Mass Gathering Health / Mass Gathering Medicine

Various publications and presentations relating to Mass Gathering and Major Event health

Bushfires

Various publications and presentations relating to Black Saturday and the 2009 Victorian Bushfires

Public Health Emergencies

Various publications and presentations relating to H1N1 2009 influenza outbreak and Salmonella outbreaks

In the media

Latest interviews and articles from the media

Invited Speaker

Various presentations given as an invited and keynote speaker.

23 May, 2016

Exploring international views on key concepts for mass gathering health through a Delphi process



ABSTRACT

Introduction: The science underpinning mass-gathering health (MGH) is developing rapidly. However, MGH terminology and concepts are not yet well defined or used consistently. These variations can complicate comparisons across settings. There is, therefore, a need to develop consensus and standardize concepts and data points to support the development of a robust MGH evidence-base for governments, event planners, responders, and researchers. This project explored the views and sought consensus of international MGH experts on previously published concepts around MGH to inform the development of a transnational minimum data set (MDS) with an accompanying data dictionary (DD).

Report: A two-round Delphi process was undertaken involving volunteers from the World Health Organization (WHO) Virtual Interdisciplinary Advisory Group (VIAG) on Mass Gatherings (MGs) and the MG section of the World Association for Disaster and Emergency Medicine (WADEM). The first online survey tested agreement on six key concepts: (1) using the term “MG HEALTH;” (2) purposes of the proposed MDS and DD; (3) event phases; (4) two MG population models; (5) a MGH conceptual diagram; and (6) a data matrix for organizing MGH data elements. Consensus was defined as ≥80% agreement. Round 2 presented five refined MGH principles based on Round 1 input that was analyzed using descriptive statistics and content analysis. Thirty-eight participants started Round 1 with 36 completing the survey and 24 (65% of 36) completing Round 2. Agreement was reached on: the term “MGH” (n = 35/38; 92%); the stated purposes for the MDS (n = 38/38; 100%); the two MG population models (n = 31/36; 86% and n = 30/36; 83%, respectively); and the event phases (n = 34/36; 94%). Consensus was not achieved on the overall conceptual MGH diagram (n = 25/37; 67%) and the proposed matrix to organize data elements (n = 28/37; 77%). In Round 2, agreement was reached on all the proposed principles and revisions, except on the MGH diagram (n = 18/24; 75%).

Discussion/Conclusions: Event health stakeholders require sound data upon which to build a robust MGH evidence-base. The move towards standardization of data points and/ or reporting items of interest will strengthen the development of such an evidence-base from which governments, researchers, clinicians, and event planners could benefit. There is substantial agreement on some broad concepts underlying MGH amongst an international group of MG experts. Refinement is needed regarding an overall conceptual diagram and proposed matrix for organizing data elements.



Steenkamp M, Hutton A, Ranse J, Arbon P, Lund A, Turris S, Bowles R. (2016). Exploring international views on key concepts for mass gathering health through a Delphi process. Prehospital Disaster Medicine.





14 March, 2016

International consensus on key concepts and data definitions for mass gathering health: Process and progress


Free full-text article is available here (PDF)

ABSTRACT
Mass gatherings (MGs) occur worldwide on any given day, yet mass-gathering health (MGH) is a relatively new field of scientific inquiry. As the science underpinning, the study of MGH continues to develop, there will be increasing opportunities to improve health and safety of those attending events. The emerging body of MG literature demonstrates considerable variation in the collection and reporting of data. This complicates comparison across settings and limits the value and utility of these reported data. Standardization of data points and/or reporting in relation to events would aid in creating a robust evidence base from which governments, researchers, clinicians, and event planners could benefit.Moving towards international consensus on any topic is a complex undertaking. This report describes a collaborative initiative to develop consensus on key concepts and data definitions for a MGH “Minimum Data Set.” This report makes transparent the process undertaken, demonstrates a pragmatic way of managing international collaboration, and proposes a number of steps for progressing international consensus. The process included correspondence through a journal, face-to-face meetings at a conference, then a four-day working meeting; virtual meetings over a two-year period supported by online project management tools; consultation with an international group of MGH researchers via an online Delphi process; and a workshop delivered at the 19thWorld Congress on Disaster and Emergency Medicine held in Cape Town, South Africa in April 2015. This resulted in an agreement by workshop participants that there is a need for international consensus on key concepts and data definitions.


Turris S, Steenkamp M, Lund A, Hutton A, Ranse J, Bowles R, Aruthnott K, Anikeeva O, Arbon P. (2016). International consensus on key concepts and data definitions for mass gathering health: Process and progress. Prehospital Disaster Medicine. 31(2):1-4.

17 November, 2015

Impact of a pilot pathway for the management of gastroenteritis-like symptoms in an emergency department: A case study following a Salmonella outbreak



Free full-text article is available here (PDF)


ABSTRACT

Objective: This research aims to describe the effect of standard care (control) versus a clinical management pathway (intervention) on patient length of stay and admission rates during a public health emergency at one Australian Emergency Department.

Method: A retrospective audit of hospital records for patients who presented in May 2013 with gastroenteritis-like symptoms was undertaken following a surge in patient presentations from a Salmonella outbreak. Patients who presented with gastroenteritis-like symptoms between 15th and 19th May 2013 received care according to a clinical management pathway (intervention). The focus of the intervention was based on symptom management, including a standardised approach to analgesia, anti-emetics and rehydration. Patient characteristics, such as age and gender are described using descriptive statistics. A Mann-Whitney test was used to compare continuous data and a Fisher exact test was used to compare categorical data, between the two groups.

Results: Over an eight-day period, 110 patients presented with gastroenteritis-like symptoms. The median length of stay was statistically different between the two groups (P< 0.001). More patients were admitted to hospital from the control group (n = 5) when compared with the intervention group (n = 0); however, given the small number of patients in these groups, inferential statistical analysis was not a reasonable consideration.

Conclusion: The length of stay for patients between the two groups was statistically different, suggesting that the implementation of a clinical management pathway for patients with gastroenteritis-like symptoms reduced the ED length of stay. This finding is useful in future planning for similar public health emergency responses and/or for use when patients present with gastroenteritis-like symptoms on a daily basis.



Ranse J, Luther M, Ranse K. (2015). Impact of a pilot pathway for the management of gastroenteritis-like symptoms in an emergency department: A case study following a Salmonella outbreak. Emergency Medicine Australasia. [in-press].

29 September, 2015

A stethoscope, a patient and me



The anecdote in this manuscript is taken directly from my thesis. The anecdote provides insight into the phenomenological natural attitude of the stethoscope and what it may be like to experience a stethoscope as a nurse or as a patient.


