Chapter 22- Sullivan, Effective Leadership and Management

A level III disaster has occurred and the hospital is receiving clients by ambulance and those who have walked in to the emergency department. The wife of a man who is critically injured screams, "Why doesn't someone do something for my husband? He is dying!" How should the nurse manager respond?

"I'm so sorry, but your husband's injuries are very severe. We have to take care of the others first." This is a kind statement of fact and is a good way to address this wife.

Multiple casualties have arrived at the emergency department following a tornado. Which instruction from the manager to staff is incorrect?

"There is no time to worry about using personal protective equipment, just try to be safe." This is an essential time to use personal protective equipment.

A hospital administrator on a disaster planning team says, "I am worried about our liability in using volunteers to provide care during a disaster." What should this team consider?

The hospital could have liability for the volunteer's performance and for his or her safety. Hospital liability could extend to actions taken by the volunteer and for anything that happens to the volunteer.

A hospital successfully implemented its disaster plan to manage providing care during a massive 3-day snow storm. What is the most likely way additional costs for this service will be paid?

The hospital will absorb the additional costs. It is likely that the hospital will absorb the additional costs.

The hospital is preparing for a tabletop test of its emergency operations plan. What is the potential for an interruption in services from this drill?

There is little potential for interruption as the drill is all done in a meeting.

A small creek has flooded, requiring the rescue of one person from a stranded automobile. Electrical service was interrupted for a short period and traffic to diverted around flood. The newspaper should report that the town suffered a level 1 ______ disaster.

True. If the response at the local level is sufficient, the disaster is categorized as level 1.

A hospital administrator initiated the emergency operations plan (EOP) after being notified that a tornado struck a nearby community. Thirty minutes later law enforcement calls to report that while significant damage was done, there were only minor injuries. What should the administrator do now?

Follow the EOP to deactivate the plan. There should be specific information in the EOP to deactivate the plan.

The nurse executive of a hospital is surveying hospitals in a four-state area in regard to their disaster preparedness. The nurse would expect to hear which response to the question "What have you done to prepare for a disaster?"

"We conduct practice disaster drills." Over half of U.S. hospitals report conducting practice disaster drills.

A nurse manager is working on a task force to develop policy for man-made disasters. There is some discussion in the committee about whether fire should be included in the policy. Which suggestion by a task force member would be most useful?

"We should only focus on arson fires." Since arson fires are man-made, they would be included in this plan."

A nurse manager has provided education to emergency department nurses regarding disaster management. Which statement would the manager interpret as indicating understanding of this education?

"We should treat as many clients as possible as quickly as possible." This is the goal of emergency treatment in a disaster

A nurse manager is leading an education session regarding disaster triage for emergency department nurses. Which statement should the manager include in this instruction?

"Your triage system will be reversed during a disaster." Triage is reversed during a disaster. The least injured clients are seen first.

A nurse is working with a hospital team to create an emergency response plan that will meet Joint Commission requirements. Which sections should be included in this plan?

1. Recognizing disasters imminent or occurring with plans to reduce the disaster's impact 2. Policies and procedures, equipment and personnel in place to handle disasters. 3. Operationalize activities during disasters, describe occurrences immediately after the disaster.

Which statements would the nurse manager interpret as indicating a nurse understands the critical thinking skills necessary for disaster management?

1. "The nurse's prioritization will be different in a disaster." 2. "Clinical judgment skills will be an essential part of nursing's contribution to disaster management." 3. "The nurse's abilities will make the difference in successful management of a disaster."

A hospital's disaster management team is reviewing the disaster plan after reading about a hospital that was destroyed by a tornado's direct hit. What questions should team members ask themselves?

1. "What are our current capabilities for evacuation?" 2. "Do we have sufficient resources in any other areas to continue operations if this happens to us?" 3. "Are there physical training needs that we have not filled?" 4. "What education should we provide to the staff and community?"

Health care providers are preparing for a worldwide outbreak of H1N1 influenza. How would this outbreak be classified in planning literature?

