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Avoidable disasters are both saddening and baffling. In 2022, 159 people, mostly in their 20s, and 30s were crushed to death in Itaewon's narrow alleyway amid South Korea's first pandemic-restrictions-free Halloween celebration. What is particularly sobering about this tragedy is that although many people called police hotlines as crowds became cramped and static, their calls went unheeded for hours. Rather than order independent investigations into the catastrophe (as of January 2024), the President of South Korea at the time focused on superficial issues such as asking the public to refer to the disaster as an "accident" (which it was not, it was an avoidable disaster) and the casualties as "the dead" (who are casualties indeed, instead of victims of a preventable tragedy). In this paper, we examine how officials' complacency about public health and safety dangers, ineffective disaster prevention, and preparedness systems, as well as the government's chronic lack of prioritization of public health and safety may have contributed to the disaster. Furthermore, we discuss the importance of creating integrated public health and safety protection systems to prevent similar tragedies from happening.

Aim: This study was carried out to investigate the perception of the main competencies of disaster management in Iranian emergency department nurses in 2023 in hospitals affiliated with Kermanshah University of Medical Sciences. The present study was conducted to explore the perceived core disaster competencies in nurses of hospitals affiliated with Kermanshah University of Medical Sciences in 2023., Background: Due to the rise in natural disasters, their escalating severity and associated regulatory response necessitate a closer look at the preparedness and core competencies of nursing personnel. The main competencies of nurses are necessary to deal with disasters in unexpected events, and they are expected to use their professional expertise to provide the required nursing services to reduce the risks caused by disasters., Methodology: This descriptive-analytical study was conducted cross-sectionally between May and September 2023. In the study, a sample of 384 nurses working in the departments of four hospitals affiliated with Kermanshah University of Medical Sciences was selected through a random stratification. The data collection instrument was a 45-item scale of nurses' perceived core competencies (NPDCC) in handling disasters. The data were analyzed using the Mann-Whitney U-test, Kruskal-Wallis test, and independent samples t-test. The significance level was set at 5%., Results: The mean total score of perceived core disaster competencies was 139.11 ± 37.65. The technical skills subscale got the highest score (51.81 ± 11.28) and critical thinking skills received the lowest (9.74 ± 3.92). Also, "technical skills" had the highest average and "critical thinking skills" had the lowest average in all three age groups. The results found a significant difference between the scores of nurses in perceived core disaster competencies in age groups, work environments, education degrees, marital statuses, and experiences of attending disaster workshops (p ≤ 0.05)., Conclusions: The results showed that nurses had different levels of core disaster competencies in the department. There are gaps in the core disaster nursing competencies that need to be filled. Nursing managers should consistently evaluate the core nursing competencies to achieve efficacious disaster preparedness. To this aim, it is recommended that authorities implement training courses and programs to enhance the preparedness of nurses in responding to disasters., (© 2024 Wiley Periodicals LLC.)

Introduction: Hospitals as the main providers of healthcare services play an essential role in the management of disasters and emergencies. Nurses are one of the important and influential elements in increasing the surge capacity of hospitals. Accordingly, the present study aimed to assess the effect of surge capacity enhancement training for nursing managers on hospital disaster preparedness and response., Methods: All nursing managers employed at Motahari Hospital in Tehran took part in this interventional pre- and post-test action research study. Ultimately, a total of 20 nursing managers were chosen through a census method and underwent training in hospital capacity fluctuations. The Iranian version of the "Hospital Emergency Response Checklist" was used to measure hospital disaster preparedness and response before and after the intervention., Results: The overall hospital disaster preparedness and response score was 184 (medium level) before the intervention and 216 (high level) after the intervention. The intervention was effective in improving the dimensions of hospital disaster preparedness, including "command and control", "triage", "human resources", "communication", "surge capacity", "logistics and supply", "safety and security", and "recovery", but had not much impact on the "continuity of essential services" component., Conclusion: The research demonstrated that enhancing the disaster preparedness of hospitals can be achieved by training nursing managers using an action research approach. Encouraging their active participation in identifying deficiencies, problems, and weaknesses related to surge capacity, and promoting the adoption and implementation of suitable strategies, can enhance overall hospital disaster preparedness., (© 2024. The Author(s).)

Considering recent earthquakes and the COVID-19 pandemic, disaster preparedness has come to the forefront of the public health agenda in Nepal. To strengthen the developing health system, many initiatives are being implemented at different levels of society to build resiliency, one of which is through training and education. The first International Conference on Disaster Preparedness and Management convened in Dhulikhel, Nepal on December 1-3, 2023. It brought together international teaching faculty to help deliver didactic and simulation-based sessions on various topics pertaining to disaster preparedness and management for over 140 Nepali healthcare professionals. This paper focuses on the tabletop exercise-based longitudinal workshop portion of the conference on disaster leadership and communication, delivered by United States-based faculty. It delves into the educational program and curriculum, delivery method, Nepali organizer and US facilitator reflections, and provides recommendations for such future conferences, and adaptation to other settings., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Pandya, Kharel, McMahon, Basnet, Soghoian, Pradhan and Arquilla.)

Background: Natural hazards are increasing in frequency and intensity due to climate change. Many of these natural disasters cannot be prevented; what may be reduced is the extent of the risk and negative impact on people and property. Research indicates that the 2019-2020 bushfires in Australia (also known as the "Black Summer Bushfires") resulted in significant psychological distress among Australians both directly and indirectly exposed to the fires. Previous intervention research suggests that communities impacted by natural hazards (eg, earthquakes, hurricanes, and floods) can benefit from interventions that integrate mental health and social support components within disaster preparedness frameworks. Research suggests that disaster-affected communities often prefer the support of community leaders, local services, and preexisting relationships over external supports, highlighting that community-based interventions, where knowledge stays within the local community, are highly beneficial. The Community-Based Disaster Mental Health Intervention (CBDMHI) is an evidence-based approach that aims to increase disaster preparedness, resilience, social cohesion, and social support (disaster-related help-seeking), and decrease mental health symptoms, such as depression and anxiety., Objective: This research aims to gain insight into rural Australian's recovery needs post natural hazards, and to enhance community resilience in advance of future fires. Specifically, this research aims to adapt the CBDMHI for the rural Australian context and for bushfires and second, to assess the acceptability and feasibility of the adapted CBDMHI in a rural Australian community., Methods: Phase 1 consists of qualitative interviews (individual or dyads) with members of the target bushfire-affected rural community. Analysis of these data will include identifying themes related to disaster preparedness, social cohesion, and mental health, which will inform the adaptation. An initial consultation phase is a key component of the adaptation process and, therefore, phase 2 will involve additional discussion with key stakeholders and members of the community to further guide adaptation of the CBDMHI to specific community needs, building on phase 1 inputs. Phase 3 includes identifying and training local community leaders in the adapted intervention. Following this, leaders will co-deliver the intervention. The acceptability and feasibility of the adapted CBDMHI within the community will be evaluated by questionnaires and semistructured interviews. Effectiveness will be evaluated by quantifying psychological distress, resilience, community cohesion, psychological preparedness, and help-seeking intentions., Results: This study has received institutional review board approval and commenced phase 1 recruitment in October 2022., Conclusions: The study will identify if the adapted CBDMHI is viable and acceptable within a village in the Northern Tablelands of New South Wales, Australia. These findings will inform future scale-up in the broader rural Australian context. If this intervention is well received, the CBDMHI may be valuable for future disaster recovery and preparedness efforts in rural Australia. These findings may inform future scale-up in the broader rural Australian context., International Registered Report Identifier (irrid): DERR1-10.2196/53454., (©Caitlin E Pike, Henriette C Dohnt, Phillip J Tully, Warren Bartik, Courtney Welton-Mitchell, Clara V Murray, Kylie Rice, Suzanne M Cosh, Amy D Lykins. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 04.06.2024.)

