Judith Atchison, MSN, RN, PHN, Assistant Director, Public Health Nursing/Maternal Child and Adolescent Health

County of Riverside Department of Public Health

Lorraine Buckley, MSN, RN, PHN

Public Health Nurse, Public Health Nursing/Maternal Child and Adolescent

Health Branch

Presenter Disclosures

HERMIA PARKS

(1) The following personal, professional, or financial

relationships with commercial interests relevant to this

presentation existed during the past 12 months:

NO RELATIONSHIPS TO DISCLOSE

Many thanks to Hermia Parks, RN, PHN, MA; Juanita Rosales, RN, PHN, MSN; Carol Hernandez, RN, PHN, BS; and Shin Newsom, RN, PHN, BSN for their important contributions to the development of this framework

The course was developed using PHN foundational principles to guide practice during emergencies and the Quad Council of Public Health Nurses Organizations Tier 1 Core competencies.

Scope of Practice

Identify and increase understanding of the PHN’s

role in disaster response.

Discuss the PHN workforce competencies training

and skills stations for use in emergency

preparedness.

Describe the success and challenges of the

emergency preparedness training implementation.

According to California Government Code

SECTION 3100 -“All public employees are

hereby declared to be disaster service

workers” (California Public Health Nursing

Disaster Handbook, 2008, p. I-2).

Preparing for, responding to, and recovering from disasters is a priority and a core function of public health.

Emergent events are occurring more frequently.

Responding to health threats from disasters challenges all those in the community and public health sector.

Public health nurses (PHN) play an important role in the response to disasters that affect communities.

To be ready to help if a disaster strikes, Health Care Professionals are urged to take advantage of training and educational opportunities.

All Health Care Professionals, in the Department of Public Health, should possess basic competencies for responding to an emergency.

Silver Wildfires

Mountain Fire

TB Outbreak

The Riverside County Department of Public Health

(RCDOPH) developed a training course to provide a

comprehensive plan to prepare PHNs to respond to mass

casualty events or acts of terrorism.

Hermia Parks-Director of Public Health

Nursing/Maternal Child and Adolescent

Health, envisioned preparing public health

nursing staff to adequately serve people

and the community in a disaster or

emergency response.

Disaster Preparedness: ◦ Presentation by-Marie Davis, Director of Red Cross Associate Regional Emergency Services

◦ Skill station demonstrations on Glucometer

Oxygen-portable oxygen cylinder

Administration of Vaccines

Inhalers, Air Chambers, nebulizers

Mental Health intervention

Medi-Man

The following responses were elicited from

survey question:

◦ Which skills do you feel that you need further training?

Hands on skills training

Medi-Man

O2 delivery

Wound care

Rapid assessment

IV insertion

Immunizations

Diabetes testing

Shelter paperwork

Increase the PHN’s/Social Workers

understanding in emergency response and

increase willingness to respond in an

emergency.

Assess, evaluate, document, and update the

PHN workforce competence in emergency

preparedness.

Web based and PowerPoint presentation

Trainer provided class and training packet

Injection

techniques

Medication

administration

Psychological

first aid

Blood glucose

monitoring

Oxygen

administration

Nebulizer

treatment

Cultural

competency

Red cross

shelter

procedures

‣Administering Vaccines

‣Vital Signs

‣Psychological First Aid

Blood Glucose monitoring

O2 Administration

Nebulizer Administration

Cultural Competency

http://www.google.com/url?q=http://blogs.vmware.com/smb/2012/03/vsphere-training-videos.html&sa=U&ei=1UAzU4SDM8b3oATh9IGgDA&ved=0CDIQ9QEwAg&usg=AFQjCNF_gvkgj44XktkGsHFWn8EBOLWZ9A

20

California Public Health Nursing Disaster Handbook

http://phncalifornia.org/wp-content/uploads/phn-disaster-manual.pdf

‣ Role of PHN

‣ Shelter task lists

‣ Reference information for local pharmacies, hospitals, and the County’s Family Care Centers

Resources

http://phncalifornia.org/wp-content/uploads/phn-disaster-manual.pdfhttp://phncalifornia.org/wp-content/uploads/phn-disaster-manual.pdfhttp://phncalifornia.org/wp-content/uploads/phn-disaster-manual.pdfhttp://phncalifornia.org/wp-content/uploads/phn-disaster-manual.pdfhttp://phncalifornia.org/wp-content/uploads/phn-disaster-manual.pdfhttp://phncalifornia.org/wp-content/uploads/phn-disaster-manual.pdfhttp://phncalifornia.org/wp-content/uploads/phn-disaster-manual.pdfhttp://phncalifornia.org/wp-content/uploads/phn-disaster-manual.pdfhttp://phncalifornia.org/wp-content/uploads/phn-disaster-manual.pdf

21

Go Bag

First Aid Book

Shelter forms

A comprehensive list of

training videos and web

sites.

Public Health Nurse Job Action Worksheet

Mission: To assist community members presenting to the shelter with screening, education,

evaluation and treatment when indicated. Serve as an advocate for the sheltered population and staff

to ensure a high level of comfort and care.

TASK COMPLETED

Contact immediate nursing supervisor for instructions and directions to the shelter.

