Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-23T21:57:11.171Z Has data issue: false hasContentIssue false

Improving Hospital Preparedness for Radiological Terrorism: Perspectives From Emergency Department Physicians and Nurses

Published online by Cambridge University Press:  08 April 2013

Abstract

Background: Hospital emergency department (ED) clinicians will play a crucial role in responding to any terrorist incident involving radioactive materials. To date, however, there has been a paucity of research focusing specifically on ED clinicians’ perspectives regarding this threat.

Methods: At the request of the Centers for Disease Control and Prevention, researchers at the University of Alabama at Birmingham conducted a series of 10 focus groups (total participants, 77) with ED physicians and nurses at hospitals in 3 US regions. Participants considered a hypothetical “dirty bomb” scenario and discussed their perceptions, concerns, information needs, preferred information sources, and views of current guidance and informational materials.

Results: Study participants consistently expressed the view that neither EDs nor hospital facilities are sufficiently prepared for a terrorist event involving radioactive materials. Key clinician concerns included the possibility of the hospital being overwhelmed, safety of loved ones, potential staffing problems, readiness problems, and contamination and self-protection. Participants also expressed a need for additional information, strongly disagreed with aspects of current response guidance, and in some cases indicated they would not carry out current protocols.

Conclusions: This study is the first to examine the views, perceptions, and information needs of hospital ED clinicians regarding radiological terrorism. As such, the findings may be useful in informing current and future efforts to improve hospital preparedness. (Disaster Med Public Health Preparedness. 2008;2:174–184)

Type
Original Research and Critical Analysis
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Burger, R, Fallon, LF Jr, MacNeal, J, et al Integrated crisis preparedness.Fallon LF Jr, Zgodzinski EJ. Essentials of Public Health Management. Boston: Jones & Bartlett; 2005:357370.Google Scholar
2.Schultz, CH, Mothershead, JL, Field, M.Bioterrorism preparedness: I. The emergency department and hospital. Emerg Med Clin N Am. 2002;20:437455.CrossRefGoogle ScholarPubMed
3.Hospital-Based Emergency Care: At the Breaking Point. Committee on the Future of Emergency Care in the United States Health System. Washington, DC: The National Academies Press; 2007.Google Scholar
4.Schur, CL, Berk, ML, Mueller, CD.Perspectives of Rural Hospitals on Bioterrorism Preparedness Planning (W Series, No. 4). Bethesda, MD: NORC Walsh Center for Rural Health Analysis; 2004.Google Scholar
5.Becker, SM.Emergency communication and information issues in terrorism events involving radioactive materials. Biosecur Bioterror. 2004;2:195207.CrossRefGoogle ScholarPubMed
6. Terrorism Survey: Frequency Questionnaire. Washington, DC: Foreign Policy/Center for American Progress; March 8–April 21, 2006.Google Scholar
7. Lugar RG. The Lugar Survey on Proliferation Threats and Responses. June 2005. http://lugar.senate.gov/reports/NPSurvey.pdf. Accessed August 4, 2008.Google Scholar
8.National Preparedness Guidelines. Washington, DC: Department of Homeland Security; 2007.Google Scholar
9.Mettler, FA, Voelz, G.Major radiation exposure—what to expect and how to respond. N Engl J Med. 2002;346:15541561.Google Scholar
10.Mettler, FA JrMedical resources and requirements for responding to radiological terrorism. Health Phys. 2005;89:488493.Google Scholar
11.Bushberg, JT, Kroger, LA, Hartman, MD, et alNuclear/radiological terrorism: emergency department management of radiation casualties. J Emerg Med. 2007;32:7185.Google Scholar
12.Dainiak, N, Delli Carpini, D, Bohan, M, et alDevelopment of a statewide hospital plan for radiologic emergencies. Int J Radiat Oncol Biol Phys. 2006;65:1624.CrossRefGoogle ScholarPubMed
13.Koenig, KL, Goans, RE, Hatchett, RJ, et alMedical treatment of radiological casualties: current concepts. Ann Emerg Med. 2005;45:643652.Google Scholar
14.Jasper, E, Miller, M, Sweeney, B, et alPreparedness of hospitals to respond to a radiological terrorism event as assessed by a full-scale exercise. J Public Health Manag Pract. 2005;11 Suppl 1S11S16.CrossRefGoogle Scholar
15.Qureshi, K, Gershon, RR, Sherman, MF, et alHealth care workers’ ability and willingness to report to duty during catastrophic disasters. J Urban Health. 2005;82:378388.CrossRefGoogle ScholarPubMed
16.Alexander, GC, Larkin, GL, Wynia, MK.Physicians’ preparedness for bioterrorism and other public health priorities. Acad Emerg Med. 2006;13:12381241.CrossRefGoogle ScholarPubMed
17.Niska, RW, Burt, CW.Terrorism preparedness: have office-based physicians been trained? Fam Med. 2007;39:357365.Google Scholar
18.Syrett, JI, Benitez, JG, Livingston, WH, et alWill emergency health care providers respond to mass casualty incidents? Prehosp Emerg Care. 2007;11:4954.CrossRefGoogle ScholarPubMed
19.Chaffee, MW.Making the decision to report to work in a disaster: nurses may have conflicting obligations. Am J Nurs. 2006;106:5457.Google Scholar
20.Soto Mas, F, Hsu, CE, Jacobson, H, et alPhysician assistants and bioterrorism preparedness. Biosecur Bioterror. 2006;4:301306.Google ScholarPubMed
21.O’Boyle, C, Robertson, C, Secor-Turner, M.Nurses’ beliefs about public health emergencies: fear of abandonment. Am J Infect Control. 2006;34:351357.Google Scholar
22.Stewart, DW, Shamdasani, PN.Focus Groups: Theory and Practice. Applied Social Research Methods, Series 20. Newbury Park, CA: Sage; 1990.Google Scholar
23. Radiological Terrorism: Emergency Management Pocket Guide for Clinicians. Centers for Disease Control and Prevention Web site. 2005. http://emergency.cdc.gov/radiation/pdf/clinicianpocketguide.pdf. Accessed August 4, 2008.Google Scholar
24.Miles, MB, Huberman, AM.Qualitative Data Analysis. 2nd ed. Thousand Oaks, CA: Sage; 1994.Google Scholar
25.Niska, RW, Burt, CW.Training for Terrorism-related Conditions in Hospitals: United States, 2003–04. Advance Data From Vital and Health Statistics; No. 380. Hyattville, MD: National Center for Health Statistics; 2006.Google Scholar
26.Slovic, P.The Perception of Risk. London: Earthscan; 2001.Google Scholar
27.Becker, SM. Psychosocial effects of radiation accidents. In: Gusev I, Guskova A, Mettler FA Jr eds. Medical Management of Radiation Accidents. 2nd ed. Boca Raton, FL: CRC Press; 2001:519525.Google Scholar
28.Coffman, JM, Rosenoff, E, Grumbach, K.Racial/ethnic disparities in nursing. Health Aff. 2001;20:263272.Google Scholar
29.Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Board on Health Sciences Policy. Institute of Medicine. Washington, DC: The National Academies Press; 2003.Google Scholar