Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-27T05:22:44.480Z Has data issue: false hasContentIssue false
  • English
  • Français

Preparing Emergency Personnel in Dialysis: A Just-in-Time Training Program for Additional Staffing During Disasters

Published online by Cambridge University Press:  15 August 2013

Genevieve B. Stoler ,
James R. Johnston ,
Judy A. Stevenson  and
Joe Suyama
Genevieve B. Stoler*
Affiliation:
University of Pittsburgh Medical Center
James R. Johnston
Affiliation:
University of Pittsburgh Medical Center
Judy A. Stevenson
Affiliation:
ESRD Network 4
Joe Suyama
Affiliation:
University of Pittsburgh Medical Center
*
Address correspondence and reprint requests to Dr Genevieve B. Stoler, Department of Emergency Medicine, University of Pittsburgh Medical Center, 230McKee Pl, Suite 500, Pittsburgh, PA 15213 (e-mail stolergb@upmc.edu).
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

There are 341 000 patients in the United States who are dependent on routine dialysis for survival. Recent large-scale disasters have emphasized the importance of disaster preparedness, including supporting dialysis units, for people with chronic disease. Contingency plans for staffing are important for providing continuity of care for a technically challenging procedure such as dialysis. PReparing Emergency Personnel in Dialysis (PREP-D) is a just-in-time training program designed to train individuals having minimum familiarity with the basic steps of dialysis to support routine dialysis staff during a disaster.

Methods

A 5-module educational program was developed through a collaborative, multidisciplinary effort. A pilot study testing the program was performed using 20 nontechnician dialysis facility employees and 20 clinical-year medical students as subjects.

Results

When comparing pretest and posttest scores, the entire study population showed a mean improvement of 28.9%, with dialysis facility employees and medical students showing improvements of 21.8% and 36.4%, respectively (P < .05 for all comparisons).

Conclusions

PREP-D participants were able to demonstrate improved tests scores when taught in a just-in-time training format. The knowledge gained by using the PREP-D program during a staffing shortage may allow for continuity of care for critical services such as dialysis during a disaster. (Disaster Med Public Health Preparedness. 2013;7:272-277).

Keywords

just-in-time trainingdialysisdisaster preparednesseducation
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 7 , Issue 3 , June 2013 , pp. 272 - 277
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2013 

