Author Archives: Roberta Lavin

Zika and Flint Water Public Health Emergencies: Disaster Training Tool Kits Relevant to Pregnant Women and Children

 2019 Jun 20. doi: 10.1097/JPN.0000000000000418. [Epub ahead of print]

Pregnant women and children and individuals suffering from chronic illness are disproportionally impacted by public health emergencies. To meet the healthcare needs of these populations, the nursing workforce must be capable of responding in a timely and appropriate manner. The goal of this project was to create interactive and engaging evidence-based educational tool kits to advance healthcare provider readiness in the management of population health in response to the Zika and Flint Water crises. A multipronged, mixed-methods approach was used to identify essential education needs and required core competencies. Data were synthesized from discussion with key informants, review of relevant documents, and surveys of schools of nursing, public health, and medicine. The ADDIE model was used to integrate results into the development of the online learning tool kits using the ThingLink software program. An innovative online educational program to prepare healthcare providers to rapidly identify, mitigate, and manage the impact of the Zika and Flint Water crises upon pregnant women and children was implemented by the Society for the Advancement of Disaster Nursing. Innovative online learning tool kits can advance healthcare provider readiness by increasing knowledge and understanding of key components of specific public health emergencies.

PMID: 31233449

 

DOI:  10.1097/JPN.0000000000000418

Disaster Nursing: From Theory to Practice

By: Cole Edmonson DNP, RN, FACHE, NEA-BC, FAAN

It’s been just over two and a half years that the SADN Practice workgroup has been meeting monthly under the guidance of the SADN organizational structure.  The Practice workgroup has included a consistent and engaged team of a dozen nurse colleagues, who have dedicated not only their time but their talents as well. Many of the members have experience responding to major disasters, teaching disaster education and are compelled to communicate their experience in ways that strengthen and support our national nursing workforce in preparedness, response, and prevention to various disasters.

As described by a collective group of disaster nursing experts (Veenema et.al 2016), the focus of the Practice workgroup is to achieve actionable steps towards the following recommendations:

Practice 1.1 Health care and related organizations support clinical nursing practice during disasters to reflect crisis standards of care and address common barriers to the willingness of nurses to respond to a disaster.

Practice 1.2 Establish a collective effort among nurse leaders to advance the practice of disaster nursing and public health emergency preparedness and response.

Practice members have delivered 7 presentations during the past two years for the national, county and local audiences on a range of topics that include; a disaster nursing call-to-action, personal preparedness, psychological resilience and the role of information technology in disaster preparedness. Six of our members were invited by the Emergency Nurses Association (ENA) to provide the evaluation for a mass casualty disaster drill during the 2017 ENA annual convention in St Louis, MO. We are currently working with the Girl Scouts to develop a disaster preparedness badge that could be integrated into the activities of the Girl Scout STEM camps and disseminated nationally. The promotion of personal preparedness serves as the cornerstone of most of our activities and we have identified the following website to use as a resource: https://dallascityhall.com/departments/officeemergencymanagement/Pages/Make-a-Plan.aspx

This past year we welcomed five new members: Including the transition of the chair position.

Cole Edmonson, D.N.P., R.N., FACHE, NEA-BC ( Chair ), June 2018

Chief Clinical Officer, AMN Healthcare

Kimberly K. Hatchel, DNP, MHA, RN, CENP, August 2018

Market CNO/Senior VP, Lexington One Health

Melinda Hirshouer, DNP, RN, MBA, MHSM, June 2018

Director of Inpatient Rehabilitation at Texas Health Presbyterian Hospital Dallas

Laurie G. Combe, MN, RN, NCSN

President-Elect, National Association of School Nurses

Nicole “Nikki” M. Ward, Maj, USAF, NC

HAF Junior Nurse Executive Fellow

Office of the Surgeon General

Medical Force Development (SG1/8AN)

We are honored to be part of the larger SADN group.  The work and success of each workgroup excite and motivates us to accomplish more.  We are all driven by a common purpose to assure nurses are prepared to competently and safely respond and lead in disaster scenarios.

