Doctoral thesis

Australian civilian hospital nurses’ lived experience of an out-of-hospital environment following a disaster

Mass Gathering Health / Mass Gathering Medicine

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

Disaster Health

Various publications and presentations relating to disaster health

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

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 



17 June, 2013

Open access to Nursing journals: An audit of the 2010 ERA journal list

Free full-text article is available here (PDF)

ABSTRACT
Objective: To determine the proportion of nursing journals that are fully open access or have some elements of openness, and hence are readily accessible by nurses in clinical settings.

Design: A descriptive study, with interpretive analysis of existing data sources. Setting Access to online journals from the perspective of a nurse as a consumer.

Subjects: Nursing specific journals from the 2010 Excellence in Research for Australia (ERA) list of publications. Main outcome measure The proportion of nursing journals with unrestricted online open access as of October 2011.

Results: Of the 224 journals included in this research, 12% (27/224) had unrestricted open access to all published manuscripts, 39% (88/224) had partial or conditional access and 49% (109/224) had no elements of open access, and required the consumer to have access to a paid subscription.

Conclusion: Approximately half (51%) of nursing journals surveyed have all or some articles that are open access. This is higher than other studies of open access research articles globally. However, barriers at an institutional level may need to be addressed to ensure nurses can be informed in their care of patients.



Bail K, Ranse J, Clarke R, Rattray B. (2013) Open access to nursing journals: an audit of the 2010 ERA journal list. Australian Journal of Advanced Nursing. 30(4):5-11

03 June, 2013

Disaster health: an Australian perspective


I was invited by the Faculty of Public Health and the Faculty of Nursing at Naresuan University, Phitsanulok, Thailand to present on the topic of disaster health from an Australian perspective. This presentation focused on the following topics:
- Willingness
- Education
- Role
- Triage

A number of clinicians and academics shared their experience of disaster assistance within the Phisanulok Province. Additionally, during this visit I had the privilege to meet with a number of public health official regarding their experience of assisting in floods and landslides that have affected their Districts.


Ranse J. (2013). Disaster health: an Australian perspective. Department of Nursing, Naresuan University, Thailand, 3rd June.

30 May, 2013

Progressing towards an international consensus on data modelling for mass gathering and mass participation events

This presentation was undertaken by Adam Lund for this research team.

ABSTRACT
There is call for increased attention to foundational theory building to support the evidence base for mass gathering medicine/health (MGM/H). There is a need for a more consistent approach to data collection, case reporting, and research methodology. Recently publications highlight the need for agreement on data points across varying MGM/H contexts.

This discussion aims to present a supportive rather than prescriptive process of building consensus that will support MGM/H researchers and clinicians to produce work with value to international events. The authors propose an ongoing, iterative, collaborative process with the goal of developing and maintaining consensus on core concepts, methodology, and reporting in MGM/H research and evaluation. Stakeholder input will be sought internationally from researchers, advocacy groups, and operational personnel who may undertake literature reviews, research collaboration, consensus meetings, as well as iterative document creation and review.

The authors propose five conceptual categories as a starting point for analysis and discussion: 1) Event & Community (prospective & retrospective) - describing events so events in different parts of the world can be compared reliably; 2) Health Team Resources - describing personnel, equipment, assets, policies, protocols and other factors that impact on-site care; 3) Patient - describing patient encounters, history, findings, treatment, response, and outcome; supporting a minimum common set of descriptors of patient factors; 4) Reporting - standardized descriptive, summative, or analytic reporting “fields” and formats that would permit a more consistent understanding of events and increase the ability to perform meta-analyses of events; and, 5) Overview of Research Methodologies – review and categorization of common methodologies in the MGM/H literature, including summarization of best practices to support future inquiry into MGM/H.

This proposed method of consensus will allow mass gathering health science to become more robust and be generalizable to other MGM/H events.



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.

Industrial considerations for Australian nurses responding to disasters

This presentation was undertaken by Shane Lenson.


