Disaster Nursing

The announcement is made that the facility may return to normal functioning after a local disaster. In the emergency operations plan, what is this referred to as? A) Demobilization response B) Post-incident response C) Crisis diffusion D) Reversion

A) Demobilization response The demobilization response occurs when it is deemed that the facility may return to normal daily functioning. This is not known as the post-incident response, crisis diffusion or reversion.

Essential Components of Emergency Preparedness Plan:

- Activation response - Internal and External communication plan - Plan for coordinated patient care - Security plans - Identification of external reosurces - Plan for people management and traffic flow - Data management strategy - Demobilization response - After-action report or corrective plan - Plan for practice drills - Anticipated resources - MCI planning Education for all of the above

NPSG goals:

- ID patients correctly - Improve staff communication - Use medicines safely - Prevent infection - ID pt safety risks - Prevent mistakes in surgery

QSEN: Defines competencies related to

- Patient-centered care - Teamwork and Collaboration - EBP - QI - Safety Informatics

A major earthquake has occurred within the vicinity of the local hospital. The nursing supervisor working the night shift at the hospital receives information that the hospital disaster plan will be activated. The supervisor will need to work with what organization responsible for coordinating interagency relief assistance? A) Office of Emergency Management B) Incident Command System C) Centers for Disease Control and Prevention D) American Red Cross

A) Office of Emergency Management The Office of Emergency Management coordinates the disaster relief efforts at state and local levels. The Incident Command System is a management tool to organize personnel, facilities, equipment, and communication in an emergency situation. The CDC is the agency for disease prevention and control and it supports state and local health departments. The American Red Cross provides additional support.

During a mass disaster, the nurse is caring for a victim whose status has been categorized as yellow during triage. How should the nurse best allocate time and resources to this client's care? A Delay the client's treatment for a few hours if other clients need immediate care B Provide high-priority, immediate care to save the client's life C Forego immediate care because the client is unlikely to survive D Place a low priority on the client's care because the client will likely recover independently

A Delay the client's treatment for a few hours if other clients need immediate care For a client categorized as yellow, care can be safely delayed for six to eight hours. Death is not imminent, but spontaneous recovery is unlikely.

A community health nurse is performing client triage while participating in a disaster drill. The nurse should recommend that which of the following client injuries receives treatment first? A. Hemothorax B. Open humeral fracture C. Multiple deep abrasions on the arms and face D. Superficial partial-thickness burns on both legs

A. Hemothorax The nurse should apply the survival potential priority-setting framework in mass casualty situations, when resources are scarce and resources must be allocated to save the greatest number of lives. While it could seem that the client who is most at risk should receive priority care, this client is the lowest priority. The nurse should assign the highest priority to the client with injuries that are severe who has the potential to survive with treatment. Therefore, the nurse should recommend that the client who has a hemothorax receives treatment first. A hemothorax is life-threatening, but with chest-tube insertion and stabilization, the client is likely to survive.

A nurse manager calls a meeting of the unit's staff members to discuss cost-containment issues. The nurse manager has asked for staff input regarding strategies to help reduce costs. Which of the following types of leadership is the nurse manager using? A. Autocratic B. Democratic C. Laissez-faire D. Moral

B. Democratic This is an example of democratic leadership. A democratic leader guides staff toward an objective and shares responsibility with the staff. This is the ideal type of leadership in this situation because a great amount of creativity can occur, and many strategies can be developed.

Core measures

Benchmark standards of best practices used to gauge how well a hospital gives care to its patients who are admitted to seek treatment for a specific disease (e.g., heart failure) or who need a specific treatment (e.g., an immunization)

Evidence based practice (EBP)

Best practice derived from valid and reliable research studies that also considers the health care setting, patient preferences and values and clinical judgment.

During a disaster, the nurse triages a victim with a fractured wrist. Which color triage tag should the nurse apply? A Yellow B Black C Green D Red

C Green

Homeland Security has alerted the disaster response teams in your region of a potential terrorist attack in the form of a nuclear blast. You are a part of the disaster response system and you know that with a nuclear blast you would need to be prepared for what classification of disaster? A Biologic B Chemical C Radiologic D Manmade

C Radiologic Radiologic disasters can occur in the following ways: Explosion of a dirty bomb; Damage to or human error in a nuclear power plant facility; Nuclear blast.

