Chemical, Biological, Radiological, Nuclear, and Explosive (CBRNe) preparedness: Perceptions of Australian emergency department (ED) doctors and nurses

ABSTRACT:

Introduction:
Clinicians working in emergency departments (ED) play a vital role in the healthcare response to chemical, biological, radiological, nuclear, and explosive (CBRNe) events. However, ED clinicians’ individual and workplace preparedness for CBRNe events is largely unknown.

Aim:
The aim of this research was to explore Australian ED nurses and doctors’ perceptions of individual and workplace preparedness related to CBRNe events.

Methods:
The study populations were Australian nurses and doctors who work in EDs. Data was collected via a survey with 43 questions requiring binary responses or a rating on a Likert scale. The survey consisted of questions relating to the participant’s previous disaster training, perceived likelihood of a CBRNe event impacting their ED, perceived level of knowledge, perceived personal preparedness, perception of ED preparedness, and willingness to attend their workplace. Data were analyzed using descriptive and inferential statistics.

Results:
There were 244 complete responses, 92 (37.7%) doctors and 152 (62.3%) nurses. When comparing doctors and nurses, there was a statistical difference between gender (p = < 0.001), length of employment (p = < 0.001), and role in the ED (p = < 0.001). Doctors and nurses had a similar level of previous training except for practical training in mask fitting (p = 0.033). CBRNe events were considered separately. Perceived level of knowledge, perceived personal preparedness, and perception of ED preparedness were significant predictors of willingness to work in all CBRNe event. Perceived likelihood of a CBRNe event impacting their ED was not a predictor of willingness.

Discussion:
This research contributes to an overview of the current status of Australian ED clinicians’ preparedness for CBRNe response. To increase the willingness of ED doctors and nurses attending their workplace for a CBRNe event, strategies should focus on enhancing individuals perceived level of knowledge, perceived personal preparedness, and perception of ED preparedness.



Hammad, K., Ranse, J., Mortelmans, L. (2019). Chemical, Biological, Radiological, Nuclear, and Explosive (CBRNe) preparedness: Perceptions of Australian emergency department (ED) doctors and nurses. Paper presented at the 22nd World Congress on Disaster and Emergency Medicine, Brisbane, 9th May.

Read More

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

Read More

Australasian emergency nurses’ willingness to attend work in a disaster: A survey

Free full-text article is available here (PDF)

ABSTRACT
Background: The type of disaster, individual demographic factors, family factors and workplace factors, have been identified in the international, multidisciplinary literature as factors that influence a person’s willingness to attend and assist in their workplace during a disaster. However, it is unknown if these factors are applicable to Australasian emergency nurses.

Aim: The research aims to determine the extent to which Australasian emergency nurses are willing to attend their workplace in a disaster.

Method: This research was exploratory and descriptive study design, using online and paper based surveys as a means of data collection. Australasian emergency nurses from two Australasian emergency nursing colleges and four Australian hospitals were recruited to participate. Data analysis was conducted using both descriptive and inferential statistics.

Results: In total, 451 Australasian emergency nurses participated in this research. Participants were more willing to attend their workplace during a conventional disaster (p≤0.001), if they worked full-time (p = 0.01), had received formal education pertaining to disasters (p≤0.001), had a family disaster plan (p = 0.008), did not have children (p = 0.001) and worked in an environment in which they perceived their colleagues, managers and organisation to be prepared.

Conclusions: The factors that influenced Australasian emergency nurses to attend their workplace in a disaster were similar to that described in the international multidisciplinary literature. Of particular note, improving disaster knowledge and skills, having a family disaster plan and improving the perceptions of the nurses’ workplace preparedness can enhance the nurses’ willingness to assist in a disaster.


Arbon P, Ranse J, Cusack L, Considine J, Shaban R, Woodman R, Bahnisch L, Kako M, Hammad K, Mitchell B. (2013). Australasian emergency nurses’ willingness to attend work in a disaster: A survey. Australasian Emergency Nursing Journal. 16(2):52-57. doi:10.1016/j.aenj.2013.05.004 

Read More

Understanding the willingness of Australian emergency nurses to respond to a disaster

This article was published in Connections, outlining some key findings from a larger report relating to the willingness of Australian emergency nurses to respond to a disaster. The full report from this research project can be located at: http://www.jamieranse.com/2011/09/understanding-willingness-of-australian.html



Ranse J. (2011). Understanding the willingness of Australian emergency nurses to respond to a disaster. Connections [Royal College of Nursing, Australia – newsletter publication]. 14(4):6-7

Read More

To work or not to work: An analysis of the willingness of Australian emergency nurses to respond to a disaster

Laura Bahnisch presented on behalf of our research team, the key findings from our project that explored the willingness of Australian emergency nurses to attend their workplace in a disaster.

