Safe intra-hospital care in context of vulnerability to socio-environmental disasters: implications for nursing

Rocha, Mayra Wilbert; Oliveira, Alexandre Barbosa de; Araújo, Diego Freitas de; Queiroz, Ana Beatriz Azevedo; Paes, Graciele Oroski

doi:10.1590/0034-7167-2019-0223

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Revista Brasileira de Enfermagem

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Brasil

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 74 (1) • 2021 • https://doi.org/10.1590/0034-7167-2019-0223 copy

Safe intra-hospital care in context of vulnerability to socio-environmental disasters: implications for nursing

Asistencia intrahospitalaria segura en el contexto de vulnerabilidad a los desastres socioambientales: implicaciones para la enfermería

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objectives:

to analyze the factors involved in safe intra-hospital care, in a context of vulnerability to socio-environmental disasters and their implications for nursing.

Methods:

a cross-sectional study of a descriptive and exploratory nature. Semi-structured interviews were conducted with 49 nursing professionals from a hospital in the mountainous region of the state of Rio de Janeiro (Brazil), which suffered a significant impact from a socio-environmental disaster in January 2011. Data were processed by software IRaMuTeQ.

Results:

aspects related to disaster assistance were presented through a thematic chunk with four classes, through descending hierarchical classification.

Conclusions:

for better nursing response in socio-environmental disasters, in an intra-hospital setting, investments for training and continuing education should be prioritized; adequate provision and provision of human, material and technological resources; psychological support for professionals after such events; appropriation of nursing competencies for the development of advanced practices in disasters and effective risk management.

Descriptors:
Nursing; Hospitals; Safety; Disasters; Disaster Vulnerability

Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
E-mail: reben@abennacional.org.br

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[1] Corresponding author: Diego Freitas de Araújo. E-mail: diegodg_05@hotmail.com

Care	- Identifying the potential risks for assistance in disaster situations, including around the hospital unit, considering environmental aspects. - Planning the attendance of emergency clinical and surgical demands, considering excessive number of victims, diversity and severity of cases. - Ensuring continuity of safe disaster assistance. - Providing first psychological care to victims who are welcomed by the hospital unit. - Developing intervention measures and technologies for the provision of safe care in the intra-hospital setting, including in the screening, transport and evacuation of victims. - Observing ethical-legal precepts of professional practice, in order to support decision making and prioritization of care in cases of disasters. - Ensuring the records of the assistance provided, and its safeguard.
Education	- Diagnosing limits of knowledge, and define skills and skills for disaster intervention. - Assessing the need for training and obtain additional resources needed for training. - Developing training plans and educational intervention systems for disaster assistance, considering multidisciplinary approach. - Conducting periodic simulations and training in workplaces and in the community. - Empowering team leaders to integrate crisis committees and risk management and management functions. - Encouraging risk perception practices among professionals working in the hospital in order to promote a safety culture. - Developing and facilitating disaster research.
Management	- Paying attention to the structural, non-structural and functional vulnerabilities of the institution, in order to protect the lives of patients, professionals and visitors. - Ensuring that hospital facilities and their equipment remain operational, even in cases of intra- or extra-hospital disasters. - Assessing the hospital's readiness and develop actions to expand it when necessary. - Monitoring measures of forecasting, provision and contingency of water services, electricity, telecommunications, among others, as well as organize and predict stocks of medicines, blood, supplies, materials and equipment. - Recognizing warning, alarm and signalling systems for emergency hospital evacuations. - Ensuring access and support to means of emergency transport. - Developing disaster preparedness and response plans, as well as protocols for mass casualty care. - Identifying suspected risks to health and/or the environment, and report them to the competent authorities (institutional and public health). - Defining chain of command and the role of nurses within the institution's incident control system. - Creating a disaster response team of the hospital guided by skills, skills and matrices of responsibilities. - Developing and making accessible to supervisors and heads telephone listing of members of the hospital health teams, to ensure quick and orderly contact in emergencies. - Maintaining communication and coordination strategies with other members of the disaster response team. - Establishing/keeping contact with the authorities, sectors and agencies responsible for local/regional disaster response. - Defining psychological support strategies for professionals.