Emergency Nurses and Disasters

Researchers: Karen Hammad, Paul Arbon, Kristine Gebbie, Alison Hutton

Nurses working in the emergency department play an important role in the healthcare response to disaster, yet very little is known about their experience. I am conducting a study about emergency nurses and disaster response. I would like to interview nurses who have worked in the emergency department during a response to an external disaster event about their experiences and understanding of disaster response. You will be asked to be involved in two interviews of approximately 60 minutes duration conducted via Skype.

If you would like to know more about this study or you would like to participate please don’t hesitate to contact me disaster.study@flinders.edu.au

Understanding and Identifying potential risks for young people at outdoor music fesitvals

Researchers: Alison Hutton, Jamie Ranse, Paul Arbon.

The aim of this research was to understand the nature of patient presentations at music festivals around Australia. This study used a minimum data set developed by Ranse and Hutton (2012) which used four main categories of presentation type.

These being illness, injury, environmental factors and mental health. Outdoor music festivals are unique events (Gleder and Robinson, 2009), and in the mass gathering literature are espoused to have a higher incident of patient presentations than other types of mass gathering (Milsten et al, 2003). Often single events are written up, which makes it difficult to generalize to other events, therefore the aim of this research is to discuss characteristics of patient presentations of 25 outdoor music festivals across four Australian states.

The project found that more than two thirds of those who present are women. In addition males were more likely to present with injuries and women were more likely to present with illness related symptons. The environmental data includes the ingestion of drugs and alcohol. This data set showed that patients that presented to onsite care with drug and alcohol related issues had the higher rate of being transferred to hospital.

The role of on-site care in hospital avoidance at mass gathering events

Researchers: Alison Hutton, Brett Aimers, Jamie Ranse, Paul Arbon.

It is generally accepted that mass gathering events have a heightened potential to produce a higher incidence of illness, injury and therefore a subsequent increase in demand for ambulance and hospital resources. The balance between planning for mass gathering health care and maintaining adequate community resources is an emerging issue for health agencies today (Gutman, Lund & Turris, 2007).

Currently, the body of literature that examines the provision of health care at mass gatherings is under developed and may not accurately reflect the impact of on site health agencies on ‘hospital avoidance ’. St John Ambulance Australia is well positioned to contribute to this subject by exploring its role in hospital avoidance when deployed to mass gatherings.

Therefore this project aims to identify the number of patients that would have ordinarily required hospital care who were provided with end-to-end care and discharged by St John Ambulance Australia. Secondly to determine the injuries and illnesses that would ordinarily require ambulance transport from a mass gathering to hospital.

World Youth Day patient presentation characteristics

Researchers: Paul Arbon, Jamie Ranse

This project aims to establish a databases of patient presentations and mass gathering event profiles across all events during the four days of World Youth Day in Sydney in 2008, to analyze quantitative data from the event and compare findings across the WYD events and with existing predictive modeling data to provide a more sophisticated understanding of the key factors that affect patient presentations at mass gatherings.

Understanding the willingness of emergency nurses to respond to a health care disaster

Researchers: Paul Arbon, Jamie Ranse, Lynette Cusack

Disaster response is an emergency nursing responsibility. However responding to disasters is becoming more hazardous as terrorism, pandemics and chemical industrial accidents challenge the safety of nurse responders and their families. International experience has shown that nurses can become victims of disasters and that fear of contaminating family and friends may prevent nurses from attending work or returning home during a disaster response.

This research contributes to disaster planning by providing insight into the factors that affect the willingness of Australian emergency nurses to respond to disasters. This research will facilitate disaster planning and policy development at national and health agency levels that better supports the personal needs of emergency nurses during disaster response.

Implications for nursing workforce of catastrophic fire rating days in rural South Australia

Researchers: Paul Arbon

This project explores whether or not there is an increase in the absentee rate of nurses from health services in rural South Australia, when a catastrophic fire rating day is declared and what the factors are that influence nursing staff absences on a catastrophic fire rating day.

In Australia, following the recent devastating Victorian bushfire disaster, a New Fire Weather Warnings were introduced in South Australia towards the end of 2009 and now refer to Fire Danger Ratings of Severe, Extreme and Catastrophic (Code Red). In November 2009 the Country Fire Service (CFS) and the Department of Education and Children’s Services in South Australia developed a policy for schools and pre‐school to be temporarily closed and school buses to be cancelled on days of declared 'catastrophic' bushfire weather conditions.

On these days the public are informed to implement their bushfire plan which may include evacuation of their home, and schools may be closed. Members of the community who are local Country Fire Service volunteers may be required to leave their jobs to standby at rural fire stations. The community is recommended not to travel on the roads in the regions where there is a catastrophic warning. This may affect the ability of services and businesses to remain open on these days.

The proposed research will inform, workforce planning in rural areas, and the contingencies that may be required for catastrophic fire rating days to enable health services to be adequately staffed. This research will assist by identifying what the pattern of work attendance is for health settings located in rural areas on catastrophic fire rating days compared to non‐catastrophic fire rating days and the issues which may influence workforce availability. This research will help to determine what issues and circumstances affect the availability of the nursing workforce and what strategies may mitigate against the impact of the new fire risk ratings on workforce availability.

Identification of the health care needs of homeless people during extreme weather events in South Australia

Researcher: Paul Arbon

Homelessness is a major cause of poor health. Exposure to extreme weather is one of the numerous risks faced by people who are homeless. Governments and non‐government agencies respond to these weather events in a variety of ways. This project seeks to identify health care needs of homeless people during extreme weather events, government and non‐government organizations providing services to these people and their response during extreme weather. On the basis of this analysis, recommendations will be made as to how organizations such as RDNS SA Inc. may respond.

Emergency Department impact and patient profile of H1Ni Infuenza 09 outbreak in Australia: A national survey

Researcher: Paul Arbon

This project responds to the urgent call for research to assess the impact of the 2009 outbreak of H1N1 influenza in Australia. The project surveys members of nursing and medical colleges and accident and emergency departments throughout Australia and provides a review of the nature of presentations, the effect on staffing and workload and the strategies adopted to effectively manage patients presenting to emergency departments.

Context‐aware mobile decision support systems for medical emergency management in mass gatherings

Researcher: Paul Arbon

This project contributes to gaining a clearer understanding of the nature and requirements of medical emergency during mass gathering events. We will build and test a mobile real‐time decision support tool for improving the efficiency of medical decisions to strengthen Australia’s ability to manage potential health‐related hazards. This project addresses the research priorities of promoting and maintaining good health. It capitalizes on smart information use and will be benefit to mass gathering emergency.

Exploring the disaster content of postgraduate emergency nursing programs in Australia

Researcher: Jamie Ranse, Paul Arbon, Ramon Shaban, Julie Considine, Belinda Mitchell, Shane Lenson

This research will describe and explore the disaster content of postgraduate emergency nursing courses as a means to better understand the disaster preparedness of emergency nurses.