However, the evaluation of the concepts of competence and willingness to respond to a disaster was not revealed in the studies. Selection bias “Allocation of participants by researchers to groups that favor one of the treatments” (Porritt et al., 2014, p. 49).
Introduction
Disaster Management
In 2005, the United Nations International Strategy for Disaster Reduction (UNISDR) developed a framework to guide disaster risk reduction, known as the Hyogo Framework. The Sendai Framework emphasizes prevention, mitigation and preparedness in disaster risk reduction.
Health Care Professionals and Disaster Preparedness
Placing greater emphasis on prevention and recovery phases and disaster risk reduction has been a focus of disaster management over the past decade. As a follow-up effort, in 2015 UNISDR launched the latest disaster risk reduction guide, the Sendai Framework, through the World Health Organization (WHO).
Core Competencies for Health Care Professionals
More specifically, nurses and healthcare professionals must know the chain of command, have skills required in emergency response, and apply creative problem-solving skills. The competencies developed by Gebbie and Qureshi (2002) and the International Council of Nurses (2009) were designed to support nurses and Hsu et al. 2006) is designed to support all health professionals in disaster preparedness and response.
Key Elements of Disaster Preparedness
- Previous Experience
- Confidence
- Willingness
- Knowledge and Education
Demonstrate the knowledge and skills necessary to fulfill your role during a critical incident (Hsu et al., 2006, p. 3). Trust is essential in disaster response, as it is one of the factors that reduces the willingness of healthcare workers to report to work in the event of a disaster (Hope et al., 2010).
Disaster Education for Health Care Professionals
These findings imply that not only nurses, but all healthcare professionals need disaster education to improve disaster preparedness. Health professionals can receive disaster education aimed at improving competence (knowledge, skills and attitudes), confidence and preparedness to respond.
Health Services and Disaster Preparedness
Working in a Team of Multi-professionals
Furthermore, the sense of collegiality is a strong factor that highlights the willingness of emergency nurses to respond to a disaster (Hammad et al., 2012). Because of the benefits that teamwork can bring, disaster education that targets multiple professions is preferable (Silenas et al., 2008).
Effectiveness of Disaster Education
A disaster health care team can be defined as “an intimate group of interpersonally connected health care providers who work towards the common goal of ensuring that disaster victims receive quality disaster care” (Larkin, 2010, p. 497). The benefits include optimized resources, improved efficiency, fostered collaboration, understanding of population issues, access to a wider range of expertise, and less stress from sharing responsibility (Larkin, 2010; World Health Organization, 2012).
Review Question
Review Objective
Significance of Study
Thesis Structure
Inclusion and exclusion criteria, search strategy, search outcome, Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), flow chart, assessment of study quality, data extraction and data synthesis will be discussed as well. Finally, the conclusions and recommendations from the systematic review will be presented and the limitations of the study will also be included in Chapter Five.
Introduction
This was followed by a summary of the systematic review question, the objective of the review, the significance of the study and the structure of the thesis. The third chapter will include the characteristics, results of the included studies and the effectiveness of the interventions from the multiple studies and the assessment of bias will also be presented.
Systematic Review
Many considerations arise in immediately applying the evidence in practice without further assessment of the effectiveness of the educational intervention. Therefore, it is necessary to review the most recent literature and update previous systematic reviews to determine the effectiveness of disaster education.
Methodology
Health professionals and policy makers are faced with a large body of evidence related to effective disaster education. Although there have been previous systematic reviews of the effectiveness of disaster education (Hsu. et al., 2004; Williams et al., 2008), the included studies could not provide clear evidence of an effective intervention to improve disaster preparedness among nurses and others. healthcare workers.
Review Objective and Question
Eligibility of the Studies
Inclusion Criteria
The systematic review examined studies of research including qualified and nurses working independently or in a team with other healthcare professionals, including doctors, paramedics and emergency medical services. Educational interventions include in-hospital-type short courses, exercises, simulations, and other forms of education programs (excluding formal education for graduation). The intervention(s) was/are intended for nurses and other healthcare professionals to increase disaster preparedness.
This systematic review was aimed at studies that contained a quantitative measure of increased competence, confidence and preparedness.
Exclusion Criteria
Search Strategy
Search Outcome
Details of databases searched, keywords used, and the number of articles identified, included, and excluded at each step of the review process were recorded. These studies only offered guidance in providing information about disasters and were therefore not included in the review. The process of identification, screening, eligibility and admission is schematically represented in an adapted version of the PRISMA flowchart (Moher, Liberati, Tetzlaff, Atmann & The PRISMA Group, 2009) (Figure 2.1).
The PRISMA flow is a diagram that describes the flow information through the stages of the review process (PRISMA, 2015).
Quality Appraisal of Studies
The questions provided in the descriptive checklist are more relevant to the studies compared to the experimental checklist. The result was agreement that all the studies were methodologically suitable to be included in the systematic review. The final number of studies included in the systematic review was five studies.