A group of providers is participating in a cardiopulmonary resuscitation effort for a client who is in cardiac arrest. Which of the following types of leadership is required for this group to function efficiently? A. Transformational B. Participative C. Autocratic D. Laissez-faire

C. Autocratic Autocratic leadership is most effective in an emergency situation. An autocratic leader will direct and issues commands that are necessary for successful cardiopulmonary resuscitation.

A charge nurse is coordinating the evacuation of clients from a facility following a bomb threat. Which of the following actions should the nurse take when implementing the evacuation process? A. Call the clients' family members to provide additional help with moving the clients. B. Ask clients who are able to ambulate to assist in moving the unstable clients. C. Instruct clients who are able to ambulate to leave. D. Direct staff members to close the doors and windows as each room is evacuated.

C. Instruct clients who are able to ambulate to leave. Clients who are able to ambulate should leave first in an evacuation process, as this quickly reduces the number of clients who require evacuation assistance.

The Goal of Providing EBP is the process of:

Collecting Processing Implementing research findings

The NATO triage system uses color-coded tagging to identify severity of injuries. A patient with survivable but life-threatening injuries (i.e., incomplete amputation) would be tagged with which color? A Black B Red C Green D Yellow

B Red Triage category "Immediate" is coded red and includes injuries that are life threatening but survivable with minimal intervention, such as an incomplete amputation.

A nurse is triaging patients after a chemical leak at a nearby fertilizer factory. The guiding principle of this activity is what? A) Assigning a high priority to the most critical injuries B) Doing the greatest good for the greatest number of people C) Allocating resources to the youngest and most critical D) Allocating resources on a first come, first served basis

B) Doing the greatest good for the greatest number of people In nondisaster situations, health care workers assign a high priority and allocate the most resources to those who are the most critically ill. However, in a disaster, when health care providers are faced with a large number of casualties, the fundamental principle guiding resource allocation is to do the greatest good for the greatest number of people. A first come, first served approach is unethical.

A nurse is caring for patients exposed to a terrorist attack involving chemicals. The nurse has been advised that personal protective equipment must be worn in order to give the highest level of respiratory protection with a lesser level of skin and eye protection. What level protection is this considered? A) Level A B) Level B C) Level C D) Level D

B) Level B Level B personal protective equipment provides the highest level of respiratory protection, with a lesser level of skin and eye protection. Level A provides the highest level of respiratory, mucous membrane, skin, and eye protection. Level C incorporates the use of an air-purified respirator, a chemical resistant coverall with splash hood, chemical resistant gloves, and boots. Level D is the same as a work uniform.

NPSG are designed to:

stimulate improvement measures for health care organization's regarding several of the most challenging pt safety issues - these goals are reviewed and published each year and are a critical component of the Joint Comission's overall efforts to improve healthcare

Goal for QSEN: To set the challenge of preparing future nurses who will have the:

Knowledge Skills Attitude

NIMS

National Incident Management System

NPSG

National Patient Safety Goals

Joint commission

Nonprofit organization that accredits hospitals and health care organizations

Disaster Types:

Type 1 and 2: National and State level Type 3: State or Metropolitan Type 4: City, county and fire district Type 5: Local village and township

Disaster Continuum and Disaster Management Phases

Preparedness, Mitigation, Response, Recovery

QSEN

Quality safety Education for Nurses

Quality and Safety Education for Nurses

a project whose aim is to develop curricula that prepare future nurses with the knowledge, skills, and attitudes (KSAs) required to continuously improve the quality and safety of the health care system through demonstrating competency in patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics

