Emergency and Disaster

Nursing in Hospital
Ronny Basirun Simatupang, S.Kep.Ns., M.Si (Han)

International Nursing Webinar

DPK Pendidikan
Sunday, 9 April 2023
LCDR Ronny Basirun Simatupang, RN., M.Sc (Def)

Rank : Liutenant Commander

Position : Relation Department Officer Surgeon General Armed
Forces
Date of Birth : Porsea, 3 December 1983
Address : Cluster Taman Asri Blok F/5 Jatiranggon Bekasi City
Religion : Christian
Education : Bachelor of Nursing – North Sumatera University
2005
Law School UNSURYA (2020 – Now)
Disaster Management Master Degree – RIDU 2017
Military Ed : Basic officer Military Training, Health Specialized
Mil Training
TOD/TOA : Navy Hospital DR. Gandhi AT Biak - Papua
Marine Hospital Cilandak Jakarta
Organization : EDNA, IDEA (Indonesian Disaster Expert Association)
Outline
Emergency Vs Disaster
Disaster Management
Disaster Nursing Competencies
Disaster Nursing in Hospital
Challenges for Nurses
Conclusion
Emergency vs Disaster ???
Emergency
Disaster
Any extraordinary event or
An Event or situation that is of greater magnitude
situation that requires an intense,
than an emergency; disrupts essential services
rapid response that can be
such as housing, transportation, communication,
addressed with existing community
sanitation, water, health care, and that requires
resources
the response of people outside the community
affected

(Kristine M. Gebbie, 2002)

Disaster Management

Mitigation

Recovery Preparedness

Response
Paradigm Shifts in Disaster Management

Response Risk Reduction

Interprofessional Multisectoral
Challenges for Nurses in Disaster
Management
1. Lack of disaster nursing training
2. Less training for nurses’ knowledge and skills in leadership
(coordinating) and psychological problems (mostly physical
problems)
3. Available training was often designed for improving nurses’
knowledge and skills in the response phase
Disaster Nursing Care Plan Model
Documentation Assessment

Mitigation Preparedness
Community

Family

Evaluation Diagnosis
Individual

Recovery Response
Illustrated by Arcellia Farosyah Putri 2021
arcel_farosy@yahoo.com

Sourcer:
Implementation Intervention ICN Framework Disaster Nursing 2019 &
Fundamental of nursing
What do nurses do?
Behaviour

Skills PEOPLE Knowledge

Beliefs
Disaster Nursing Competencies
Competency Domains

(ICN, 2019)
Disaster Nursing Competencies

Level 1 Any nurse who completed basic programme, general education

and authorised to practice
Level 2 Any nurse who has achieved the level 1 competencies and
designated disaster responder within an institution, organisation
or system
Level 3 Any nurse who has achieved level I and II competencies and
prepared to respond to a wide range of disasters and
emergencies and to serve on a deployable team

(ICN, 2019)
(ICN, 2019)
(ICN, 2019)
(ICN, 2019)
DISASTER NURSING IN HOSPITAL

Mitigation

Preparedness

Response

Recovery
 Mitigation

Risk assessment: Hazard

Vurnerability Assesment

Advocating all Staff and Patients in

Hospital

Hospital Disaster Plan

(Bullock et al., 2012)

HAZARD MAPS
PEMETAAN KEPADATAN MASYARAKAT DI RS
(POPULATION DENSITY)
OFFICE Emergency Unit
200 People 500 People

IN PATIENT ROOM POLICLINIC

300 People 1000 People
PEMETAAN PERALATAN KESELAMATAN
(Fire Safety Equipment)
EVACUATION ROUTE
 RESCUE MEANS
 Emergency Stairs
 “EXIT WAY”
 Assembly Point
 Emergency Exit
 Do not Use Elevators
 Preparedness

Training

Simulation

(Bullock et al., 2012)

Delivering Direct Care Response
 Wound care
 Bandaging and splinting
 Control bleeding
 IV insertion and fluid resuscitation
 Airway – breathing management
 Basic Life Support
 Disaster triage
 Evacuation, Stabilization and Transportation
 Response
 Activate Incident Command System
 Communication System
 Human Resources
 Logistics
 Essential Support Service
 Surge Capacity
 Infection and Prevention Control