Ranse J. (2015). A stethoscope, a patient and me. Journal of Advanced Nursing Interactive. [http://journalofadvancednursing.blogspot.com.au/2015/09/the-stethoscope-patient-and-me.html]

15 September, 2015

Pandemics and environmental emergencies



This chapter has a primary focus on environmental emergencies, such as heat-related emergencies, cold-related emergencies, drowning, and atmospheric-pressure-related emergencies. Each section within this chapter provides a good overview of anatomy, physiology, patient assessment and interventions, with an emphasis on both the pre-hospital and in-hospital care of the patient.

 My contribution to this chapter was particularly in the areas of

  • Pandemics, and 
  • Mass gathering health 


 The pandemic section highlights the historical background to pandemics. However, much of this section focuses on the challenges for health professionals, drawing on recent literature and examples from H1N1 2009 influenza. Mass gathering health presents unique challenges for the health system and health professionals. This section of the chapter highlights these challenges. Additionally, this section outlines the characteristics of mass gatherings that influence the demand for health services (such as temperature, crowd mood, venue type). In particular, this section outlines the public health considerations for mass gatherings.


Mateer J, Cusack L, Ranse J. (2015). Chapter 28: Pandemics and environmental emergencies in Curtis K, Ramsden C (eds). Emergency and trauma care: For nurses and paramedics 2nd ed. Elsevier Australia.

23 July, 2015

Planning Healthcare for a Mass Gathering

 

I had a conversation with Craig Hooper from Operational Health about mass gathering health. To listen to the podcast, visit http://www.operationalhealth.com/#!204-planning-mass-gathering-healthcare/c1srl


The following is taken directly from the Operational Health website.

----START----
Craig chats with Assistant Professor Jamie Ranse about the clinical and operational planning that sits behind mass gatherings. Using World Youth Day 2008 as a case study, Jamie discusses the need to engage a cross section of health and healthcare providers. International perspectives are also discussed with the underlying messaging being that progress toward improved health planning at mass gathers relies on shared definitions and data points and moving away from purely descriptive journal articles to articles.

About my guest:
Assistant Professor Jamie Ranse of the University of Canberra has a keen professional and personal interest in the area of disaster and mass gathering health. He is currently undertaking a PhD exploring the experience of nurses who participate in disasters. He is an Associate Editor for the Australasian Emergency Nursing Journal, holding the disaster portfolio and peer-reviews a number of national and international journals relating to disaster and primary health care. Jamie remains engaged in the clinical setting as a casual RN at the Emergency Department of Calvary Health Care ACT.

About the Podcast Host:
Craig is a health and emergency service management specialist with more than 30 years experience in operational management, emergency planning, health service delivery and service redevelopment. More information can be found at www.cahooper.com

Academic Publications
Jamie Ranse has a large number of publications and presentations relating to Mass Gathering and Major Event health on his website, www.jamieranse.com Some of those discussed on this episode include;

Data Sets
  • Ranse J, Hutton A. (2012). Minimum data set for mass gathering health research and evaluation: A discussion paper. Prehospital and Disaster Medicine. 27(6):1-8. doi:10.1017/S1049023X12001288 (Direct Link)
  • Ranse J, Hutton A. (2013). Minimum data set for mass-gatherings health research and evaluation: The beginning of an international dialogue. Prehospital and Disaster Medicine. [author reply]. 28(2):3 (Direct Link)
  • Lund A, Turris S, Bowles R, Gutman S, Hutton A, Ranse J, Arbon P. (2013). Progressing towards an international consensus on data modelling for mass gathering and mass participation events; paper presented at the 18th World Congress on Disaster and Emergency Medicine, Manchester, UK, May. (Direct Link)
Hutton A*, Ranse J, Arbon P. (2012). Understanding and identifying potential risks for participants at music festivals; paper presented at the St John Ambulance Australia Member Convention, Sydney, New South Wales, Australia, 19th May. (Direct link)

Hutton A, Ranse J, Verdonk N, Ullah S, Arbon P. Understanding the characteristics of patient presentations of young people at outdoor music festivals. Prehospital Disaster Medicine. 2014;29(2):1-7. (Direct Link)

Ranse J, Arbon P. Evaluating the influential factors in mass gathering casualty presentation characteristics – World Youth Day, Sydney, Australia, 2008; paper presented at the 7th International Conference for Emergency Nurses, Gold Coast, Australia, 8th October 2009. (Direct link)

----FINISH-----

Ranse J (Interviewee), Hooper C (Producer). (2015). Mass gathering health; audio podcast for Operational Health, 23rd July. Series 2, Episode 4. Retrieved from http://www.operationalhealth.com/#!204-planning-mass-gathering-healthcare/c1srl

21 June, 2015

Leadership opportunities for Mental Health Nurses in the field of disaster preparation, response, and recovery.


Free full-text article is available here (PDF)


ABSTRACT

Disasters occur internationally and are nondiscriminatory. The loss resulting from the destruction associated with disasters leads to the development of various levels of psychological trauma in survivors. Health teams provide assistance to survivors before, during and after disasters, and mental health nurses make an important contribution to these teams. However, the leadership role of mental health nurses in disaster situations has not been extensively explored in the literature. This article discusses aspects of mental health nursing leadership in preparation for, response to and recovery from disasters. In particular, recommendations are made to enhance the leadership of mental health nurses in the context of disasters.



Ranse J, Hutton A, Wilson R, Usher K. (2015). Leadership opportunities for Mental Health Nurses in the field of disaster preparation, response and recovery. Issues in Mental Health Nursing.36(5):391-394.

03 June, 2015

The realities of assisting in a disaster: An Australian perspective



I presented on the topic of disaster health, with a particular focus on an Australian perspective, to students and faculty staff of the University of Santo Tomas, Philippines.

The focus of this presentation included:

  • Disaster health arrangements,
  • Willingness of nurses to assist in a disaster,
  • Educational preparedness of nurses,
  • Role of nurses in a disaster,
  • Leadership and teamwork,
  • Hospital surge capacity,
  • Disaster triage,
  • Nursing student role in a disaster, and
  • Future research priorities 


Ranse J. (2015). The realities of assisting in a disaster: An Australian perspective; presentation to Student and Faculty staff of the University of Santo Tomas, Philippines, Canberra, ACT, 3rd June.





11 May, 2015

Disaster health: what emergency nursing students need to know




I was invited by the Canberra Emergency Nursing Student Society to discuss aspects of disaster health, particularly as it relates the the realities of nursing in a disaster and the role of student nurses.

This presentation discussed research related to:

  • Willingness,
  • Education,
  • Nursing roles,
  • Leadership and teamwork,
  • Hospital surge capacity,
  • Triage,
  • Disaster tourism, and
  • Future research priorities.




Ranse J. (2015). Disaster health: what emergency nursing students need to know; presentation to Canberra Emergency Nursing Student Society, Canberra, ACT, 12th May.