This article summarizes how pediatricians may be uniquely positioned to mitigate the long-term trajectory of COVID-19 on the health and wellness of pediatric patients especially with regard to screening for social determinants of health that are recognized drivers of disparate health outcomes. Health inequities, that is, disproportionately deleterious health outcomes that affect marginalized populations, have been a major source of vulnerability in past public health emergencies and natural disasters. Recommendations are provided for pediatricians to collaborate with disaster planning networks and lead strategies for public health communication and community engagement in pediatric pandemic and disaster planning, response, and recovery efforts., Competing Interests: Disclosure The authors have no relevant financial or non-financial interests to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Disaster preparedness is crucial for mitigating the impact of disasters and saving lives. Ensuring preparedness for disaster response and management, particularly among nurses in disaster-prone countries, is essential due to the serious threats disasters pose to affected populations. This study was conducted to appraise and synthesize the literature examining preparedness for disaster management and response among nurses in countries with the highest disaster risks., Methods: A systematic review of the literature published from 2000 onwards was conducted using five databases: SCOPUS, PubMed, MEDLINE, PsychINFO, and CINAHL. Twenty-one relevant articles were identified for this review., Results: The findings revealed that nurses in countries at high risk of disasters had inadequate disaster knowledge and skills, leaving them ill-prepared to respond to such situations. Previous experience in disaster relief, disaster-related education and training, and higher academic qualifications were associated with increased readiness for disaster response and management., Conclusion: The review's findings provide insight into the current state of disaster preparedness among nurses in disaster-prone nations. The review identified evidence highlighting the value of disaster-related education and training, as well as disaster response experience, in fostering preparedness among nurses. These results can inform policymakers, hospital administrators, and nurse administrators in developing strategies for promoting disaster preparedness in nurses through evidence-based training programs and interventions., Competing Interests: Declaration of Competing Interest The authors declare that there is no conflict of interest., (Copyright © 2023. Published by Elsevier Ltd.)

When considering disaster preparedness, one challenge is mitigating the health impacts of evacuations. Nuclear disaster preparedness has evolved based on past experiences from numerous disasters, including the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident. However, there is a lack of comprehensive reporting on the awareness of administrative staff, medical personnel, and residents in the areas surrounding nuclear power plants (NPPs). This study reports on a survey aimed at gaining insights into the understanding and current state of disaster preparedness and elucidating the differences in perceptions of nuclear disaster preparedness among the relevant stakeholders surrounding NPPs. Interview surveys were conducted from 14 to 16 September 2022 in the area surrounding Kyushu Electric Power's Genkai NPP in Saga Prefecture and from 11 to 13 January 2023 in the area around Shikoku Electric Power's Ikata NPP. The surveys targeted administrative, medical, and nursing care facilities and residents. Responses from 57 participants indicated a lack of awareness of natural and nuclear disasters, challenges in evacuation planning, and a gap between nuclear disaster training and residents' understanding of evacuation protocols. This study highlights inadequacies in nuclear disaster preparedness and the need for a better understanding among residents regarding evacuation procedures. This study identified three key issues: (1) a lack of awareness about disasters, including nuclear disasters; (2) concerns about complex disasters and the difficulties in creating evacuation plans; and (3) a discrepancy between nuclear disaster training and residents' understanding of evacuation procedures. To bridge this gap, it is important to deepen residents' understanding of nuclear disasters, continuously convey the lessons learned from the FDNPP accident, and regularly reassess and update nuclear disaster preparedness strategies., (Creative Commons Attribution license.)

Tailored disaster preparedness interventions may be more effective and equitable, yet little is known about specific factors associated with disaster household preparedness for older adults and/or those with African American/Black identities. This study aims to ascertain differences in the importance features of machine learning models of household disaster preparedness for four groups to inform culturally tailored intervention recommendations for nursing practice. A machine learning model was developed and tested by combining data from the 2018, 2019, and 2020 Federal Emergency Management Agency National Household Survey . The primary outcome variable was a composite readiness score. A total of 252 variables from 15,048 participants were included. Over 10% of the sample self-identified as African American/Black and 30.3% reported being 65 years of age or older. Importance features varied regarding financial and insurance preparedness, information seeking and transportation between groups. These results reiterate the need for targeted interventions to support financial resilience and equitable resource access. Notably, older adults with Black racial identities were the only group where TV, TV news, and the Weather Channel was a priority feature for household disaster preparedness. Additionally, reliance on public transportation was most important among older adults with Black racial identities, highlighting priority needs for equity in disaster preparedness and policy.

Aim: The aim of this paper is to outline the steps taken to develop an operational checklist to assess primary healthcare (PHC) all-hazards disaster preparedness. It then describes a study testing the applicability of the checklist., Background: A PHC approach is an essential foundation for health emergency and disaster risk management (H-EDRM) because it can prevent and mitigate risks prior to disasters and support an effective response and recovery, thereby contributing to communities' and countries' resilience across the continuum of the disaster cycle. This approach is in line with the H-EDRM framework, published by the World Health Organization (WHO) in 2019, which emphasizes a whole-of-health system approach in disaster management and highlights the importance of integrating PHC into countries' H-EDRM. Nevertheless, literature focusing on how to practically integrate PHC into disaster management, both at the facility and at the policy level, is in its infancy. As of yet, there is no standardized, validated way to assess the specific characteristics that render PHC prepared for disasters nor a method to evaluate its role in H-EDRM., Methods: The checklist was developed through an iterative process that leveraged academic literature and expert consultations at different stages of the elaboration process. It was then used to assess primary care facilities in a province in Italy., Findings: The checklist offers a practical instrument for assessing and enhancing PHC disaster preparedness and for improving planning, coordination, and funding allocation. The study identified three critical areas for improvement in the province's PHC disaster preparedness. First, primary care teams should be more interdisciplinary. Second, primary care services should be more thoroughly integrated into the broader health system. Third, there is a notable lack of awareness of H-EDRM principles among PHC professionals. In the future, the checklist can be elaborated into a weighted tool to be more broadly applicable.

Natural and human-provoked disasters pose serious health risks to children, particularly children and youth with special healthcare needs, including many cardiology patients. The American Academy of Pediatrics (AAP) provides preparedness recommendations for families, but little is known about recommendation adherence. Caregivers of children seen in a pediatric cardiology clinic network were recruited to complete an electronic survey. Participants self-reported child medical history and their household's implementation of AAP recommended disaster preparedness items. Families received a link to AAP resources and a child ID card. Data were analyzed using descriptive statistics with Fisher's exact and Wilcoxon rank sum tests. 320 caregivers participated in the study, of whom 124 (38.8%) indicated that their child has a diagnosed cardiac condition, and 150 (46.9%) indicated that their child had special healthcare needs. The average preparedness item completion rate was 70.7% for household preparedness, 40.1% for reunification preparedness, and 26.3% for community preparedness. Households of children with medical needs had similar rates of preparedness compared to overall rates. Of all respondents, 27.8% previously received disaster preparedness resources, 67.7% would like resources on discussing disaster preparedness, and 93.0% intend to talk with their household about disaster preparedness after completing the survey. These results demonstrate a gap between AAP recommendations and household-level disaster preparedness, including patients with cardiac conditions and those with special healthcare needs. Families expressed that they were interested in getting resources for disaster preparedness. Pediatric cardiologists may consider asking about disaster preparedness and providing disaster preparedness resources tailored to the needs of their patients., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Considerable political, structural, environmental and epidemiological change will affect high socioeconomic index (SDI) countries over the next 25 years. These changes will impact healthcare provision and consequently trauma systems. This review attempts to anticipate the potential impact on trauma systems and how they could adapt to meet the changing priorities. The first section describes possible epidemiological trajectories. A second section exposes existing governance and funding challenges, how these can be met, and the need to incorporate data and information science into a learning and adaptive trauma system. The last section suggests an international harmonization of trauma education to improve care standards, optimize immediate and long-term patient needs and enhance disaster preparedness and crisis resilience. By demonstrating their capacity for adaptation, trauma systems can play a leading role in the transformation of care systems to tackle future health challenges., (© 2024. The Author(s).)

