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A Review of Competencies Developed for Disaster Healthcare Providers: Limitations of Current Processes and Applicability

Published online by Cambridge University Press:  28 June 2012

Elaine Daily*
Affiliation:
Independent Consultant, Madison, Wisconsin USA; Immediate Past-President, Nursing Section, World Association for Disaster and Emergency Medicine
Patricia Padjen
Affiliation:
Program Manager/BSN Advisor, University of Wisconsin Oshkosh College of Nursing, Oshkosh, Wisconsin, USA
Marvin Birnbaum
Affiliation:
Professor Emeritus, Department of Medicine, University of Wisconsin, Madison, Wisconsin, USA

Abstract

Introduction:

In order to prepare the healthcare system and healthcare personnel to meet the health needs of populations affected by disasters, educational programs have been developed by numerous academic institutions, hospitals, professional organizations, governments, and non-government organizations. Lacking standards for best practices as a foundation, many organizations and institutions have developed “core competencies” that they consider essential knowledge and skills for disaster healthcare personnel.

Problem:

The Nursing Section of the World Association for Disaster and Emergency Medicine (WADEM) considered the possibility of endorsing an existing set of competencies that could be used to prepare nurses universally to participate in disaster health activities. This study was undertaken for the purpose of reviewing published disaster health competencies to determine commonalities and universal applicability for disaster preparedness.

Methods:

In 2007, a review of the electronic literature databases was conducted using the major keywords: disaster response competencies; disaster preparedness competencies; emergency response competencies; disaster planning competencies; emergency planning competencies; public health emergency preparedness competencies; disaster nursing competencies; and disaster nursing education competencies. A manual search of references and selected literature from public and private sources also was conducted. Inclusion criteria included: English language; competencies listed or specifically referred to; competencies relevant to disaster, mass-casualty incident (MCI), or public health emergency; and competencies relevant to healthcare.

Results:

Eighty-six articles were identified; 20 articles failed to meet the initial inclusion criteria; 27 articles did not meet the additional criteria, leaving 39 articles for analysis. Twenty-eight articles described competencies targeted to a specific profession/discipline, while 10 articles described competencies targeted to a defined role or function during a disaster. Four of the articles described specific competencies according to skill level, rather than to a specific role or function. One article defined competencies according to specific roles as well as proficiency levels. Two articles categorized disaster nursing competencies according to the phases of the disaster management continuum. Fourteen articles described specified competencies as “core” competencies for various target groups, while one article described “cross-cutting” competencies applicable to all healthcare workers.

Conclusions:

Hundreds of competencies for disaster healthcare personnel have been developed and endorsed by governmental and professional organizations and societies. Imprecise and inconsistent terminology and structure are evident throughout the reviewed competency sets. Universal acceptance and application of these competencies are lacking and none have been validated. Further efforts must be directed to developing a framework and standardized terminology for the articulation of competency sets for disaster health professionals that can by accepted and adapted universally.

Type
Comprehensive Review
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2010

