Running head: COMMUNITY HEALTH AND DISASTER PLANNING Community Health and Disaster Planning Tawnya P Brock University of the Cumberland’s Nursing 441-21 Spring 2020 Second Bi-Term 1 COMMUNITY HEALTH AND DISASTER PLANNING 2 Community Health and Disaster Planning The purpose of this paper is to provide the components of a disaster plan, explain why they are necessary, provide one real example and discuss the role of a community health nurse in the development and implementation of those plans. I find this a very interesting subject, especially since I have completed CMS training specifically for Emergency Preparedness in health care with an emphasis in rural communities. I have cited the lack of Emergency Preparedness Plans many times during survey, most recently less than four short weeks ago. As a health care provider with a background in middle management I often struggle with those citations, especially in the Rural Health Clinic survey since Emergency Preparedness is a Condition Level Deficiency, meaning…. The facility has ninety days to correct the problem or they cannot participate in the Medicare Program, we all know how that impacts a facility! I’ve often battled within myself over this citation, however, with the recent pandemic events I am not only relieved but happy of those very citations over the last few weeks and months. Facilities, their staff, and patients will benefit from the tools they have on hand to assist them during this pandemic due to the readiness of their Emergency Preparedness Plans. The pandemic we find ourselves currently struggling through is a real life, real time example. This is why I am relieved those citations were given, it forced many to have the tools in place they need today! As we write these papers, emergency preparedness planning and coordinating is going on all across America. Our states, cities, counties and local communities are gathering and working with national leaders and governments to review, predict, plan and perhaps even guess what our health care COMMUNITY HEALTH AND DISASTER PLANNING 3 needs are going to be and how or if our current health care system can meet the need. The collaboration we see today not only of our leaders and health care communities but each individual citizen to participate and, “flatten the curve” of this pandemic is about as real as it gets! This assignment requested a focus on a Disaster Plan, however, my current understanding of a Disaster Plan is very similar to the CMS Emergency Preparedness Plan, for this paper I will consider them one and the same. What are components of a Disaster Plan or Emergency Preparedness Plan? According to The Centers for Medicare and Medicaid (CMS), “The emergency preparedness program must describe a facility's comprehensive approach to meeting the health, safety, and security needs of their staff and patient population during an emergency or disaster situation. The program must also address how the facility would coordinate with other healthcare facilities, as well as the whole community during an emergency or disaster, natural, man-made or a facility disaster” (Quality, Safety & Oversight Group - Emergency Preparedness, 2018). CMS describes the following four items as the core components of an Emergency Preparedness Plan. First is Risk Assessment and Emergency Planning, these should be site specific, in other words the hazards addressed in your plan should be geographically appropriate, for example we probably would not identify a tsunami wave as a high risk for our clinic in Williamsburg Kentucky, however, we may very well identify flooding as a high risk due to our recent spring rains/floods and geographic location near the Cumberland River. After our risk assessment we need to address the care related emergencies we expect or predict might follow and how we plan to mitigate those risks. In our current situation a good example of this is the availability of PPE and ICU beds. The second step in Emergency Preparedness is Communications. How would a facility develop a communication plan that complies with the regulations, meaning, how would staff communicate COMMUNITY HEALTH AND DISASTER PLANNING 4 if land lines were down, cell services were overloaded? How will we communicate with our staff, providers, state and local health departments, and other emergency management services. Many hospital campuses identify runners in their plans, other have short wave radios or radios that monitor emergency broadcast systems, etc. The third step is the development of policies and procedures. They must be written in such a way they are easily understood in order to be followed, they should be instructive and inclusive, with organizational structures, chain of command, team coordinators and central command posts identified, location of emergency supplies, evacuation routes, and so forth. Number four which is last but certainly not least is training activities. All of the