TEAM WORK COMPETENCE IN DISASTER RESPONSE: A QUALITATIVE CONTENT ANALYSIS STUDY OF EMERGENCY NURSES EXPERIENCES

Background and aim: Statistics show high prevalence of disasters across the world and Iran. Since nurses are one of the most important members in the disaster team and they have unique role as a professional and volunteer in time of responding to disaster, they should be able to participate within a team framework and have necessary competences for teamwork in a disaster. This paper reported the results of a qualitative study on the teamwork competences needed by nurses for effective teamwork in response to crisis. Methods: This is a part of larger qualitative study, performed on nurses’ competences in 2012, in Iran. 35 interviews were conducted with nurses who had experience of presence and providing care in a disaster situation. The sampling of participants was done purposefully and continued until data saturation. The data were collected through in-depth unstructured interviews and analyzed using a conventional content analysis approach. Results: Data analysis of qualitative study revealed work qualification in crisis team that includes two main categories: 1) knowledge of duties and organizational hierarchy and 2) maintenance of unity of command. “Obedience from commander”, “avoidance of doing in parallel”, and “coordination and cooperation with leader, relief forces, and other team members” were of the extracted competences in this study, which were highly important for teamwork in crisis. Conclusions: This article presented the results on the qualifications required by nurses for successful teamwork in phase of response to crisis. The analysis of participants’ viewpoints indicated that the nurses need to be completely familiar with their and other team members’ limitations and duties, to know managerial hierarchy, and to be able to maintain unity of commanding. Therefore, nurses’ in-service training to be prepared for response to crisis should address this dimension, as well

Team work competence in disaster response: an explorative study about Emergency nurses experiences: A qualitative content analysis study

Background and aims: Since the nurses are as the most important members respondent to team crisis, they must be able to have the necessary qualification and capability in a team frame for group work when they faced with crisis. This study was done to evaluate the capability of nurses when facing with crisis. Methods: In this descriptive analytical study, 35 nurses who had the experiences of presence and providing care in a disaster situation were enrolled by purposefully sampling. The data were collected through in-depth unstructured interviews and analyzed using a conventional content analysis approach. Results: The results, introduced knowledge of duties and organizational hierarchy and maintenance of unity of command in two category of capability in work for crisis group. “Obedience from commander”, “avoidance of doing in parallel”, and “coordination and cooperation with leader, relief forces, and other team members” were of the extracted competences in this study, which were highly important for teamwork in crisis Conclusion: The analysis of participants’ viewpoints indicates that the nurses need to be completely familiar with their and other team members’ limitations and duties, to know managerial hierarchy, and to be able to maintain unity of commanding. Therefore, nurses’ inservice training to be prepared for response to crisis should address this dimension, as well

Assessment competencies among emergency nurses for responding in disaster situation with Objective Structured Clinical Examination

Introduction: Nurses are the first people that attend the accident site. Therefore, they must be able to take care of victims and have skill to prevent detrimental effects of disaster. The aim of this study was to determine competencies among Shahrekord emergency nurses responded in disaster situation with Objective Structured Clinical Examination (OSCE). Materials & Methods: This study was a descriptive study which 25 emergency nurses of educational hospital in Shahrekord were recruited by census statistical methods. Competency of nurses for responding in disaster situation were evaluated by utilizing 8-station objective structured clinical examination (OSCE). In each station "Task Based Checklist" has been used for evaluation. For measuring validity, content validity and for reliability, test re test was used. Data were analyzed by using SPSS/16. Findings: The mean scores of nurses' performance in 8 stations were less than average. In triage station was (3.5±1.6), life support (4.4±1.2), airway management (3.9±1.5), Chest tube insertion (4.9±1.5), naso gastric tube insertion (6.1±2.2), IV therapy (1.9±0.7), IV line insertion (5.4±1.3), suturing (8.6±1.5) urinary catheterization (9.1±1.5). Conclusion: Competencies of nurses in providing care in disaster were undesirable and less than average in all skills. So it is essential for nurses to acquire clinical and special skills to prepare for disaster situation

Investigation of competencies of nurses in disaster response by utilizing objective structured clinical examination.