ABSTRACT
Within the Australian out-of-hospital environment, nurses have been deployed from various States and Territories to assist in the response to events such as the Victorian Bushfires [2009] and the Queensland floods [2011]. Similarly, nurses have been deployed overseas to assist in events including the Christchurch earthquake [2011] and Sumatra-Andaman earthquake and tsunami [2004]. Nurses are likely to continue in the health response to a disaster. However, consideration needs to be given to the industrial agreements for nurses when released from their normal employment arrangements to assist in disastrous events.

An integrative literature review methodology was used to collect, evaluate, analyse and integrate sources of evidence to inform this discussion on the current enterprise arrangements for nurses with respect to disaster response. Nursing and midwifery public sector enterprise agreements were sourced from each of the eight Australian jurisdictions. These were evaluated for the industrial provisions made available to nurses wanting to assist in responding to disasters.

Only five enterprise agreements mentioned provisions for nurses to assist in disasters. Where these provisions exist they vary in the their consistency, terminology and the quantity of the entitlements potentially leading in inequality and variability in the financial support frameworks of nursing involved in disaster events.

There is no national approach by nursing industrial organisations to standardise provisions related to an emergency event or disaster. Those agreements that had provisions were notable in their variability in the definition of disasters and the terminology used to define the entitlements for nurses willing to respond to disasters. This variability may leads to inequity and sustainability of nurses who are willing to respond to disaster with nurses sent from some states or territories being financially supported compared to nurses from other regions possibility not being renumerated for undertaking the same role and responsibilities.


Lenson S, Ranse J, Cusack L. (2013). Industrial considerations for Australian nurses responding to disasters; paper presented at the 18th World Congress on Disaster and Emergency Medicine, Manchester, UK, May.

28 May, 2013

Biomedical data collection for mass gathering research and evaluation: A review of the literature


ABSTRACT
Internationally, planned events such as mass gatherings occur frequently. Known factors influencing the usage of health services, or patient presentations, at mass-gatherings are acknowledged within the environmental, psychosocial and biomedical domains. Health-related research and evaluation from mass gatherings commonly include biomedical information pertaining to patient presentations. The aim of this research was to review the various categorisations reported by authors to describe the patient populations at mass-gatherings, with a focus only on the biomedical domain.

This research utilised an integrative literature review methodology to identify papers from within the last ten years that included research or evaluation from a mass-gathering event in which the authors included published biomedical information.

Numerous papers were identified that included information pertaining to biomedical information from mass gathering events. It was noted that the coding and categorisation of patient-level biomedical information seems inconsistent, varied, haphazard and author dependent.

Recently, there has been literary discussion about the need for consistency and consensus in reporting on biomedical information. This literature review supports this notion. In particular, this presentation builds on a previously published minimum data set proposed by Ranse and Hutton and enhances it by including additional categorisations of biomedical information. As such, a revised minimum data set with a data dictionary is proposed in an effort to generate conversation about a possible agreed minimum amount and the type of information that should be collected consistently for research and evaluation at mass gatherings.


Ranse J, Hutton A. (2013). Biomedical data collection for mass gathering research and evaluation: A review of the literature; paper presented at the 18th World Congress on Disaster and Emergency Medicine, Manchester, UK, May.

Disaster and emergency medicine online research repository: A retrospective review


ABSTRACT
Internationally, there is an increasing amount of literature published in the disciplines of disaster and emergency medicine. However, there is a limited opportunity to openly share research progress prior to peer-reviewed publication. Having the ability to share research prior to peer-reviewed publication has many benefits. As such, an online research repository for unpublished non-peer-reviewed research summaries was originally created by the authors of this presentation for the World Association for Disaster and Emergency Medicine (WADEM) nursing section. Later, this repository was launched to the wider WADEM membership. This presentation aims to showcase the research repository and highlight its usage since its launch in August 2012.