27 February, 2015

The use of Haddon’s matrix to plan for injury and illness prevention at Outdoor Music Festivals


Free full-text article is available here (PDF)


ABSTRACT

Introduction: Mass-gathering music events, such as outdoor music festivals (OMFs), increase the risk of injuries and illnesses among attendees. This increased risk is associated with access to alcohol and other drugs by young people and an environment that places many people in close contact with each other.

Aim: The purpose of this report was to demonstrate how Haddon’s matrix was used to examine the factors that contributed to injuries and illnesses that occurred at 26 OMFs using data from the Ranse and Hutton’s minimum data set.

Methods: To help understand the kinds of injuries and illnesses experienced, Hutton et al identified previous patterns of patient presentations at 26 OMFs in Australia. To develop effective prevention strategies, the next logical step was to examine the risk factors associated with each illness/injury event. The Haddon matrix allows event practitioners to formulate anticipatory planning for celebratory-type events.

Results: What was evident from this work was that the host, the agent, and the physical and social environments contributed to the development of injuries and illness at an event. The physical environment could be controlled, to a certain extent, through event design, safety guidelines, and legislation. However, balancing cultural norms, such as the importance placed on celebratory events, with the social environment is more difficult.

Discussion: The use of the Haddon matrix demonstrates that interventions need to be targeted at all stages of the event, particularly both pre-event and during the event. The opportunity to promote health is lost by the time of post event. The matrix provided vital information on what factors may contribute to injury at OMFs; form this information, event planners can strategize possible interventions.


COMMENTS:

The publication of this work has generated international interest in applying the Haddon's matrix to other mass gathering events, such as the Hajj.



Hutton A, Savage C, Ranse J, Finnell D, Kub J. (2015). The use of Haddon’s matrix to plan for injury and illness prevention at Outdoor Music Festivals. Prehospital Disaster Medicine.

31 January, 2015

Patient presentations and health service impact: A case study from a mass gathering.




This is a preliminary report relating to research undertaken with an aim to enhance the understanding of the health service requirements at an outdoor music festival by describing the health service usage in one Australian jurisdiction. In particular, this research aims to describe the patient characteristics for the following patient populations:

  1. Those patients who presented for onsite care at the event, provided by St John Ambulance Australia (ACT), 
  2. Those patients whose care was escalated to onsite doctors, nurses and paramedics volunteering at the event with St John Ambulance Australia (ACT), 
  3. Those patients whose care was escalated to the care of ACT Ambulance Service, and 
  4. Those patients who had care provided at either the Canberra Hospital or Calvary Hospital in the ACT.

Ranse, J., Lenson, S., Keene, T., Luther, M., Burke, B., Hutton, A., & Jones, N. 2015.Patient presentations and health service impact: A case study from a mass gathering.[Report]


31 December, 2014

Mass-gathering health research foundational theory: Part 1 - Population models for mass gatherings


Free full-text article is available here (PDF)

ABSTRACT
Background: The science underpinning the study of mass-gathering health (MGH) is developing rapidly. Current knowledge fails to adequately inform the understanding of the science of mass gatherings (MGs) because of the lack of theory development and adequate conceptual analysis. Defining populations of interest in the context of MGs is required to permit meaningful comparison and meta-analysis between events.

Process: A critique of existing definitions and descriptions of MGs was undertaken. Analyzing gaps in current knowledge, the authors sought to delineate the populations affected by MGs, employing a consensus approach to formulating a population model. The proposed conceptual model evolved through face-to-face group meetings, structured breakout sessions, asynchronous collaboration, and virtual international meetings.

Findings and Interpretation: Reporting on the incidence of health conditions at specific MGs, and comparing those rates between and across events, requires a common understanding of the denominators, or the total populations in question. There are many, nested populations to consider within a MG, such as the population of patients, the population of medical services providers, the population of attendees/audience/participants, the crew, contractors, staff, and volunteers, as well as the population of the host community affected by, but not necessarily attending, the event. A pictorial representation of a basic population model was generated, followed by a more complex representation, capturing a global-health perspective, as well as academically- and operationally-relevant divisions in MG populations.

Conclusions: Consistent definitions of MG populations will support more rigorous data collection. This, in turn, will support meta-analysis and pooling of data sources internationally, creating a foundation for risk assessment as well as illness and injury prediction modeling. Ultimately, more rigorous data collection will support methodology for evaluating health promotion, harm reduction, and clinical-response interventions at MGs. Delineating MG populations progresses the current body of knowledge of MGs and informs the understanding of the full scope of their health effects.



Lund A, Turris S, Bowles R, Steenkamp M, Hutton A, Ranse J, Arbon P. (2014). Mass gathering health research foundational theory: Part 1 Population models for mass gatherings. Prehospital Disaster Medicine. 29(6):648-654

Mass-gathering health research foundational theory: Part 2 - Event modelling for mass gatherings.


ABSTRACT 
Background: Current knowledge about mass-gathering health (MGH) fails to adequately inform the understanding of mass gatherings (MGs) because of a relative lack of theory development and adequate conceptual analysis. This report describes the development of a series of event lenses that serve as a beginning ‘‘MG event model,’’ complimenting the ‘‘MG population model’’ reported elsewhere.

Methods: Existing descriptions of ‘‘MGs’’ were considered. Analyzing gaps in current knowledge, the authors sought to delineate the population of events being reported. Employing a consensus approach, the authors strove to capture the diversity, range, and scope of MG events, identifying common variables that might assist researchers in determining when events are similar and might be compared. Through face-to-face group meetings, structured breakout sessions, asynchronous collaboration, and virtual international meetings, a conceptual approach to classifying and describing events evolved in an iterative fashion.

Findings: Embedded within existing literature are a variety of approaches to event classification and description. Arising from these approaches, the authors discuss the interplay between event demographics, event dynamics, and event design. Specifically, the report details current understandings about event types, geography, scale, temporarily, crowd dynamics, medical support, protective factors, and special hazards. A series of tables are presented to model the different analytic lenses that might be employed in understanding the context of MG events.

Interpretation: The development of an event model addresses a gap in the current body of knowledge vis a vis understanding and reporting the full scope of the health effects related to MGs. Consistent use of a consensus-based event model will support more rigorous data collection. This in turn will support meta-analysis, create a foundation for risk assessment, allow for the pooling of data for illness and injury prediction, and support methodology for evaluating health promotion, harm reduction, and clinical response interventions at MGs.


Turris S, Lund A, Hutton A, Bowles R, Ellerson E, Steenkamp M, Ranse J, Arbon P. (2014). Mass gathering health research foundational theory: Part 2 Event modelling for mass gatherings. Prehospital Disaster Medicine. 29(6):655-663.