BACKGROUND Nurses are members of the health care team for crisis response. Identifying nurses' capability in responding to a disaster and promoting their preparedness will lead to effective use of human resources and decreasing the detrimental effects of disaster. The purpose of this article was to determine emergency nurses' competences in triage, life support, and basic clinical skills in disaster response. MATERIALS AND METHODS This study was a descriptive study in which 40 emergency nurses were recruited by purposeful sampling. Moreover, their competencies in performing triage, life support, and basic clinical skills were evaluated by utilizing eight-station objective structured clinical examination (OSCE). RESULTS Our findings showed that the mean scores of nurses' performance were: In triage (4.3 ± 1.27), life support (4 ± 1.5), airway management (5.3 ± 1.7), chest tube insertion (7.3 ± 1.8), nasogastric tube insertion (5.6 ± 2.5), IV therapy (2.5 ± 0.8), IV line insertion (6 ± 1.4), suturing (9.1 ± 1.6), and urinary catheterization (10.4 ± 2.2). No statistically significant correlation was found between demographic variables and nurses' performance (P > 0.05). CONCLUSION According to our findings, it can be concluded that competencies of nurses in performing triage, life support, and basic clinical skills were undesirable. Because emergency nurses are members of the emergency medical team, they should be prepared for disaster response via continuous training programs

Reliability Constrained Unit Commitment Considering the Effect of DG and DR Program

Due to increase in energy prices at peak periods and increase in fuel cost, involving Distributed Generation (DG) and consumption management by Demand Response (DR) will be unavoidable options for optimal system operations. Also, with high penetration of DGs and DR programs into power system operation, the reliability criterion is taken into account as one of the most important concerns of system operators in management of power system. In this paper, a Reliability Constrained Unit Commitment (RCUC) at presence of time-based DR program and DGs integrated with conventional units is proposed and executed to reach a reliable and economic operation. Designated cost function has been minimized considering reliability constraint in prevailing UC formulation. The UC scheduling is accomplished in short-term so that the reliability is maintained in acceptable level. Because of complex nature of RCUC problem and full AC load flow constraints, the hybrid algorithm included Simulated Annealing (SA) and Binary Particle Swarm Optimization (BPSO) has been proposed to optimize the problem. Numerical results demonstrate the effectiveness of the proposed method and considerable efficacy of the time-based DR program in reducing operational costs by implementing it on IEEE-RTS79

Iranian nurses' experience of essential technical competences in disaster response: A qualitative content analysis study.

BACKGROUND Today disasters are a part of many people's lives. Iran has a long history of disaster events and nurses are one of the most significant groups within the Iranian disaster relief operations, providing immediate and long-term care for those affected by the disaster. However, the technical competence of Iranian nurses and their training for this work has received little attention. This article presents the results of a study that aims to explore this context. MATERIALS AND METHODS A qualitative study was conducted using in-depth interviews to collect data from 30 nurses, who were deliberately selected from the health centers affiliated to the Isfahan University of Medical Sciences. Themes were identified using the conventional qualitative content analysis. The trustworthiness of the study was supported by considering the auditability, neutrality, consistency, and transferability. The study lasted from 2011 to 2012. RESULTS Data analysis undertaken for the qualitative study resulted in the identification of five main themes, which included: (1) Management competences, (2) ethical and legal competences, (3) team working, and (4) personal abilities and the specific technical competences presented in this report. CONCLUSIONS This report presents an overview of the nursing technical capabilities required for Iranian nurses during disaster relief. It is argued that additional competencies are required for nurses who care in high-risk situations, including disasters. Nurses need to prepare themselves more effectively to be responsible and effective in nursing care

Ethical and legal challenges associated with disaster nursing

Background: In disaster situations, nurses may face new and unfamiliar ethical and legal challenges not common in their everyday practice. Research question/objectives/hypothesis: The aim of this study was to explore Iranian nurses' experience of disaster response and their perception of the competencies required by nurses in this environment. Research design: This article discusses the findings of a descriptive study conducted in Iran in 2012. Participants and research context: This research was conducted in Iran in 2012. Participants included 35 nurses who had experience in healthcare delivery following a disaster event in the past 10 years, either in a hospital or out-of-hospital context. Ethical considerations: This research study was approved by the Ethics Committee of the Isfahan University of Medical Sciences. Findings: From this study, five themes emerged as areas that nurses require competence in to work effectively in the disaster setting. This article focusses on one theme, the ethical and legal issues that arise during disaster response. Within the theme of ethical and legal issues, two sub-themes emerged. (1) Professional ethics explores professional responsibility of nurses as well as sense of ethical obligation. (2) Adherence to law refers to nurses' familiarity with and observation of legal requirements. Discussion: This article adds to a growing pool of literature which explores the role of nurses in disasters. The findings of this study emphasize the need for nurses working in the disaster setting to be aware of professional responsibilities and familiar with legal requirements and the challenges related to observing ethical responsibilities. Conclusion: In highlighting these issues, this article may provide a useful starting point for the development of an educational framework for preparing nurses and other health professionals to work in the disaster setting

