The Canadian Forces' (CF) deployable hospital, 1 Canadian Field Hospital, was deployed to Haiti after an earthquake that caused massive devastation. Two surgical teams performed 167 operations over a 39-day period starting 17 days after the index event. Most operations were unrelated to the earthquake. Replacing or supplementing the destroyed local surgical capacity for a brief period after a disaster can be a valuable contribution to relief efforts. For future humanitarian operations/disaster response missions, the CF will study the feasibility of accelerating the deployment of surgical capabilities.
There is a common interest in Swedish society in preparing nurses well for disasters. A special course in the basic nurse education programme is devoted to disaster nursing. The aim of this study is to investigate nursing students' knowledge and views of their own action at the disaster site, both in their professional role and as private persons. The present study is a descriptive one based on the students' written answers. The result shows that the students emphasize contacting the overall disaster officer, surveying the situation and carrying out basic life-saving measures in Sweden known as the ABCs. They also stress the importance of staying calm and, to a lesser extent, seeing to the needs of the mentally shocked. Thus the nursing students seem to regard treatment of physical injuries as most important in the disaster situation.
Capital Health is the largest integrated academic health district in Atlantic Canada. It provides tertiary health services to Atlantic Canadians and to 40 per cent of Nova Scotia's population. Capital Health consists of nine facilities, one of which is the Queen Elizabeth II Health Sciences Centre. The QEII is the largest adult academic health centre in Atlantic Canada, occupying 10 buildings on two sites. It employs 8500 staff and has 1075 beds. The QEII was created in 1996 with the merger of the Victoria General (VG), Halifax Infirmary (HI), Abbie J. Lane Memorial, Camp Hill Veterans' Memorial, Nova Scotia Rehabilitation Centre and the Nova Scotia Cancer Centre. There are 33 operating rooms at the HI and VG sites; together about 29,000 operations are performed there each year. The two hospitals are located about five city blocks away from each other. This article discusses how the two facilities coped after the devastation of Hurricane Juan in September 2003.
We describe an evidence-based approach to enhancing the resilience of healthcare workers in preparation for an influenza pandemic, based on evidence about the stress associated with working in healthcare during the SARS outbreak. SARS was associated with significant long-term stress in healthcare workers, but not with increased mental illness. Reducing pandemic-related stress may best be accomplished through interventions designed to enhance resilience in psychologically healthy people. Applicable models to improve adaptation in individuals include Folkman and Greer's framework for stress appraisal and coping along with psychological first aid. Resilience is supported at an organizational level by effective training and support, development of material and relational reserves, effective leadership, the effects of the characteristics of "magnet hospitals," and a culture of organizational justice. Evidence supports the goal of developing and maintaining an organizational culture of resilience in order to reduce the expected stress of an influenza pandemic on healthcare workers. This recommendation goes well beyond the provision of adequate training and counseling. Although the severity of a pandemic is unpredictable, this effort is not likely to be wasted because it will also support the health of both patients and staff in normal times.
Federal, provincial and municipal leaders in Canada have adopted a culture of preparedness with the development and update of emergency plans in anticipation of different types of disasters. As evident during the 2003 global outbreak of Severe Acute Respiratory Syndrome (SARS), it is important to provide support for health care workers (HCWs) who are vulnerable during infectious outbreak scenarios. Here we focus on the identification and evaluation of existing support mechanisms incorporated within emergency plans across various jurisdictional levels.
Qualitative content analysis of 12 emergency plans from national, provincial and municipal levels were conducted using NVIVO software. The plans were scanned and coded according to 1) informational, 2) instrumental, and 3) emotional support mechanisms for HCWs and other first responders.
Emergency plans were comprised of a predominance of informational and instrumental supports, yet few emotional or social support mechanisms. All the plans lacked gender-based analysis of how infectious disease outbreaks impact male and female HCWs differently. Acknowledgement of the need for emotional supports was evident at higher jurisdictional levels, but recommended for implementation locally.
While support mechanisms for HCWs are included in this sample of emergency plans, content analysis revealed few emotional or social supports planned for critical personnel; particularly for those who will be required to work in extremely stressful conditions under significant personal risk. The implications of transferring responsibilities for support to local and institutional jurisdictions are discussed.
A seven-step approach to structure emergency planning has helped Montfort Hospital in Ottawa to promote prevention and achieve a higher degree of preparedness. The seven steps include: using the mission statement to form goals and objectives; creating an organizational structure to delegate responsibilities; upgrading systems to comply with existing codes and standards and to include their costs in annual budgets; compiling main, secondary and condensed emergency plan manuals for different levels of staff; planning activities to stimulate staff interest and promote the program; training staff and evaluating the process. A collective approach to emergency planning and a prepared facility should result from the implementation of a comprehensive emergency measures program.
Biological weapons have been known for centuries, and since World War II, offensive programs have accelerated the development of these weapons considerably. The anthrax attacks in the fall 2001 and speculations regarding the research and development of Iraqi bioweapons have been causes for concern. The effect of biological weapons may be overwhelming, in particular when one is dealing with a contagious agent. The National Centre for Biological Defence provides a preparedness capability through evidence-based research and practical operational capabilities.