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References

1.Centers for Disease Control and Prevention: A National Public Health Strategy For Terrorism Preparedness and Response: 2003 -2008. Available at http://www.bt.cdc.gov/cotper/cphp/downloads/CPHP_fy2004_rfa.pdf. Accessed 14 December 2009.Google Scholar
2.US Department of Health and Human Services, Health Resources and Service Administration. Available at http://www.federalgrantswire.com/bioterrorism-training-and-curriculum-development-program.html. Accessed 22 July 2010.Google Scholar
3.Schroeter, K: Competence literature review. 2008. Available at http://www.cc-institute.org/docs_upload/competence_lit_review.pdf. Accessed 07 December 2009.Google Scholar
4.Eraut, M: Developing Knowledge and Competence. London: RoutledgeFahmer, 1994.Google Scholar
5.US Department of Education, National Center for Education Statistics: Defining and Assessing Learning: Exploring Competency-Based Initiatives. Washington DC: US Department of Education, National Center for Education Statistics, 2001.Google Scholar
6.Barnett, DJ, Everly, GS, Parker, CL, Links, JM: Applying educational gaming to public health workforce emergency preparedness. Am J Prevent Med 2005;28:390395.CrossRefGoogle ScholarPubMed
7.Berkowitz, B: Public health nursing practice: Aftermath of September 11, 2001. Online J Issues Nurs 2002;7:5.CrossRefGoogle ScholarPubMed
8.Chmar, JE, Ranney, RR, Guay, AH, Haden, NK, Valachovic, RW: Incorporating bioterrorism training into dental education: Report of ADA-ADEA terrorism and mass casualty curriculum development workshop. J Dent Educ 2004;68:1191199.CrossRefGoogle ScholarPubMed
9.Couig, MP, Martinelli, A, Lavin, RP: The National Response Plan: Health and Human Services the lead for Emergency Support Function #8. Disaster Manag Response 2005;3:3440.CrossRefGoogle Scholar
10.Estrada, LC, Fraser, MR, Cioffi, JP, et al: Partnering for preparedness: The project Public Health Ready experience. Public Health Rep 2005;120:6975.CrossRefGoogle Scholar
11.Everly, GS Jr : Thoughts on training guidelines in emergency mental health and crisis intervention. Int J Emerg Ment Health 2002;4:139141.Google ScholarPubMed
12.Fahlgren, TL, Drenkard, KN: Healthcare system disaster preparedness, Part 2: Nursing executive role in leadership. J Nurs Adm 2002;32:531537.CrossRefGoogle ScholarPubMed
13.Gebbie, K, Merrill, J, Hwang, I, et al: Identifying individual competency in emerging areas of practice: An applied approach. Qual Health Res 2002;12:990999.CrossRefGoogle ScholarPubMed
14.Gebbie, K, Merrill, J: Public health worker competencies for emergency response. J Public Health Manag Pract 2002;8:7381.CrossRefGoogle ScholarPubMed
15.Harrison, LM, Davis, MV, MacDonald, PDM et al: Development and implementation of a public health workforce training needs assessment survey in North Carolina. Public Health Rep 2005;120:2834.CrossRefGoogle ScholarPubMed
16.Hsu, EB, Thomas, TL, Bass, EB, et al: Healthcare worker competencies for disaster training. BMC Med Educ 2006;6:19.CrossRefGoogle ScholarPubMed
17.Kerby, DS, Brand, MW, Elledge, BL, Johnson, DL, Magas, OK: Are public health workers aware of what they don't know? Biosecurity and BioterrorismBiodefense Strategy Practice and Science 2005;3:3138.CrossRefGoogle ScholarPubMed
18.Mitchell, CS, Doyle, ML, Moran, JB, et al: Worker training for new threats: A proposed framework. Am J Indust Med 2004;46:423431.CrossRefGoogle ScholarPubMed
19.Kerby, DS, Brand, MW, Johnson, DL, Ghouri, FS: Self-assessment in the measurement of public health workforce preparedness for bioterrorism or other public health disasters. Public Health Rep 2005;120:186191.CrossRefGoogle ScholarPubMed
20.More, FG, Phelan, J, Boylan, R, et al: Predoctoral dental school curriculum for catastrophe preparedness. J Dent Educ 2004;68:851858.CrossRefGoogle ScholarPubMed
21.Mosca, NW, Sweeney, PM, Hazy, JM, Brenner, P: Assessing bioterrorism and disaster preparedness training needs for school nurses. J Public Health Man 2005;s38–s44.CrossRefGoogle Scholar
22.Rottman, SJ, Shoaf, KI, Dorian, A: Development of a training curriculum for public health preparedness. J Public Health Man 2005;s128–s131.CrossRefGoogle Scholar
23.Wisniewski, R, Dennik-Champion, G, Peltier, JW: Emergency preparedness competencies: Assessing nurses' educational needs J Nurs Adm 2004;34:475480.CrossRefGoogle ScholarPubMed
24.Parker, CL, Barnett, DJ, Fews, AL, Blodgett, D, Links, JM: The road map to preparedness: A competency-based approach to all-hazards emergency readiness training for the public health workforce. Public Health Rep 2005;120:504514.CrossRefGoogle ScholarPubMed
25.Slepski, LA: Emergency preparedness and professional competency among health care providers during hurricanes Katrina and Rita: Pilot study results. Disaster Manag Response 2007;5:99110.CrossRefGoogle ScholarPubMed
26.International Nursing Coalition for Mass Casualty Education: Educational competencies for Registered Nurses responding to mass casualty incidents. 2003. Available at http://www.aacn.nche.edu/education/pdf/INCMEcompetencies.pdf. Accessed 12 February 2008.Google Scholar
27.Subbarao, I, Lyznicki, J, Hsu, EB, et al: A consensus-based educational frame-work and competency set for the discipline of disaster medicine and public health preparedness. Disaster Medicine and Public Health Preparedness 2008;2:5768.CrossRefGoogle Scholar