Access options

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

References

1.US Renal Data System. USRDS 2007 Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2007.Google Scholar
2.Counts, CS. Disaster preparedness: is your unit ready? Nephrol Nurs J. 2001;28(5):491-499.Google Scholar
3.Kopp, JB, Ball, LK, Cohen, A, et al. Kidney patient care in disasters: emergency planning for patients and dialysis facilities. Clin J Am Soc Nephrol. 2007;2(4):825-838.Google Scholar
4.Duley, MG. The next pandemic: anticipating an overwhelmed health care system. Yale J Biol Med. 2005;78(5):355-362.Google Scholar
5.Toner, E, Waldhorn, R, Maldin, B, etal. Hospital preparedness for pandemic influenza. Biosecur Bioterror. 2006;4(2):207-217.Google Scholar
6.Hick, JL, Hanfling, D, Burstein, JL, etal. Health care facility and community strategies for patient care surge capacity. Ann Emerg Med. 2004;44(3):253-261.CrossRefGoogle ScholarPubMed
7.Lam, C, Waldhorn, R, Toner, E, Inglesby, TV, O'Toole, T. The prospect of using alternative medical care facilities in an influenza pandemic. Bio-secur Bioterror. 2006;4(4):384-390.Google Scholar
8.Ellis, KJ. Disaster readiness: lessons from Katrina. Nephrol Nurs J. 2007;34(1):82-83, 98.Google Scholar
9.Shapira, Y, Marganitt, B, Roziner, I, Shochet, T, Bar, Y, Shemer, J. Willingness of staff to report to their hospital duties following an unconventional missile attack: a state-wide survey. Isr J Med Sci. 1991;27(11-12):704-711.Google Scholar
10.Secor-Turner, M, O'Boyle, C. Nurses and emergency disasters: what is known. Am J Infect Control. 2006;34(7):414-420.Google Scholar
11.French, ED, Sole, ML, Byers, JF. A comparison of nurses’ needs/concerns and hospital disaster plans following Florida's Hurricane Floyd. J Emerg Nurs. 2002;28(2):111-117.Google Scholar
12.Franco, C, Toner, E, Waldhorn, R, Maldin, B, O'Toole, T, Inglesby, TV. Systemic collapse: Medical care in the aftermath of Hurricane Katrina. Bio-secur Bioterror. 2006;4(2):135-146.Google Scholar
13.Arrieta, MI, Foreman, RD, Crook, ED, Icenogle, ML. Providing continuity of care for chronic diseases in the aftermath of Katrina: from field experience to policy recommendations. Disaster Med Public Health Prep. 2009;3(3):174-182.CrossRefGoogle ScholarPubMed
14.Kopp, JB, Ball, LK, Cohen, A, etal. Kidney patient care in disasters: lessons from the hurricanes and earthquake of 2005. Clin J Am Soc Nephrol. 2007;2(4):814-824.Google Scholar
15.Sever, MS, Erek, E, Vanholder, R, etal. Features of chronic hemodialysis practice after the Marmara earthquake. J Am Soc Nephrol. 2004;15(4):1071-1076.Google Scholar
16.Leach, A, Haun, DE. Deliver the lesson now: just-in-time training. MLO Med Lab Obs. 2003;35(7):42-46.Google Scholar
17.Schatell, D, ed. Core Curriculum for the Dialysis Technician: A Comprehen-sive Review ofHemodialysis, 3rd ed. Thousand Oaks, CA: Amgen Inc; 2006.Google Scholar
18.Nichols, AA, Palmer, DG. Cross-training in perinatal units. J Perinat Neonatal Nurs. 1994;8(3):33-45.Google Scholar
19.Riley, J. Cross-training: maximizing staffing flexibility. Nurs Manage. 1990;21(6):48I-48J.Google Scholar
20.Crissman, S, Jelsma, N. Cross-training: practicing effectively on two levels. Nurs Manage. 1990;21(3):64A-64D, 64D, 64H.Google Scholar
21.Altimier, LB, Sanders, JM. Cross-training in 3-D. Nurs Manage. 1999;30(11):59-62.Google Scholar
22.Snyder, J, Nethersole-Chong, D. Is cross-training medical/surgical RNs to ICU the answer? Nurs Manage. 1999;30(2):58-60.Google Scholar
23.Phillips, CR, Griffin, T. Cross-training: does it really promote safe and effective perinatal nursing care? MCN Am J Matern Child Nurs. 1999;24(3):120-121.Google Scholar
24.Komara, C, Stefaniak, K. Cross-training for obstetrics using an internship program. J Nurses Staff Dev. 1998;14(3):154-158.Google Scholar
25.Kozlowski, S. Cross-training. Concepts, considerations, and challenges. MLO Med Lab Obs. 1996;28(2): 50, 52-54.Google Scholar
26.del Bueno, DJ, Barker, F, Christmyer, C. Implementing a competency-based orientation program. J Nurs Adm. 1981;11(2):24-29.Google Scholar
27.Benedek, DM, Ritchie, EC. “Just-in-time” mental health training and surveillance for the Project HOPE mission. Mil Med. 2006;171(10) (Suppl 1): 63-65.Google Scholar
28.Chotani, RA, LaPorte, RE, Linkov, F, Dodani, S, Ahmed, D, Ibrahim, KM. Just-in-time lectures: SARS. Lancet. 2003;361(9373):1996.Google Scholar
29.Linkov, F, Ardalan, A, Dodani, S, etal. Building just-in-time lectures during the prodrome of Hurricanes Katrina and Rita. Prehosp Disaster Med. 2006;21(2):132.Google Scholar
30.Kahn, CE Jr, Santos, A, Thao, C, Rock, JJ, Nagy, PG, Ehlers, KC. A presentation system for just-in-time learning in radiology. J Digit Imaging. 2007;20(1):6-16.Google Scholar
31.Kahn, CE Jr, Ehlers, KC, Wood, BP. Radiologists’ preferences for just-in-time learning. J Digit Imaging. 2006;19(3):202-206.Google Scholar
32.Agency for Healthcare Research and Quality. Project XTREME: Model for Health Professionals’ Cross-Training for Mass Casualty Respiratory Needs. Rockville, MD: Agency for Healthcare Research and Quality; 2007.Google Scholar
33. Department of Health and Human Services. October 24, 2009 - President Obama Signs Emergency Declaration for H1N1 Flu. http://pandemicflu.gov/professional/federal/h1n1emergency10242009.html. Accessed April 19, 2011.Google Scholar