Nurs-fpx 4060 assessment 3 Disaster Recovery Plan

Nurs-fpx 4060 assessment 3 Disaster Recovery Plan

Slide 2

Disaster Plan and Recovery (Mobilize collaborative partners)

A disaster is considered anything out of the ordinary that happens and prevents access to key processes. Planning makes it possible to manage the entire life cycle of a potential disaster. Strategic and operational planning establishes priorities, identifies expected levels of performance and capability requirements, provides the standard for assessing capabilities, and helps stakeholders learn their roles (U.S. Homeland Security, 2020). A major component of a disaster plan is the recovery phase; recovery is defined as the activities that occur before, during, and after a disastrous event. Following a disaster, survival rates depend on healthcare facilities’ ability to provide care under duress and to handle a sudden influx of large numbers of victims. Much depends on the staff, supplies, equipment, structure, and systems that are required to treat a significant increase in patients seeking medical and nursing care (Veenema, 2016). The disaster recovery process is focused on restoring and revitalizing communities that have been impacted by the disaster, such as the train derailment disaster that affected the Villa Health community. Both planning and recovery are essential components for proper management and restoration of community disasters. After speaking with the Vila Health Hospital and community officials, it is clear their disaster recovery plan needs to be revised.

Slide 3

MAP-IT Framework

Adopted from the Health People 2020 initiative, the MAP-IT framework is used to plan and evaluate public health interventions such as disaster recovery. The framework outlines a path to success, mobilizes collaborative partners, assesses community needs, plans to lessen health disparities and improve access to services, implements a plan to reach healthy people 2020 objectives, and tracks community progress (“MAP-IT,” 2020). To achieve the first step in the framework, goals for recovery need to be established. As mentioned earlier, the Villa Health community was affected by a train derailment, and after speaking with the Vila Health hospital and community officials, gaps in their current disaster plan were identified. The first goal should be enhancing collaboration and communication with local emergency services. Collaboration with hospital personnel should include a new triage and treatment process. In addition, the promotion of community services, including rehabilitation to disabled and injured individuals. Collaborative partners will also include state and government officials and awareness of government policies, as the implications of the disaster will more than likely overwhelm the community’s resources.

Nurs-fpx 4060 assessment 3 Disaster Recovery Plan

Slide 4

Barriers that Impact Safety, Health, and Recovery Efforts (Assess community needs)

The range of personal, social, economic, and environmental factors that influence health status are known as determinants of health. Determinants of health fall under several broad categories: policymaking, social factors, health services, individual behavior, biology, and genetics. It is the interrelationships among these factors that determine individual and population health (Healthy People 2020, May 2020). Vulnerable populations include social groups with an increased relative risk or predisposition toward adverse health outcomes. Such as those in the Villa Health community; 204 residents are elderly with complex health conditions; 147 are physically disabled and/or use lip-reading or American Sign Language to communicate. According to (Reinhardt, 2011), studies show that persons with pre-existing disabilities are more likely to die in a natural disaster. Obstacles arise, such as impairments that affect one’s ability to escape a situation and their ability to recognize and communicate that a disaster is occurring.

Slide 5

The resources within VCRH’s health system greatly affect the care that can be delivered; both VCRH’s ambulances are aging and in need of an overhaul. Also, much of the hospital’s basic infrastructure and equipment is old and showing wear; the hospital has run at persistent deficits and has been unable to upgrade. According to the director of facilities, supplies are also in short supply, as they run out of essential resources during the disaster.

The city is in the midst of a financial crisis, with bankruptcy looming, and has instituted layoffs at the police and fire departments. Also, maybe look at downsizing nursing staff. Without funding and a proper budget, the hospital and emergency services cannot function effectively.