28.Waeckerle, JF, Seamans, J, Whiteside, M et al: Executive summary: Developing objectives, content, and competencies for the training of emergency medical technicians, emergency physicians, and emergency nurses to care for casualties resulting from nuclear, biological, or chemical (NBC) incidents. Ann Emerg Med 2001;37:587601.CrossRefGoogle ScholarPubMed
29.Gebbie, KM, Qureshi, K: Emergency and disaster preparedness. AJN 2002;102:4651.CrossRefGoogle ScholarPubMed
30.The Hosptial Cometency SubCommittee and Health, Medical, Hospital and EMS Committee Florida State Working Group: State of Florida recommended core competencies and planning/mitigation strategies for hospital personnel. 2004.Google Scholar
31.WHO Health Actions in Crises Cluster: Integrating Emergency Preparedness and Response into Undergraduate Nursing Curriculum. Geneva: WHO, 2007.Google Scholar
32.Dorsey DM for the International Council of Nurses: ICN Framework of Disaster Nursing Competencies (Draft), 2008.Google Scholar
33.NEPEC Competency Committee: Educational competencies for registered nurses responding to mass casualty incidents. 2003. Available at www.nepec.com. Accessed 07 December 2007.Google Scholar
34.Pryor, E, Heck, E, Norman, L, et al: Integrated decision-making in response to weapons of mass destruction incidents: Development and initial evaluation of a course for healthcare professionals. Prehosp Disaster Med 2006;21(1):2431.CrossRefGoogle ScholarPubMed
35.Polivka, BJ, Stanley, SAR, Gordon, D, et al: Public health nursing competencies for public health surge events. Public Health Nurs 2008;25(2):159165.CrossRefGoogle ScholarPubMed
36.Weiner, E: Preparing nurses internationally for emergency planning and response. Online J Issues Nurs 2006;11(3).CrossRefGoogle ScholarPubMed
37.Markenson, D, DiMaggio, C, Redlener, I: Preparing health professions students for terrorism, disaster, and public health emergencies: Core competencies. Acad Med 2005;80(6):517525.CrossRefGoogle Scholar
38.American Red Cross: Develop nursing students' disaster competency by working with the American Red Cross. 2004.Google Scholar
39.US Department of Health and Human Services Office of the Surgeon General: Medical Reserve Corps: MRC Core Competencies Matrix. 2007. Available at http://www.medicalreservecorps.gov/File/MRC%20TRAIN/Core%20Competency%20Resources/Core_Competencies_Matrix_April_2007.pdf. Accessed 04 February 2008.Google Scholar
40.Centers for Disease Control and Prevention: Bioterrorism and emergency readiness: Competencies for all public health workers. 2002. Available at http://www.training.fema.gov/emiweb/downloads/Bioterrorism%20and%20Emergency%20Readiness.pdf. Accessed 04 February 2008.Google Scholar
41.Council on Linkages Between Academia and Public Health Practice: Competencies for public health professionals. 2001. Available at http://www.phf.org/link/corecompetencies.htm. Accessed 07 February 2008.Google Scholar
42.Center of Public Health Preparedness Columbia University Mailman School of Public Health, Columbia University School of Nursing, and Greater New York Hospital Association: Emergency preparedness response competencies for hospital workers. 2003. Available at www.ncdp.mailman.columbia.edu/files/hospcomps.pdf. Accessed 10 March 2009.Google Scholar
43.Ablah, E, Molgaard, CA, Frederickson, DD, Wetta-Hall, R, Cook, DJ: Quantitative evaluation of “Can it happen in Kansas”: Response to terrorism and emerging infections. J Public Health Man 2005;November (Suppl):s17–s24.CrossRefGoogle Scholar
44.Calhoun, JG, Rowney, R, Eng, E, Hoffman, Y: Competency mapping and analysis for public health preparedness training initiatives. Public Health Rep 2005;120:s91–s99.CrossRefGoogle ScholarPubMed
45.Calhoun, JG, Davidson, PL, Sinioris, ME, Vincent, ET, Griffith, JR: Toward an understanding of competency identification and assessment in health care management. Quality Management in Health Care 2002;11(1):1438.CrossRefGoogle ScholarPubMed
46.Accreditation Criteria—Schools of Public Health. June 2005. Available at http://www.ceph.org/files/public/SPH-Criteria-2005.SO5.pdf. Accessed 14 December 2009.Google Scholar
47.Humphress, R: Building an emergency response competency system: Optimizing emergency personnel mobilization. J Homel Secur Emerg 2007;4(3):No.04-E015-1.Google Scholar
48.Task Force for Quality Control of Disaster Management: Guidelines for Evaluation and Research in the Utstein Style. Madison: World Association for Disaster and Emergency Medicine, 2003.Google Scholar
49.Birnbaum, ML: Structure and science. Prehosp Disaster Med 2006;21(6):369370.CrossRefGoogle ScholarPubMed
50.Westera, W: Competencies in education: A confusion of tongues. J Curriculum Stud 2001;33(1):7588.CrossRefGoogle Scholar
51.Stefl, ME: Common competencies for all healthcare managers: the Healthcare Leadership Alliance model. J Healthc Manag 2008;53(6):360374.Google ScholarPubMed
52.Shewchuk, RM, O'Connor, SJ, Fine, DJ: Building an understanding of the competencies needed for health administration practice. J Healthc Manag 2005;50(1):3247.Google ScholarPubMed
53.The Sphere Project. Available at http://www.sphereproject.org/handbook. Accessed 07 March 2007.Google Scholar
54.Punnitami, W: The application of competency modeling for human resource management: A holistic inquiry. J Thai Public Admin 2002;3:113131.Google Scholar
55.Miner, KR, Childers, WK, Alperin, M, Cioffi, J, Hunt, N: The MACH model: From competencies to instruction and performance of the public health workforce. Pub Health Rep 2005;120:s9–.CrossRefGoogle ScholarPubMed
56.Green, P: Building Robust Competencies. San Francisco: Jossey-Bass, Inc., 1999.Google Scholar