1. As a pandemic spreads around the world 2. As a health disaster spreads around the world 3. As a natural disaster naturally occurring

As part of the disaster plan, the nurse executive is planning an education session on the core competencies for nurses established by the National Emergency Preparedness Education Coalition. Which topics should be included in the handout being written for this session?

1. Communication-Communication is a core competency for nurses established by this group. 2. Technical skills- Technical skills are a core competency for nurses established by this group.

A hospital has written a well-defined surge call-back system for employees to use in case of a disaster. What are key vulnerabilities of this system?

1. Employees may be unwilling to come back into the disaster. 2. Employees may be personally affected by the disaster. 3. There may be no way to contact employees for call-back. 4. The employee may not physically be able to return to the hospital.

A hospital on the Gulf Coast of the United States would list which situations among its top vulnerabilities?

1. Flooding 2. Hurricane 3. Tornado 4. Industrial accident

A hospital administrator receives a call that mass casualty shootings have occurred at several different locations within the city. Early information indicates that up to 50 victims may be arriving at the hospital starting within minutes. What action should the administrator take?

1. Mobilize the hospital incident command system. 2. Notify other administrators and order a rapid needs assessment in all critical areas. 3. Authorize the implementation of the hospital's disaster plan.

An emergency department has been notified that hundreds of injuries have occurred following the collapse of bleachers at a football game. The emergency department nurses should prepare to make which types of assessments?

1. Physical 2. Self 3. Situational 4. Family

A nurse executive is assigned to a task force working on a surge system for the hospital in case of a disaster. This group should write strategies to cover which procedures?

1. Supplies 2. Physical space 3. Management infrastructure 4. Personnel

Why is post disaster follow-up an essential part of disaster planning?

1. To evaluate the performance of those involved 2. To initiate any improvements needed 3. To evaluate the overall effectiveness of the plan

Fire departments from a three county area have responded to a wildfire that has threatened several homes and a hospital in a wooded area. The fire is now under control and the fire chief is completing paperwork on the response. The disaster should be classified at level ______.

2- A level 2 disaster is one that requires a regional response—in this case, fire departments from three counties.

A tornado destroyed 65% of the businesses and homes in a small Midwestern city. Aid would be requested based on categorization as a level ______ disaster.

3- Tornado damage of this magnitude would require statewide or national assistance, which is the definition of a level 3 disaster.

The hospital is conducting a drill of its emergency operations plan (EOP). A nurse is acting as triage officer. Which client would be triaged for immediate care?

A client with a minor forearm laceration that will require a simple bandage and tetanus immunization-The least serious people are seen first in a disaster.

An outbreak of smallpox has followed a national sporting event. Terrorist activity is suspected. How would this event be categorized?

As a man-made, biologic disaster. The dispersion of the biologic agent in this case is thought to be man-made.

A disaster planning task force has been asked to focus on communication. Which instruction should this group provide to nursing staff?

Be certain to maintain the client tracking system. A system to track the client's presence in the facility should be a part of the disaster plan. It is essential to maintain this system so that victims can be accounted for by rescuers

Hospital administration is aware that staff may be reluctant to be called back to work in a disaster. How can the hospital be proactive in encouraging staff to make the decision to serve?

Develop a caring relationship with staff during normal times. If staff members have a caring relationship and feel ownership of the hospital, they are more likely to respond in an emergency.

A hospital has sustained massive destruction after being struck by a tornado. The disaster plan has been activated. The administrator would expect help from which agency to coordinate the disaster efforts?

The Federal Emergency Management Agency (FEMA). Congress directed FEMA to coordinate disaster efforts.

During discussion about the hospital's disaster plan, the administrator says, "I am concerned about our current surge capacity." How should the members of the group interpret this concern?

The administrator is worried about the hospital's ability to respond to a large influx of clients from a disaster. Surge capacity, when discussed in disaster planning, describes the facility's ability to mobilize when suddenly confronted with a vast increase in client demand