 

Kimberly Hatchel

The experience of Kimberly Hatchel, Chief Nursing Officer

My name is Kimberly Hatchel and I was the Chief Nursing Officer at Sunrise Hospital and Medical Center – a Level II Trauma Center when the October 1st, 2017 Mass Casualty Incident – Active Shooter event occurred in Las Vegas. The event officially announced a little after 10pm, produced 24 hours full of actions aimed at saving human life.

At approximately 2225 the first private vehicle arrived at Sunrise carrying patients. This notation is significant as the number of patients shot in this event thrust those not injured into the immediate role of the first responder. Arrival patterns of patients were also uncertain as there was no ability to announce their arrival. At 2229 the first ambulance arrived carrying patients.  At 2300 the first patient was triaged to the ICU and by 2330 a code triage was called as the magnitude of the event was both being felt and understood. By 2359 five surgeries had been completed.

By 0112 over 100 physicians had responded and by 0200 over 200 nurses had responded. This number proved to be significant as the severity of patient injury required 1:1 nursing care of patients in the initial stabilization and transfer to surgery or ICU. By 0247 the Emergency Department had 228 patients in various stages of treatment in a 52-bed Emergency Department. By 0451 we had 167 patients discharged/transferred from the hospital. By 0545 the Clark County Corner arrived to clear the release of the non-surviving victims of the mass casualty shooting. By 1100 Emergency Department Operations had returned to normal. By midnight on 10/2 – 56 surgeries had been completed. There were 212 known victims treated and an additional 30 who elected not to remain and allow the more severely injured patients to be treated in the first few hours after the event.

The Level I trauma center had been put on diversion. This was the catalyst for the Level II to take twice as many patients.

 

Research Request from Nizar Said

Information for member nurses

RE: Psychological preparedness for disasters among nurses with disaster field experience (an Online Survey)

Dear Colleagues,

You are cordially invited to participate in a disaster preparedness study conducted by a PhD candidate, Mr. Nizar SAID, who is supervised by Associate Professor Dr Vico Chiang, and co-supervised by Professor Alex Molasiotis of the School of Nursing in The Hong Kong Polytechnic University.  The project has been approved by the Human Subjects Ethics Sub-committee (HSESC) of The Hong Kong Polytechnic University (HSESC Reference Number: HSEARS20190118001).

The disaster preparedness study has the purpose to investigate the outcomes of a psychological first aid (PFA) training programme, with the aim of this phase I as an online survey to 1) investigate psychological preparedness for disasters among nurses with disaster field experience, and 2) evaluate the extent of psychological preparedness of nurses with disaster filed experience in relation to self-efficacy, dispositional optimism, trait anxiety, and self-esteem.

The results obtained from this survey will be useful to inform the better structure of the PFA training for further study in the next phase. This study will involve completing a questionnaire, which will take you about twenty minutes to complete. The questionnaires contain five sections.

The study should not result in any undue discomfort. All information related to you will remain confidential and will be identifiable by codes only known to the researchers.

As a participant, you should have participation in at least one disaster relief work on-site or in the related clinical setting (e.g. hospital).

We would be very grateful if you may also further spread the online survey link for other nurses whom you know and have disaster filed experience to join the study.

In order to appreciate your participation in this survey, three free registrations for the upcoming Asia Pacific Emergency and Disaster Nursing Network (APEDNN ) conference in September 2019 at Hong Kong will be offered. If you would like to join this lucky draw, please provide your email address at the end of this survey.

The survey link: https://www.polyu.edu.hk/mysurvey/index.php/693374?lang=en

Sincerely Yours,

Mr. Nizar Said

MSN, BSN, RN

The NHDP-BC exam, a certification for disaster professionals

By Bonnie McIntosh, BSN, RN, CEN, NHDP-BC

The ANCC just made available a new certification for disaster professionals. It is called National Healthcare Disaster Professional by Certification or NHDP-BC. The cost when I took it was $290.  I noticed that the price stayed the same even though the ANCC website said the cost would go up by $100 starting in 2018.

