Integrating Disaster Preparedness and Response Training Into the BSN Curriculum

Nursing is the nation's largest health care profession, nurses possess a wealth of medical knowledge and communication skills, yet many don’t know how to care for a person outside their clinical environment. The American Nurse Association (ANA) considers disaster preparedness and response a part of nursing practice. In addition, the American Association of Colleges of Nursing (AACN) requires nursing baccalaureate programs to “assess the health, healthcare, and emergency preparedness needs of a defined population and use clinical judgment and decision ­making skills in appropriate, timely nursing care during a disaster, mass casualty, and other emergency situations”. Accepted competencies and gaps in education have contributed to the difficulty in recruiting nurses prepared to respond to a disaster and provide assistance in an effective manner effectively provide assistance to the World Health Organization (WHO) and International Council of Nurses (ICN). In the last few years, there has been an increasing number and severity of both natural and man-made disasters. The major categories of disasters include natural (earthquake, landslides, tsunami, and hurricanes), biological (epidemic disease, infestation of pests), technological (chemical, substance radiological agent, transport crashes), and societal (conflict, stampedes, acts of terrorism).

Existing literature regarding this issue is limited, with the majority of articles being evaluative in nature. The theoretical framework for the study was Bandura’s Theory of Self-Efficacy. The purpose of this study was to quantifiably determine if training increased the perceived self-efficacy of undergraduate nursing students regarding patient care in a disaster setting. Study participants were undergraduate nursing students at a university in Texas. The study design was a two-group, posttest experimental design, where participants were randomly assigned to either a control group, that did not receive training, or an experimental group, that received training. The 1.5 hour training session consisted of: an introduction to the Incident Command System, a review of the SALT triage algorithm, and demonstrations and participation regarding improvising litters, slings, bandages, tourniquets and splints. Study participants filled out a demographic questionnaire and a six item Likert-style survey based on the General Self-Efficacy survey. Twenty female nursing students, mean age of 20 years, participated in the study. Results found that specific training related to disaster response had a significant effect on the perceived self-efficacy of a group of undergraduate nursing students compared to a group of undergraduate nursing students who did not receive training. There was a large effect size associated with these results, with Hedge’s g=1.66. While this study produced quantifiable results, time constraints, study sample size and participation demographic were limitations.

Future studies replicating or associated with this topic would benefit faculty wishing to increase disaster nursing education in their colleges. Disaster training and simulation events are very expensive, and the school will need administrative support for it to be sustainable. Collaboration from the various disciplines/schools will be required to share experiences, knowledge, and resources. Interprofessional education is essential for a cohesive, collaborative response to support a community in a time of disaster. To fulfill ANA and AACN’s vision, we need student nurses trained in disaster preparedness. To prepare these future nurses we need faculty well-trained and versed in disaster preparedness, and the sustainability within the schools of nursing to support the faculty. This knowledge is currently available off the shelf via the Federal Emergency Management Agency (FEMA), Centers for Disease Control and Prevention (CDC), and Homeland Security as well as many private entities.