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

Copyright © 2008 Delmar. All rights reserved.

Part V

Public Health Nursing in the 21st Century


Chapter 29

Disaster Preparedness and Public Health Nursing


3

Disasters

• Occur with little to no warning:– Avalanches– Fires– Explosions– Tsunamis– Hurricanes, floods– Winter storms, droughts


4

Two Disaster Classifications

• Natural disasters (Table 29-1)– Hurricanes– Emerging diseases

• Avian influenza

• Man-made disasters (Table 29-2)– Accidental– Deliberate


5

Terrorism

• Purpose: – Injure– Kill– Instill fear


6

Terrorism

• Targeted sites:– Critical infrastructure systems– Public buildings or assembly areas– Symbolic or historic sites– Controversial facilities or businesses


7

Terrorism

• Code of Federal Regulations

• Federal Bureau of Investigation (FBI)– Domestic – International

• Emerging threat– Cyber terrorism


8

Weapons of Mass Destruction

• Categories of weapons of mass destruction:– Biological– Nuclear– Chemical– Incendiary/explosive


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

Biological Weapons

• Categorized into three groups (Table 29-4)– Bacterial agents– Viral agents– Biological toxins


11

Biological Weapons

• Three routes of exposure:1. Inhalation

2. Contact

3. Gastrointestinal


12

Smallpox

• Smallpox– Isolation– Quarantine


13

Smallpox

• Smallpox Vaccine Guidelines by CDC– Assess for contraindications– Choose site

• Deltoid

– Prepare skin• Do not use alcohol to prep skin


14

Smallpox

• Administer vaccine with a bifurcated needle:– Absorb excess vaccine – Cover site until scab forms– Record vaccination– Educate the client


15

Nuclear/Radiological Weapons

• Two types:1. Radiological dispersal device

• Dirty bomb

2. Radiation hidden in public place


16

Nuclear/Radiological Weapons

• Most effective way to protect the public from exposure: – Time, distance, shielding

• Acute Radiation Syndrome


17

Chemical Weapons

• Four categories:1. Nerve agents

2. Vesicant or blistering agents

3. Choking agents

4. Blood agents


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

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

Effects of Disasters

• Mental health effects:– Depression– Post-traumatic stress disorder– Emotional disorders


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

Coping with Disasters

• Guidebook of Psychological Intervention, Coping with Disasters

– Four phases:1. Rescue

2. Honeymoon

3. Disillusionment

4. Reconstruction


23

Public Health Role

• Community assessment

• Diagnosing and reporting

• Providing preventative measure

• Preventing spread of disease

• Assisting with outbreak investigation

• Discouraging inappropriate responses


24

Public Health Role

• Disease surveillance– Public Health Information Network– National Electronic Disease Surveillance

System

• Strategic national stockpile– Technical Advisory Response Unit


25

Public Health Role

• Disaster life cycle– Preparedness stage– Response stage– Recovery stage– Mitigation stage– Risk reduction– Prevention stage


26

Disaster Response and Management

• National Response Plan

• National Incident Management System– Incident command structure


27

Public Health Preparedness

• Eight domains of core competencies:1. Analytic/assessment

2. Policy development/program planning

3. Communication

4. Cultural competency


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

Public Health Nurse Practice Model

• Framework for developing a disaster plan:– Assessment– Diagnosis– Outcome identification– Planning– Assurance– Evaluation

Documents

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