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Role of Hospitals in Disaster Planning
1. Occupancy characteristics
2. Role during disaster situations
3. Economic and social costs
Occupancy characteristics
At any one time hospitals have three types of populations; resident patients, transient patients,
staff, and visitors. This has three major implications for disaster preparedness:
i. Treatment of patients duri ng a hazardous event provision must be made for staff and
support services to be readily available at all times.
ii. The safety and security of all occupants must be assured; a vulnerability needs analysis
needs to be done.
iii. Might be necessary to evacuate ambulant and non ambulant patients. The problem can
be exacerbated if the event is sudden and occurs at a time when the hospital is full of
The Role of Hospitals in Disaster Situations
Acute care hospitals are expected to treat patients and deal with anticipated increases in injuries
during a disaster. This means that staff must be in place and know how to respond. Contents
must also be in a serviceable condition. It is important to have alternative arrangements for
housing patients in case there is a disaster. If there are no alternative arrangements and damage
occurs to the hospital, this could present a major crisis for the hospital and the country.
Systematic and easy mobilization of staff, equipment and supplies in a safe and secure
environment is important for an effective disaster response. This emphasizes the critical nature
and interdependency of processes, buildings and contents.
These are concerned with the mobilization of people, equipment and supplies.
Plans should include alternative arrangements in the event of a serious damage to the hospital
facility. Critical areas which must be considered are: A&E, diagnostic facilities, OTs, the
pharmacy, medical and food stores, utility backup services.
Building Contents
Earthquakes tend to cause more damage than hurricanes. Much damage can be avoided by
securing shelving to walls, and siting plant and equipment in strategic and secure positions.
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Economic and Social Costs
Most health care facilities in the Caribbean are owned and operated by governments, and
financed through revenue taxation. On average these countries spend about 5%-15% of the
national budget, with 40% of the health budget being spent on hospital services.
Any adverse impact on the economy of a country will affect the capacity to provide health
services. Further, it will also affect the human productive capacity and would erode the public
finances due to the high costs of restoration.
Impact of Hurricanes
Because of the frequency and large area they cover, and the smallness of island in the Caribbean
hurricanes can be very dangerous.
Capital Investments
Throughout the Caribbean there has been much expansion and retrofitting of hospitals despite
the additional burdens of running these facilities. This makes it critical that such investments in
social programs and economics strategies are secure and not subject to the vagaries of natural
Disaster nursing can be defined as “the adaptation of professional nursing knowledge, skills and
attitude in recognizing and meeting the nursing, health and emotional needs of disaster victims.”
The overall goal of disaster nursing is to achieve the best possible level of health for the people
and the community involved in the disaster.
Other goals of disaster nursing are the following:
1. To meet the immediate basic survival needs of populations affected by disasters (water,
food, shelter, and security).
2. To identify the potential for a secondary disaster.
3. To appraise both risks and resources in the environment.
4. To correct inequalities in access to health care or appropriate resources.
5. To empower survivors to participate in and advocate for their own health and well-being.
6. To respect cultural, lingual, and religious diversity in individuals and families and to apply
this principle in all health promotion activities.
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7. To promote the highest achievable quality of life for survivors.
The basic principles of nursing during special (events) circumstances and disaster conditions
1. Rapid assessment of the situation and of nursing care needs.
2. Triage and initiation of life-saving measures first.
3. The selected use of essential nursing interventions and the elimination of nonessential
nursing activities.
4. Adaptation of necessary nursing skills to disaster and other emergency situations. The
nurse must use imagination and resourcefulness in dealing with a lack of supplies, equipment,
and personnel.
5. Evaluation of the environment and the mitigation or removal of any health hazards.
6. Prevention of further injury or illness.
7. Leadership in coordinating patient triage, care, and transport during times of crisis.
8. The teaching, supervision, and utilization of auxiliary medical personnel and volunteers.
9. Provision of understanding, compassion, and emotional support to all victims and their
“Disaster preparedness, including risk assessment and multi-disciplinary management strategies
at all system levels, is critical to the delivery of effective responses to the short, medium, and
long-term health needs of a disaster-stricken population.” (International Council of Nurses,
1. Determine the magnitude of the event
2. Define health needs of the affected groups
3. Establish priorities and objectives
4. Identify actual and potential public health problems
5. Determine resources needed to respond to the needs identified
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6. Collaborate with other professional disciplines, governmental and non-governmental
7. Maintain a unified chain of command
8. Communication
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