Disaster Continuum and Disaster Management Phases: Mitigation

Reducing potential disaster damages before a disaster threatens

Disaster Continuum and Disaster Management Phases: Recovery

Returns infrastructure systems to minimum operating standards

Level C personal protective equipment has been deemed necessary in the response to an unknown substance. The nurse is aware that the equipment will include what? A) A self-contained breathing apparatus B) A vapor-tight, chemical-resistant suit C) A uniform only D) An air-purified respirator

D) An air-purified respirator Level C incorporates the use of an air-purified respirator, a chemical resistant coverall with splash hood, chemical-resistant gloves, and boots. Level A provides the highest level of respiratory, mucous membrane, skin, and eye protection, incorporating a vapor-tight, chemical-resistant suit and self- contained breathing apparatus (SCBA). Level B personal protective equipment provides the highest level of respiratory protection, with a lesser level of skin and eye protection, incorporating a chemical- resistant suit and SCBA. Level D is the same as a work uniform.

The nurse has been notified that the ED is expecting terrorist attack victims and that level D personal protective equipment is appropriate. What does level D PPE include? A) A chemical-resistant coverall with splash hood, chemical-resistant gloves, and boots B) A self-contained breathing apparatus (SCBA) and a fully encapsulating, vapor-tight, chemical- resistant suit with chemical-resistant gloves and boots. C) The SCBA and a chemical-resistant suit, but the suit is not vapor tight D) The nurses typical work uniform

D) The nurses typical work uniform The typical work uniform is appropriate for Level D protection

A nurse is selecting clients for discharge following an environmental disaster. Which of the following clients should the nurse select? A. A client who had a cast removal due to compartment syndrome B. A client who is scheduled for dialysis and has a potassium level of 6.2 mEq/L C. A client who has type 1 diabetes mellitus and a blood glucose of 320 mg/dL D. A client who is 1 day postoperative following an inguinal hernia repair

D. A client who is 1 day postoperative following an inguinal hernia repair The nurse should select the client who had an inguinal hernia repair for discharge because this client is stable.

A new nurse manager on a busy oncology unit keeps her door closed when she is in the office and does not offer to help resolve daily staffing issues. Which of the following types of leadership behavior is this nurse manager displaying? A. Transformational B. Democratic C. Autocratic D. Laissez-faire

D. Laissez-faire This nurse manager is a laissez-faire leader, providing little support or guidance. The leader's activity is minimal and contributes to reduced staff efficiency.

While participating in a continuous quality-improvement program, a nurse is reviewing medical records to determine the time of first postoperative ambulation of clients who had abdominal surgery. In which type of quality audit is the nurse participating? A. Outcome B. Structure C. Strategic planning D. Process

D. Process A process audit measures the interventions used to facilitate expected and desired outcomes for clients. Early ambulation is essential for the prevention of postoperative complications.

A nurse is tracking the outcomes of clients on the unit who have received postoperative pain management. This activity demonstrates which of the following competencies of the Quality and Safety Education for Nurses (QSEN) initiative? A. Safety B. Informatics C. Patient-centered care D. Quality improvement

D. Quality Improvement A strong education plan for all personnel regarding each step of the plan allows for improved readiness and additional input for fine-tuning of the EOP.

Disaster Continuum and Disaster Management Phases: Preparedness

Developing operational capabilities and facilitating an effective response before and emergency occurs

A charge nurse is planning a department in-service training session about radioactive implants for a group of staff nurses. Which of the following points should the charge nurse include in the presentation? (Select all that apply.) A. Clients should be placed in a private room. B. Throw away an implant that has fallen out in the client's trash can. C. Staff members should wear a dosimeter badge when caring for the client. D. Clients should be on bed rest. E. Children over the age of 12 years can visit if they are accompanied by an adult.

A. Clients should be placed in a private room. C. Staff members should wear a dosimeter badge when caring for the client. D. Clients should be on bed rest. Clients should be placed in a private room to avoid exposing other clients to radiation from the implant. The nurse should follow the principles of time, distance, and shielding when working with a client who is receiving internal radiation therapy.

Disaster Continuum and Disaster Management Phases: Response

Actions taken immediately before, during or directly after an emergency occurs

FEMA

Federal Emergency Management Agency