As described earlier in this chapter, the summary of search process and quality assessment is presented in the PRISMA flow (Figure 2.1).
Data Extraction
Data Synthesis
If similarities of outcomes of the factors and methods of the statistical analysis between articles were revealed, a summarized version of statistical analysis of multiple studies is provided with the help of a forest plot. Forest plot is a graph that shows the strength of an intervention effect from multiple quantitative studies addressing the same question (Schneider, 2007). In this systematic review, the forest plot will serve as a graphic illustration of the degree of effectiveness of intervention in the included studies.
Conclusion
Introduction
First, characteristics of included studies, study design, sample, sampling method, educational intervention, evaluation tool, statistical analysis, and time interval of evaluation. The results of included studies and the effectiveness of intervention from several studies are also indicated.
Characteristics of Included Studies
Study Design
Sample
Sampling Method
Then, bias that appeared in the studies is provided at the end of this chapter. performed by Chiu et al. 2013) has unclear description of sampling method.
Educational Intervention
Evaluation Tool
Statistical Analysis
Time Interval of Evaluation
Results of Included Studies
- Knowledge
- Confidence
- Personal and Departmental Preparedness
- Demographic Characteristic Effect on Evaluation Score
- Position Effect on Evaluation Score
- Previous Disaster Education Effect on Evaluation Score
- Disaster Intervention Evaluation
- Need for Further Training
Two studies evaluated whether or not there was an effect of gender on pre- and post-test scores (Bistaraki et al., 2011; On the contrary, Colander et al. 2008) reported similarities of pre-test and post-test scores between occupations with all professions has improved significantly. One study analyzed the effect of disaster education in pre-intervention participants on pre-test and post-test score (Bistaraki et al., 2011) (Appendix B).
One study examined participants' need for further training following an educational intervention (Chiu et al., 2011) (Appendix B).
Effectiveness of Intervention from Multiple Studies
Bias Assessment
Selection Bias
Performance Bias
Detection Bias
Attrition Bias
Conclusion
Introduction
Key Results
- Study Settings
- Samples
- Types and Effectiveness of Educational Intervention
- Evaluation Tool
- Improvement of Disaster Preparedness
However, it can be easy to get off topic, which interferes with the achievement of learning objectives (Bastable et al., 2011). However, it is limited with students who have low literacy skills and require a high level of motivation (Bastable et al., 2011). Table-based exercise, using group discussion and simulation, facilitates students to become more active and involved in the learning process (Bastable et al., 2011).
However, these methods have a high risk of bias as they depend on the perception and standard of the rater (Bastable et al., 2011).
Limitations
This suggests that regularly conducted disaster education is necessary to retain knowledge that has been acquired in previous disaster education.
Quality of Evidence
The method that most of the authors of the included studies used to collect the samples for their study may introduce sampling bias. Only two of the included studies recruited their sample using stratified random sampling, which may reduce the likelihood of bias. Four of the five included studies did not have a control group as a comparison to the intervention group.
Among all the studies, Bistaraki et al. 2011)'s study is the only one that the authors considered to be the strongest methodologically.
Potential Bias in the Review Process
Thus, the sample in these three studies may not represent the entire target population (Schneider et al., 2013). 2011) recruited a control group consisting of 35 health workers from the same population as the intervention group. A published study is more likely to report an intervention group outcome analysis that is statistically significant than one that is not significant (Chan & Altman, 2005; Cochrane Collaboration, 2015).
Emphasizing the evidence from published studies can therefore lead to misunderstandings of what is significant for the target group, and the result from this review can be misleading (Dwan et al., 2008).
Comparison to Other Reviews
A quantitative outcome that measured change in knowledge and skill was one of the inclusion criteria of Williams et al. With these inclusion criteria, Williams et al. 2008) managed to identify a total of nine studies to be included in the review. Critical evaluation in Williams et al. 2008)'s review was clearly explained, although the evaluation tool used was not mentioned.
In a study by Williams et al. 2008) stated that it was difficult to conduct a study that accurately measures the effectiveness of a disaster education intervention.
Recent Study
In this way, the ability to draw conclusions about the effectiveness of an intervention can be strengthened. This systematic review was the only review that aimed to explore the effectiveness of intervention methods that can improve the disaster preparedness competence, confidence and willingness of nurses and other healthcare professionals as a whole.
Introduction
Implications for Practice
Implications for Research
The purpose of this review is to identify the effectiveness of disaster education for nurses and other healthcare professionals. Clear competencies are essential because competent healthcare professionals are expected to respond in an organized, efficient and effective way to a disaster (Gebbie et al., 2012). Healthcare professionals can take disaster training aimed at improving competence (knowledge, skill and attitude), confidence and willingness to respond.
Nurses are one of many healthcare providers who can respond quickly to a disaster. Two systematic reviews have been conducted regarding the effectiveness of disaster training for health professionals (Hsu. et al., 2004; Williams et al., 2008). The intervention(s) were provided to nurses and other healthcare professionals to increase disaster preparedness.