The recent extreme weather events in Queensland and Victoria highlight that natural disasters occur regularly in Australia. Arguably, the Australian health care system has had little experience with disasters that overwhelm health resources. This raises questions about the ability of health care providers to respond under conditions of increased demands and personal vulnerability. International experience, including earthquakes in Japan [2011], Christchurch [2011] and Haiti [2009], has shown that uncertainty about their safety and that of their family and friends may prevent nurses from attending work during a disaster. An understanding of the factors that enable or disable nurses’ disaster preparedness will underpin future disaster policy and planning for Australian and international health care organisations.

A study of the willingness of Australian emergency nurses to respond to a disaster was conducted. A 3-phase mixed-method design was used, consisting of a national survey, focus groups and in-depth interviews with emergency nurses at four hospitals. This presentation builds upon preliminary results delivered at the 8th International Conference for Emergency Nurses (2010). The findings indicate that emergency nurses’ willingness to respond to disasters is dependent on a number of factors, including their out-of-work responsibilities, changes to their roles at work, their confidence in management, protective equipment and work teams, the information received, the type of disaster and the degree of risk involved. The nurses’ willingness also differs according to their age, family status, personal preparedness and disaster related qualifications. These and other factors will be examined, exploring the implications for individual nurses and planners.



Bahnisch L*, Arbon P, Cusack L, Ranse J, Shaban R, Hammad K, Considine J, Mitchelle B. (2011). To work or not to work: An analysis of the willingness of Australian emergency nurses to respond to a disaster; paper presented at the 9th International Conference for Emergency Nurses, Adelaide, South Australia, 30th September.

Read More

Understanding the Willingness of Australian Nurses to respond to a disaster

This final report of the project ‘Understanding the Willingness of Australian Nurses to Respond to a Disaster’ was launched at the 9th International Conference for Emergency Nurses, held in Adelaide on 29th September 2011. The launch included an overview of the report, and key findings.

Speakers at the launch (left-to-right): Professor Paul Arbon (Chief Investigator), Dr Julie Considine (Co-Investigator), and the Honourable John Hill MP, (South Australia, Minister for Health).

Arbon P, Cusack L, Ranse J, Shaban R, Considine J, Mitchell B, et al. (2011). Understanding the willingness of Australian emergency nurses to respond to a disaster. Adelaide: Flinders University.

Read More

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

This poster was presented at the 17th World Congress on Disaster and Emergency Medicine, in Beijing, China. This research project aimed to explore the willingness of emergency nurses to work in a disaster. This study used a mixed-methods approach to data collection and analysis. Firstly, a national survey was undertaken, circulated via the College of Emergency Nursing Australasia, the Australian College of Emergency Nursing and in four partner hospitals in Australia. Secondly, a number of focus groups were undertaken at the partner hospitals. Finally, individual interviews were conducted with participants who had previously participated in a focus group session.

This poster highlights some of the preliminary findings from this project.


Arbon P, Cusack L, Ranse J, Shaban R, Considine J, Mitchell B, Hammond K, Kako M, Bahnisch L. (2011). Understanding the willingness of Australian emergency nurses to respond to a health care disaster; poster presented at the 17th World Congress on Disaster and Emergency Medicine, Beijing, China, 31st May – 3rd June.

Read More

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

This presentation outlined the findings from the first phase of a national project exploring the willingness of emergency nurses to attend their workplace during a disaster.

Ranse J, Arbon P, Shaban R, Considine J, Mitchell B, Hammond K, Cusack L, Kako M, Bahnisch L. Understanding the Willingness of Australian Emergency Nurses to Respond to a Health Care Disaster; paper presented at the 8th International Conference for Emergency Nurses, Canberra, Australia, 14th October 2010.

Read More