Diane Vines, R.N., Ph.D. and Lori Chorpenning, R.N., M.S.

1. Learning of Student Nurse Volunteers in Federal Disaster ExerciseUniversity of Portland Portland, Oregon Diane Vines, R.N., Ph.D. and Lori Chorpenning, R.N., M.S.

2. University of Portland • Established in 1901 • 3200 students • Teaching, Faith, Service • Faith-based institution

3. UP School of Nursing • Large undergraduate program • Graduate programs - Master’s entry program - Clinical Nurse Leaders Masters program - Doctorate of Nursing Practice program beginning Summer 2008

4. TOPOFF 4 Disaster Exercise • 15,000 participants • Scenario-Terrorists bring radioactive material into the U.S. • Guam, Portland and Phoenix

5. TOPOFF 4 Goals • Policy and strategic issues • Difficult decisions • Essential functions • Common operating picture

6. University of Portland Participation • The athletic center as site of 50 bed stabilization area (medical care point) • Student nurses, faculty, and staff volunteers

7. UP Participation

8. Importance of Disaster Preparedness • ACHNE White Paper on disaster preparedness • ANA White Paper • Essentials of Baccalaureate Nursing • Homeland Security training funds

9. Literature Review Disaster exercises • Stimulating training (Jasper et al, 2005) • Importance of simulation (Smith, 2007) • Multidisciplinary team in Israel (Waisman et al (2006) • Healthcare worker training in a rural community hospital drill (Vinson, 2007)

10. Literature Review Student nurse involvement in exercises • Physical injuries focus (Jennings-Sanders et al, 2005) • Clayton State University students increased confidence in caring for patients (Eichelberger & Odom, 2006)

11. Literature Review Provider reactions to disaster exercises • Communication (Behney et al, 2006) • Responders experienced stress reactions (Burkle, 1996) • Exercise reactions similar to actual disaster (Sanner & Wolcott, 1983)

12. Literature Review Curricular implications • Disaster preparedness -basic competency (Pattillo, 2003) • Competency for entry-level RN’s- International Coalition for Mass Casualty Education (INCMCE) now called National Emergency Preparedness Education Coalition (NEPEC)

13. Literature Review • No increase in teaching disaster preparedness (Weiner et al, 2005) • Lecture only (Weiner, 2005) • Barrier- time (Martin et al, 2006)

14. Study Design Survey instrument 1. Category 2. Role 3. Experience during drill 4. Feelings during drill 5. Problems or challenges 6. What worked well

15. Study Design Data Collection • After drill • Likert Scale • Debriefing

16. Study Design Data analysis • Quantitative and qualitative • Compared responses of victims and caregivers • Emotions experienced and suggestions for improvement

17. Findings – Demographics and Roles • 45 total participants • 32 served as victims • 13 served as caregivers

18. Nursing Student Responses: This will enhance my nursing student abilities

19. Nursing Student Responses: This will enhance my future skills as a practicing nurse

20. Preparation for Exercise Was the training sufficient: Was the info received sufficient: Prepared for real disaster:

21. Preparation for Exercise Experience felt realistic:

22. Preparation for Exercise • Would participate in future drills:

23. I was Anxious… • Caregivers • Victims

24. Emotions Experienced during drill

25. Suggestions for Improvement Role performance • Caregiver • Act more like victims • Wanted child victims • Severely affected victims • Wanted more preparation • Better definition of caregiver role

26. Suggestions for Improvement Curriculum improvement • More disaster preparedness • More preparation beforehand

27. Suggestions for Improvement Information • Underclassmen- more simulations • More information • Wanted handout

28. Suggestions for Improvement Operational • Too slow • Better clock placement • Better data collection • Better preparation on use of students

29. Discussion of Findings • Caregivers more negative in assessment of value of exercise • Anxiety for all • Not sufficiently realistic

30. Discussion of Findings • Encourage assertiveness • More preparation is needed • Agreement- participation in future drills

31. Need for Further Study • Simulation should be realistic • Students should participate more

32. Conclusions • Valuable learning experience • Suggestions shared

33. Questions ? • Diane Vines: vines@up.edu • Lori Chorpenning: chorpenn@up.edu

34. References • Behney, A., Briet, M., & Phillips, C. (2006). Pediatric Mass Casualty: Are You Ready. Journal of Emergency Medicine, 32(3), 241-245. • Burkle, F. (1996). Acute Phase Mental Health Consequences of Disasters: Implications for Triage and Emergency Medical Services. Annals of Emergency Medicine, 28(2), 119-128. • Eichelberger, L., & Odom, S. (2006). Disaster response: a clinical experience: students and faculty reflecting on Hurricane Katrina. American Journal of Nursing, 106(9), 72AAA-72DDD. • International Coalition For Mass Casualty Education. (2003, July). Educational competencies for registered nurses responding to mass casualty incidents. Retrieved November 27, 2007, from http://www.incmce.org/competenciespage.html

35. References • Jasper, E., Miller, M., Sweeney, B., Berg, D., Feuer, E., & Reganato, D. (2005). Preparedness of hospitalas to respond to a radiological terrorism event as assessed by a full-scale exercise. Journal of Public Health Management and Practice, 11(6), S11-S16. • Jennings-Sanders, A., Frisch, N., & Wing, S. (2005). Nursing students' perceptions about disaster nursing. Disaster Management and Response, 3(3), 80-85. • Martin, S., Bush, A., & Lynch, J. (2006). A National Survey of Terrorism Preparedness Training Among Pediatric, Family Practice, and EmergencyMedicine Programs. Pediatrics, 118 (3), 620-626. • Pattillo, M. M. (2003). Mass casualty disaster nursing course. Nurse Educator, 28(6), 271-275. • Sanner, P., & Wolcott, B. (1983). Stress Reactions among Participants in Mass Casualty Simulations. Annals of Emergency Medicine, 12(7), 426-428.

36. References • Smith, R. (2007). Making a Case for Integration of Disaster Preparedness Content in Associate Degree Nursing Programs. Thinking & Learning in Nursing, 2 (4), 100-104. • Vinson, E. (2007). Managing Bioterrorism Mass Casualties in an Emergency Department: Lesson Learned From a Rural Community Hospital Disaster Drill. Disaster Management and Response, 5 (1), 18-21 • Waisman, Y., Amir, L., Mor, M., Figenberg, Z., Aharonson, L., Peleg, K., et al. (2006). Prehospital Response & Field Triage in Pediatric Mass Casualty Incidents : The Israeli Experience. Clinical Pediatric Emergency Medicine, 7(1), 52-58. • Weiner, E. F. (2005). A national curriculum for nurses in emergency preparedness and response. Nursing Clinics of North America, 40, 469-479. • Weiner, E., Irwin, M., Trangenstein, P., & Gordon, J. (2005). Emergency preparedness curriculum in nursing schools in the United States. Nursing Education Perspectives, 26(6), 334-339.