The Future of Nursing 2020-2030 Charting a Path to Achieve Health Equity (2021) / Chapter Skim
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8 Nurses in Disaster Preparedness and Public Health Emergency Response
8 Nurses in Disaster Preparedness and Public Health Emergency Response
Pages 247-274
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But fundamental reform is needed in nursing education, practice, research, and policy across both health care and public health settings to ensure that all nurses -- from front-line professionals to researchers -- have the baseline knowledge, skills, abilities, and autonomy they need to protect populations at greatest risk and improve the readiness, safety, and sup port of the nursing workforce. The increasing frequency of natural and environmental disasters, along with public health emergencies such as the COVID-19 pandemic, highlights the critical importance of having a national nursing workforce prepared with the knowledge, skills, and abilities to respond.
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and inequities in access to health and health care that are a primary focus of this report. As natural disasters and public health emergencies continue to threaten population health in the decades ahead, articulation of the roles and responsibilities of nurses in disaster preparedness and public health emergency response will be critical to the nation's capacity to plan for and respond to such events.
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Nurses' Roles in Pandemics and Other Infectious Disease Outbreaks Nurses' roles in pandemics and other infectious disease outbreaks are multifaceted and may include • supporting and advising in epidemic surveillance and detection, such as contact tracing; • working in point-of-distribution clinics to screen, test, and distribute vaccines and other medical countermeasures; • employing prevention and response interventions; • providing direct hospital-based treatment for impacted individuals; • educating patients and the public to decrease risk for infection; 2 For the sake of brevity, the term "disaster" is used throughout the remainder of this chapter to refer to both natural disasters and public health emergencies.
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Evaluate the need for/ components of activate additional disaster nursing response. nurse response plans)
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. Infectious disease outbreaks have been occurring more frequently and at a higher intensity over the past few decades (Fauci and Morens, 2012; Lam et al., 2018)
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. 5 See https://www.theguardian.com/us-news/ng-interactive/2020/dec/22/lost-on-the-frontline-our findings-to-date (accessed March 18, 2021)
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Nurses' Response to Human-Caused Disasters In addition to natural disasters and public health emergencies, the United States is currently experiencing significant increases in gun-related violence, civil unrest against systemic racism, and social upheaval associated with growing political polarization (see Box 8-1)
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. Just a few months prior to the Pulse Nightclub shooting, there had been a community-wide exercise in disaster response that involved responding to an active shooter.
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. And according to national survey data from the Federal Emergency Management Agency (FEMA)
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The COVID-19 pandemic has had a disproportionate effect on Black, Hispanic, and American Indian populations, who have experienced greater levels of suffering and death. Long-standing racial and ethnic inequities in access to health care services prior to the pandemic have translated into disparities in access to COVID-19 testing and treatment (Duke Margolis Center for Health Policy, 2020; Poteat et al., 2020)
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. This concept engages the community in disaster planning, such as creating "community emergency response teams" and helping families compile their own disaster preparedness kits (Wells et al., 2013)
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. For example, one study of evacuees living in Red Cross shelters after Hurricane Katrina found that nearly half lacked health insurance, 55 percent had a preexisting chronic disease, and 48 percent lacked access to medication (Greenough et al., 2008)
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. NURSES' PREPAREDNESS FOR DISASTER RESPONSE Critical lessons learned during the response to prior infectious disease outbreaks, such as the 2003 severe acute respiratory syndrome (SARS)
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Aggressive actions taken now to transform nursing education, practice, and policy across health care and public health systems and organizations can improve the readiness, safety, and support of the national nursing workforce for COVID-19 as well as future disasters. The factors reviewed below that affect nurse preparedness include government strategies, research funding, education and accreditation, responsibilities of hospitals and health care organizations, and the role of professional nursing organizations.
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Federal response strategies and frameworks beyond those of ASPR include FEMA's National Response Framework and CDC's Public Health Emergency Preparedness and Response Capabilities. Concern has been expressed that the above federal strategies may not accurately reflect and incorporate the capacity of the nursing workforce to respond to disasters.
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There has been little funding for academic public health emergency programs since 2015, with the exception of CDC's Center for Preparedness and Response's Broad Agency Announcement for Public Health Emergency Preparedness and Response Applied Research, and no funding for academic disaster nursing. Overall funding for disaster research has declined since 2009 (NASEM, 2020)
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Fundamental and seismic change also is required in nursing education if the profession is to keep pace with the increasing numbers of natural disasters and public health emergencies. The major threats to global human health (climate change, air pollution, influenza, emerging infectious diseases, vaccine hesitancy)
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Schools of nursing can expand their use of educational technology, including telenursing and virtual simulations to increase interprofessional disaster training opportunities in partnership with community disaster response agencies. The Commission on Collegiate Nursing Education (CCNE)
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Health system leaders, mandated to have emergency management response plans in place, can ensure that all disaster and pandemic response plans address training content, including issues of health equity and communication with and protection of their workforce. The Role of Professional Nursing Organizations Professional nursing organizations have an important role in ensuring that their members and the profession at large have the expertise and support to respond to unanticipated events that threaten the health of the public.
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Conclusion 8-3: Rapid action is needed across nursing education, practice, policy, and research to address the gaps in nursing's disaster preparedness and improve its capacity as a profession to advocate for population health and health equity during such events. REFERENCES AACN (American Association of Colleges of Nursing)
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Stop AAPI Hate, Asian Pacific Policy & Planning Council, Chinese for Affirmative Action, and San Francisco State University Asian American Studies. http://www.asianpacificpolicyandplanningcouncil.org/wp-content/uploads/PRESS_ RELEASE_National-Report_August27_2020.pdf (accessed March 31, 2021)
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2016. Nurses' roles, knowledge and experience in national disaster preparedness and emergency response: A lit erature review. South Eastern European Journal of Public Health.
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2012. Nursing leadership in disaster preparedness and response. Annual Review of Nursing Research 30(1)
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National Center for Disaster Preparedness at Columbia University's Earth Institute, Research Brief 2016. https://academiccommons.columbia.edu/doi/10.7916/D84Q7TZN (ac cessed April 5, 2021)
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2019. American Academy of Nursing on policy position state ment: Disaster preparedness for older adults.
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. Disaster nursing and emergency preparedness for chemi cal, biological, and radiological terrorism and other hazards.
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https://www.who.int/surgery/challenges/esc_ disasters_emergencies/en (accessed March 31, 2021)
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