Background: The efficacy of household emergency preparedness interventions for community-dwelling, non-institutionalized people is largely unknown., Objective: To ascertain the state of the science on social support, educational, and behavioral modification interventions to improve all-hazard household disaster preparedness., Design: Systematic review and meta-analysis., Methods: Databases, trial registers, reports, and websites were searched, and citation trails followed utilizing replicable methods. Individual, cluster, and cross-over randomized controlled trials of non-institutionalized, community-dwelling populations and non-randomized controlled trials, controlled before-after, and program evaluation studies were included. At least two review authors independently screened each potentially relevant study for inclusion, extracted data, and assessed the risk of bias. Risk of bias was assessed using Cochrane's RoB2 tool for randomized studies and ROBINS-I tool for nonrandomized studies. Meta-analyses were applied using a random-effects model. Where meta-analysis was not indicated, results were synthesized using summary statistics of intervention effect estimates and vote counting based on effect direction. The evidence was rated using GRADE., Results: 17 studies were included with substantial methodological and clinical diversity. No intervention effect was observed for preparedness supplies (OR = 6.12, 95% 0.13 to 284.37) or knowledge (SMD = 0.96, 95% CI -0.15 to 2.08) outcomes. A small positive effect (SMD = 0.53, 95% CI 0.16 to 0.91) was observed for preparedness behaviors, with very low certainty of evidence. No studies reported adverse effects from the interventions., Conclusion: Research designs elucidating the efficacy of practical yet complex and multi- faceted social support, educational, and behavioral modification interventions present substantial methodological challenges where rigorous study design elements may not match the contextual public health priority needs and resources where interventions were delivered. While the overall strength of the evidence was evaluated as low to very low, we acknowledge the valuable and informative work of the included studies. The research represents the seminal work in this field and provides an important foundation for the state of the science of household emergency preparedness intervention effectiveness and efficacy. The findings are relevant to disaster preparedness practice and research, and we encourage researchers to continue this line of research, using these studies and this review to inform ongoing improvements in study designs., Competing Interests: TH reports conducting two household preparedness intervention studies. Neither study met inclusion criteria for this review. TH did not determine whether her studies should be included in this systematic review. JC reports being the principal owner of Castner Incorporated, a woman-owned enterprise small business where she is employed; Editor-in-Chief (Independent Contractor) for Journal of Emergency Nursing: paid to institution; reports NIH/NIA award subcontract to University at Louisville and Kansas University Medical Center: paid to institution; reports lecture payments from Notify, LLC: paid to institution; and Emergency Nurses Association Trauma Nursing Core Course: paid to institution and author. SB reports payments from HDR, Inc., a subcontractor for the US Army Corps of Engineers. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Amberson, Heagele, Wyte-Lake, Couig, Bell, Mammen, Wells and Castner.)

Objective: Pharmacies have a particularly important responsibility to supply medicine to disaster victims in order to save lives. This study investigated the characteristics of pharmacies that are well prepared for disasters as well as the efforts of the prefectural pharmaceutical association (PPA) to which the pharmacies belong., Methods: Questionnaires on matters related to disaster preparedness were mailed to 50 randomly selected pharmacies in each of Japan's 47 prefectures as well as all 47 PPAs in Japan. Logistic regression analysis was performed to examine the association of pharmacy background and the activities of the PPA to which they belong with pharmacy disaster preparedness as well as the association with pharmacies' awareness of disaster preparedness., Results: Pharmacies in prefectures that conducted disaster preparedness training at least three times a year were better prepared for disasters. In addition, pharmacies with high online utilization and high disaster-preparedness awareness were significantly more prepared for disasters., Conclusions: Pharmacies that can promptly provide medicine to disaster victims are considered to be well-prepared for disasters. The results suggest that pharmacy preparedness is also influenced by the disaster preparedness activities of their prefectures.

Objective: In general, medical students perceive themselves as inadequately prepared to assist in disasters. This study evaluated the impact of a disaster preparedness curriculum and medical students' views toward required preparedness education for health care professionals., Methods: A comprehensive disaster preparedness curriculum was evaluated on its effect on medical students' views on preparedness education requirements, preparedness, and prior disaster training using self-report survey methodology., Results: Results provide evidence to support curricular effectiveness in significantly increasing initial participant views of health professionals' education requirements, perceived preparedness for integrating professional roles into the emergency response system, and confidence in exposure risk assessment and triage skills. Most participants possessed limited recent prior disaster training and drill experience. Most interestingly, the majority consistently believed throughout the study that disaster preparedness training should be a medical license mandate., Conclusions: For those instructing current medical students in disaster preparedness, it is suggested that a curriculum be chosen that can create participant initial anticipation, awareness, and belief in the importance of and need for disaster preparedness training. Further investigation is recommended into the relationship between students' perceived training importance and any future curriculum delivery efforts on behalf of required or mandatory preparedness offerings in continuing professional development.

Objective: The purpose of the study is to determine the disaster preparedness perceptions, psychological resilences and empathy levels of nurses after 2023 Great Turkiye Earthquake., Method: This descriptive study was conducted in 2023 using with E-Anket. This study was carried out with voluntary participation of 464 nurses living in different geographical regions of Turkiye. The data of the study were obtained utilizing Nurses' Disasters Prepardeness Perception Scale (NDPPS), Pyschological Resileince Scale (PRS) and Empathy Scale (ES)., Results: In this study, the disaster preparedness perception of the nurses was found to be at medium level. More than half of the nurses (65.1%) reported that they did not received any disaster training before. A meaningful was found between the nurses' disaster preparedness perceptions and their empathy levels and psychological resilence., Conclusions: As in many countries, it is possible to state that also in Turkiye, the training of nurses for disasters are inadequate and that the studies on this subject are limited. This study will provide a theoretical platform to develop nurses' awareness of disaster preparedness and pyschological resilience and empathic approach programs to increase disaster resilience, and to conduct future research on disaster nursing., (© 2023 Wiley Periodicals LLC.)

Background: Worldwide, children, newborns, and pregnant or postpartum women are vulnerable to disasters and emergency situations, and providing support to this population is of great concern. Japan is located in a disaster-prone area, so disaster response and risk reduction strategies are important priorities., Methods: We introduce a system called the Disaster Liaison for Pediatric and Perinatal Medicine (DLPPM). This was created with a specific focus on perinatal children and pregnant women in Japan. We report the details of its activities, discuss its challenges, and draw on lessons learned for the further development of perinatal support systems, particularly for children., Results: The lessons learned from the activities of the DLPPM include the following: (1) establish a support system for emergency specialists beyond those with pediatric and perinatal specialties; (2) mitigate the risk of indirect damage caused by primary disasters; and (3) establish a networking function linked to existing pediatric and perinatal medicine facilities., Conclusions: By establishing similar systems, we believe that it will be feasible to address pediatric and perinatal care needs in disaster response contexts in other countries and regions around the world., (© 2024 Japan Pediatric Society.)

