Healthcare worker response to disaster conditions

May 17 2007

When disaster strikes, getting care to the victims is at the top of everyone's attention. But who will provide that care? In two studies to be presented at the 2007 Society for Academic Emergency Medicine (SAEM) Annual Meeting, researchers examined the factors that might affect whether healthcare workers and support staff would report to work during a disaster.

Linda Kruus, PhD, of Temple University Medical School's Department of Emergency Medicine, in collaboration with the Temple University Center for Preparedness Research, Education and Practice and the Temple University Health System Emergency Response & Preparedness Institute, surveyed healthcare workers from five urban hospitals who had viewed videos and written presentations of three hypothetical scenarios: A public riot, an infectious disease outbreak and a regional power outage. Workers were more willing to work when they felt that their role in a disaster was important, and that they could be effective in that role. They were also more likely to work when they felt safe traveling to work and in the workplace, believed contracting an illness would be unlikely, were less worried about exposing family members to an illness, and felt supported by their family in their decision to work. Since support staff and administrators provide essential services during disasters, freeing doctors and nurses for medical needs, this survey was important in uncovering the factors that might keep many types of key healthcare workers at home. According to Kruus, "Workers want to know that the role they play will be meaningful. And, if they put themselves out there for the benefit of others, that their institution will, in turn, be taking care of them and their families."

Charlene Irvin, MD, of the St. John Hospital and Medical Center, Wayne State University School of Medicine, surveyed almost 200 nurses, doctors and other hospital workers regarding a hypothetical outbreak of avian flu. Only 50% of the workers said "Yes," they would report to work, with 42% responding "Maybe" and another 8% responding "No, even if I would lose my job." The author believes that this may still represent an overestimation of the number of people responding to work as many workers may feel obligated on a survey to respond "Yes." However, in a real pandemic with neighbors dying, they may feel compelled to stay home with their families. Workers must believe they will be protected and they must be given accurate information on steps in place to keep them from becoming infected.

Media hype has increased the fear factor concerning influenza pandemics with reports of almost 50% mortality rate, but many experts believe the real mortality rate may be closer to the pandemic of 1918 at less than 5%. Lack of accurate information is likely to cause many more workers to stay home. "If fear and uncertainty are allowed to take over, many more workers will stay away, and pandemic staffing will turn out to be inadequate, complicating the disaster even more," says Dr. Irvin.

The first presentation above is entitled "Healthcare Worker Response to Disaster Conditions" by Linda K Kruus, PhD, David J Karras, MD, Brenda Seals, PhD, MPH, Chad Thomas, MPH, and Gerald Wydro, MD. It will be presented at the 2007 SAEM Annual Meeting, May 16-19, 2007, Chicago, IL on Saturday, May 19th, in the poster session beginning at 1:00 PM in the River Exhibition Halls A & B of the Sheraton Chicago Hotel & Towers. This project is funded, in part, under a grant with the Pennsylvania Department of Health. The Department specifically disclaims responsibility for any analyses, interpretations or conclusions.

The second presentation mentioned above is "Survey of Hospital Health Care Professionals Response During a Potential Avian Influenza Pandemic: Will They Come to Work"" by Charlene Irvin, MD, Lauren Cindrich, William Patterson, and Anthony Southall, MD. It will be presented on Wednesday, May 16th, in the Disaster Session beginning at 3:30 PM in room Michigan A of the Sheraton Chicago Hotel & Towers. Abstracts of the papers presented are published in Volume 14, Issue 5S, the May 2007 supplement of the official journal of the SAEM, Academic Emergency Medicine.

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