Lessons Learned from Emergency and Disaster from Thailand Orapan Thosingha, RN,DNS WHOCC, Faculty of Nursing, Mahidol University Mahidol University, Wisdom

Lessons Learned from Emergency and Disaster from

Thailand

Orapan Thosingha, RN,DNS

WHOCC, Faculty of Nursing, Mahidol University

Mahidol University, Wisdom of the land


Scope of the presentation1.Major disasters in Thailand from Nov 2013-Oct 2014 : with a focus on health problems and nursing contribution. 2.Researches conducted by nurses in the area of emergency and disaster 3.Workshop, meeting and training in the area of emergency and disaster4.Curriculum development on disaster nursing in Surat Thani (Southern part of Thailand)5.Collaboratively work with the network members


Major emergency and disaster in Thailandfrom November 2013 to October 2014

Mass gathering

From October 2013 – May 2014


Mass gatheringFrom October 2013 – May 2014

Amnesty law

protest

More than 100,000 people gathering on Rajdumnean

Road, Bangkok

Oct – November

2013

Protest to force the government

to resign from their position

November – December

2013

More than 2,000,000 people

gathering on every main road in

Bangkok

Raise up the protest to cover many province in

Thailand, walk rally activities, shut down

Bangkok activity

Request the government to

resign /people need country reform

January - May 2014


Health problems foundInfectious diseases, diarrhea ,Acute symptoms among people with non communicable diseases, ie, DM, hypertension, heart disease, COPD


Health problems found

Heat stroke, injuries, eye injury from tear gas, mass casualty incidence


Establish a working

group called Caring Thais

Nursing network


Activities1.Form the mobile clinic to perform need assessment of people

2.Conduct primary medical care for people who gathering in the protest mob

3.Fund raising to help people who were injured and became disable during the protest

4.Establish an on line network to update the current situation and providing information to prevent communicable diseases and injuries

The Earth Quake5th May 2014 at 6.39PM (Thailand local time)5.8 Ritters, cover the area of 24 square KM in Chieng-Rai, the northern province of Thailand



practice guidelines developmentDevelop and implement a national Guidelines on Earth

Quake preparedness and response

Ms. Saikaew Yapalohit, RN,MNS (adult nursing)ER, Chieng Rai Prachanukraw General Hospital


Research in area of emergency and disaster1.The accuracy of Modified Early Warning Score (MEWS) on emergency patients triage.Objective: to evaluate the effectiveness of MEWS Setting: Emergency room in the provincial hospital Results : (preliminary report) 150 patients age 19-92 Years, MEWS can be used to identify physiological deterioration

2.Factors related to time to get access to trauma level I among patients with Road Traffic Injuries. Objective: to evaluate if injury severity, perceived severity of injury, type of responders, distance from the scene to the hospital could co predict time to get access to trauma care


3.The coping mechanism of family members of severe injured patients from Mass casualty incident during ICU stay.Objective: to evaluate the coping mechanism of family members.4.Factors related to The accuracy of Emergency Severity Index (ESI) among patients with trauma Objective : To explore the relationship between (a) patient characteristics (age, symptom presentation), (b) RN characteristics (age, years of experience, years of ED experience, and education), and (c) accuracy of ED RN triage and level designations the Emergency Severity Index (ESI) triage tool.


5. Factors predicting circulatory failure among severe trauma patients in emergency phase.Objective: to explore if patient temperature, level of injury severity, transportation time can predict patients circulatory failure (measure by Shock Index).Sample: 130 trauma patientsResults: level of injury can predict patients circulatory failure (measure by Shock Index).40 % of Patients experienced shock (circulatory failure) within 2 hours after their arrival to ER.


Curriculum development

There are 26 Colleges of Nursing under the governance of Ministry of Public health Thailand.There is not a special subject on emergency and disaster management.

Surat Thanee College of Nursing developed an additional contents on disaster preparedness , response and facilitation during the recovery phase. Using 2 days lecture and 1 day workshop.


Revision of the teaching styleFaculty of Nursing, Mahidol University

Emergency and disaster nursing 2 credits(30 Hours lecture & workshop)


To be more active learning using scenario to improve student engagement


Students had more satisfaction and higher

achievement


Continuing Nursing Education text book on disaster management

Sponsored by Thailand Nursing and Midwifery Council

15 Chapters

Editors: Orapan Thosingha, Piyaporn Yauwaresh, Kedsiri WongKongkum

Authors: Mahidol University, Thailand Red Cross CON, Royal Air Force Hospital, Ministry of Public Health (will be published and distributed in December 2014)


Collaboratively work with network membersDr Lidia Mayner serves as a co advisor for Thai graduate nursing students.


Collaboratively work with the

other community of practice

nurses group to add knowledge

of disaster preparedness

Reach out from the network


Work with the Infusion Nurses Network of Thailand (INNT)

Establish a group work to

develop national

guidelines on IV care

Evidence selection, appraisal,

analysis and synthesis

Content on IV care during limited resources from

emergency and disaster are added

Public hearing in Jan 2015

/present to HA national forum in March 2015


Keys to success1.Work with others2.Engage in different group3.Always remember to insert the essence of emergency and disaster in all areas 4.The succession plan is needed (indeed)

Documents

Lessons Learned from Emergency and Disaster from Thailand Orapan Thosingha, RN,DNS WHOCC, Faculty of Nursing, Mahidol University Mahidol University, Wisdom