A survey of the practice of nurses' skills in Wenchuan earthquake disaster sites: implications for disaster training.

To determine nursing skills most relevant for nurses participating in disaster response medical teams; make recommendations to enhance training of nurses who will be first responders to a disaster site; to improve the capacity of nurses to prepare and respond to severe natural disasters. Worldwide, nurses play a key role in disaster response teams at disaster sites. They are often not prepared for the challenges of dealing with mass casualties; little research exists into what basic nursing skills are required by nurses who are first responders to a disaster situation. This study assessed the most relevant disaster nursing skills of first responder nurses at the 2008 Wenchuan earthquake disaster site. Data were collected in China in 2008 using a self-designed questionnaire, with 24 participants who had been part of the medical teams that were dispatched to the disaster sites. The top three skills essential for nurses were: intravenous insertion; observation and monitoring; mass casualty triage. The three most frequently used skills were: debridement and dressing; observation and monitoring; intravenous insertion. The three skills performed most proficiently were: intravenous insertion; observation and monitoring; urethral catheterization. The top three ranking skills most important for training were: mass casualty transportation; emergency management; haemostasis, bandaging, fixation, manual handling. The core nursing skills for disaster response training are: mass casualty transportation; emergency management; haemostasis, bandaging, fixation, manual handling; observation and monitoring; mass casualty triage; controlling specific infection; psychological crisis intervention; cardiopulmonary resuscitation; debridement and dressing; central venous catheter insertion; patient care recording.

Yin H ，He H ，Arbon P ，Zhu J ... -  《-》

Disaster nursing skills, knowledge and attitudes required in earthquake relief: Implications for nursing education.

Globally, nurses becoming more aware of getting better prepared for disaster relief, but in China, disaster nursing knowledge, courses and research are still limited. China has long been prone to disasters, but disaster nursing education and training is in its infancy. This study explored the skills, knowledge and attitudes required by registered nurses from across China who worked in the aftermath of three large earthquakes to try to determine future disaster nursing education requirements. The Questionnaire of Nurses' Disaster Nursing Skills at Earthquake Sites, assessing nursing skills, knowledge and attitudes, was distributed to 139 registered nurses in 38 hospitals in 13 provinces across China who had worked in one or more earthquake disaster zones. Descriptive statistics were used for quantitative data, and content analysis for qualitative data. Eighty-nine questionnaires were returned, a response rate of 68.3%. No respondent had ever received specific disaster nursing training prior to their post-earthquake nursing. Skills most often used by respondents were haemostasis bandaging, fixation, manual handling, observation and monitoring, debridement and dressing, and mass casualty transportation. Respondents identified that the most important groups of skills required were cardiopulmonary resuscitation; haemostasis, bandaging, fixation, and manual handling; and emergency management. They emphasized the need for psychological care of victims as well as that of fellow health workers. No respondent had ever received disaster nursing training prior to engagement at the earthquake disaster sites. All believed that there were important gaps in their knowledge and skills, and supported disaster nursing courses in the future. China urgently needs to develop disaster nursing courses, with the support of nurse leaders, educationalists and government, to implement training using an all hazards approach in accordance with international best practice and trainees' background clinical experience and knowledge.

Yan YE ，Turale S ，Stone T ，Petrini M ... -  《-》

Chinese nurses' experience in the Wenchuan earthquake relief.

Yang YN ，Xiao LD ，Cheng HY ，Zhu JC ，Arbon P ... -  《-》

Optimal qualifications, staffing and scope of practice for first responder nurses in disaster.

To explore: the selection criteria for first responder nurses during disaster; scope of practice for disaster relief nurses; appropriate nurse - medical practitioner ratio at the disaster site. Nurses are key members of disaster response medical teams. A scarcity of literature exists relating to nurses attending disasters, their qualifications, experience, scope of practice and appropriate staffing ratios. Qualitative and quantitative data were collected via survey using self-developed questionnaires. Participants were 95 medical workers, who participated in emergency rescue teams following the 2008 Wenchuan earthquake in China. A response rate of 93·7% achieved. The questionnaire included questions relating to nurses: previous experience in disaster relief; scope of practice at the disaster site; optimal ratio of medical practitioners to nurses in disaster relief teams. Following a disaster, first responder nurses considered most suitable were those with at least three years clinical experience, particularly in the emergency department or having emergency rescue skills training. The scope of practice for disaster relief nurses was different to that of nurses working in a hospital. The majority of participants reported insufficient nurses during the relief effort, concluding the optimal ratio of medical practitioner to nurse should range between 1:1-1:2 depending on the task and situation. At the scene of disaster, the preferred first responder nurses were nurses: with emergency rescue training; experienced in the emergency department; with at least three years clinical experience. The scope of practice for first responder nurses needs to be extended. Appropriate nurse - medical practitioner ratios in responding medical teams is dependant on the specific medical requirements of the disaster. The recommendations made by this study provide a guide to ensure that nurses can contribute effectively as essential members of first responder emergency disaster relief teams.

Yin H ，He H ，Arbon P ，Zhu J ，Tan J ，Zhang L ... -  《-》

A grounded theory study of 'turning into a strong nurse': Earthquake experiences and perspectives on disaster nursing education.

While Asia has the dubious distinction of being the world's most natural disaster-prone area, disaster nursing education and training are sparse in many Asian countries, especially China where this study took place. To explore the earthquake disaster experiences of Chinese nurses and develop a substantive theory of earthquake disaster nursing that will help inform future development of disaster nursing education. A qualitative study employing grounded theory, informed by symbolic interactionism. Fifteen Chinese registered nurses from five hospitals in Jiangxi Province who undertook relief efforts after the 2008 Wenchuan Earthquake. Data were collected in 2012-2013 in digitally-recorded, semi-structured, in-depth interviews and reflective field notes, and analyzed using Glaser's grounded theory method. Participants were unprepared educationally and psychologically for their disaster work. Supporting the emergent theory of "working in that terrible environment", was the core category of "turning into a strong nurse", a process of three stages: "going to the disaster"; "immersing in the disaster"; and "trying to let disaster experiences fade away". The participants found themselves thrust in "terrible" scenes of destruction, experienced personal dangers and ethical dilemmas, and tried the best they could to help survivors, communities and themselves, with limited resources and confronting professional work. Our rich findings confirm those of other studies in China and elsewhere, that attention must be paid to disaster education and training for nurses, as well as the mental health of nurses who work in disaster areas. Emergent theory helps to inform nurse educators, researchers, leaders and policy makers in China, and elsewhere in developing strategies to better prepare nurses for future disasters, and assist communities to prepare for and recover after earthquake disasters.

Li Y ，Turale S ，Stone TE ，Petrini M ... -  《-》