Data regarding visitations to the WADEM research repository was obtained retrospectively from an existing application within Google Blogger, the research repository platform. Data was analysed using descriptive statistics.

The research repository was launched in August 2012 with 21 research summaries. Between August and December 2012, 6 additional summaries were submitted. Additionally, the research repository had been visited on 2734 occasions. The median visits per month are 550 (IQR: 429.5 – 663.5). The most commonly viewed research summaries related to disaster preparedness (n=158), occupational stress (n=110), emergency nurses willingness to assist in disasters (n=59), and simulation in education (n=52).

The results demonstrate that the research repository is being viewed and used. By showcasing the research repository in this presentation, it is hoped that contributions and views to this repository will be enhanced. In particular, this presentation highlights the benefits of openly submitting research summaries to the research repository, such as an opportunity for possible collaboration and sharing of research work.


Ranse J, Lenson S. (2013). Disaster and emergency medicine on-line research repository: A retrospective review; paper presented at the 18th World Congress on Disaster and Emergency Medicine, Manchester, UK, May. 

The characteristics of patient presentations from Australian outdoor music festivals


ABSTRACT
The literature pertaining to patient characteristics from outdoor music festivals is predominately reported from single descriptive events. These events demonstrate a higher incidence of patient presentations when compared to other types of mass gatherings. Outdoor music festivals rely on on-site care and clinicians to assess and manage patients. However little is known about characteristics of patient presentations across a large number of outdoor music festivals within the Australian context. As such, this research aimed to describe the characteristics of patient presentations from Australian outdoor music festivals.

The setting for this research was 25 outdoor music festivals across four Australian states in 2010. Patient information from these events was obtained from Patient Care Records from St John Ambulance Australia. The patient information from these records was entered into a de-identifiable database using the Ranse and Hutton minimum data set. Data was then analyzed using descriptive and inferential statistics in SPSS.

In total 5,000 patients presented to the 25 events for clinical assessment and management. This research found that females present in greater numbers to on-site care than males. In addition, it was found that the majority of females present with whereas males presented to on-site care with injuries. The majority of patients transferred to hospital where those who presented with alcohol and/or other drugs related concerns.

This is the first research that explored patient characteristics at multiple outdoor music festivals in Australia. The research has highlighted some key results that may inform public health policy and assist clinical providers and event managers in the planning of health services at future events.


Hutton A, Ranse J, Arbon P, Ullah, S. (2013). The characteristics of patient presentations from Australian outdoor music festivals; paper presented at the 18th World Congress on Disaster and Emergency Medicine, Manchester, UK, May

01 May, 2013

Author response — Letter to the editor: Beyond a clinical role: Nurses were psychosocial supporters, coordinators and problem solvers in the Black Saturday and Victorian bushfires in 2009.

I was fortunate to have someone write a letter to the editor to my original article titled: Beyond a clinical role: Nurses were psychosocial supporters, coordinators and problem solvers in the Black Saturday and Victorian bushfires in 2009, which was coauthored with Shane Lenson. This letter to the editor was published in the journal Australasian Emergency Nursing Journal. The author make a number of observations regarding our work. 




In response to this letter to the editor, Shane Lenson and I wrote a response. This response was also published in the Australasian Emergency Nursing Journal .



The response is available here in full text

24 February, 2013

Phenomenology



This presentation was delivered to students of the Professional Doctorate in Nurse Practitioner (Research) at the University of Canberra. This presentation commenced with a definition of phenomenology and discussed some of the key notion in phenomenology that builds this definition. In particular, the notions of conscious awareness, intentionality, perception and being were explored. Additionally, this presentation discussed some elements of the method of ‘doing’ phenomenology, focusing on the process of data collection and data analysis.