Background: Resilience is vital for facing natural disasters and public health challenges. Despite the significance of resilience-building activities, there is a scarcity of locally-tailored planning and response strategies, leaving communities incapable of addressing the unique challenges posed by natural disasters and public health crises. This study aims to explore how the "One Community at a Time" approach enhances community resilience in facing natural hazards and public health challenges., Methods: A systematic review was conducted over journal articles published from January 2001 to April 2023 through PRISMA approach. Multiple databases such as Web of Science and Scopus were thoroughly searched. We used independent screening by two researchers and painstaking data extraction using standardized forms. This approach was adopted to assure the reliability, validity, and precision of our study selection and analysis. The included studies' quality was evaluated by the Mixed Methods Appraisal Tool., Results: In the evaluation, 35 studies were deemed eligible for inclusion and underwent in-depth examination. Several major components of "One Community at a Time" have been identified, including social capital and networks, local knowledge and learning, effective governance and leadership, preparedness and response capacity, and adaptive infrastructure and resources. This framework highlights the significance of individualized approaches to resilience-building initiatives, recognizing that each community has specific strengths, needs, and challenges., Conclusion: Relevant stakeholders can adapt suitable resilient strategies to help prepare and recover from natural hazards and public health challenges. By adopting a localized strategy, stakeholders can collaborate to develop a culture of readiness and resilience, ultimately leading to more sustainable and resilient communities. This framework advises community-based groups, local government, and other stakeholders on prioritizing partnerships, preparedness planning, community participation, and leadership as essential components of creating and maintaining resilience. "One Community at a Time" framework offers practical guidance for community-based organizations, local government, and other stakeholders to prioritize partnerships, preparedness planning, community participation, and leadership as essential components of creating and sustaining resilience., (© 2023. The Author(s).)

Background: In recent years, Iran has encountered a growing frequency of earthquake disasters. Given that nurses constitute the largest group of healthcare providers, it is imperative that they possess adequate disaster preparedness skills, irrespective of the location or time. Despite the operating room nurses' roles in disasters, their experiences and challenges in disaster preparedness have been overlooked. Consequently, this study aimed to investigate the experiences, challenges, perspectives, and factors influencing the disaster preparedness of operating room nurses during the 2017 earthquake in Kermanshah, Iran., Methods: The present qualitative research was carried out in Iran In 2022 utilizing conventional content analysis. The study involved conducting semi-structured interviews with 16 operating room nurses who had participated in disaster preparedness during the Kermanshah earthquake. The participants were selected using a purposive sampling approach that aimed to achieve maximum diversity. The interviews were continued until the point of data saturation was reached, and the verbatim transcripts were analyzed using conventional content analysis in MAXQDA software. To ensure the rigor of the research, Guba and Lincoln's criteria were employed., Results: The study conducted data analysis to identify the main theme as "insufficient disaster preparedness due to a faded preparedness", along with six major categories and eighteen subcategories related to earthquake disaster preparedness. The major categories included: knowledge and perception of preparedness for disasters; educational and training programs for disaster preparedness; equipment preparedness for disasters; managerial-organizational preparedness for disasters; clinical skills for responding to disasters; and resilient ability in disaster response situations., Conclusion: The findings of the study provide valuable insights into the dimensions of disaster preparedness in earthquake disasters among operating room nurses. Nursing managers can utilize these findings to develop effective strategies and provide support in areas such as improving knowledge and educational level, equipment preparedness, strengthening plans and managerial structures, enhancing skills, and explaining resilience strategies to improve the disaster preparedness of operating room nurses and medical organizations' disaster response teams., (© 2023. The Author(s).)

This paper investigates the impact of a community disaster awareness training on subjective disaster preparedness, focusing on the case of a Republic of Korean aid-supported disaster risk reduction project in the Ayeyarwaddy region of Myanmar. A subsequent survey by the authors of a total of 182 households, an equal number of project participating and control households, produced encouraging results regarding the endeavour. Although both ordinal logistic regression and ordinary least squares models support overall robust effectiveness of participating in the project, the results also reveal different effects of specific activities. Disaster risk reduction (DRR) awareness meetings and trainings, and personal visits to share knowledge and/or to distribute informative flyers, are important. In contrast, the significance of drills or community activities, in mass, is lost in a combined model. Consequently, 'personalising risk' should be prioritised in any DRR undertaking, as well as, and in particular, development cooperation aimed at increasing confidence in disaster preparedness., (© 2023 The Authors Disasters © 2023 ODI.)

Extreme weather events are increasing in frequency and severity owing to climate change. Individual-level behavioural responses-notably, disaster preparedness and community helping actions (such as donating and volunteering)-supplement government efforts to respond to such phenomena, but rarely have they been explored together. Using data from a survey administered soon after the 2020 Oregon wildfires, this paper compares a range of socio-demographic, experiential, attitudinal, and communication-related factors associated with these two individual-level behavioural responses. Findings indicate that respondents who reported experiencing a higher degree of harm and heightened concern about climate change after the wildfires were more likely to report disaster preparedness and community helping actions. Those who reported more frequent informal discussions about the wildfires, consulting more sources to seek information on them, and higher percentages of friends, neighbours, and community members taking actions to prepare for future wildfires also reported more disaster preparedness and community helping actions. Disaster preparedness actions were also positively associated with seeking information from formal/official sources., (© 2023 The Authors Disasters © 2023 ODI.)

This study examined how community vulnerabilities contextualized the impact of exposure to five major disasters in 2017 on individuals' disaster preparedness. We pooled two panels of the Federal Emergency Management Agency (FEMA)'s National Household Survey in 2017 (pre-disaster) and 2018 (post-disaster) and further merged the data with 15 Centers for Disease Control and Prevention Social Vulnerability Index factors to examine the moderating impact of county-level vulnerabilities. Latent class analysis was used to identify patterns of disaster preparedness based on six preparedness items defined by FEMA with a total of 10,045 individuals. Three groups were identified and named basic preparedness (BP) group, high preparedness: socially engaged (HP-SE) group, and high preparedness: advanced socially engaged (HP-ASE) group. A working sample with a smaller sample size was constructed to include 2,179 individuals from 92 counties with disaster declarations of Hurricane Harvey, Hurricane Irma, Hurricane Maria, Hurricane Nate, and California Wildfires in 2017. Multinomial logistic regression indicated that post-disaster respondents were more likely to be in the HP-SE relative to the BP group. Two-level multinomial logistic regression showed that post-disaster respondents in communities with higher percentages of single-parent households and those of no vehicles were less likely to be in the HP-SE vs. the BP group. Post-disaster respondents in communities with higher percentages of unemployment, no high school diploma, and occupied housing units with more people than rooms were less likely to be in the HP-ASE vs. the BP group. Post-disaster respondents in communities with higher percentages of older adults and mobile homes were more likely to be in the HP-SE vs. the BP group. The findings also highlighted the importance of social engagement in disaster preparedness disparities and the need for community-level intervention to promote individuals' disaster preparedness., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: The threat of a disaster or potential for a disaster is something that may be experienced by individuals globally. Schools are places of daily mass gatherings which make them an ideal target for mass casualty, natural disasters, and biological incidents., Methods: An integrative review using Whittemore and Knafl's model was conducted to explore peer-reviewed publications about K-12 schools and natural disasters and pandemic preparedness and planning., Results: Themes identified from the systematic review of 12 articles reflected determinants and level of school preparedness, disaster plan components, compliance with government requirements, emergency equipment, supplies, drills, and training, collaboration with outside agencies, and perceptions of school preparedness. Preparedness for disasters and biological events among schools varies and multiple factors contribute to the level of preparedness. Perceptions of school preparedness differ among school community members. Schools perceive more preparedness for disasters than their actual level., Conclusions: Our nation's schools are not adequately prepared for disasters. There is a need for further research in schools to identify and understand preparedness for disasters., (© 2023 American School Health Association.)

Health care workers (HCWs) are increasingly faced with the continuous threat of confronting acute disasters, extreme weather-related events, and protracted public health emergencies. One of the major factors that determines emergency-department-based HCWs' willingness to respond during public health emergencies and disasters is self-efficacy. Despite increased public awareness of the threat of disasters and heightened possibility of future public health emergencies, the emphasis on preparing the health care workforce for such disasters is inadequate in low-and-middle-income countries (LMICs). Interventions for boosting self-efficacy and response willingness in public health emergencies and disasters have yet to be implemented or examined among emergency HCWs in LMICs. Mobile health (mHealth) technology seems to be a promising platform for such interventions, especially in a resource-constrained setting. This paper introduces an mHealth-focused project that demonstrates a model of multi-institutional and multidisciplinary collaboration for research and training to enhance disaster response willingness among emergency department workers in Pakistan.