information in the world is useless if staff on the front lines do not have access to it and are not familiar with the plan to know what, when, where and how to do when the emergency or disaster strikes! Our text also list’s components of a disaster plan which are very much the same, “delegation of authority, communications, equipment and supplies, human resources, team coordinators, documentation, evacuations, rescue, transportation, acute care, supportive care, recovery and evaluation” (Karen Saucier Lundy, 2016). What is our role as the community health nurse in Emergency Preparedness Planning? In previous writings for this BSN program I have noted that nurses make up the majority of the health care work force, therefore, if we are discussing any topic related to health care it is my belief that nursing professionals should be the voice of expertise that is heard. This class is specific to community health nursing, nevertheless, nursing in every profession would be impacted by a disaster. In support of that theory I again reference our current COVID-19 pandemic, while we may not all be on the front lines of the ICU in New York, we certainly are dealing with our small rural hospitals, clinics, rehabilitation facilities, administration, employee health, public health, the list goes on and on. If they are not actively working with patients, a COMMUNITY HEALTH AND DISASTER PLANNING 5 nurse may very well be the person behind the scenes coordinating resources, interventions, communications and planning at multiple levels in those same facilities. I know many semiretired nurses that have returned to work to help and fully retired nurses that are making a mask, offering positive encouragement or simply remembering their peers in a prayer! That said, it is my professional belief that we all are and will be involved in a disaster when it strikes close to home or when it is large scale at a national level. Now, from a purely scholastic perspective, in additional to our text, there are multiple references that address the involvement of a community health nurse in the development and implementation of the Emergency Preparedness Plan. “Public Health Nurses play a critical role in coordinating and implementing any disaster response plan, as the largest segment of the public health workforce and the most trusted profession, nurses are community advocates with unique skill sets. Nurses must understand the disaster cycle and be able to be integrated at every phase and ensure that the services provided should be consistent with their scope of practice. The public health nurse’s clinical knowledge regarding disease pathophysiology and epidemiology in conjunction with community assessment skills can serve a crucial role in emergency preparedness and response as well as participation in healthcare policy development during a disaster” (Clair Millet, 2013). Another source adds to these skill sets by also addressing surge capacities, which is something nurses deal with daily in the current pandemic. “As experts in planning and coordinating patient care, nurses have a crucial role to play in disaster planning. Nurses must become familiar with the concept of surge capacity and understand both how it relates to the health and safety of communities and how it is applicable to their nursing practice. The ability to respond effectively to events producing a massive influx of patients that disrupt daily operations requires surge capacity. Key components of surge capacity include the COMMUNITY HEALTH AND DISASTER PLANNING 6 four S’s: ‘staff,’ ‘stuff,’ ‘structure,’ and ‘systems.’ Nurses must become familiar with the concept of surge capacity and understand both how it relates to the health and safety of communities and how it is applicable to their nursing practice” (Lavonne M. Adams, 2019). In closing I would share the following quote that in my opinion ultimately summarizes the role of a community health nurse during disasters. “The mission of public health, core functions, and essential services, do NOT change in a disaster. Neither does the practice of public health nursing” (Clair Millet, 2013). COMMUNITY HEALTH AND DISASTER PLANNING References Clair Millet, M. A.-B. (July, July 31). The Role of Public Health Nurses in Disaster Preparedness, Response, and Recovery A Position Paper. Retrieved from Massachusetts Association of Public Health Nurses (MAPHN): www.https://www.maphn.org/Resources/Documents/CMilletpostver073113.pdf Karen Saucier Lundy, S. J. (2016). Community Health Nursing Caring for the Public's Health. Burlington, MA: Jones & Bartlett Learning. Lavonne M. Adams, P. R. (2019, May 2). Exploring the Concept of Surge Capacity. Retrieved from Online Journal of Issues in Nursing : http://www.https://ojin.nursingworld.org/ Quality, Safety & Oversight Group - Emergency Preparedness. (2018, Jan 5). Retrieved from Centers for Medicare & Medicaid Service: http://www.cms.gov>Medicare 7