Ranse J. (2013). Phenomenology; paper presented students of the University of Canberra – Professional Doctorate in Nurse Practitioner (Research), Canberra, ACT, 24th February

14 February, 2013

Minimum data set for mass-gatherings health research and evaluation: The beginning of an international dialogue

I was fortunate to have someone write a letter to the editor to my original article titled: Minimum data set for mass-gatherings health research and evaluation, which was coauthored with Dr Allison Hutton. This letter to the editor was published in the journal Prehospital and Disaster Medicine. The authors make a number of suggestions to enhance our proposed minimum data set. Additionally, the authors invite us to meet and collaborate with them on future research activities.

In response to this letter to the editor, Allison Hutton and I wrote a response. This response was also published in Prehospital and Disaster Medicine.


Essentially, this response reiterated our original discussion paper regarding the need for some consistency internationally in the reporting of research and evaluations from mass gatherings. In particular, our original work focused on the need to move from author-dependent, author-varied and author-self-generated data sets to an internationally agreed set of minimum variables for collection at mass gatherings. The aim of this would be to compare events internationally, to gain a better understanding of health service requirements during a mass gathering. Additionally, we have accepted the invitation to meet with the authors who wrote the letter to the editor, and will meet with them face-to-face in May 2013 in Manchester, United Kingdom.


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

31 January, 2013

Developing a professional presence online: using google blogger


This was an interactive workshop presented to Higher Degree Research (HDR) students at University of Canberra. The aim of this workshop was to provide students with the skills and ability to develop an online professional portfolio using Google Blogger.


Ranse J. (2013). Developing a professional presence online: Using google blogger; workshop presented to Higher Degree Research (HDR) students of the University of Canberra, University of Canberra, ACT, 31st January

24 January, 2013

A comparison of open access in exercise science journals: 2010 to 2012


ABSTRACT:
The aim of this study was to complete an audit on the number of open access journals within the discipline of Exercise Science. Publishing in open access journals results in wide dissemination of material in a very short period of time compared with the more traditional way of publishing in a subscription journal. The 2010 ERA journal list, category Human Movement and Sport Science, was initially utilised and then compared with the openness of the same journals in 2012.

In this study journals were audited for their degree of open access, open licensing and open format. Open access relates to the free online availability of research results and hence research publications and in the discipline of exercise science relates to the concept of an idealised level playing field. Open licensing relates to the ability of the consumers to replicate and share those publications freely whilst open format relates to the use of open and transferrable format types. Open access increased (p=0.014) as did our measurement of open licensing (p=0.000) and open formats (p=0.021) between the 2010 and 2012 reviews of the journals in 1106 FOR code.

This study reveals an increase in the number of Exercise Science journals that have full or partial open access over the two year period and suggests that authors are increasingly adopting peer reviewed open access journal publications. It is evident from this study that the impact of open access journals be assessed and further research into the feasibility of such a rating is imperative.


Rattray B, Cooke J, Bail K, Ranse J. (2013). A Comparison of open access in exercise science journals: 2010 to 2012. The Open Sports Science Journal. 6:1-7.

15 October, 2012

Disaster health: An Australian nursing perspective


This presentation was delivered to delegates visiting the University of Canberra from the Naresuan University, Thailand. This presentation focused on what is known about the Australian disaster environment. In particular, this presentation highlighted the various disasters Australian nurses have participated in nationally and internationally. Additionally, various other factors that impact on a health professional to perform in a disaster was discussed, such as: education, willingess to assist in a disaster and role. Finally, future collaborative opportunities between the University of Canberra and Naresuan University were discussed.

Ranse J. (2012). Disaster health: An Australian nursing perspective; paper presented to delegates of the Mahidol University Thailand, University of Canberra, ACT, 15th October

11 October, 2012

Beyond a clinical role: nursing is disasters


This presentation highlighted the key findings of research that explored the role of nurses who participated in the Black Saturday and Victorian bushfires in February 2009. It was highlighted that the nurses’ role in providing health care during and/or following a disaster is more than a clinical care role. Nurses undertook roles including being a psychosocial supporter, a coordinator of care and resources, and problem solvers.

