What are the responsibilities of a hospital and its medical staff for developing and implementing an effective community disaster plan?
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Because of the changing complexities of the world the potential for disaster changes from day to day. It is, therefore, the responsibility of every community to plan for possible disasters and to alter their plans as the disaster potential for their community changes. "Exercise London" showed that a workable community plan can be prepared, and illustrated the errors that can occur in handling a large number of casualties. These errors are now being corrected and, when it seems feasible, another exercise will be carried out.
The involvement of a hospital pharmacy department in a mass casualty disaster revealed strengths and weaknesses of the department's disaster response plan. Effective communication and notification within the pharmacy department and the need to plan to have pharmacists in the triage area to determine patients' lost medications are important areas that the department had not practiced in disaster drills.
It is probable that in the event of thermonuclear attack, the outlying areas to which metropolitan evacuees would be sent would have problems quite as great as the problems at the center of attack. Unless the focus of planning is altered, they could have great numbers of casualties sent to them, yet have far from adequate facilities, material and personnel to do the job.
This article provides a description of the eight phases of the Mental Health Outreach Program (MHOP) cofounded by the author to address the needs of the surviving community following the 1988 earthquake in Armenia. For the purposes of the MHOP, the nursing process was expanded from five to eight phases: 1) preassessment, 2) assessment, 3) analysis, 4) community diagnosis, 5) planning, 6) implementation, 7) evaluation, and 8) remodification. A framework for assessing the level of trauma in an unfamiliar community (with its mnemonic acronym COPE), which was formulated by the author to expedite the assessment and implementation phases, is described. The article concludes with a set of recommendations for psychiatric mental health nurses in mitigating the negative impact and consequences of disasters.
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