Providing a Chemical Events and Threat’s Preparedness Model for Hospitals in the Country: A Qualitative Study

Document Type : Original Research

Authors

1 Health management and Economics Research Center, Health management research institute, Iran University of Medical Sciences, Tehran, Iran

2 Department of Anesthesia, School of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran

3 Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran

4 Department of Medical-Surgical Nursing and Basic Sciences, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran

5 Department of Health in Emergencies, Disasters and Passive Defense, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, Iran

Abstract

Background and Aim: Iran always exposed many chemical events and threats. Although, chemical events not common, they cause widespread and severe casualties. Hospital preparedness for these events has an important role in reduced morbidity and mortality. This study has attempted to develop a comprehensive and operational model of hospital preparedness against chemical events and threats in order to address existing challenges in hospitals and to fill the gaps.
Methods: A qualitative approach was used to identify the dimensions and factors affecting hospital preparedness and through content analysis, 37 semi-structured face-to-face interviews with managers, experts and victims of chemical disasters were analyzed. In the third stage, the extracted components from the previous stage were presented as initial model and validated by Delphi method. Finally, after validation of the initial model, the final model was explained and presented.
Results: Qualitative study findings included 9 themes: hospital risk assessment, management and organization, human resource empowerment, law, coordination and communication, documenting and recording, socio-cultural origins, hospital contamination, and challenges. Each of these themes had several categories and sub-categories. Following a Delphi step, all questions reached a percentage of agreement above 75%. Drawing the relationships of the final extracted themes formed the initial conceptual model of hospital preparedness against chemical events and threats.
Conclusion: The present study showed that a model-based preparedness plan should be designed based on hospital capacities, hospital preparing level, up to date knowledge, personal protective equipment and adequate decontamination. Avoiding Security chemical events and raising the risk perception of managers, officials, and people will provide the basis for hospital preparedness. Followed by reduced the various undesirable consequences of chemical accidents.