It was argued that this understanding regarding the role of nurses in disasters should be applied to the development of education programs, competencies and policies, with a particular focus on contextualising the education to the realities of possible disastrous scenarios that incorporates elements of coordination, problem solving and psychosocial care within a national framework. Additionally, this awareness education should be used to inform nurses about the realities of working in disaster environments.


Ranse J, Lenson S. (2012). Beyond a clinical role; paper presented at the 2nd Australian Capital Region Nursing and Midwifery Research Conference, Canberra, Australia, 11th October.

19 September, 2012

Minimum data set for mass gathering health research and evaluation: A discussion paper


This paper aims to commence international discussions regarding the need to have a standardised approach to the reporting of biomedical information from mass gatherings. In particular it focuses on the need to have consistency in the reporting of patient presentation rates, medical usage rates, referral to hospital rates and transport to hospital rates. Additionally, it highlights the need for the consistent use of a research and evaluation tool, such as a minimum data set. This paper provides an example of a minimum data set, as an opportunity to commence these international discussions.


ABSTRACT
This paper discusses the need for consistency in mass gathering data collection and biomedical reporting. Mass gatherings occur frequently throughout the world and having an understanding of the complexities of mass gatherings is important to inform health services about the possible required health resources. Factors within the environmental, psychosocial and biomedical domains influence the usage of health services at mass gatherings. The biomedical domain includes the categorisation of presenting injury or illness and rates such as patient presentation rate, transferred to hospital rate and referred to hospital rate. These rates provide insight into the usage of onsite health services, prehospital ambulance services and hospital emergency department services.

Within the literature these rates are reported in a manner that is varied, haphazard and author dependent. This paper proposes moving from an author dependent practice of collection and reporting of data. An expert consensus approach is proposed as a means of further developing mass gathering theory and moving beyond the current situation of reporting on individual case studies. To achieve this minimum data set with a data dictionary is proposed in an effort to generate conversation about a possible agreed minimum amount and type of information that should be consistently collected for research and evaluation at mass gatherings. Finally, this paper outlines future opportunities that will emerge from the consistent collection and reporting of mass gathering data, including the possibility for meta-analysis, comparison of events across societies and modelling of various rates to inform various health services.


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

17 September, 2012

Role of mental health nurses in disasters



This presentation provided an overview of the role of Australian nurses in disasters, both locally, nationally and internationally. In particular the focus of this presentation was on the mental health aspects of disasters - particularly from a population health perspective. Following the presentation, the group discussion focused on the role of mental health nurses in disasters.

Ranse J. (2012). Role of mental health nurses in disasters; presented to students of the University of Canberra – Postgraduate Mental Health Nursing, Canberra, ACT, 17th September.

11 September, 2012

Role of critical care nurses in disasters



I presented to a group of students undertaking postgraduate studies in Critical Care Nursing at the University of Canberra. My presentation focused on both the in-hospital and out-of-hospital role of critical care nurses, in disasters. The presentation was a superficial overview of a number of issues associated with the health effects of a disaster, and the role of nurses in these circumstances

This presentation covered topics such as: the nurse role, willingness to assist during a disaster, disaster triage concepts, education for nurses in disaster health and other topics of consideration for emergency and intensive care nurses.


Ranse J. (2012). Role of critical care nurses in disasters; presented to students of the University of Canberra – Postgraduate Critical Care Nursing, Canberra, ACT, 11th September.

04 September, 2012

In the wake of disaster: treating physical and mental injuries


This article was published in NursingReview. It highlights that nurses during the Black Saturday and Victorian Bushfire in 2009 undertook a variety of roles:
  • Minimal clinical care
  • Coordinator of care
  • Problem solver
  • Psychosocial support
In particular, this paper argues the need to think about which 'group' of nurses is most appropriate to assist in the response / recovery to a disaster. This article highlights that we commonly send emergency, intensive care  and/or peri-operative nurses to disasters; whereas, community, mental health, general practice and public health nurses should also be considered.