To qualify to take the test you have to be one of ten healthcare professions with 3 years of disaster experience in the last 10 years. The other requirements include certificates from completing FEMA web-based classes (IS 100.b, 200.b, 700.a, 800.b), and participated in a MCI exercise.

Just like any other certification exam, it is at a testing center.  The test has 175 questions – 150 are scored and you need 70% to pass. The ANCC does not give you a score but I called and the test is worth ‘500’ and passing is ‘350’. It is a long test time – you have up to 3.5 hours to complete it. I was able to complete the test in 2 hours and not rush.

To prepare for the test I used a web-based company called Exam Edge which was the only one I could find with practice questions. Comparing the actual test with Exam Edge, I found the ANCC test was a lot less wordy and had more questions related to HAZMAT levels, PPE levels, triage of victim scenarios, etc. For anyone liking alphabet soup, a whole lot of acronyms are used.

When you pass the exam, you will receive a certificate to frame for your office, a card to carry in your wallet, and a cool coin. I would recommend the certifications to anyone in disaster management.

Emergency Management Training in Post-Acute Settings

by: Melinda Hirshouer

Hospital leaders must prepare for a variety of internal or external events that cause enough disruption to force normal operations into crisis mode.   If the employees designated to lead the hospital in its response to casualties, property damage, or suspending patient care are unprepared or make ineffective decisions, the crisis will quickly escalate to a disaster (Sternberg, 2003). In a 2008 study, Niska and Shimizu found that while greater than 95% of hospitals have emergency preparedness plans for chemical, biological, or natural disasters, only 73.37% of facilities were prepared for loss of utilities and 47.6% of hospitals were prepared to manage and shelter mobility impaired patients (Niska & Shimizu, 2011).  This is particularly important to post-acute areas as most of their patients would fit this description.

In the post-acute care setting, there is some reluctance by leaders to admit that these practice settings are also susceptible to the same types of crises as acute care hospitals. Post-acute care areas face additional challenges that come from having space, skill, and equipment to provide care for patients with physical and cognitive disabilities and having to contemplate a complex evacuation while maintaining their care or receiving patients from another unit or facility that may have been impacted. It is during these times of crisis, when the post-acute care staff members, including the nurses, look to their leaders for guidance and support.

As a part of my DNP program, I completed a scholarly project entitled Use of a Structured Emergency Management Training Protocol in a Post-Acute Care Setting.  The project intervention included providing a structured disaster training protocol specifically targeted to post-acute leaders.  The protocol included an introductory in-service, successful completion of four FEMA online training modules and participation in two tabletop exercises. The in-service was designed to expose leaders to emergency management in post-acute care areas and the brief tabletop exercises were developed to highlight specific post-acute care scenarios and set realistic expectations for the probability of an event occurrence.

The evidence-based practice project improved the number of post-acute leaders with emergency management training from 0%-92%.  Additionally there was an increase in the participants’ ability to retain knowledge from the training, with an increase of the mean number of questions correct (before the training was 9.5 compared to 16.3 after the training) which represented a statistically significant increase (p<0.001),   as well as an increase from 35% to 90% in the ability to complete critical tasks in the tabletop exercises.  Finally, there was a significant increase in the participants’ perception of their emergency management preparedness at the completion of the training with a mean level of readiness before the training of 2.4 compared to 8.2 after the training (p<0.001).  The project demonstrated that post-acute leaders were able to successfully complete emergency management training and apply the knowledge that they had learned.