Slide 6

Disaster Recovery Plan (Plan to lessen health disparities and improve access to services) Medical Care Improvement

The disaster recovery process focuses on restoring, redeveloping, and revitalizing communities impacted by a disaster. This would include increasing the hospital and clinical care standards at which they function during a disaster. Medical care must promote the use of limited resources to benefit the population as a whole. As well as training medical professionals to shift their work pattern from general daily care to a model (emergency response system) that accommodates the sudden unanticipated surge in demand for health care. This model may force them to make very difficult legal, ethical, and moral decisions; examples include triaging. Who gets care first and who does not get care at all, allocating limited numbers of ventilators and deciding who has access to lifesaving medications. (Veenema, 2016). Ideally, these will include a centralized structure for control (incident command system), a framework for the allocation of scarce resources, and an effective adaptation of standards for crisis care. Despite the ethical strain that is imposed on the medical staff, the emergency response system implies a decrease in health disparities and is supported by the Department of Homeland Security; EOC = emergency operations center; NRP = National Response Plan. Source: (U.S. Department of Homeland Security)

Nurs-fpx 4060 assessment 3 Disaster Recovery Plan

Slide 7

Rehabilitation (implement a plan to reach healthy people 2020)

Lack of access, or limited access, to health services, greatly impacts an individual’s health status and recovery from disasters. Health-related rehabilitation potentially results in decreased morbidity due to disabling injuries sustained during a natural disaster and is, therefore, an essential component of the medical response plan within communities. Significant systematic challenges to the effective delivery of rehabilitation interventions during disasters include a lack of trained responders as well as a lack of medical recordkeeping, data collection, and established outcome measures (Reinhardt, 2011). Since a person’s functional needs require attention in the immediate living environment as well as in the greater community, a range of activities, including the provision of accessible and appropriate home care; housing; transportation; and educational, vocational, and social opportunities, is necessary. Based on the person’s unique medical needs, health-related rehabilitation is best delivered by a multi-disciplinary team. The Vila health community would benefit from officials working with federal funding agencies to identify a disaster relief plan with the aim of strengthening the rehabilitation perspective in response to natural disasters. These findings would support the employment of interdisciplinary health teams and rehabilitation services. The rehabilitation services would also support the goals addressed by Healthy People 2020, including attaining high-quality, longer lives free of preventable disease, disability, injury, and premature death; achieving health equity, eliminating disparities, and improving the health of all groups; creating social and physical environments that promote good health for all; and promote quality of life, healthy development (Healthy People, 2020).

Slide 8

Health and Governmental Policy Impact Disaster Recovery Efforts

The Centers for Medicare and Medicaid Services (CMS) offers funding designed to help healthcare organizations manage operations during and after a disastrous event. All healthcare facilities must comply with all applicable federal and state emergency preparedness requirements in order to participate in CMS programs and receive CMS funding. These regulations require healthcare facilities to develop specific emergency plans, communications, policies, and training that complies with both federal and state law and also ensure coordination of patient care across the continuum (Veenema, 2016). These findings may be beneficial in addressing the lack of supplies and resources the city is suffering from.

Health and Governmental Policy Impact Disaster Recovery Efforts cont.

 Slide 9

The Stafford Act, Disaster Relief and Emergency Assistance Act is the main source of authority for the Federal Emergency Management Agency’s (FEMA’s) disaster assistance programs. Under this act, the President is authorized to issue major disaster or emergency declarations, resulting in the distribution of wide-ranging federal aid to individuals and families, certain nonprofit organizations, and public agencies (Committee on Post-Disaster Recovery, 2015). If the governor of an affected state is slow in executing the state’s emergency response plan, the President may provide accelerated federal assistance where it is necessary to save lives or prevent severe damage. The Stafford Act covers major disasters and emergencies defined as any natural catastrophe or fire, flood, or explosion, regardless of cause, which is of sufficient severity to warrant assistance under the act to alleviate the damage, loss, or hardship caused by the event. Three types of assistance are authorized; individual assistance—which provides immediate direct and financial assistance to individuals for housing and other disaster-related needs; hazard mitigation—which provides grants to affected governments to implement long-term hazard mitigation measures after a major disaster declaration, public assistance—provides aid to eligible applicants seeking assistance with eligible costs for eligible work performed at eligible facilities (Committee on Post-Disaster Recovery, 2015).