14 December, 2014

Review: The mental health imaginary vis-a`-vis its nurses and Australian environs: an essay


Free full-text article is available here (PDF)

I was invited to provide a review and response to a manuscript that was published in the 'Nursing in Crisis' special issue of the Journal of Research in Nursing. This manuscript is reviewed was:

Nicholls, D. (2014). The mental health imaginary vis-à-vis its nurses and Australian environs: an essay Journal of Research in Nursing. 19:580-589.

The work reviewed takes a unique exploration of the future of mental health nursing in the Australian environs. To do this, the author work presents an historical account of what it may have been like to be a mental health nurse in Australian in the late 1900s. This account is a philosophical view that does not necessarily aim to resolve an issue, build a theory or seek agreement, but instead is a philosophical work taking shape from the author’s lifeworld.

My review discusses the progress, challenges and complexities of the mental health context, highlighting that they are not of uniqueness or of singularity to mental health nursing. Instead, aspects of the author’s lifeworld and the mental health imaginary vis-a`-vis its nurses and Australian environs has a broader application to the discussion of changes over time related to nursing and its natural attitude, education, and culture.

Ranse, J. (2014). Review: The mental health imaginary vis-à-vis its nurses and Australian environs: An essay. Journal of Research in Nursing. 19(7-8):590-591.

09 October, 2014

Understanding the effect of clinician dependent versus evidence-based pathway for the management of Salmonella-like symptoms in an emergency department.


ABSTRACT
Introduction: On Monday the 13th of May 2013, a surge in patients with vomiting and diarrhoea presented to an Emergency Department (ED) in Canberra. Contract tracing identified a focal point between patients, and pathology samples identified Salmonella as the responsible agent. On the following Wednesday, upon a hospital based disaster being declared, a just-in-time evidence-based pathway was introduced to ensure consistency in patient management. This research aims to describe the effect of this pathway (intervention) versus clinician dependent (control) management of such patients.

Method: This research was retrospective in design. The sample includes 110 patients who presented in May 2013 to one ED, with Salmonella-like symptoms. Data was collected from the Emergency Department Information System. Patient characteristics, such as age and gender are described using descriptive statistics. A Mann-Whitney test was used to compare continuous data and a Fisher exact test was used to compare categorical data, between the two groups. This research has ethics approval from the health care facility.

Results: Over an eight day period, 110 patients presented with salmonella-like symptoms. Of these, 47 were male and 63 were female, with a median age of 30 years (IQR: 20-42). Both age (p=0.65) and gender (p=0.84) were statistically similar between the two groups. Overall, the mean length of stay in minutes (±SD) was 735 (1112). However, the mean length of stay in minutes was statistically different between the two groups, with the control being 975 (1280) and the intervention being 230 (251) (p=0.0001).

Discussion: The length of stay for patients between the two groups was statistically significantly different, suggesting that the implementation of a just-in-time evidence-based pathway for the management of patients with Salmonella-like symptoms reduced the ED length of stay. This finding is useful in that it may assist in the future planning of similar public health emergencies or for use when patients present with Salmonella-like symptoms on a daily basis.






Ranse J, Luther M, Ranse K. (2014). Understanding the effect of clinician dependent versus evidence-based pathway for the management of Salmonella-like symptoms in an emergency department; paper presented at the 12th International Conference for Emergency Nurses, Perth, Australia, 9th October.






Patient presentations to onsite health providers, ambulance paramedics and hospital emergency departments from a mass gathering: a case study.



ABSTRACT:

Introduction: Health providers at mass gatherings aim to minimise the disruption to the health services of the surrounding community. The mass gathering literature focuses on patients presenting to onsite care providers at events, and scantly reports on patients presenting to prehospital care providers (ambulance paramedics) and hospital emergency departments (EDs). In 2012, an outdoor music festival with approximately 20,000 participants was held in Canberra. The festival had one first aid post, and a medical assistance team staffed by doctors, nurses and paramedics. This research describes the characteristics of patients and health service usage from this event.

Method: Data was collected retrospectively from the event onsite care provider (St John Ambulance Australia) patient records. These records were linked to both prehospital (ACT Ambulance Service) and hospital EDs (Canberra Hospital and Calvary Health Care ACT) patient records. A preexisting minimum data set was used to code patient characteristics. Data analysis included descriptive statistics, such as frequencies and means of central tendency.

Results: In total, 197 (9.86/1,000) patients presented for clinical assessment and/or management at the event. Two patients who required hospitalisation bypassed the onsite care providers and were transferred directly via the ambulance service to hospital. The onsite medical assistance team managed 22 patients (1.1/1,000), of whom two were referred to police, five transported to hospital and 15 discharged to the event. In total, seven patients were transported to hospital by ambulance (0.35/1,000). Hospital presentation rate and patient characteristics are currently being determined at the time of this abstract submission.

Discussion: This is the first research to describe patient presentations to onsite care providers, prehospital and hospitals from a mass gathering. This research provides insight into the health service usage associated with mass gathering. Strategies to minimising the disruption to the prehospital and hospital health services of the surrounding community will be discussed.





Ranse J, Lenson S, Keene T, Luther M, Burke B, Hutton A. Patient presentations to onsite health providers, ambulance paramedics and hospital emergency departments from a mass gathering: a case study. 12th International Conference for Emergency Nurses.



02 October, 2014

Drugs, pills top emergency list for evacuation too


I was interviewed by Natasha Body from the Canberra Times. The interview focused on the health preparedness of the community in a disaster.

The full text article is available here

This article was among the most read articles for the day across Australia as demonstrated below:


26 September, 2014

Canberra's hospitals ability to cope in a disaster

I was interviewed by Mark Parton on 1206AM Canberra 2CC regarding the ability of Canberra's health system to cope if a disaster or mass casualty incident was to occur in the region.

The interview was initiated on the background of a number of reports in The Canberra Times relating to the overcapacity of Canberra's hospitals, and in particular the Emergency Departments:
My interview highlighted that the health system in Canberra had coped in the past with major incidents. Additionally, I discussed the educational preparedness of nurses and the ability of the health systems to adapt based on previous events. For example, the establishment of influenza assessment clinics as adjunct to the emergency departments in communicable diseases such as H1N109 Influenza.

My interview is below:







19 September, 2014

Patient presentations to onsite health providers, ambulance paramedics and hospital emergency departments from a mass gathering: a case study





ABSTRACT:
Background:
A number of challenges exist in providing adequate health care at a mass gathering. Health providers aim to maximise their efficiency in responding to health emergencies within the mass gathering environment, whilst minimising potential impact of surge presentations to the health service in the surrounding community or region. The mass gathering literature commonly reports on the onsite care from single events, and does not consider the effect on prehospital or hospital services.

Aim:
This research aims to enhance our understanding of the health service requirements of an outdoor music festival.