Identifying that emergency management (EM) training is necessary is not enough to encourage completion.  The value of why this matters to me must be addressed in order to engage participants from the beginning.  Additionally, constructing the TTX so that there is a safe environment for the team to talk through the scenario and discuss solutions helps to reinforce a culture of learning and preparedness.  Current events that can be applied to TTXs and can be used to reinforce the importance of training also proved helpful.  Finally, as the FEMA modules ICS 700 and ICS 800 provided basic information on the structure of the ICS, the completion of these modules before ICS 100 and ICS 200 seemed to improve the participants’ understanding of the material that was being presented.  Leaders from acute care and post-acute care areas should be brought together for training and planning for any event whether natural or manmade, planned or unplanned that may cause a surge of patients into any area of the facility.

References

  • Niska, R. W., & Shimizu, I. (2011). Hospital preparedness for emergency response United States, 2008.  Hyattsville, MD: U.S. Dept. of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics.
  • Sternberg, E. (2003). Planning for Resilience in Hospital Internal Disaster. Prehospital and Disaster Medicine,18(4), 291-299. doi:10.1017/S1049023X00001230

Secondary Trauma: No Bruises Left Behind

By Elizabeth Fiegel DNP, MSN, RN NEA-BC

I know that when I inventoried nine full oxygen tanks just this morning they were all there in the rack.  I have looked everywhere and for the life of me, I cannot determine where three of the nine might have gone.  If there is not at least a full rack, we will simply not have enough to last throughout the night. These patients desperately need oxygen to survive.  Then I checked everywhere, and our supply of saline has also run critically short; we certainly had at least a full case just this morning, and will not be getting another delivery until after the hurricane has passed, maybe for many days.  We have an emergency room full of patients who might need this saline for their critical injuries.  What am I going to do?  I must report back to the incident command center and I am confident that the supplies were correctly inventoried, and ready for the storm just this morning.  Surely, I will be held to blame, I feel my heart racing, my mouth is dry and the sweat droplets are forming on my brow, the room is spinning. Oh no, I must sit down for just a moment; I am not sure… I just can’t hold back the tears and can’t do this anymore.  As I hold my face in my hands, in this very dark room, my pillow now stained with my tears, I suddenly realize that my husband is gently rousing me from my deep sleep and this terrible nightmare. Then, I recall that I was just reliving the hurricane preparations at my local hospital, where I had worked for seven twelve hour shifts in a row after volunteering at the emergency shelter.  It has been over two months since the hurricane, and I still cannot sleep through an entire night, and have had trouble focusing at work.  My husband is worried about me and I just don’t seem to find joy in anything right now.Fiegel photo-3.jpgFiegel-photo-2.jpg

This story is an example of secondary trauma suffered by a nurse who volunteered during a major hurricane.  She had been a nurse for over 35 years during some of the worst hurricanes ever to hit the gulf coast.  She was a seasoned nurse with a clinical background in emergency and trauma care.  She had seen some of the worst types of injuries and nothing seemed to faze her; she could tolerate blood and traumatic injuries with the best of them. Clinicians, however, are not immune to Secondary Trauma, which is defined as trauma-related stress reactions and symptoms resulting from exposure to another individual’s traumatic experiences, or the event itself (SAMHSA, 2014).  Secondary Traumatization is also referred to as compassion fatigue (Figley, 1995) and vicarious traumatization (Pearlman and Saakvitne, 1995).

As Hurricane Florence struck a heavy blow to the east coast this last month resulting in devastation and loss of life, I am reminded that healthcare workers respond to disasters often in a moment’s notice in the dark of night and leave their family and personal needs behind to care for others.  They put in long hours without sleep and work under grueling conditions, even neglecting their own health and safety at times.  The combination and interaction of systemic and traumatic stresses place nurses and others working in the health care field at an increased risk of suffering from serious negative stress effects in the areas of physical, emotional, cognitive, behavioral and interpersonal well-being (Rosh, 1996).  There are no bruises or scars in Secondary Trauma; the signs of Secondary Trauma are often missed in healthcare providers but demonstrate themselves as:

  • Fatigue
  • Sleep disturbances
  • Changes in appetite
  • Chronic muscle tension
  • Sexual dysfunction
  • Irritability
  • Fear of impending doom
  • Isolation
  • Replaying events in one’s mind over & over
  • Difficulty making decisions or problem-solving