Nurs-fpx 4060 assessment 3 Disaster Recovery Plan

Slide 10

Enhance Communication

The actions of first responders, including local fire, police, and emergency medical services (EMS), are driven by the procedures and protocols developed by those responding agencies. The Vila Health hospital workers identified an issue when communicating with local emergency services, lack of communication led to ineffective triage and waste of resources. It is imperative that all voluntary healthcare professionals learn the chain of command within their disaster response system. The chain of command is critical to making sure services and resources are utilized in a timely manner without duplication. The World Health Organization Regional Office has developed the hospital emergency response checklist to assist hospital administrators and emergency managers in responding effectively to the most likely disaster scenarios. The checklist includes clear and accurate internal and external communication guidelines and protocols for a safe environment for healthcare workers (WHO, 2020). Some examples of the guidelines include; briefing hospital staff on their roles and responsibilities within the incident action plan, ensuring that all communications to the public, and media, ensuring that all decisions related to patient prioritization, and more. The principles and recommendations included in this tool may be used in the Vila Health Hospital at any level for emergency preparedness.

Slide 11

Timeline (Track community progress)

To ensure the goals have been met, measurable actions should be taken. Communication should occur between federal funders and community officials, like the Hospital CFO and Facility director. These communications should provide an outline of coverage and limitations for the possible occurrence of future disasters. This would help to avoid confusion about the resources available and protect the community. The director of hospital operations would need to work with the CFO and director in organizing rehabilitation and interprofessional teams that would treat injured community members. This will also need the involvement of funders to ensure the community budget can support these efforts. Training and mock drills for healthcare workers should be designed and implemented ASAP. These drills would provide the staff with the knowledge and skill to properly communicate, triage, and utilize resources during a future disaster. The new skills would ultimately ensure the community is getting the help they need in an organized, well-functioning system. The hospital and leaders would implement the changes and a new disaster plan within three months. After the plan is implemented, they will hold annual meetings to address any new concerns and changes, keeping the leadership team up to-date and prepared.

Nurs-fpx 4060 assessment 3 Disaster Recovery Plan

Slide 11

Conclusion

Slide 12

Creating a revamped disaster plan will ensure the protection of the Villa Health community. A healthy relationship between the Villa Health community workers and leaders can be facilitated in an effort to improve recovery goals. An effective recovery plan utilizes government resources while addressing health disparities, the needs of the community, and communication barriers. Organized planning and implementation will result in a positive outcome for the community.

References

Committee on Post-Disaster Recovery of a Community’s Public Health, Medical, and Social Services; Board on Health Sciences Policy; Institute of Medicine. Healthy, Resilient, and Sustainable Communities After Disasters: Strategies, Opportunities, and Planning for Recovery. Washington (D.C.): National Academies Press (U.S.); 2015 Sep 10. A, The Federal Policy Environment Influencing Disaster Recovery. Available from: https://www.ncbi.nlm.nih.gov/books/NBK316538/

“Healthy People 2020|About DHDSP|DHDSP|CDC.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 13 Mar. 2014, www.cdc.gov/dhdsp/hp2020.htm.

“Hospital Emergency Response Checklist.” World Health Organization, World Health Organization, www.who.int/publications-detail/hospital-emergency-response-checklist.

MAP-IT: a guide to using Healthy People 2020 in your community. (2020). Retrieved from https://www.healthypeople.gov/2020/tools-and-resources/Program-Planning

“Natural Disaster Response and Recovery.” U.S. Department of the Interior, 4 Sept. 2018, www.doi.gov/recovery.

“Program Planning.” Program Planning | Healthy People 2020, www.healthypeople.gov/2020/tools-and-resources/Program-Planning.

Reinhardt, J. D., Li, J., Gosney, J., Rathore, F. A., Haig, A. J., Marx, M., DeLisa, J. A., & International Society of Physical and Rehabilitation Medicine’s Sub-Committee on Rehabilitation Disaster Relief (2011). Disability and health-related rehabilitation in international disaster relief. Global health action, 4, 7191. https://doi.org/10.3402/gha.v4i0.7191

Veenema, T. G. , Losinski, S. L. & Hilmi, L. M. (2016). Increasing Emergency Preparedness. AJN, American Journal of Nursing, 116(1), 49–53. doi: 10.1097/01.NAJ.0000476169.28424.0b.

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Develop a disaster recovery plan to lessen health disparities and improve access to community services after a disaster. Develop an oral presentation, 6 pages, for the Vila Health system, city officials, and the disaster relief team.