In the last decades, Chemical, Biological, Radiological and Nuclear (CBRN) threats have become serious risks prompting countries to prioritize preparedness for such incidents. As CBRN scenarios are very difficult and expensive to recreate in real life, computer simulation is particularly suited for assessing the effectiveness of contingency plans and identifying areas of improvement. These computer simulation exercises require realistic and dynamic victim profiles, which are unavailable in a civilian context. In this paper we present a set of civilian nerve agent injury profiles consisting of clinical parameters and their evolution, as well as the methodology used to create them. These injury profiles are based on military injury profiles and adapted to the civilian population, using sarin for the purpose of illustration. They include commonly measured parameters in the prehospital setting. We demonstrate that information found in military sources can easily be adjusted for a civilian population using a few simple assumptions and validated methods. This methodology can easily be expanded to other chemical warfare agents as well as different ways of exposure. The resulting injury profiles are generic so they can also be used in tabletop and live simulation exercises. Modeling and simulation, if used correctly and in conjunction with empirical data gathered from lessons learned, can assist in providing the evidence practices for effective and efficient response decisions and interventions, considering the contextual factors of the affected area and the specific disaster scenario., Competing Interests: ED is employed by and the owner of DO Consultancy BV. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 De Rouck, Benhassine, Debacker, Dugauquier, Dhondt, Van Utterbeeck and Hubloue.)

Background: Ethiopian policy and strategy aim to make health care systems capable of dealing with emergencies. However, Ethiopian health care still lacks a comprehensive "all-hazard" approach and a disaster preparedness program. Thus, this study aimed to assess the level of disaster preparedness in selected public hospitals for mass-casualty incidents (MCIs) in Amhara Regional State, Northwest Ethiopia., Methods: A descriptive cross-sectional study was conducted at general and comprehensive specialized hospitals (CSHs) in Amhara Regional State, Ethiopia using a World Health Organization (WHO) hospital emergency response checklist that included a domain on mass-casualty management (MCM) adapted from a literature review., Results: Seventeen (17) hospitals were evaluated (response rate: 81%). Five (29.4%) were teaching hospitals (tertiary health care) and 12 (70.5%) were non-teaching (secondary health care) hospitals. With an average mean of 97.3 (SD = 33.68; range 31-160), most hospitals under WHO required an Acceptable level of preparedness. Two were at an Unacceptable (0-67) level of preparedness, 12 (70.5%) hospitals were at an Insufficient (68-134) state, while the other three had an Acceptable (135-192) level of preparedness., Conclusion: The preparedness level of hospitals is Insufficient for potential MCIs in this region and needs prior attention in implementing existing strategic guidelines to develop and activate hospital disaster plans if and when needed.

Introduction: The simulation exercise (SimEx) simulates an emergency in which an elaboration or description of the response is applied. The purpose of these exercises is to validate and improve plans, procedures, and systems for responding to all hazards. The purpose of this study was to review disaster preparation exercises conducted by various national, non-government, and academic institutions., Methodology: Several databases, including PubMed (Medline), Cumulative Index to Nursing and Allied Health Literature (CINAHL), BioMed Central, and Google Scholar, were used to review the literature. Information was retrieved using Medical Subject Headings (MeSH) and documents were selected according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). To assess the quality of the selected articles, the Newcastle-Ottawa Scale (NOS) technique was utilized., Results: A total of 29 papers were selected for final review based on PRISMA guidelines and the NOS quality assessment. Studies have shown that many forms of SimEx commonly used in disaster management including tabletop exercises, functional exercises, and full-scale exercises have their benefits and limitations. There is no doubt that SimEx is an excellent tool for improving disaster planning and response. It is still necessary to give SimEx programs a more rigorous evaluation and to standardize the processes more thoroughly., Conclusions: Drills and training can be improved for disaster management, which will enable medical professionals to face the challenges of disaster management in the 21st century., (© 2023. The Author(s).)

The COVID-19 pandemic exacerbated the child mental health crisis and existing disparities. Child anxiety, depression, suicide attempts and completions, and mental-health-related emergency department visits significantly increased. In response to this crisis, the Administration for Strategic Preparedness and Response (ASPR) developed behavioral health task forces associated with funded pediatric centers of disaster excellence. The Health Resources and Services Administration (HRSA) funded the Pediatric Pandemic Network (PPN) to prepare for future endemics and pandemics, with behavioral health identified as a priority in mitigation, preparedness, response, and recovery. This commentary provides insights from pediatric disaster preparedness and response behavioral health subject matter experts. Our roles have been to identify how to build behavioral health professional competencies across disciplines and various medical settings and to strengthen emergency interdisciplinary behavioral health care capability regionally and at the national level. Specific examples of interdisciplinary training and demonstration projects are included as models for enhancing behavioral health situational awareness and developing curricula to support preparedness and response for the current ongoing pandemic and future natural and biological disasters. This commentary also includes a call to action for workforce development to move beyond a boots-on-the-ground mentality for pediatric behavioral health disaster preparedness and response toward a more inclusive role for behavioral health providers of varied specialties. This means that behavioral health providers should become more informed of federal programs in this area, seek further training, and find innovative ways to collaborate with their medical colleagues and community partners.

Children and youth with special healthcare needs (CYSHCN) are at disproportionate risk of harm from widespread disasters and from life-safety emergencies. These risks may be mitigated by providing preparedness training and support to family caregivers. We conducted a scoping review to identify and map the scholarly literature on home-focused preparedness of families with CYSHCN. Our search strategy yielded 22 relevant articles; 13 pertained to life-safety emergencies, 5 centered on widespread disasters, and 4 addressed preparedness on multiple scales. Approaches to measure or attempt to improve emergency preparedness levels in CYSHCN and their families were diverse and included interviews and focus groups; didactic, video-based, or side-by-side instruction; simulated medical crises; and provisioning of emergency kits. For the studies that involved an intervention (n=15, 68%), several proxy indicators of preparedness were used, including caregiver knowledge, skill, or comfort level with managing emergencies that could affect their CYSHCN; completion of preparedness tasks; and reduction in adverse clinical outcomes. Despite the varied methodologies, prevailing themes in the studies were that family caregivers of CYSHCN felt underprepared for emergencies and disasters, desired training to improve their preparedness at home, and benefited from such trainings, at least in the short term, across domains of self-efficacy, skill, and health outcomes of their CYSHCN. Although more research is needed to compare preparedness interventions and evaluate the durability of these interventions in larger, more diverse samples of CYSHCN and their families, our findings support incorporating preparedness training into preventive care encounters and the hospital-to-home transition.

The increasing risk of disasters worldwide poses challenges both to health care infrastructures and to home care providers, who must maintain decentralised services for those in need of long-term care for as long as possible, even under adverse circumstances. However, both the kind of organisational precautions that home care providers consider in preparation for disasters and the available evidence on the effectiveness of these precautions remain largely unclear. An integrative literature review was thus performed via a systematic search of several international databases in order to identify original research on organisational disaster planning by home care providers and to determine the evidence base of this research. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool. Of the 286 results, 12 articles met the inclusion criteria and presented results from nine studies on disaster planning. Three overarching types of activities carried out by home care providers were identified inductively. The overall scientific quality of the studies was moderate, and none investigated the effectiveness of disaster planning by home care providers. Despite the variety of possible activities that home care providers already consider, evidence on how to make organisational disaster planning effective and sustainable remains lacking.