Ranse J. (2012). In the wake of disaster: treat physical and mental injuries. Nursing Review [Australian College of Nursing – newsletter publication]. September:

02 September, 2012

Beyond a clinical role: Nurses were psychosocial supporters, coordinators and problem solvers in the Black Saturday and Victorian bushfires in 2009


Aim: This research explores the roles of nurses that participated in the Black Saturday and Victorian bushfires in February 2009, including aspects that influence nurses’ roles, such as prior education, training and availability of resources.

Background: It is acknowledged that nurses play an important role in disaster response and recovery. However, our understanding of nurses’ roles is superficial and commonly based on descriptions of events in which specifics relating to the nurses’ roles are embedded within other topics or issues. Similarly, aspects that support nurses in the disaster environment, including previous experience, education and the provision of resources, are not well understood.


Method: Single, semi-structured telephone interviews were conducted with 11 volunteer nursing members of St John Ambulance Australia. These interviews were electronically recorded, transcribed verbatim and thematically analysed using a well-recognised human science approach.

Findings: The thematic analysis identified two broad themes: being prepared and having an expansive role. Participants indicated that they were educationally prepared and had adequate clinical experience. They outlined that they took many resources with them; however, they were used very little, as their role consisted of minimal clinical care. Additionally, nurses performed roles including a psychosocial supporter, a coordinator of care and resources, and problem solvers.

Conclusions: The nurses’ role in providing health care during and/or following a disaster is more than a clinical care role. This understanding should be applied to the development of education programs, competencies and policies, with a particular focus on contextualising the education to the realities of possible disastrous scenarios that incorporates elements of coordination, problem solving and psychosocial care within a national framework. Additionally, this awareness education should be used to inform nurses about the realities of working in disaster environments.


Ranse J, Lenson S. 2012. Beyond a clinical role: Nurses were psychosocial supporters, coordinators and problem solvers in the Black Saturday and Victorian bushfires in 2009. Australasian Emergency Nursing Journal. 15(3):156-163. doi:10.1016/j.aenj.2012.05.001

27 August, 2012

How to survive a mass gathering


I was interviewed for an article in Science Illustrated on 'how to survive a mass gathering'. Overall, the final article summarised our telephone conversation. In particular, it highlighted some key points to survive a mass gathering, such as the:
  • Early identification of 'safe' places within the event, such as first aid, police, and event officials,
  • Organisation of a meeting place with family and friends, if you become lost,
  • Ensure you have a list of your medications, previous medical and surgical history
  • Remain well hydrated in hot weather, and
  • Ensure you have adequate sun protection,
The article makes reference to surviving the effects of tear gas during a mass gathering - I did not make any comments related to tear gas as it has not been an element of Australian mass gatherings. 

03 July, 2012

Hermeneutic phenomenology: Australian civilian nurses' lived experience of assisting in disasters

This presentation was delivered as part of my PhD progress at the Flinders University, School of Nursing and Midwifery, Higher Degrees Research Week.




ABSTRACT
Australian civilian nurses actively participate in disasters, both nationally and internationally. This participation is understood primarily from anecdotal descriptions of single events. Additionally, our understanding stems from small volumes of Australian research pertaining to the nurses’ role, educational preparedness and willingness to assist in disasters. To date, an in-depth understanding of the experiences of Australian nurses’ who have participated in disasters remains superficial, relying on anecdotal descriptions.

This research aims to explore and interpret the lived experience of Australian civilian nurses (division 1) working in the out-of-hospital disaster environment. To achieve this, this research will use a hermeneutic phenomenological approach, employing a traditional snowballing purposive sampling technique and individual in-depth interviews as a means of data collection.

This presentation will provide an overview of phenomenology, focusing on hermeneutic phenomenology. This overview will include a historical account of the development of the phenomenological movement. Key philosophers and their contribution to the philosophical thinking that underpins phenomenology will be discussed, such as Husserl, Heidegger, Satre, Merleau-Ponty, Dilthey and Gadamer. Primarily, this presentation will highlight the suitability of hermeneutic phenomenology as an approach to address the research aim.

