans
2. Business recovery/ continuity plans
Plan that serves as an excellent template for a disaster plan
All-Hazard Disaster Management Plan
Objectives for the all-hazard disaster plan
- To eliminate or reduce the chance of disaster occurring
- To reduce the resulting impact, injury, illness and/or damage
- To use emergency response to prevent additional harm
- To strengthen the ability to withstand disruption of infrastructure
- To enable rapid recovery and restoration of production, services and pre-disaster conditions
Several key principles that determine the success or failure of the plan
- Support of upper management is essential
- Disaster planning requires the expertise of many people
- Businesses must avoid the attitude that they can handle events by themselves
- The planning process takes time and proper project management
- The occupational and environmental health nurse should be prepared to be the prime mover or motivating force for the plan
Disaster planners may include:
- Company management
- Occupational health and safety personnel
- Human resources
- Risk managers
- Accounting
- Security
- Union representatives
Why is it important to have the expertise of many people in disaster planning?
- More people will be participating and investing in the plan
- The plan experiences increased visibility and importance
- The plan receives a more broad perspective on key issues
- Important networking and collaborative relationships can develop
Developing a disaster management plan
- Establish a planning team
- Clear line of authority between group members and the group chairperson defined
- Logistical preparations completed
- Existing plans located and reviewed
Establishing a planning team
- Some persons are active members and some are advisors
- Input from personnel in all key functional areas obtained
- Team appointments made in writing from upper management
When establishing a disaster management plan input should be obtained from personnel in all of the following key functional areas:
- Upper management
- Line management
- Environmental health and safety
- Occupational and environmental health
- Human resources
- Maintenance
- Security
- Public relations
- Marketing
- Legal
- Financial
- Purchasing
- Telecommunications
- Other workers in accordance with the size and sophistication if the facility
How should line of authority between group members be defined?
- Senior management should give and announce the authority to the planning team to develop the plan
- Authority may be provided through a mission statement
Logistical preparations that need to be made to develop a disaster management plan
- Preliminary deadlines and timelines should be established
2. Progressive budgetary needs should be outlined
Progressive budgetary needs that should be outlined
- Consulting fees
- Travel fees
- Research costs
- Clerical costs
- Other expenses
Existing plans that should be located and reviewed with developing a disaster management plan
- Site evacuation plan
- Fire protection plan
- Security procedures
- Bomb threat procedure
- Hazardous materials response plan
- Risk management plan
- Others
Analyzing potential disasters to include in the disaster management plan
- Conduct a hazards identification
- Perform a vulnerability assessment
- Set priorities by performing risk analysis
Hazards identification
Determines what adverse events are possible