Methods:
Design: Retrospective review of patient report forms from onsite health services at outdoor music festival.
Setting: One outdoor music festival in 2012 in the Australian Capital Territory with approximately 20,000 participants. The festival had one first aid post and a health team staffed by doctors, nurses and paramedics.
Data collection: Data was obtained and linked between onsite care providers (St John Ambulance Australia), prehospital (ACT Ambulance Service) and hospitals (Canberra Hospital and Calvary Health Care ACT). A pre-existing and used minimum data set1 was used to code patient characteristics from this event.
Data analysis: Descriptive statistics such as frequency distributions and means of central tendency. 

Results:
This is a summary of some of the key findings.

  • Onsite first aid care: The most frequent illness was headaches (n=94), injury was superficial lacerations (n=13), environmental was substance and/or alcohol intoxication (n=12).
  • Onsite health professional care: The most frequent illness was headaches (n=3), injury was fractures (n=2), environmental was substance and/or alcohol intoxication (n=12).
  • Ambulance transport: The most frequent injury was fractures (n=2), environmental was substance and/or alcohol intoxication (n=4). One patient required prehospital endotracheal intubation, Three patients required airway adjuncts, Six patients received intravenous medications from paramedics including opioids.
  • Hospital services: One patient required an open reduction and internal fixation in the operating theatre. One patient required intubation and ventilator support in the Intensive Care Unit.


Discussion:
This is the first research to describe patient presentations to onsite care providers, prehospital services and hospitals from a mass gathering. This research provides insight into the health service usage from one event. Presentation to the onsite health professionals resulted in a longer length of stay in the onsite medical facility. Onsite health professionals may have diverted 15 patients who would have otherwise been seen by local ambulance and hospital services. Multi-site research should be undertaken to explore the health service usage from a variety of mass gatherings.



Ranse J, Lenson S, Keene T, Luther M, Burke B, Hutton A. (2014). Patient presentations to onsite health providers, ambulance paramedics and hospital emergency departments from a mass gathering: a case study; poster presented at the Paramedics Australasia International Conference 2014, Gold Coast, Australia, 18-20 September.

28 August, 2014

What are the research needs for the field of disaster nursing in the next five years? An international Delphi study


Free full-text article is available here (PDF)

ABSTRACT

Background: Internationally there is an increasing amount of peer-reviewed literature pertaining to disaster nursing. The literature includes personal anecdotes, reflections, and accounts of single case studies. Furthermore, issues such as the willingness of nurses to assist in disasters, the role of nurses in disasters, leadership, competencies, and educational preparedness for nurses have been the focus of the literature.

Aim: The aim of this research was to determine the international research priorities for disaster nursing.

Method: This research used a three-round Delphi technique. The first round used a face-to-face workshop to generate research statements with nursing members of the World Association for Disaster and Emergency Medicine (WADEM). The second and third rounds included the ranking of statements on a 5-point Likert scale with nursing members of WADEM and the World Society of Disaster Nursing (WSDN). Statements that achieved a mean of four or greater were considered a priority and progressed.

Results: Participants were from multiple countries. Research statements were generated in the areas of: education, training, and curriculum; psychosocial; strategy, relationship, and networking; and clinical practice. Psychosocial aspects of disaster nursing ranked the highest, with five statements appearing in the top ten research areas, followed by statements relating to: education, training, and curriculum; clinical practice; and finally, strategy, relationship, and networking.

Conclusions: Future disaster nursing research should focus on the area of psychosocial aspects of disaster nursing, in particular, both the psychosocial needs of a disaster-affected community and the psychosocial well-being of nurses who assist in disaster health activities.




Ranse J, Hutton A, Jeeawody B, Wilson R. What are the research needs for the field of disaster nursing in the next five years? An international Delphi study. Prehospital Disaster Medicine. 2014

21 July, 2014

National consistency in industrial awards for disaster release for Australian Nurses: An integrative review of enterprise agrrangements



Free full-text article is available here (PDF)

ABSTRACT
This research explores the types of provisions made available to nurses within Australian public employment agreements to respond to disasters and alternate provisions made available to provide personal property protection and personal care during a disaster. An integrative literature review methodology is used to collect, evaluate, analyse and integrate sources of evidence to inform a discussion on the current enterprise arrangements for nurses with respect to eight Australian jurisdictions. These were evaluated for the industrial provisions made available to nurses wanting to assist in responding to disasters. Only five of these agreements mentioned provisions for nurses to assist in disasters. Where these provisions exist, they vary in their consistency, terminology and the quantity of the entitlements, potentially leading to inequality and variability in the financial support frameworks for nurses involved in disaster events.



Lenson S, Ranse J, Cusack L. (2014). National consistency in industrial awards for disaster release for Australian nurses: An integrative review of enterprise arrangements. Asia Pacific Journal of Health Management. 9(2):53-58.

30 June, 2014

Doing phenomenology and hermeneutics: Australian civilian nurses' lived experience of being in a disasters


This presentation was presented at the Higher Degrees Week - Flinders University, Faculty of Health Sciences, School of Nursing and Midwifery as a progress seminar for my PhD studies.

ABSTRACT
This presentation will focus on the theoretical underpinnings of phenomenology and hermeneutics as they are applied to a research paradigm which aims to: provide insight into the experience of being an Australian civilian nurse within the out-of-hospital environment during a disaster. A purposive sampling technique was employed to recruit participants for this research. Subsequently, data was collected from eight participants using semi-structured interviews at two points in time, one week apart. The first interview was primarily phenomenological, whilst the second was more hermeneutic in nature. Participant narrative was captured on an electronic audio recording device and transcribed. In terms of data analysis, phenomenology is neither inductive nor deductive, rather phenomenology is reductive. This research primarily used an eidetic reduction of participant narrative, returning to the experience as it is in itself; by uncover the uniqueness or ‘whatness’ of the experience. The result of the reduction is a lived experience description, a description of the experience that is recognisable by others of what it may be like being an Australian civilian nurse within the out-of-hospital environment during a disaster.




Ranse J. (2014). Doing phenomenology and hermeneutics: Australian civilian nurses' lived experience of being in a disasters; presentation at the Higher Degrees Week - Flinders University, Faculty of Health Sciences, School of Nursing and Midwifery. Adelaide, South Australia, 30th June.

05 June, 2014

Disasters happen: the realities of being in a disaster


I was invited to the University of New England, Armidale, New South Wales to present on the topic of disaster health and to participate in some research collaboration with academic staff members.

ABSTRACT:
Disasters happen, and health professionals are involved in restoring and maintaining the health and health services of disaster-affected communities. This presentation will provide an overview of what is known about disaster health in the Australian context, such as the willingness of health professionals to assist in a disaster and their educational preparedness. In particular, this presentation will focus on the realities of what it is like to be a health professional in a disaster.





Ranse J. (2014). Disasters happen: the realities of being in a disaster; presentation to Faculty at University of New England, Armidale, NSW, 5th June.

