This act provided training to first responders (police and fire department) and to assist with the formation of metropolitan medical strike teams (MMSTs). The National Defense Authorization Act for FY 1997 saw the allocation of funds aimed at enhancing domestic preparedness capabilities to respond to a weapons of mass destruction (WMD) incident. Highly virulent public health threats including Ebola virus disease (EVD), pandemic influenza, severe acute respiratory syndrome (SARS), and Zika virus disease require close coordination of both hospitals and public health officials to ensure accurate case counts, worker protection, protocols for testing, processing of laboratory samples, and early identification of those with the disease. Public health departments have historically taken the lead with viral or bacterial diseases that have had the potential to impact large numbers of the population such as norovirus, polio, varicella, rubella, meningitis, foodborne illness, and influenza. Hospitals have coordinated as needed with local and state health departments, particularly in the development of large systems such as Emergency Medical Services for Children (EMSC), developing resources for large-scale mass emergency pediatric critical care, 4 emergency medical systems (EMS), and state trauma systems. It is important to note that things have now changed. The greatest effort for training usually occurred in the ED. Training on the hospital disaster plan usually occurred once a year and included a review of specific processes through table-top exercises.
#STOCKPILE TURNOVER GENERATOR#
The hospital engineering staff checked the emergency generator as part of the requirements for facility management, and load bank tests were carried out. Hospital EDs maintained a supply of medical surgical supplies, triage tags, and premade patient charts. Leadership for the hospital disaster plan was often carried out by nurses and other hospital leaders including: the nurse manager in the ED, trauma nurse coordinator, ED medical director, trauma medical director, hospital safety officer, or the hospital facility manager. The disaster plan began in the emergency department (ED) and ended when the patient was admitted to the hospital, died, or was discharged.
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Historically, hospitals crafted a disaster plan with a trauma or mass casualty focus.
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One the earliest hospital evacuation exercises took place in Portland, Oregon, in 1955 as part of Operation Green Light, a civil defense exercise. World War II civil defense efforts and later on in the 1950s continued as communities prepared for potential nuclear attacks, and hospitals prepared for mass casualties. Hospitals as part of cities and towns in the 1930s were involved with civil defense programs after learning of the prewar activities in Europe. Hospital emergency preparedness is not a new idea. Nursing process involves collaboration, which is the foundation for effective emergency preparedness and the process of emergency management.
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Historically, the nurse has not only been the bedside caregiver but a leader in seeing the larger picture when it applies to the hospital or health care community. 1 The role of the nurse in emergency preparedness may not always be visible. The ability of hospitals, health care systems and the emergency medical system (EMS) to quickly transfer patients, be ready for critically injured people, provide medical counter measures (MCMs), or to initiate just-in-time training to staff to keep people safe is always uppermost for any first responder or hospital first receiver. Whether it is the threat of terrorism, climate change resulting in flooding, or a new virus for which there is no cure, the health care system will be on the forefront of response. Health care emergency preparedness and the importance of a well-rehearsed, coordinated response have never been more important to the health security of a community or to the nation.