The Hospital Safety Index is a tool developed by the World Health Organization and the Pan American Health Organization in 2008 and updated in 2015. Although it is the most widely used instrument of its kind to assess the level of hospital preparedness, scientific literature on its application in real life is scarce. This study aimed to investigate the use of the Hospital Safety Index to assess disaster preparedness in healthcare facilities. A retrospective, qualitative study employing semi-structured online interviews was conducted to gather the opinions and perspectives of professionals who have experience in applying the Hospital Safety Index. Authors of scientific publications using the Hospital Safety Index were recruited. A semi-structured interview guide was developed. It addressed different phases of data collection with the Hospital Safety Index, the challenges and facilitators of using it, and recommendations for future adaptations. Data were analysed using inductive thematic analysis. Nine participants who were from three countries (Serbia, Sri Lanka, and Indonesia) and had different professional backgrounds (medical doctors, engineers, spatial planners, etc.) participated in this study. A total of 5 themes and 15 subthemes emerged during data analysis. Most of the participants reported their reasons for choosing the Hospital Safety Index as being its comprehensiveness and the fact that it was issued by the World Health Organization. The tool appears to be very specific and allows investigators to spot details in hospitals; however, it is not easy to use, and training is highly encouraged to learn how to navigate the different components of the tool. Governmental support is a crucial facilitator for investigators to be able to enter hospitals and conduct their evaluations. Overall, the tool has a lot of potential, and it should be used to reach a broader audience, such as community members, and assess the preparedness of other facilities that can take part in the response to disasters (hotels, stadiums, schools, etc.). Nevertheless, it still needs more adaptations to be tailored to different contexts and settings.

Students have long been among those most emotionally and physically affected by natural or manmade disasters, yet universities and colleges continue to lack effective disaster response and mitigation practices. This research identifies how students' socio-demographics and disaster preparedness indicators (DPIs) impact their awareness of the dangers of disasters and their ability to survive and cope with the changes that disasters bring. A comprehensive survey was designed and distributed to university students to gain an in-depth understanding of their perceptions of disaster risk reduction factors. A total of 111 responses were received, and the impact of the socio-demographics and DPIs on the students' disaster awareness and preparedness were evaluated by employing structural equation modeling. The results indicate that the university curriculum impacts the disaster awareness of students while the establishment of university emergency procedures impacts the disaster preparedness of students. The purpose of this research is to enable university stakeholders to identify the DPIs that are important to the students so that they can upgrade their programs and design effective DRR courses. It will also aid policymakers in redesigning effective emergency preparedness policies and procedures.

Objective: The objective of this study was to describe and compare almost all the components of disaster preparedness between private and government hospitals in the Eastern Province of the Kingdom of Saudi Arabia, using the World Health Organization's (WHO) checklist., Methods: We assessed and compared the disaster preparedness between government and private hospitals in Province, using the 10-key component WHO checklist in a descriptive cross-sectional study. Of 72 hospitals in the region, 63 responded to the survey., Results: All 63 hospitals had an HDP plan and reported having a multidisciplinary HDP committee. In all responding hospitals, HDP was acceptable in most indicators of preparedness; however, some hospitals to some extent fell short of preparedness in surge capacity, equipment and logistic services, and post-disaster recovery. Government and private hospitals were generally comparable in disaster preparedness. However, government hospitals were more likely to have HDP plans that cover WHO's "all-hazard" approach, both internal and external disasters, compared to private hospitals., Conclusion: HDP was acceptable, however, preparedness in surge capacity, equipment and logistic services, and post-disaster recovery fell short. Government and private hospitals were comparable in preparedness with regards to all indicators except surge capacity, post-disaster recovery, and availability of some equipment.

Objective: The study aimed to identify the factors that influence the disaster preparedness of hospitals and validate an evaluation framework to assess hospital disaster preparedness (HDP) capability in the Eastern Province of Saudi Arabia., Methods: A cross-sectional survey of all hospitals (n = 72) in the Eastern Region of Saudi Arabia was conducted. A factor analysis method was used to identify common factors and validate the evaluation framework to assess HDP capacity., Results: Sixty-three (63) hospitals responded to the survey. A 3-factor structure was identified as key predicators of HDP capacity. The first factor was the most highly weighted factor, which included education and training (0.849), monitoring and assessing HDP (0.723), disaster planning (0.721), and command and control (0.713). The second factor included surge capacity (0.708), triage system (0.844), post-disaster recovery (0.809), and communication (0.678). The third factor represented safety and security (0.638) as well as logistics, equipment, and supplies (0.766)., Conclusion: The identified 3-factor structure provides an innovative approach to assist the operationalization of the concept of HDP capacity building and service improvement, as well as serve as a groundwork to further develop instrument for assessing HDP in future studies.

The COVID-19 pandemic illuminated shortcomings in the ability of community hospitals in the United States to respond to crises of this nature. This has led to questions about the effectiveness of community hospital disaster preparedness. A study of hospital preparedness in New York State in 2017 revealed a number of barriers to preparedness. Among the most significant are economic barriers, given that disaster preparedness is not a reimbursable cost like patient care. The economic challenges have been exacerbated by a decline in federal disaster preparedness funding in recent years. Reflecting on previous writings, the author provides several options for overcoming these barriers to ensure hospitals are better prepared for future disasters.

By 2050, one in five Americans will be 65 years and older. The growing proportion of older adults in the U.S. population has implications for many aspects of health including disaster preparedness. This study assessed correlates of disaster preparedness among community-dwelling minority older adults and explored unique differences for African American and Hispanic older adults. An electronic survey was disseminated to older minority adults 55+, between November 2020 and January 2021 ( n = 522). An empirical framework was used to contextualize 12 disaster-related activities into survival an0000000d planning actions. Multivariate logistic regression models were stratified by race/ethnicity to examine the correlates of survival and planning actions in African American and Hispanic older adults, separately. We found that approximately 6 in 10 older minority adults did not perceive themselves to be disaster prepared. Medicare coverage was positively associated with survival and planning actions. Income level and prior experience with disaster were related to survival actions in the African American population. In conclusion, recognizing the gaps in disaster-preparedness in elderly minority communities can inform culturally sensitive interventions to improve disaster preparedness and recovery.

Objective: To quantify differences in preparedness for and adaptations to COVID-19 in a cohort sample of New York City residents., Methods: A proportional quota sample (n = 1020) of individuals residing in New York City during the COVID-19 pandemic participated in a Qualtrics web survey. Quotas were set for age, sex, race, and income to mirror the population of New York City based on the 2018 American Community Survey., Results: Low self-efficacy, low social support, and low sense of community increased the odds of securing provisions to prepare for COVID-19. Being an essential worker, poor mental health, and having children in the household reduced the likelihood of engaging in preparedness practices. Essential workers and individuals with probable serious mental illness were less likely to report preparedness planning for the pandemic., Conclusions: The findings contribute to evolving theories of preparedness. There are differences across the sample in preparedness types, and different kinds of preparedness are associated with different household characteristics. Findings suggest that public officials and others concerned with population wellbeing might productively turn attention to education and outreach activities indexed to these characteristics.

Objective: The aim of this study was to measure the perception of readiness to manage a sanitary crisis for hospital workers and to study the factors related to this perception., Methods: This study was a cross-sectional study; 408 French hospital workers responded to an online questionnaire. The variables studied concerned the perceived personal preparedness, the perception of colleagues' and hospital's preparedness, perception of the situation, and preparatory behavioral acts. Correlations, partial correlations, and multiple linear regressions were applied., Results: Based on Pearson's correlations, the higher the participants' sense of personal efficacy and control over their behavior, the more ready they feel (r p = 0.77*** and r p = 0.55***). The more participants perceive their colleagues as ready and their hospital as prepared, the more ready they feel (r p = 0.52*** and r p = 0.46***). Based on Pearson's partial correlations, upon controlling the effect of preparedness perception, declared preparedness is not significantly correlated with personal readiness perception (r p = 0.01)., Conclusion: The perception of personal readiness does not depend only on actual preparedness but also on individual and collective variables. Technically, these results confirm the value of relying on psychosocial variables during training. It would be interesting to propose empowerment in training courses. It also seems necessary to demonstrate crisis management efficacy at different levels: institutional, collective, and individual.