According to The International Society of Traumatic Stress Studies (2018), there are effective strategies for preventing and reducing the effects of stress reactions, and preventing secondary traumatic stress in healthcare providers:

  • Eat nutritiously and regularly every day
  • Get adequate sleep each night at least 6-8 hours
  • Exercise regularly for at least 30-60 minutes each day
  • Be aware of your stress level; take precautions against exceeding your own limits, by practicing mindfulness, yoga or meditation
  • Acknowledge your reactions to stressful circumstances; allow yourself time to cope with these emotions, seek personal or group therapy
  • Take scheduled vacation or days off in between work shifts

Some organizations attempt to reduce the incidence of secondary trauma in healthcare workers by offering formalized post-event debriefings. Structured events allow for a review of readiness to response and evaluation of reactions to the events themselves.   Practice guidelines on debriefing formulated by the International Society for Traumatic Stress Studies (2018) conclude there is little evidence that debriefing prevents the effects of secondary trauma. The guidelines do recognize that debriefing is often well received and that it may help (1) facilitate the screening of those at risk, (2) disseminate education and referral information, and (3) improve organizational morale. However, the practice guidelines specify that if debriefing is employed, it should be conducted by experienced, well-trained practitioners, not be mandatory, utilize some clinical assessment of potential participants, and be accompanied by clear and objective evaluation procedures.   Currently, many mental-health workers consider some form of stress debriefing the standard of care following both natural (earthquakes) and human-caused (workplace shootings, bombings) stressful events  For individuals who demonstrate serious signs and symptoms of Post-Traumatic Stress Disorder, and/or harm to themselves or others, individual therapy and immediate crisis intervention may be needed (Dept. of Veterans Affairs, 2018).

Disaster response is often a well-coordinated event by healthcare workers and first responders, rending lifesaving aid to millions of others, providing hope to the hopeless, and compassion to the heartbroken; truly, this has been evident during and after Hurricane Florence, Katrina, and many other natural disasters. Understanding the etiology of Secondary Trauma, early recognition of signs and symptoms and strategies to avoid the negative impact of Secondary Trauma can result in healing for both the healthcare worker and those they aide.  While valuables, personal treasures, and homes can be lost, lives can be restored and healthcare workers and first responders play a unique and important role in recovery; providing for their health and wellness is essential in disaster management.

 

 

 

 

Crisis Standards of Care: Are You Familiar?

by: Denise M. Danna, RN, DNS, NEA, BC, CNE. FACHE

Due to such disasters as Hurricane Katrina, the tornado in Joplin, and various other
catastrophic events across the country and globe, the Department of Health and Human Services (HHS) requested that the Institute of Medicine (IOM) create a committee to develop standards of care during disasters. As citizens, we frequently experience how our health care system and the infrastructure of a community can be overwhelmed in such catastrophic disasters.

Several reports were generated from the IOM committee on Crisis Standards of Care (CSC). The first report in 2009, Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations developed a definition of crisis standards of care “as a substantial change in usual health care operations and the level of care it is possible to deliver, which is made necessary by a pervasive (e.g. pandemic influenza) or catastrophic (e.g. earthquake, hurricane) disaster. This change in the level of care delivered is justified by specific circumstances and is formally declared by a state government, in recognition that crisis operations will be in effect for a sustained period. The formal declaration that crisis standards of care are in operation enables specific legal/regulatory powers and protections for healthcare providers in the necessary tasks of allocating and using scarce medical resources and implementing alternate care facility operations” (IOM, 2009). The second report entitled, Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Response (IOM, 2012) developed CSC templates to assist and guide individuals and organizations in CSC planning and implementation (IOM, 2012). Some of the main reasons that CSC protocols are needed in catastrophic disasters are to ensure that critical resources are provided to those individuals who will benefit the most, conserve limited resources, and ensure that all individuals receive the same access to the best possible care.

