A Challenge in Developing the Center of Excellence for Disaster Nursing



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World Health Organisation Western Pacific Region Nursing and Midwifery Leadership Summit 2006 A Challenge in Developing the Center of Excellence for Disaster Nursing University of Hyogo College of Nursing Art & Science Noriko Katada, RN, DNS

21 st Century COE Program Ministry of Education, Culture, Sports, Science, & Technology of Japan Started on: 2002 A Policy for the Structural Reform of Universities To cultivate a competitive academic environment To raise the level of research and foster creative individuals who can lead the world in the academic field

Ansei Nankai EQ Tsunami 1854 Furuta S. Anseibunroku http://www.seisvol.kishou.go.jp/eq/ina mura/p2/html http://www.jma.go.jp/jma/indexe.html

Why: Disaster Nursing? Labor Defense NGO GOV/gov Red Cross 1995 NPO PEOPLE Human Inflicted Mass Casualty Incidents War Plain Clash Ship Wreckage Nature Inflicted Mass Casualty Incidents Earth Quake/Tsunami Volcano Eruption Typhoon/Flood Hanshin Awaji EQ Sarin Gas in Tky Hospital Affected Nurses worked with the People Nursing Academic Professional Org. Care for Caregiver Revisited Nursing role at the time of disaster cycle: Mid- to Long- Net Working Preparedness Education Research

Why: Disaster Nursing? Threats to Life Mental Anguish Unstable Feeling of Security & Safety The Disruption Of Life & Society Minami et al. 2005

The Aims of the Program To develop nursing care strategies and establish information and human support networks in order to minimize the affect of disasters on the health and life of people. To develop self-care abilities of communities and individuals to independently regenerate and recover from the consequences of disasters.

Structure of the Program Development of of Information Base Establishment of of Nursing Support Network Center of Excellence for Disaster Nursing Development of of Nursing Care Strategies

Information Base Project(1) Development Development of of Information Information Base Base Database Accumulation Data Mining/ Warehousing Information Distribution System Internet Tool Development Establishment Establishment of of Support Support Network Network Participatory community support network Professional nursing support network International disaster nursing network Database Accumulation Data Mining/ Warehousing Information Center of Distribution Excellence for System Disaster Nursing Internet Tool Development Development Development of of Nursing Nursing Care Care Strategies Strategies Develop nursing care strategies Develop educational/training programs

Network Project(2) Development Development of of Information Information Base Base Database Accumulation Data Mining/ Warehousing Information Distribution System Internet Tool Development Center of Excellence for Disaster Nursing Establishment Establishment of of Support Support Network Network Professional nursing support network Participatory community support network Participatory community support network International disaster nursing network Professional nursing support network Development Development of of Nursing Nursing Care Care Strategies Strategies International disaster nursing network Develop nursing care strategies Develop educational/training programs

Network Building/Coordination with Other Organization Nationa Government Abroad Prefecture Government COE Program Affected Area Networking with Professional Organization & others Local Networks Nursing Colleges Nursing Associations Nurses at Shelters, Temporary Housing and Communities People in the Community

Nursing Care Strategies Project(3) Nursing Care Method Development Development Development of of Information Information Base Base Persons with various health needs and requiring considerable supports At affected sites, shelters, homes, and medical facilities Immediate, mid-term, & long-term Database Accumulation Data Mining/ Warehousing Information Distribution System Internet Tool Development Center of Excellence for Disaster Nursing Establishment Establishment of of Support Support Network Network Participatory community support network Professional nursing support network International disaster nursing network Education and Training Development Development Development of of Nursing Nursing Care Care Strategies Strategies Develop nursing care strategies Develop educational/training programs

Inadequate Disaster Preparedness 1) Individuals level: Inadequate stockpiles (emergency rations & daily supplies) / No provision for disrupted family communication or medical consultation during a disaster / No home safety plan (secured furniture, etc.) 2) Nursing Staff level Inadequate stockpiles (medical supplies, water, etc.) / No links to other medical facilities - Care giver do not need and should not get any help/ No contingency plan for utility disruptions / No disaster manuals (how to evacuate, no information on transportation systems, etc.)

It s Hard to change own way of thinking & behavior at the time of Emergency People want to continue life style as usual Nurses want to continue their usual routines - People flush their toilets even during a water shortage - - Volunteer nurses are given orientations in detail-

Education/Training Education for preparedness Development of Disaster Preparedness Handbook Implementation of Educational program to nurses Conduct of information exchange at conference or training Clarification of Core Competencies on Disaster Nursing Extract and structure of contents with knowledge obtained by other groups

Development of Young Researchers Sending Researcher to Disaster Districts Offering Opportunities to Establish Information Networks Subsidizing Research Grants Development of Research Abilities Establishing Organizing the Course of Disaster Nursing Global Training Programs in a Master and Doctoral Program JNA, Universities, Inviting to Disaster prevention the COE Research Projectcenters, etc.

Integration Development Development of of Information Information Base Base Database Accumulation Data Mining/ Warehousing Information Distribution System Internet Tool Development Establishment Establishment of of Support Support Network Network Participatory community support network Professional nursing support network International disaster nursing network Center of Excellence for Disaster Nursing Integration and Creating Research Agenda Development Development of of Nursing Nursing Care Care Strategies Strategies Develop nursing care strategies Develop educational/training programs

Ex. Niigata Chuetsu Earthquake Provide Consultant Network with Ministry of Health Sending vn Provide Consultant Network with Prefecture Program Network with JNA/PNA Consultation for system development Disaster area Local Network Human and information resources Consultation for PHN Direct Care Providing Information and Coordination on Demand Nursing College Nursing Association Shelter/ Temp. Housing Nursing in Community

Outcomes Clarification of the key concept Care receivers + Care offers People who need primary support in disasters (e.g. the elderly, the mentally disabled, child, pregnant, chronic illness) Clarification of mid- and long-term health problems impacted by disasters Respiratory systems Circulatory systemschronic diseases PTSD Clarification of caring methods Support for daily environments and dietary lives Protection of one s sleep and privacy Gurantee of a sense of security and safety Collaboration with other related organizations Establishment of networks

Outcomes Consultations, manpower dispatching, information services, and so on) Earthquake and tsunami disaster in the Indian Ocean Niigata Chuetsu Earthquake Defining basic abilities required for disaster nursing in collaboration with WPRO Organization of international conferences regarding disaster nursing Participating and presenting suggestions in the World Conference on Disaster Reduction Organizing the forum on disaster nursing in Asia Internationally dissemination of the concept of disasters and health

Disaster will happen before we forget! 21 st Century COE Program: Development of Disaster Nursing in a Ubiquitous Society Primary Investigator: Dr. Aiko Yamamoto