Nurse's personal competences for disaster response: a qualitative study

Introduction: In recent years, the number of natural and man-made disasters has increased considerably around the world. Iran has a long history of disaster events. Because of nurses’ unique role as professional and volunteer responders in times of disaster, more information is required regarding the personal competencies they need in order to provide more effective disaster response. This paper presented the results of a study aimed to explore the required specific personal competencies of nurses in disaster response. Method: This study was part of a larger qualitative content analysis on nurses’ competencies in disaster response in 2012 in Iran. In the present study, 35 interviews were conducted with nurses who had recent experiences of providing care in a disaster situation. Purposeful sampling was performed and continued until data saturation. The data were collected through in-depth unstructured interviews and analyzed using a conventional content analysis approach. Results: Data analysis resulted in the identification of the main theme of “specific personal competencies” and its 4 subcategories of physical abilities, self-management, meta-competencies, and communication abilities. Conclusion: Considering the stress and biopsychospiritual pressure of disaster on nurses, personal competencies such as physical abilities, self-management, decision-making skills, speed in taking action, the ability to act independently, tolerance, critical thinking skills, and professional communication skills are necessary for nurses for effective disaster response. Our findings can be used as a guide for selecting nurses with appropriate personal abilities for effective disaster response and preparation of nurses for such circumstances. Keywords: Disaster nursing, Personal competences, Disaster response, Qualitative stud

Iranian nurses’ perception of essential competences in disaster response: A qualitative study

Background: Today disasters, natural and man‑made, are a part of many people’s lives. Iran has a long history of disaster events. Nurses are one of the most significant groups within Iranian disaster relief operations, providing immediate and longer term care for those affected by the disaster. However, the competence of Iranian nurses and their training for this work has received little attention. This paper presented the results of a study aimed to explore the context. Materials and Methods: A qualitative study was performed in 2012 in Iran. Interviews were conducted with 35 nurses. The sampling of participants was purposeful and continued until data saturation was achieved. Themes were identified using inductive qualitative content analysis. Trustworthiness of the study was supported considering auditability, neutrality, consistency, and transferability. Findings: Data analysis undertaken for the qualitative study resulted in the identification of five main themes included 1‑management competences, 2‑ ethical and legal competences, 3‑team working, 4‑personal competences, and specific technical competences that presented in this report. Conclusions: This report presents an overview of nursing competences required for Iranian nurses in disaster relief. It is argued that additional competencies are required for nurses who care in high‑risk situations, including disaster. Nurses need to prepare themselves more effectively to be responsible and effective in the nursing care

Development, Psychometric Testing, and Use of a Disaster Nursing Competency Scale in Iran: A Mixed Methods Study

Nurses play an important role during disaster response and recovery. Few tools are available to assess the relative competence of nurses in disaster. This study aimed to develop, test, and evaluate a disaster nursing competency scale. This was an exploratory mixed methods study. In the qualitative phase, 35 Iranian nurses and managers with experience in disaster relief were asked about the skills they need to respond effectively to a disaster event. From the qualitative data, a 50-item questionnaire was developed. In the quantitative phase, exploratory factor analysis was conducted with 400 samples followed by a test-retest reliability assessment with 30 nurses. The developed and validated instrument was applied to 200 nurses in Iran to assess their competency. From content analysis of the qualitative data, 5 main themes emerged. In the quantitative phase, exploratory factor analysis loaded 50 items into 4 domains named management, legal and ethical, specific personal, and technical competence. Use of the tool showed that nurses estimated their competence overall at 70.28. Findings demonstrate the necessity for new domains in disaster nursing competencies; which may be applicable as a useful tool and guideline to improve nursing education and practice