Background: For hospitals, learning from disaster response efforts and adapting organizational practices can improve resilience in dealing with future disruptions. However, amidst global disruptions by climate change, the coronavirus disease 2019 (COVID-19) pandemic, and other disasters, hospitals' ability to cope continues to be highly variable. Hence, there are increasing calls to improve hospitals' capabilities to grow and adapt towards enhanced resilience., Aim: This study aims two-fold: (1) to characterize the current state of knowledge about how hospitals are gaining knowledge from their responses to disasters, and (2) to explore how this knowledge can be applied to inform organizational practices for hospital resilience., Method: This study used Preferred Reporting Items of Systematic Reviews and Meta-Analysis (PRISMA) guidelines for data collection and framework for data analysis, Covidence software, and Medical Subject Headings (MeSH) terms and keywords relevant to "hospitals," "learn," "disaster response," and "resilience." The quality appraisal used an adapted version of the Mixed Methods Assessment Tool (MMAT)., Results: After applying inclusion and exclusion criteria and quality appraisal, out of the 420 articles retrieved, 22 articles remained for thematic and content analysis. The thematic analysis included the hospital's functional (operational) and physical (structural and non-structural) sections. The content analysis followed nine learning areas (Governance and Leadership, Planning and Risk Assessment, Surveillance and Monitoring, Communication and Network Engagement, Staff Practices and Safety, Equipment and Resources, Facilities and Infrastructure, Novelty and Innovation, and Learning and Evaluation).On applying the Deming cycle, only four studies described a completed learning cycle wherein hospitals adapted their organizational structures using the prior experience and evaluation gained in responding to disaster(s)., Conclusions: There is a gap between hospitals' organizational learning and institutionalized practice. The conceptualized Hybrid Resilience Learning Framework (HRLF) aims to guide the hospitals' decision makers in evaluating organizational resilience and knowledge.In the face of disasters, both the stressful factors and the coping strategies that affect the health care workers (HCWs) should be substantially considered.

Introduction: Recent disasters emphasize the need for disaster risk mitigation in the health sector. A lack of standardized tools to assess hospital disaster preparedness hinders the improvement of emergency/disaster preparedness in hospitals. There is very limited research on evaluation of hospital disaster preparedness tools., Objective: This study aimed to determine the presence and availability of hospital preparedness tools across the world, and to identify the important components of those study instruments., Method: A systematic review was performed using three databases, namely Ovid Medline, Embase, and CINAHL, as well as available grey literature sourced by Google, relevant websites, and also from the reference lists of selected articles. The studies published on hospital disaster preparedness across the world from 2011-2020, written in English language, were selected by two independent reviewers. The global distribution of studies was analyzed according to the World Health Organization's (WHO) six geographical regions, and also according to the four categories of the United Nations Human Development Index (UNHDI). The preparedness themes were identified and categorized according to the 4S conceptual framework: space, stuff, staff, and systems., Result: From a total of 1,568 articles, 53 met inclusion criteria and were selected for data extraction and synthesis. Few published studies had used a study instrument to assess hospital disaster preparedness. The Eastern Mediterranean region recorded the highest number of such publications. The countries with a low UNHDI were found to have a smaller number of publications. Developing countries had more focus on preparedness for natural disasters and less focus on chemical, biological, radiological, and nuclear (CBRN) preparedness. Infrastructure, logistics, capacity building, and communication were the priority themes under the space, stuff, staff, and system domains of the 4S framework, respectively. The majority of studies had neglected some crucial aspects of hospital disaster preparedness, such as transport, back-up power, morgue facilities and dead body handling, vaccination, rewards/incentive, and volunteers., Conclusion: Important preparedness themes were identified under each domain of the 4S framework. The neglected aspects should be properly addressed in order to ensure adequate preparedness of hospitals. The results of this review can be used for planning a comprehensive disaster preparedness tool.

Introduction: Emergency nurses serve a vital role in disaster situations. Understanding their disaster preparedness and willingness to respond to a disaster is important in maintaining appropriate disaster management. The purpose of this study was to explore emergency nurses' disaster preparedness and willingness to respond based on demographic and disaster-related characteristics, and their willingness to respond based on specific disaster situations., Methods: In this descriptive, cross-sectional study, the Disaster Preparedness Questionnaire for Nurses and willingness to report to duty by type of event were used to collect data from 158 nurses working in four regional emergency medical centers from 1 December 2019 to 30 April 2020 in the early stages of the COVID-19 pandemic., Results: Emergency nurses with personal disaster experience as a victim or witness ( t = 3.65, p < 0.001), professional disaster experience (i.e., working as a nurse) ( t = 3.58, p < 0.001), who were current members of Korean Disaster Medical Assistance Teams ( t = 6.26, p < 0.001), and who received disaster-related training within a year ( t = 5.84, p < 0.001) showed a high level of perceived disaster preparedness. Emergency nurses who have professional disaster experience (i.e., working as a nurse) ( t = 2.42, p = 0.017), are on a current disaster team ( t = 2.39, p = 0.018), and have received disaster training ( t = 2.73, p = 0.007) showed a high level of willingness to respond. Our study showed a high willingness to respond to natural disasters and low willingness to respond to technological disasters., Discussion: To promote the engagement of emergency nurses in disaster response, disaster education programs should be expanded. Enhancing the safety of disaster response environments through supplementing medical personnel, distributing available resources, and providing sufficient compensation for emergency nurses is also essential.

The likelihood of a mega-earthquake, the COVID-19 pandemic, and the threat of other disasters in the Tokyo Metropolitan area have necessitated collective responsibilities to take all possible actions to reduce their impacts. The experiences from past disasters have, however, highlighted the plight of foreign residents in coping with disasters and have reinvigorated calls for rigorous counteractions. As the population of foreign residents continues to increase in the metropolis, this research examines their awareness of risks and the obstacles that hinder disaster preparedness in the wake of future disasters. An Extended Parallel Process Model is utilized to analyze both secondary and primary data sources, and the results reveal that 65% perceive the severity of disaster as a threat and believe in a likelihood of occurrence in the city; however, the confidence to undertake some recommended countermeasures are lacking (with low efficacy of 70%). This is causing many to control their fear by not actively seeking further risk information or participating in disaster prevention activities. In consideration of these instances, the study recommends a collective approach built upon the merits of stakeholder engagements to provide vicarious experiences, verbal persuasions, and mastery experiences to boost the response capacities of foreign residents for disaster preparedness. This will be relevant for city authorities to enhance risk communication and foster foreigner-Japanese community integration.

Background: Mid-way through the 'Sendai Framework for Disaster Risk Reduction 2015-2030', many nations are spending time, money and effort to enhance their level of preparedness facing disasters, on the other hand communities, countries and even continents are being left behind., Objectives: This study was conducted aiming at evaluating the level of disaster preparedness and response of Tunisian University Hospitals., Methods: This is a cross-sectional nationwide study conducted in Tunisia, from November 2020 to April 2021. Including 9 Tunisian University Hospitals and using the Hospital Safety Index. The data were analysed using the 'Module and safety index calculator'., Results: This study showed that 7 out of the 9 University Hospitals were assigned the 'B' category of safety with overall safety indexes that ranges between 0.37 and 0.62. Also, 4 out of 9 University Hospitals had safety scores less than 0.20 regarding their emergency and disaster management., Conclusions: This is the first study to evaluate disaster preparedness and response of university hospitals in Tunisia and in north Africa. It showed that the lack of knowledge, resources and willingness, are the most important issues that needs to be addressed in order to enhance the preparedness of Tunisian hospitals., (© 2022 Lamine H et al.)