(WHO, 2009)
(FEMA, 2016)
 CILANDAK MARINE HOSPITAL
DISASTER MANAGEMENT TEAM
Human Resources
 Human Resources Policy
 Minimum Essential Health Workers
 Recruitment and Training
 Nursing Staff Rotation
 Routine Medical Check Up for Staff
 Family services as long as disaster
Response
 Multisector collaboration and Coordination
 Assurance for Health Workers

“Adapted human resource management is

required to ensure adequate staff capacity
and continuity of operations in response to
an increased demand for human resources”
 Logistics & Suplay Chain Management
 Logistics comprises such activities as procurement,
transport, warehousing and stock monitoring,
tracking and reporting.
 Coordination of logistics between the various
hospital departments and units is a core function of
the hospital’s Incident Command Group.
 Providing support for patient transport is an
essential logistic function for the transfer of
patients between hospitals, especially referral
hospitals.
 Ensuring the availability of back-up resources and
providing support for the maintenance of essential
equipment are important logistic functions. “The continuity of hospital services and
 Logistics management can be facilitated by the availability of essential equipment and
procuring standard equipment and adopting supplies, including pharmaceuticals,
standard procedures. require a proactive approach to resource
Essential Support Services
 Food and nutritional Services
 Security
 Engineering and maintenance
 Laundry, cleaning, waste management
 Cleaning
 Mortuary services

To optimize patient care, it is

necessary to identify and maintain
essential support services (e.g.,
laundry, cleaning, waste
management, dietary services and
security).
Surge Capacity
“Surge capacity is the ability of a health
service to expand beyond its normal capacity
to meet this increased demand”.

 Total Number of Nurses

 Plan the action when the patients arise
 Standard of Procedure
 Triage Patients
 Posting Patients based on level of severity
 Recruit Health Worker Volunteer if needed
Infection and Prevention Control (IPC)
 Adapt the infection prevention and control
component of the Hospital Emergency Response
Plan
 Assess infection prevention and control staffing
needs for the emergency
 Make sure that the hospital’s infection prevention
and control policies are consistent with the
presumed mode of transmission of the epidemic
infection and with locally available resources.
 Reinforce standard infection control precautions
and establish additional precautions if required by “An operational IPC policy is essential to
the specific nature of the epidemic. minimize the risk of transmission of
 Establish patient flow based on transmission nosocomial infection to patients, hospital
risks and on patients' clinical status staff, and visitors”
Activities Recovery

 Preventing outbreaks
 Maintaining sanitation and clean environment
 Psychological first aid
 RE- Evaluation Hospital Disaster Plan
Challenges for Nurses
Nurse’s Roles

Nurse’s Competencies
Next Challenges …………..
Conclusions
1. Good Preparedness will be a key of good Response
2. Nurses need to have knowledge and skills needed to carried
out their roles in disaster management in Hospital
3. Continues professional development for disaster nurses needs
to be established
4. Urgently needs comprehensive disaster nursing training that
addressing each level of disaster nurse’s competency
Disaster Nurses

https://www.sheffield.ac.uk/rs/ecr/training/cpd
References
1. Bullock, J. A., Haddow, G. D., & Coppola, D. P. (2013). Mitigation, Prevention, and
Preparedness. Introduction to Homeland Security, 435–494.
https://doi.org/10.1016/B978-0-12-415802-3.00010-5
2. Efendi, F., Indarwati, R., Aurizki, G. E., Susanti, I. A., & Maulana, A. E. F. (2021). Policymakers’
perspectives on responding to the elderly’s mental health needs in post-disaster situations. Journal
of Public Health Research, 11(1). https://doi.org/10.4081/jphr.2021.2386
3. UNDRR https://www.preventionweb.net/
4. ICN. (2019) Core competencies in disaster nursing version 2.0.
https://www.icn.ch/sites/default/files/inline-files/ICN_Disaster-Comp-Report_WEB.pdf
5. Infection prevention and control of epidemic-and pandemic prone acute respiratory infections in
health care - WHO guidelines. World Health Organization, 2014.
THANK YOU