Ranse J. (2012). Hermeneutic phenomenology: exploring Australian nurses' lived experience of assisting in disasters; paper presented at the Flinders University, School of Nursing and Midwifery, Higher Degrees Research Week, Adelaide, South Australia, 3rd July.

30 June, 2012

Examining the roles nurses play in disasters


I was interviewed by Sue Goss from The Age regarding my nursing career and current nursing activities. This was published in the My Career section in a lift-out for the Royal College of Nursing, Australia – Melbourne Nursing and Health Expo.


Examining the roles nurses play in disasters. The Age. June 30 2012. p.6 of the My Career lift-out.

26 June, 2012

Invitation to share your experience of disasters for a PhD research project


Below is the 'invitation and information' that I used in the participant recruitment phase of my PhD. I used a purposive snowballing technique to recruit participants, and this ivitation was initially e-mailed to members and associates of the Flinders University, Disaster Research Centre.

Dear ............

I obtained your contact details through your affiliation with the Flinders University, Disaster Research Centre. I wonder if you could assist me in the recruitment of participants for my PhD research? To assist could you circulate this e-mail and the attached ‘invitation and information’ sheet to your colleagues and associates that may be interested in participating?

I wish to recruit nurses who:
• Primarily work as a clinician in a hospital,
• Have participated in the health response and/or recovery to a disaster, in the last five years,
• Responded with a civilian (non-military) organisation, association, group or health service, and
• Worked in the out-of-hospital environment during the disaster.

The attached document outlines additional information about the project such as an overview of the project, the project aim, what participation will involve, information about the researcher and research ethics relating to this project.

Please feel free to contact me if you have any questions or wish to participate.

Kind Regards,

Jamie

The document below was attached to the initial e-mail. It outlines information about the project such as an overview of the project, the project aim, what participation will involve, information about the researcher and research ethics relating to the project.

19 May, 2012

Understanding and identifying potential risks for participants at music festivals


This presentation provided an overview of the preliminary findings of a project that aimed to enhance our understanding of the nature of patient presentations of young people (aged between 18 and 25 years) at music festivals in Australia. This presentation focused on data from outdoor music festivals in four Australian States.


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.

13 February, 2012

Be prepared – thinking of your health during natural disasters



I published an article in The Conversation regarding the role of first responders during disasters. In particular, this article focused on the need for governemnt to support first responders, and the need for communities to prepare for thier health needs prior, during and following a disaster.


Ranse J. (2012) Be prepared - thinking of yoru health during natural disasters. The Conversation. https://theconversation.edu.au/be-prepared-thinking-of-your-health-during-natural-disasters-5160

22 January, 2012

"UC expert urges Australians to be ‘health prepared’ for disasters"

Photo from University of Canberra - Monitor Online by Michelle McAulay

In late January / early February I participated in a number of media interviews that focused on the need for members of the community to be 'health prepared' for disasters.

Print media appearances: 
Article above from the City News, 21st June 2012

Radio media appearances:
  • What you can do to be health prepared for a disaster; radio interview on 2CC Canberra weekend lifestyle program, 21st January
  • News headlines on the following stations (January / February): Radio National; ABC 891 Adelaide; ABC North and West SA (Port Pirie); ABC Riverland SA (Renmark); ABC South East SA (Mt Gambier); ABC West Coast SA (Port Lincoln); ABC 612 Brisbane; ABC Capricornia (Rockhampton); ABC Far North (Cairns); ABC Gold and Tweed Coasts (Gold Coast); ABC North Queensland (Townsville); ABC North West Qld (Mt Isa); ABC Southern Queensland (Toowoomba); ABC Sunshine and Cooloola Coasts (Sunshine Coast); ABC Tropical North (Mackay); ABC Western Queensland (Longreach); ABC Wide Bay (Bundaberg); 2CA (Canberra); 2CC (Canberra).
Media release:
We are used to preparing our homes and belongings for the threat of bushfires, storms and floods in the summer disaster season, but Australians need to be prepared to look after their own health in emergency, according to a University of Canberra disaster response expert.