28 May, 2014

Enhancing the minimum data set for mass-gathering research and evaluation: An integrative literature review


Free full-text article is available here (PDF)

ABSTRACT:
Introduction: In 2012, a minimum data set (MDS) was proposed to enable the standardized collection of biomedical data across various mass gatherings. However, the existing 2012 MDS could be enhanced to allow for its uptake and usability in the international context. The 2012 MDS is arguably Australian-centric and not substantially informed by the literature. As such, an MDS with contributions from the literature and application in the international settings is required.

Methods: This research used an integrative literature review design. Manuscripts were collected using keyword searches from databases and journal content pages from 2003 through 2013. Data were analyzed and categorized using the existing 2012 MDS as a framework.

Results: In total, 19 manuscripts were identified that met the inclusion criteria. Variation in the patient presentation types was described in the literature from the mass-gathering papers reviewed. Patient presentation types identified in the literature review were compared to the 2012 MDS. As a result, 16 high-level patient presentation types were identified that were not included in the 2012 MDS.

Conclusion: Adding patient presentation types to the 2012 MDS ensures that the collection of biomedical data for mass-gathering health research and evaluation remains contemporary and comprehensive. This review proposes the addition of 16 high-level patient presentation categories to the 2012 MDS in the following broad areas: gastrointestinal, obstetrics and gynecology, minor illness, mental health, and patient outcomes. Additionally, a section for self-treatment has been added, which was previously not included in the 2012 MDS, but was widely reported in the literature.


Ranse J, Hutton A, Turris S, Lund A. (2014). Enhancing the minimum data set for mass gathering research and evaluation: An integrative literature review. Prehospital Disaster Medicine. 29(3):1-10.


13 May, 2014

What was the role of nurses during the 2011 Great East Earthquake of Japan? An integrative review of the Japanese literature


Free full-text article is available here (PDF)

ABSTRACT

Background: An earthquake and tsunami hit the east coast of Japan on March 11, 2011. Nurses were actively involved in the health response to this disaster and, subsequently, many authors have reported on the role nurses played in these efforts in Japanese nursing professional journals.

Aim: To describe the role of nurses who assisted in the 2011 Great East Earthquake of Japan by reviewing Japanese literature and reporting the findings in English.

Method: This research used an integrative literature review methodology. Manuscripts were obtained from the Japanese database Ichushi Ver. 5 (Japan Medical Abstracts Society, Tokyo, Japan). A total of 44 manuscripts were identified and included in a thematic analysis.

Results: Three main themes were identified: (1) nursing roles, (2) specialized nursing roles, and (3) preparedness education. Nurses fulfilled different roles in the period after the disaster (ie, as a clinician, a communicator, a leader, and a provider of psychosocial support). Additionally, the specialized nurse role was identified, along with the need for preparedness education to support the nurse’s role in a disaster.

Conclusion: The understanding of the role of nurses in disasters is expanding. There is a need to further explore the roles of specialized nurses in disasters. Further disaster education opportunities should be available as a part of continuing education for all nurses. Radiation aspects of disaster assistance should be included in disaster education programs where there are radio-nuclear hazards present in the environment

Kako M, Ranse J, Yamamoto A, Arbon P. (2014). What was the role of nurses during the 2011 Great East Earthquake of Japan? An integrative review of the Japanese literature. Prehospital Disaster Medicine. 29(3):1-5.

09 May, 2014

Operational aspects of health care delivery at World Youth Day 2008: Lessons learnt by an emergency management organisation


Free full-text article is available from the Australasian Journal of Paramedicine


SUMMARY

Hundreds of thousands of people attended World Youth Day 2008 [WYD08] in Sydney. Pilgrims from over 170 nations attended the week-long event (15-20th July) culminating in one of the largest mass gatherings in Australia. St John Ambulance Australia was the primary health care agency chosen for the provision of health services to WYD08 participants and officials. WYD08 posed a number of challenges during the planning and deployment stages of operational activities; due to the extremely large number of participants and varying location of WYD08 events. This article provides an overview of WYD08, the involvement of an emergency management organisation with a focus on their experiences and lessons learnt. These experiences and lessons are useful for any health care agency or emergency management organisation, tasked with planning similar large-scale mass gathering events.


Moutia D, Ranse J, Banu-Lawrence H. Operational aspects of health delivery at World Youth Day 2008: Lesions learnt by an emergency management organisation. Australasian Journal of Paramedicine. 2014;11(3):[accepted]



29 April, 2014

Understanding patient presentations among young people at mass gatherings









Ranse J. (2014). Understanding patient presentations among young people at mass gatherings; presentation to Paramedics Australasia, Paramedics Australasia Student Association and St John Ambulance (ACT), Canberra, ACT, 29th April.

24 February, 2014

Understanding the characteristics of patient presentations of young people at outdoor music festivals


Free full-text article is available here (PDF)

ABSTRACT 

Outdoor music festivals are unique events given that they are, for the most part, bounded and ticketed, and alcohol is served. They frequently have a higher incidence of patient presentations when compared with similar types of mass gatherings. Often, however, single events are reported in the literature, making it difficult to generalize the findings across multiple events and limiting the understanding of the ‘‘typical’’ patient presentations at these mass gatherings. The aim of this paper was to understand the characteristics of young people who have presented as patients to on-site health care at outdoor music festivals in Australia, and the relative proportion and type of injury and illness presentations at these events. This research used a nonexperimental design, utilizing a retrospective review of patient report forms from outdoor music festivals. Data were collected from 26 outdoor music festivals across four States of Australia during the year 2010. Females presented at greater numbers than males, and over two-thirds presented with minor illnesses, such as headaches. Males presented with injuries, in particular lacerations to their face and their hands, and alcohol and substance use made up 15% of all presentations.



Hutton A, Ranse J, Verdonk N, Ullah S, Arbon P. Understanding the characteristics of patient presentations of young people at outdoor music festivals. Prehospital Disaster Medicine. 2014;29(2):1-7.

01 February, 2014

Nurses and Twitter: The good, the bad and the reluctant



Free full-text article is available here (PDF)

ABSTRACT
Nurses and other health professionals are adopting social media to network with health care professionals and organizations, support health education, deliver health promotion messages, enhance professional development and employment opportunities, and communicate within political forums. This paper explores the growing use of social media, and examines the current dynamics of Twitter as an example of the uptake of social media. This paper also offers practical guidance for new Twitter users who are interested in using this social media approach in clinical or educational settings, and for professional development.



Wilson RL, Ranse J, Cashin A, McNamara P. (2014). Nurses and Twitter: The good, the bad, and the reluctant. Collegian. 21(2):111-119.

16 December, 2013

The role of Australian nurses in disasters: what ‘group’ of nurses should assist?