Wear county identification badge in order to obtain access into the shelter. Bring BP cuff, stethoscope, Shelter Surveillance Form, Activity Log, Assessment Forms, and a fully changed cell phone.

Upon arrival at the shelter, check in at the volunteer desk area.

Report to the shelter manager to receive instructions

Report to the shelter nurse to receive report and further instructions.

Administer first aid as needed. Assist all shelter residents and staff who are in need of general health education and advice. Assist shelter residents with special health care needs, such as replacing lost medications and medical appliances. Refer to Social Services for case management needs as indicated.

Provide emotional support and skilled nurse counseling to persons suffering from traumatic stress caused by the emergency and the resulting disruption in their lives. Refer to mental health.

Conduct 1 training on hand washing daily before the evening meal. Ensure hand washing instructions are posted in all restroom areas.

Report to immediate nursing supervisor any problems or concerns involving staffing or sheltering needs of clients that exceed the limitations of what the Public Health Nurses can provide. This includes any questions regarding OTC medications as nurses cannot prescribe nor dispense and shelter residents may dispense their own from an available supply of over the counter medications.

Brief supervisor on any media contact. Do not hesitate to call supervisor for any questions or concerns.

Complete Surveillance Form once per shift. Complete 1 Assessment Form for each shelter resident assessed. Complete activity log ongoing throughout the shift noting times for training and other activities or incidents occurring.

At the end of each shift or the beginning of the next working day fax all the logs and forms filled out during the shift to 951-358-4762 attn: Hermia Parks.

June 18, 2013:

Basic Emergency Preparedness

Competencies Training for Health Care

Professionals Power point presented to

Public Health Nursing Administration team.

October 2013:

Basic Emergency Preparedness

Competencies Training for Health Care

Professionals Power Point presented to

Public Health Nursing Staff.

Evaluations

• What did you

particularly

like about the

program?

• Videos

• Handouts

• Overall presentation

• Hands on skills

• Shelter paperwork

• Good review of skills

• Relevant to our field

• References

http://www.google.com/url?q=http://www.dirtandseeds.com/the-lack-of-choice-and-the-facebook-like-button/&sa=U&ei=7UUzU4aCIdKIogTaiYLoBg&ved=0CEgQ9QEwDTgU&usg=AFQjCNHZjophpxZVpPFmwxL0GtaG7XIWRQ

• What did you particularly dislike

about the program?

Videos a little too long

Not enough information pertaining to

to role of SW/HSA/OA

http://www.google.com/url?q=http://www.careergravity.com/why-do-job-seekers-dislike-facebook/&sa=U&ei=t0YzU62JGMnqoATM44LwDA&ved=0CDwQ9QEwBzg8&usg=AFQjCNEUKJSKN22s4o-KmF4QcDFuF504pA

Staff states:

◦ Better prepared to participate in a shelter.

◦More willing to volunteer when called to work in a shelter setting.

◦ More aware of what to expect if called to work in a shelter.

Finding the appropriate web videos for

experienced nursing staff.

◦ Not too basic

◦ Not too long

Required Pre-Requisite Trainings

Competency Skills Stations

Mandatory to attend pre-requisite

workshop training before attending

competency skills trainings.

Supervisors responsible for keeping an

account whether staff attended the

training.

CPR- every 2 years

First Aid Certificate-every 2 years

N-95 Fit Testing annually

Basic SEMS/NIMS

Provide opportunities for staff to practice and perform return demonstration skill sets.

Enhances skills acquisition.

Staff benefit from role-playing with application of knowledge, skills, and abilities in a controlled environment.

Each skill station will offer an opportunity

for staff:

◦ To practice skills

◦ Complete assessment test for skills they are proficient in.

Subject Matter Experts (SME) are

available at each station to answer

questions and give demonstrations on

skills.

Skill Demonstration

Competency Check List

◦ Each participant is required to complete a competency check list and turn it in to their

supervisor.

The training course is offered to new hires and annually to existing staff

These mandatory training will be part of the annual evaluation and certificates of completion will be provided.

CEU’s offered

Successful implementation of Basic

Emergency Preparedness Competencies

Training for Health Care Professionals is

measured by completion of competency

skills checklist, current first aid, and CPR

certifications.

Training costs for Public Health Nursing

/MCAH staff: ◦ Cost for training and skill station

materials/supplies will be absorbed by Public

Health Nursing/MCAH Branch budget.

Serves as a model for training nurses in

other Riverside County Public Health

Departments and Community Based

Organizations.

55555

Judith Atchison, MSN, RN, PHN, Assistant Director, Public Health Nursing/Maternal Child and Adolescent Health

County of Riverside Department of Public Health

JAtchison@rivcocha.org

(951) 358-5202

Juanita Rosales, MSN, RN, PHN Nurse Educator, Public Health Nursing/Maternal, Child and Adolescent Health Branch

County of Riverside Department of Public Health

jrosales@rivcocha.org

(951) 955-5345

Lorraine Buckley, MSN, RN, PHN Public Health Nurse, Public Health Nursing/Maternal Child and Adolescent

Health Branch

Lobuckle@riversidedpss.org

951-358-3982

mailto:JAtchison@rivcocha.orgmailto:jrosales@rivcocha.orgmailto:Lobuckle@riversidedpss.org