Worldwide strategies for managing medical disasters andthe necessity of designing and operating a crisis center in Cyprus Health Services

R.Constantinou RN, Bsc,MSc(c)

Cyprus Ambulance Services

ATLS-PHTLS-DSTC Cyprus Coordinator

‘‘Νext week cannot be any crisis.

My schedule is already full‘‘

Ηenry Kinssinger

Unfortunately disasters cannot be stop

The overall aim of a Disaster preparedness management is to provide as rabidly as possible the greadest benefit for the largest number of casualties and to achieve a critical reduction in morbility and mortality.

Disasters or large-scale casualty incidents cannot be managed successfully by simply extending the procedures and protocols that apply as routine emergency.

VITAL TO HANE EMERGENCY PLANS IN PLACE

CRISIS CENTER

• Emergency plans should be well designed in a well organized crisis center. This appears to be the best solution to deal with a situation where the lack of personnel and overall logistics are presented.

• The recovery from a disaster should proceed in a systematic and coordinated fashion in accordance with international standards. Countries are recommended to develop a Crisis center and preparedness plans for managing fatalities following disasters.

Disasters require a change in phylosophy

Crisis Center for PPRR

• Distaster management is central to the mission of European Union and other Countries such Australia and USA. They provide disaster preparedness, response and recovery services which aim to reduce disaster risk alleviate immediate suffering and improve recovery.

Not all countries have a national policy or guidelines on emergency disaster management.

• World Health organization is the lead agency for emergency preparedness and response.

• 2010-2011 World Disaster Reduction campaign- United Nation International Strategy.

• 2005-2015 Buílding the resilience of nations and communities to disaster.

WHO supports countries in building national capacity in risk reduction and emergency preparedness, and to assist the health sector in Member States in reducing the adverse public health consequences for communities in terms of mortality, morbidity, disability and damage to health care delivery services resulting from emergencies, disasters and other crises.

Strategy

• Multi-agency• Multi-sectoral• Multi-disciplinary• All-hazard• Risk management• Disaster Risk Reduction• Emergency preparedness

Cyprus • European Country• Has a key role in the Mediteranean

2011 still without a Crisis CenterIn Public Health Services

Local Disaster Plans is not the solution in a Crisis!!!!!!!!!

• Estia• Egelados• Maleas• Hospitals Emergency plans

Why ??Is there a necessity of designing and

operating a crisis center in Cyprus Health Services

Health professionals have the ANSWER !!!

Aim

• The aim of the research was to explore the knoweldge and preparedness skills of Medical Doctors and Nurses in Cyprus Emergency Departments for disaster management.

Sample and methods

• The sample consisted of 228 health care professionals from 7 hospitals of Cyprus.

• A structured questionnaire has been developed to assess the preparedness of the Health professionals for the Disasters management.

• 350 questionnaires distributed• 228 questionnaires have been collected

between April to May of 2011

The selection criteria for persons of the sample were:

• Health professionals (doctor-Nurses) in Emergency Departments.

• Cyprus public hospitals employees.• Willingness to participate in the

research.

Statistical analysis

• All the items were coded and scored, and the completed questionnaires were included in the data analysis set. Software IBM-SPSS 19 was used to analyse the data. The chi-square test statistic was used to explore the existence of a statistically significant relationship between categorical variables.

• The t-test has been used to assess whether the means of two groups are statistically different from each other.

• The Paired-Samples T Test procedure compares the means of two variables that represent the same group at different times or related groups. Values less than 0.05 were considered statistically significant, unless otherwise stated.

• Chi-squared test was used to compare categorical variables.

Table 1Percentages of men and women who have participated in the research

Table 2Participating Hospitals

Table 5Define triage ?

Table 7In case of Disaster–massive loss do you know what is your action-role according to the local disaster plan?

Table 8In case of disaster do you know who is the official contact person?

Table 9In case of mass infective accident is there any protective equipment in your Hospital?

Table 15Do you feel ready to manage a disaster with massive losses ?

Table 17Do you know how you should make your emergency contacts in case of telecommunications disconnection? 

Table 17What is the meaning of the definition ‘‘red zone‘‘ in disasters ?

Conclusions • Lack of knowledge for the management of a

crisis• A gap between the top management

authorities and the staff for emergency disaster management

• Lack of information about the guidelines and the equipment

• No experience on the preparedness of a disaster

• No official authority in the Ministry of Health for the management of a crisis

Goals of designing and operating a crisis center in Cyprus Health Services

• Reseach/Knoweldge Management• Policy and Governance• Disaster Risk Assesement• Disaster Mitigation• Disaster Preparedness• Disaster Response• Disaster Recovery• Post-disaster assesment

Goverments are responsible for the protection and preservation for the lives of citizens, and exercise control over most of the functions essential for effective emergency-disaster management.

Its time for a different philosophy…………

Resources• Community Emergency Preparedness, a manual for Managers and

Policy makers, WHO Geneva 1999,ISBN 92 4 154519 4.

• World Disasters Report 2010,International federation of Red Cross and Red Crescent Societies 2010.

• WHO Reduction and Emergency preparedness ,Who six-year Strategy for the health sector and community capasity development , 2007.

• International Strategy for Disaster Reduction, ISDR 2009.

• Disaster Preparedness 2nd edition ,Randolph Kent DHA 1994.

• Queensland state Disaster management plant, Queensland government 2003.

• Principles of Disaster Management ,Peter Aitken at al.

Thank you for your attention