Nurses play a vital part in participating in the development of CSC. I was asked to participate in an interdisciplinary task force charged with developing crisis standards of care protocol. My section was writing “Delivery of Care Guidelines for Essential Inpatient Nursing Care” (Louisiana Department of Health & Hospitals, 2011). In developing the essential inpatient nursing care guidelines, the ANA report, Adapting Standards of Care Under Extreme Conditions: Guidance for Professionals During Disasters, Pandemics, and Other Extreme Emergencies (2008) was referenced. This report identified critical standards for healthcare providers that should always be maintained during a disaster (e.g. worker and patient safety, maintaining airway and breathing, circulation, control blood loss, and infection control (ANA, p. 16). Standards of care that could be adapted under extreme conditions included such activities as routine care (e.g. vital signs for non-acute patients), extensive documentation of care, and elective procedures (ANA, p. 16).

It is recommended that each hospital develop its own recommendations for providing essential nursing care during a catastrophic disaster that mirrors the community’s in which they live (Murray, 2012). Nurses serve an important role in disasters. Nurses should familiarize themselves with CSC and work within their organizations and communities to develop and implement CSC. During times of disasters, scarce resources may occur and nurses need to know how standards of care may be adapted while still providing safe, ethical and quality nursing care (Murray, 2012).

References

ANA (2008). Adapting Standards of Care Under Extreme Conditions: Guidance for
Professionals During Disasters, Pandemics, and Other Extreme Emergencies. Retrieved
from: http://www.homecareprepare.com/files/AdaptingStandardsofCare.pdf

Institute of Medicine (2009). Report Brief. Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations: A Letter Report. Retrieved from:
https://www.phe.gov/coi/Documents/Guidance%20for%20Est%20CSC%20for%20Use%20in%20Disaster%20Situations%20A%20Letter%20Rpt.pdf

Institute of Medicine (2012). Crisis Standards of Care: A Systems Framework for Catastrophic Disaster Response. Retrieved from: http://www.nationalacademies.org/hmd/Reports/2012/Crisis-Standards-of-
Care-A-Systems-Framework-for-Catastrophic-Disaster-Response.aspx

Louisiana Department of Health & Hospitals. ESF-8 Health & Medical Section. State Hospital Crisis Standard of Care Guidelines in Disasters (Version 1.2 September 2011).Retrieved from:
https://www.phe.gov/coi/Documents/LA%20State%20Hospital%20CSC%20Guidelines%20in%20Disasters.pdf

Murray, J. (2012). Crisis Standards of Care: A framework for responding to catastrophic disasters. AJN, 112 (10), 61-63.

Are Mass Shootings A Disaster

by Cole Edmonson, DNP, RN, FACHE, NEA-BC, FAAN

Mass Shooting Events (MSE) are a public health crisis in America. “We are on track in this country to have more mass shootings this year than in 2017 (Gunviolence.org, 2018). That is clearly unacceptable. Although, it’s not about the numbers, it’s about people, and people are not statistics. The numbers speak to the ever-increasing plague of gun violence on individuals, families, communities, and our country. Thirty-four mass shootings (Gunviolence.org) in the first month-and-a-half alone of 2018”. Lack of effective gun control measures, mental health resources in this country along with extreme political views, extreme religious views, racism, hate are a deadly combination. Of course, these are not the only factors in the epidemic we are facing. If we can get upstream in this epidemic, perhaps we will need less reactive measures or even be able to prevent mass shootings.

2017 Gun Violence Statistics 

  • 61,507 Active Shooter Incidents
  • 15,592 Deaths
  • 3,996   Children / Teens killed or injured
  • 19 days in the year without a mass shooting.