Objective: Individuals with spinal cord injuries (SCIs) are vulnerable in case of disaster, and it is unknown how they can prepare themselves for such events. This study explored factors associated with self-assistance behaviors against disasters., Methods: An internet-based cross-sectional survey was conducted in Japan. The participants were 70 individuals with SCI in a self-help group in Japan. Self-assistance behaviors against disaster were defined in terms of personal network, escape, information, essential items, disaster drill participation, and list registration. After identifying significant variables through binary analyses, logistic regression analysis was conducted to adjust for age and sex., Results: Neighborhood association and peer communication significantly predicted list registration (AOR:2.97; 95% CI:1.05 - 8.40; P = 0.04; AOR:2.79, 95% CI:1.00-7.74, P = 0.05). However, no significant factor was found in relation to other self-assistance behaviors against disasters., Conclusion: Belonging to a neighborhood association and having communication with peers could help individuals with SCI register on a list for assistance during disaster. To promote self-assistance behaviors against disasters, access to neighborhood associations, and opportunities for peer communication should be increased.

This paper describes the design and function of an application that enables vulnerable people to provide medical information for use in disasters, and presents the results of an initial test of its usability in Nankoku, Japan. The application consists of two parts: K-DiPS Solo, a smartphone app, and K-DiPS Online, a web application for disaster management by local governments. We asked vulnerable people or their family caregivers to enter medical information into the app on their smartphones and connected this information to a local government application as a demonstration of a disaster response solution that manages information. We targeted a group of 14 healthy older people. The user information that they entered into the app was stored in the cloud via the communication system of the mobile phone. A ledger of vulnerable people for use in the event of a disaster was automatically created on the web application using the information supplied by the individuals. Local government staff corrected the location information, if necessary, by dragging points plotted on a map. This disaster response solution was shown to connect individuals to government offices, and to enable a consistent flow of information from patient details to stocking of supplies, and for simulation, training, and response during disasters.

Objectives: Factors associated with an individual's awareness of vulnerability can be modified by the infrastructure of a city. These factors may impact disaster preparedness among local populations in an infrastructure-resilient city, which further influences the health risks of various population subgroups., Study Design: This was a population-based study., Methods: Four population subgroups, which have previously been reported to be related to awareness of vulnerability (i.e. past experiences, sociodemographic deprivation, poor housing conditions and family medical needs), were analysed for their impacts on disaster preparedness. Validated population-based phone interviews (n = 856) were conducted in Hong Kong. Three types of disaster preparedness were studied: (1) physical preparedness; (2) social preparedness; and (3) education preparedness., Results: Previous experience of social hazards, accidental hazards and epidemics increased disaster preparedness among the local population. Specifically, experiences of accidental hazards and social hazards were positively associated with physical preparedness (odds ratios 1.626, 95% confidence interval [95% CI] 1.215, 2.172) and 1.501 [95% CI 1.114, 2.024], respectively). However, experiences of natural hazards did not increase preparedness, even in Hong Kong, which is a city with high 'disaster resilience' because of its well-developed infrastructure. Moreover, individuals with a low educational level or low income had lower education preparedness, unmarried individuals had lower social preparedness, and poor housing conditions of non-private-housing households had negative associations with education preparedness. These findings partially align with local disaster responses to the 2018 Typhoon Mangkhut, the 2019 social unrest and the 2020 COVID-19 pandemic, all of which were observed after the 2018 survey reported in this study., Conclusions: Social and environmental interventions should be targeted to marginalised subpopulations through location-based community strategies to encourage increased environmental knowledge and participation in disaster preparedness activities., (Copyright © 2022 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)

The American Society for Reproductive Medicine compels centers providing reproductive medicine care to develop and implement an emergency preparedness plan in the event of a disaster. Reproductive care is vulnerable to disruptions in energy, transportation, and supply chains as well as may have potential destructive impacts on infrastructure. With the relentless progression of events related to climate change, centers can expect a growing number of such disruptive events and must prepare to deal with them. This article provides a case study of the impact of Hurricane Sandy on one center in New York City and proposes recommendations for future preparedness and mitigation., (Copyright © 2022 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)

Background: Hospital and pre-hospital emergency nurses are at the forefront of disaster response. Disaster incidents continue to pose a threat to healthcare systems by exposing them to an overwhelming surge of patients., Methods: This descriptive cross-sectional study was performed on 472 hospital and pre-hospital emergency nurses in Ardabil province, in the northwest Iran, from March to April 2021, were recruited by convenience sampling method. Data were collected using valid and reliable self-reported questionnaires, including the Emergency Preparedness Information questionnaire (EPIQ) and Triage Decision-making Inventory (TDMI). Data were analyzed using SPSS (Version 22) software using descriptive statistics, Pearson correlation coefficient test, t-test, ANOVA test, and multiple linear regression analysis., Results: Emergency nurses' disaster preparedness knowledge was low according to the mean score of total disaster preparedness knowledge. Furthermore, multiple linear regression analysis showed triage decision-making, age, residence, disaster preparedness training, working on duty during a disaster, and training organization variables were predictors of disaster preparedness knowledge in hospital and pre-hospital emergency nurses (p < 0.05)., Conclusion: Emergency nurses who have higher disaster preparedness knowledge have higher triage decision-making skills. It is suggested that the managers of educational and medical centres and professional organizations provide favourable conditions for training and increasing disaster preparedness of emergency nurses according to their age and residence., (© 2022. The Author(s).)

Background: Disaster relief operations involve a variety of components of healthcare efforts. The post-disaster recovery is a key component of hospital preparedness. This study aimed to investigate the role of hospital nurses in the disaster area and their challenges during the relief efforts after the Great East Japan Earthquake in 2011., Methods: Semi-structured interviews were conducted with ten nurses who worked in a general public hospital before the Great East Japan Earthquake and were dispatched to the evacuation centers after the disaster. A qualitative approach with the thematic analysis method was employed. Three research queries (RQs) were prepared before the interview., Results: The study participants played administrative roles as city employees in addition to performing nursing services as healthcare providers in evacuation centers. The first RQ on their challenges in evacuation centers gave us four themes: criticism by the evacuees, conflicts between multiple roles, difficulties in performing the first experience, and anxiety in working. The second RQ asking about motivation to accomplish disaster relief efforts raised three themes of carrying out the nursing role, acceptance by evacuees, and strengths of human connections. Two themes of awareness of disaster medicine and professional growth were raised from the third RQ of gains from the experiences in the evacuation centers., Conclusions: The hospital nurses in the disaster area performed multiple roles in the relief efforts in the evacuation centers, which developed a psychological burden on them. A sense of competence supported the motivation to accomplish the disaster relief activities and professional growth as a specialist in disaster medicine. A study limitation is missing hospital nurses who resigned during the relief efforts. Further study is warranted to refine the disaster preparedness of hospital operations., (© 2022. The Author(s).)

Disaster preparedness is the most important measure that can be taken to reduce damage. However, disaster preparedness is predicted to be difficult for older adults with cognitive impairment. Thus, we investigated the effects on disaster preparedness of cognitive impairment in persons requiring special care who are 75 or older. The survey included subject characteristics such as demographic indicators, physical function, cognitive function impairments, community involvement, and disaster preparedness. Cross-sectional data from 711 subjects were divided into two groups, a cognitive impairment group and an unimpaired group. Next, to show the effects of subject characteristics in each group on disaster preparedness, a binomial logistic regression analysis was performed. Then, the effects on disaster preparedness were compared between the two groups. This study showed that persons requiring special care who are 75 or older, and have the characteristics of "living alone," "requiring care," and "needing mobility assistance" in addition to cognitive impairment, have increased difficulty making disaster preparedness. Government officials and community supporters therefore need to recognize that these people should be supported on a priority basis, and to provide continuing support for disaster preparedness.