Free full-text article is available here (PDF)

OVERVIEW
This publication builds on the understanding of the Australian nurses role in a disaster. In particular it focuses on research conducted following the Black Saturday and Victorian Bushfires of 2009. It highlights the need for nurses from multiple disciplines to assist following a disaster.


Ranse J. (2013). The role of Australian nurses in disasters: what ‘group’ of nurses should assist? The Hive [Australian College of Nursing – newsletter publication]. (4):24-25

06 November, 2013

Future considerations for Australian nurses and their disaster educational preparedness: a discussion


Free full-text article is available here (PDF)

ABSTRACT
Australian nurses have been active participants in disaster assistance both within the in-hospital and out-of-hospital environment. This paper discusses the current disaster education opportunities and challenges for nurses. Additionally, various educational strategies for different cohorts of nurses are discussed highlighting the need for education to be targeted at the right cohort of nurses, at the right time, using the right strategy. To enhance the educational preparedness of Australian nurses and subsequently their willingness to assist in a disaster it is suggested that the education should replicate the realities of ‘what it is like’ to assist in a disaster. Additionally, education should be positioned within a national framework for disaster health education.


Ranse J, Hammad K, Ranse K. (2013). Future considerations for Australian nurses and their disaster educational preparedness: a discussion. Australian Journal of Emergency Management. 28(4):49-53.

04 November, 2013

Who is my leader? Lessons from a hospital disaster drill in a less developed country


Introduction: A paucity of literature exists pertaining to the role of leaders during the health response to disasters. The minimal published literature regarding disaster leadership suggests that health leadership in a disaster should adopt an approach similar to that of professions such as law enforcement, military and freighting.

Aim: This paper aims to describe observations pertaining to disaster leadership during a mock disaster scenario.

Background: This case study is set in Surkhet, Nepal, a small city prone to disasters such as earthquakes and floods. This case presents a mock disaster scenario of an earthquake set at a nongovernment health facility.

Methods: Observations were made of the performance of responders in establishing triage, treatment and command centers. Results: Institutional leaders among the responders struggled to apply the disaster plans in the face of spontaneous disaster leadership.

Conclusions: Both the recognised leadership of an organisation, and those who in a disaster may step up as disaster leaders need to be confident in implementing the disaster contingency plans. Leadership in disasters must have a clear distinction between incident controller and ‘clinical leader’ roles.

Discussion and recommendations: This paper provides recommendations that may have applicability to leadership in real world disasters.


Filmer L, Ranse J. (2013). Who is my leader? Lessons from a hospital disaster drill in a less developed country. Australasian Emergency Nursing Journal. 16(4)170-174. doi:10.1016/j.aenj.2013.08.004 

24 October, 2013

Add health needs to your emergency checklist


In October I participated in a number of media interviews that focused on the need for members of the community to be 'health prepared' for disasters. These interviews were undertaken within the context of bushfires. At the time of the interviews, a number of large bushfires were devastating regions of New South Wales.

Print media appearances:
  • ‘Add health needs to your emergency checklist’; print media in Canberra Weekly, 24th October

Article above from the Canberra Weekly


Radio media appearances:
  • Adding health needs to your emergency checklist; radio interview on ABC Radio Illawarra, 20th October
  • News headlines regarding ‘adding health needs to your emergency checklist’, on the following: FM 104.7 (Canberra); Mix 106.3 (Canberra)

Media release:

Australians should not only prepare their house and belongings against the threat of bushfires, floods or storms this summer, but also be ready to look after their health during an emergency, advises a University of Canberra disaster response expert.

Jamie Ranse, a health academic who specialises in disasters, said that in the wake of a major incident emergency services are stretched and medicines are in short supply, so residents should be ready to look after themselves.

“When preparing for potential evacuation, people often think about sentimental items they would like to take with them, such as photo albums and computers, but they often forget to think about items that will support their health needs,” he said.

Mr Ranse said during previous disasters such as the Queensland floods, Victorian and Canberra bushfires, people were relocated to evacuation centres where they remained for days or weeks.

“Whilst in these centres, a number of people required medications of some kind. However, during a disaster, medications become increasingly hard to access, and this is made even harder if people don't know what medications they take.”

Mr Ranse said there are a few simple steps people can take to be health prepared, including preparing a list of previous medical and surgical history, as well as a list and a supply of current medication.

“This list should be placed with other items you might take in an evacuation such as blankets and warm clothes. People should also have a basic understanding of first aid and have a small first aid kit in an accessible location.

“It’s also a good idea to get to know your neighbours as you may be able to help them prepare for a disaster, or provide assistance during a disaster.

“It is important that people are as self-sufficient as possible as emergency services are stretched beyond capacity, and they will not be able to respond in a timely matter to minor injuries or ailments.”

Key points for being health prepared:
  • Have a current list of medications, ailments and previous medical/surgical history. 
  • Keep this list with other items you might take in an evacuation, such as photo albums or computers 
  • Keep a stocked first aid kit in your car 
  • Learn first aid and know basic first aid principles such as how to control bleeding, how to open an airway and how to do CPR 
  • Get to know your neighbours, you might need each other’s help in an emergency

23 October, 2013

Health considerations at major events (mass gatherings)


This presentation was delivered in 2011, 2012 and in 2013 to students at the University of Canberra who are undertaking the unit: sports as entertainment. This presentation provides an overview of some key points for event managers, when considering health care for participants and/or spectators of their event. In particular this presentation focused on event managers of sporting events.

My presentation mentions the Bradford City Football Stadium disaster. The original footage from this event can be found on YouTube (below). The disaster starts to unfold at the 30 second point.
   

Additionally, footage from the Hillsborough stadium disaster may be of interest, this is also available on YouTube:
 


Ranse J. (2013). Health considerations at major events (mass gatherings); presented to students of the University of Canberra – Undergraduate Sports Studies in the unit: Sport as entertainment, Canberra, ACT, 23rd October.

Ranse J. (2012). Health considerations at major events (mass gatherings); presented to students of the University of Canberra – Undergraduate Sports Studies in the unit: Sport as entertainment, Canberra, ACT, 22nd August.

Ranse J. (2011). Health considerations at major events (mass gatherings); presented to students of the University of Canberra – Undergraduate Sports Studies in the unit: Sport as entertainment, Canberra, ACT, 28th September.

14 September, 2013

Injury patterns and crowd behaviour at mass gathering events


This presentation was delivered to members of St John Ambulance Australia (ACT) during the symposium: Sex, Drugs, and Rock and Roll. This symposium focused on the various aspects of health care at mass gatherings.

My presentation was divided into two distinct sections. Firstly, the theory of mass gatherings was presented together with the current evidence pertaining to factors that influence patient presentation rates. Secondly, a case study was presented outlining the characteristics of ~5,000 patients who presented to Australian outdoor music festivals in 2009/2010 for clinical assessment and/or management. In particular, the patients presentations related to injury, illness, environmental factors and mental health were discussed.