Keywords

References

1. Torani S, Majd P.M, Maroufi, S.S, Dowlati, M, Sheikhi, R.A. The importance of education on disasters and emergencies: A review article. Journal of education and health promotion. 2019. 8 2. Yarmohammadian MH; Nasr-Isfahani M, Anbari E. Assessment of preparedness and response of teaching hospitals of Isfahan, Iran, to chemical, biological, radiological, and nuclear incidents. Healthc Inf Manage. 2016; 12(6): 777-84 [in persian]. 3. Natural disasters in the Middle East and North Africa: A regional overview. August 2013; the international bank for reconstruction and development the world bank. . 4. Emergency disasters data base. The em-dat classification. Http://www.Emdat.Be/classification: Centre for research on the epidemiology of disasters (cred); 2017. 5. Prockop LD. Weapons of mass destruction: Overview of the CBRNEs (chemical, biological, radiological, nuclear, and explosives). J Neurol Sci. 2006;249(1):50-4. 6. Tan GA,Fitzgerald MC. Chemical-biological-radiological (CBR) response: A template for hospital emergency departments. Med J Aust. 2002;177(4):196-9. 7. DeBacker M. Hospital preparedness for incidents with chemical agents. International Journal of Disaster Medicine. 2003;1(1):42-50. 8. Fitzgerald GJ. Chemical warfare and medical response during world war I. Am J Public Health. 2008;98(4):611-25. 9. De Marchi B, Funtowicz S,Ravetz J. Seveso: A paradoxical classic disaster. The long road to recovery: Community responses to industrial disaster. 1996;926:86. 10. Blacconiere WG,Patten DM. Environmental disclosures, regulatory costs, and changes in firm value. Hosp Financ Manage. 1994;18(3):357-77. 11. Summary of historical attacks using chemical or biological weapons [database on the Internet]2017. Available from: http://Summary of historical attacks using chemical or biological weapons.htm. 12. Taebi G, Sourosh M, Modirian E, Khateri S, Mousavi B, Ganjparvar Z, et al. Human costs of Iraqs chemical war against Iran; an epidemiological study. Danesh Afarand Zistagen. 2015;7(2):115-21. 13. Okumura T, Ninomiya N,Ohta M. The chemical disaster response system in Japan. Prehosp Disaster Med. 2003;18(3):189-92. 14. Wetter DC, Daniell WE,Treser CD. Hospital preparedness for victims of chemical or biological terrorism. Am J Public Health. 2001;91(5):710. 15. Organization WH. Manual for the public health management of chemical incidents. 2009. 16. Detail of the occurrence of chlorine gas leakage event in Dezful [database on the Internet]Aug 13, 2017. Available from: www.isna.ir/news/96052213073/. 17. Amiriani T, Haqiqi H, Zendehbad A, Roshandel G, Haftsavar M, Moradi A, et al. Effects of chemical warfare on hematological indices in chemical agents victims. Iranian Journal of War and Public Health. 2009;2(1):50-5. 18. Moore BL, Geller RJ,Clark C. Hospital preparedness for chemical and radiological disasters. Emerg Med Clin North Am. 2015;33(1):37-49. 19. Chemical defense and hazard protection of the country. Special Letter to National Day Against Chemical Weapons. 2016. P.1-25. [In Persian] 20. Olivieri C, Ingrassia PL, Della Corte F, Carenzo L, Sapori JM, Gabilly L, Segond F, Grieger F, Arnod-Prin P, Larrucea X, Violi C. Hospital preparedness and response in CBRN emergencies: TIER assessment tool. European Journal of Emergency Medicine. 2017 Oct 1;24(5):366-70. 21. Majd PM, Seyedin H, Bagheri H, Tavakoli N. Hospital preparedness plans for chemical incidents and threats: A systematic review. Disaster Medicine and Public Health Preparedness. 2019. 1-9. 22. Ramesh AC,Kumar S. Triage, monitoring, and treatment of mass casualty events involving chemical, biological, radiological, or nuclear agents. J Pharm Bioallied Sci. 2010;2(3):239. 23. Bahram Nejad F, Sanaee N, Moradi Majd P. Research Method Overview. Jame Negar. 2018. P.190-230. [In Persian] 24. Parvizy S, Adib-Hajibagheri M,Salsali M. Principles and methods in qualitative research. Tehran: Jameenegar Publisher; 2015. [In Persian] 25. Elo S, Kyngäs H. The qualitative content analysis process. Journal of advanced nursing. 2008 Apr; 62(1):107-15. 26. Gale NK, Heath G, Cameron E, Rashid S, Redwood S. Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Method. 2013;13(1):117. 27. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse education today. 2004 Feb 1; 24(2):105-12. 28. Morris L, Elston HJ. Medical management guidelines for acute chemical exposures. Chemical Health and Safety. 2002;6(9):35-7. 29. Chan JTS, et al. Hospital preparedness for chemical and biological incidents in Hong Kong. Hong Kong Med J. 2002 Dec; 8(6):440-6. 30. Crawford IW, Mack way-Jones K, Russell DR, Carley SD. Delphi based consensus study into planning for chemical incidents. Emergency medicine journal. 2004 Jan 1; 21(1):24-8. 32. 31. Veenema TG. Chemical and biological terrorism preparedness for staff development specialists. Journal for Nurses in Professional Development. 2003 Sep 1;19(5):215-22. 32. Georgopoulos PG, Fedele P, Shade P, et al. Hospital response to chemical terrorism: personal protective equipment, training, and operations planning. Am J Ind Med 2004;46(5):432–45. 33. Niska RW, Shimizu I. Hospital preparedness for emergency response; United States, National Health Statistics Reports, 37. 2008. 34. Arelli A, Biondi I, Soave M, Tafani C, Bononi F. The comprehensive medical preparedness in chemical emergencies: ‘the chain of chemical survival’. European journal of emergency medicine. 2008 Apr 1; 15(2):110-8. 35. Grimes DE, Mendias EP. Nurses' intentions to respond to bioterrorism and other infectious disease emergencies. Nursing outlook. 2010 Jan 1;58(1):10-6. 36. Vardell E. Chemical Hazards Emergency Medical Management (CHEMM). Medical Reference Services Quarterly, 2012.31(1):73–83.
Journal of Military Medicine
Volume 23, Issue 3 - Serial Number 100
May and June 2021
Pages 220-227

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