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

“People often think about sentimental items they would collect if they were evacuated from their homes, such as photo albums and computers, but they often forget to think about items that support their health needs,” he said.

Mr Ranse said during 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 to being health prepared:
  • Have a current list of medications, aliments 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

13 December, 2011

The lived experience of Australian nurses working in disaster environments - PhD progress


This presentation outlines the literature review, research question, methodology and progress of my PhD. Overall, this presentation provided a superficial outline of what I plan to undertake for this work.

01 December, 2011

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

26 November, 2011

Rural health issues in disasters



I was invited by the Australian Capital Territory / Southern New South Wales Chapter of the Royal College of Nursing, Australia to present about disaster health. My presentation focused on the issues in rural health, specifically for nurses. My discussion focused on nurses' educational preparedness, willingness and role. Additionally, I discussed the agreements between nurses and government (in terms of leave and pay entitlements) and issues in disaster tourism.

  

Ranse J. (2011). Rural health issues in disasters; invited speaker for the RCNA Acute Care Conference, Wagga Wagga, NSW, 26th November.

06 November, 2011

'Stressful jobs prove costly'


I was interviewed by a reporter from the Canberra Times, Phillip Thompson regarding my experience of being a ‘front line’ emergency service worker – particularly from an emergency nursing perspective. The interview focused on the stress related with the profession and the variety of available strategies to manage stress.

The published article ‘Stressful jobs prove costly’ outlines the cost of stress related leave from emergency services. Additionally, the article discusses my contribution regarding coping strategies and comments regarding the benefit of debriefing.

The published article generated some interesting discussions from persons who read the article. I refrained from commenting...

21 October, 2011

Disaster health: An Australian nursing perspective



This presentation was delivered to delegates visiting the University of Canberra from the Mahidol University, Thailand. This presentation focused on what is known about the Australian disaster environment, from an Australian perspective. In particular, this presentation outlined the disasters Australian nurses have participated in, disaster nursing education, the nurses out-of-hospital role, in-hospital role and future research collaborative opportunities between the University of Canberra and Mahidol University.

Ranse J. (2011). Disaster health: An Australian nursing perspective; paper presented to delegates of the Mahidol University Thailand, University of Canberra, ACT, 21st October

19 October, 2011

The role of new graduate nurses in disasters (workshop)



Shane Lenson assisted me in presenting this workshop to graduate nurses at Calvary Health Care ACT during a study day focusing on 'codes'. The workshop focused on 'code brown' or external disasters / emergencies. The workshop comprised of a short oral presentation (above) followed by a number of workshop activities. The activities focused on the role a graduate nurse may undertake during disasters. Broadly this included:
• Prioritisation of care
• Accommodating surge capacity
• Communication
• Business continuity (or continuing adequate patient care) during power, water and/or oxygen supply shortages.


Ranse J. (2011). The role of new graduate nurses in disasters; workshop presented to new graduate nurse at Calvary Health Care ACT, Canberra, ACT, 28th September.

05 October, 2011

The lived experience of Australian nurses working in disaster environments - my PhD progress


This is my second PhD progress presentation. It outlines my progress in my PhD to date. In particular, it focuses on what we currently know about Australian nurses in the context of out-of-hospital disaster work, and the research methodology and method that will be used for my (current) proposed PhD plan. This presentation was delivered at the University of Canberra, Disciplines of Nursing and Midwifery Research Residential School, 5 October 2011.

Ranse J (2011). The lived experience of Australian nurses working in disaster environments; PhD progress presented at the University of Canberra, Disciplines of Nursing and Midwifery Research Residential School, 5th October.

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