Ranse J. (2013). Injury patterns and crowd behaviour at mass gathering events. Sex, Drugs, and Rock and Roll - St John Ambulance Australia (ACT), Canberra, ACT, 14th September.

28 August, 2013

Epidemiology of injuries at the Australian 24 hour mountain bike championships


Free full-text article is available here (PDF)

ABSTRACT
Introduction: To describe injury type and frequency, and the factors influencing these, in endurance mountain bike riders.

Method: This study used a cross-sectional retrospective audit of patient report forms, prospective meteorological information and race data over an eight-year period. The Australian twenty-four hour mountain bike championships is held annually in Canberra, Australia. All riders who presented to a first aid station for treatment during the race from 2000-2007, were included. Studied factors influencing injury were race time, ambient temperature and rider gender. Studied outcome measures were injury frequency, location, type and management.

Results: Of the 14,777 riders over the eight years, 596 required first aid treatment for injuries (4.03%), the majority for minor injuries to extremities. Only 0.25% of riders were referred to hospital, 0.06% by ambulance. The injury incidence was 8.4/1000 bike hours with a race-ending presentation (a patient referred to hospital) incidence of 0.5/1000 bike hours. Patient presentation rates were highest in the first eight hours of a race. Higher average temperatures per year were associated with a greater risk of injury. Females were more likely to be injured.

Conclusion: This mountain bike competition was safe with minor injuries to extremities predominating and low referral rates to hospital, as a result, first aid service organisations provided adequate clinical care at this event.



Taylor N, Ranse J. (2013). Epidemiology of injuries at the Australian 24 hour mountain bike championships, 2000 – 2007. Australasian Journal of Paramedicine. 10(1)a4:1-5

22 August, 2013

Social Media: Friend or Foe




I was invited by the Princess Alexandra Hospital to participate as a panel member of a lunchtime debate regarding social media. I was on the side of social media being a 'friend'.

My five minutes of the debate focused on three aspects of social media:
  • Social / personal social media, such as ‘what I had for breakfast’. In discussing social and personal aspects of social media, I highlighted that this is one way, but not the only way to use social media.
  • Professional communication and engagement, such as engaging at a conference, networking with like-minded people, and linking with professional organisations. I emphasised that this is of most benefit to health professions. It allows for the extension of our existing professional networks. Additionally, social media has significant benefits for health professionals attending (and not attending) conferences, as social media exists as an extension of the conference allowing for parallel conversations and sharing of information
  • Important information delivery and public messages, such as social media in disasters. This aspect was discussed in the context of comparing Cyclone Tracy in 1974 in which it took many hours before those outside Darwin Australia knew about the event, and the Christ Church Earthquake in New Zealand, 2011 in which we knew about the event in seconds - complete with images, video and messages from those trapped.  


Ranse J. (2013). Social media: Friend or Foe; debate panel member for the Princess Alexandra Hospital Health Symposium, Brisbane, Queensland, 22nd August.

21 August, 2013

Exploring staff willingness to attend work during a disaster: A study of nurses employed in four Australian emergency departments



Free full-text article is available here (PDF)

ABSTRACT
Background: Much of the literature about emergency nurses willingness to work during disasters has been from a non-Australian perspective. Despite the many recent disasters, little is known of Australian nurse’s willingness to participate in disaster response. This paper presents findings from a study that explored nurses willingness to attend work during a disaster and the factors that influenced this decision.

Methods: Data were collected consecutively using a combination of focus group and interview methods. Participants in this study, registered nurses from emergency departments, were recruited through convenience sampling from four hospitals in Australia. Participant narrative was electronically recorded, transcribed and thematically analysed.

Results: The participants for both the focus groups and interviews compromised a mix of ages, genders and years of experience as emergency nurses from across four jurisdictions within Australia. Three major themes that influenced willingness emerged with a number of subthemes. Theme one reflected the uncertainty of the situation such as the type of disaster. The second theme surrounded the preparedness of the workplace, emergency nurse and colleagues, and the third theme considered personal and professional choice based on home and work circumstances and responsibilities.

Conclusions: The decision to attend work or not during a disaster, includes a number of complex personal, work-related and professional factors that can change, depending on the type of disaster, preparedness of the work environment and the emergency nurses’ personal responsibilities at that time.


Arbon P, Cusack, L, Ranse J, Shaban R, Considine J, Kako M, Woodman R, Mitchell B, Bahnisch L, Hammad K. (2013). Exploring staff willingness to attend work during a disaster: a study of nurses employed in four Australian emergency departments. Australasian Emergency Nursing Journal.16(3):103-109 doi:10.1016/j.aenj.2013.05.004

02 July, 2013

Nursing through disasters


Free full-text article is available here (HTML)

I was interviewed by Karen Keast of Style My Words for Nursing Careers Allied Health. This interview and subsequent article discussed much of my work relating to disaster nursing in Australia. In particular it focuses on the need for all nurses to have some awareness of disasters, and their potential roles in a disaster.




18 June, 2013

Disaster content in Australian tertiary postgraduate emergency nursing courses: A survey

Free full-text article is available here (PDF)

ABSTRACT
Background: Emergency nurses play a pivotal role in disaster relief during the response to, and recovery of both in-hospital and out-of-hospital disasters. Postgraduate education is important in preparing and enhancing emergency nurses’ preparation for disaster nursing practice. The disaster nursing content of Australian tertiary postgraduate emergency nursing courses has not been compared across courses and the level of agreement about suitable content is not known.

Aim: To explore and describe the disaster content in Australian tertiary postgraduate emergency nursing courses.

Method: A retrospective, exploratory and descriptive study of the disaster content of Australian tertiary postgraduate emergency nursing courses conducted in 2009. Course convenors from 12 universities were invited to participate in a single structured telephone survey. Data was analysed using descriptive statistics. 

Results: Ten of the twelve course convenors from Australian tertiary postgraduate emergency nursing courses participated in this study. The content related to disasters was varied, both in terms of the topics covered and duration of disaster content. Seven of these courses included some content relating to disaster health, including types of disasters, hospital response, nurses’ roles in disasters and triage. The management of the dead and dying, and practical application of disaster response skills featured in only one course. Three courses had learning objectives specific to disasters.

Conclusion: The majority of courses had some disaster content but there were considerable differences in the content chosen for inclusion across courses. The incorporation of core competencies such as those from the International Council of Nurses and the World Health Organisation, may enhance content consistency in curriculum. Additionally, this content could be embedded within a proposed national education framework for disaster health.



Ranse J, Shaban R, Considine J, Hammad K, Arbon P, Mitchell B, Lenson S. (2013). Disaster content in Australian tertiary postgraduate emergency nursing courses: A survey. Australasian Emergency Nursing Journal. 16(2):58-63. doi:10.1016/j.aenj.2013.04.002

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