Mass shootings represent a clear disaster event for public servants, the health care system and the nursing profession among many others. “Schnur makes several recommendations as a nurse researcher in her article ‘Is there a cure for gun violence’ for the nursing profession ultimately assisting in the prevention of mass shooting. https://www.nursingcenter.com/ncblog/january-2016/is-there-a-cure-for-gun-violence

  1. Increase access to mental health programs for individuals, families, and students from elementary school through college:
  2. Include a gun safety assessment as part of routine health screenings for all patients:4
  3. Several states continue to propose legislation to ban practitioners from documenting gun ownership in the patient’s record.
  4. Develop and implement Evidence-based Hospital Violence Intervention Programs focusing on:
  5. Improve Community engagement/outreach and education programs with initiatives targeting:
  6. Gather more data, conduct research and educate families on how to best protect themselves and their families from gun injuries”

“We can’t solve a wicked problem with naïve eclecticism. An epidemic of this proportion will take all sectors, public, private, non-profit and governmental, working together to solve this crisis. We, as nurses, some 3.9 million strong in the U.S., can be a powerful voice. Those with greater expertise will propose possible solutions including universal background checks, raising age limits, making bump stocks illegal, restricting certain types of guns from the general population, mandatory waiting periods, database reporting and many more.” We have the knowledge and wisdom to work from local, state, and national levels, from grassroots advocacy to legislative action. Prevention and mitigation should be our first priority along with preparedness, readiness, response, and recovery.

I can continue to applaud the bravery of those advocating for change, especially our youth – as small passionate groups of people can make a change, that can grow into a tsunami of moral virtue to do what is right!

References

Edmonson, Cole (2018) TONE Newsletter. Retrieved from http://www.naylornetwork.com/tne-nwl/articles/index-v2.aspaid=495235&issueID=58241

Gun Violence Archive (2018). Retrieved from http://gunviolencearchive.org/

Kodjak, A. (2018).What if we treated gun violence like a public health crisis. Retrieved from https://www.npr.org/sections/health-shots/2017/11/15/564384012/what-if-we-treated-gun-violence-like-a-public-health-crisis

Schnur, M. (2016). Retrieved from https://www.nursingcenter.com/ncblog/january-2016/is-there-a-cure-for-gun-violence

Hurricane Season—Are You Ready?

by: Lavonne Adams, PhD, RN, CCRN

How ready are you for a hurricane? Even if you don’t live along the coast, you are not immune to hurricane effects, since remnants of major storms can produce widespread damage from heavy rain, flooding, and tornadoes. Such conditions pose risks to health and safety, so prior preparation is crucial. As I write this entry, we are well into hurricane season, which runs June 1st to November 30th for the Atlantic, and May 15th to November 30th for the Pacific. If you haven’t already done so, consult https://www.nhc.noaa.gov/prepare/ready.php for many helpful recommendations and links so you can prepare your family, home, and vehicle before a storm and learn how to act in the event of a storm.

Highlights include:

  • Know if you live in an evacuation area.
  • Become familiar with National Weather System watches and warnings
  • Have a weather radio
  • Establish a communication plan in case your family isn’t together when hazardous weather strikes
  • Develop an emergency plan that includes your pets and includes locations away from home
  • Keep an emergency kit—including food and water—on hand in the event power goes out or roads are impassable
  • Check on elderly or disabled family and neighbors
  • Get your home ready for a storm. Be aware of what to do in case of power outages. Make sure you consider:
    • Clearing the yard of anything that could blow around and damage your home
    • Covering windows and doors
    • How to turn off your power
    • Filling clean containers with drinking water; filling bathtub and sinks for washing
    • Emergency charging options for devices like cell phones
    • Alternatives if home medical equipment uses electricity
  • Ensure your vehicle is travel-ready and has a full tank of gas
  • Keep an emergency kit in your car
  • Consider whether you need to shelter in place or evacuate
  • Be ready to leave; if you need to evacuate, follow instructions by local officials
  • Be careful while evacuating; watch for:
    • Flying debris
    • Broken objects
    • Downed power lines
    • Flooded roads
    • Tornadoes
  • Wait until the area is declared safe before you return home

The American Red Cross also has a useful Checklist for hurricane preparedness.

Lavonne Adams is an Associate Professor at TCU Harris College of  Nursing and Health Sciences

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