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Effectiveness of Hospital Staff Mass-Casualty Incident Training Methods: A Systematic Literature Review

Published online by Cambridge University Press:  28 June 2012

Edbert B. Hsu ,
Mollie W. Jenckes ,
Christina L. Catlett ,
Karen A. Robinson ,
Carolyn Feuerstein ,
Sara E. Cosgrove ,
Gary B. Green  and
Eric B. Bass
Edbert B. Hsu*
Affiliation:
Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
Mollie W. Jenckes
Affiliation:
Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
Christina L. Catlett
Affiliation:
Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
Karen A. Robinson
Affiliation:
Department of Epidemiology, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
Carolyn Feuerstein
Affiliation:
Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
Sara E. Cosgrove
Affiliation:
Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
Gary B. Green
Affiliation:
Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
Eric B. Bass
Affiliation:
Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA Department of Epidemiology, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA Department of Health Policy and Management, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
*
201 N. Charles Street, Suite 1400Baltimore, MDUSA21201 E-mail: ehsu@jhmi.edu
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Abstract

Introduction:

Recently, mass-casualty incident (MCI) preparedness and training has received increasing attention at the hospital level.

Objectives:

To review the existing evidence on the effectiveness of disaster drills, technology-based interventions and tabletop exercises in training hospital staff to respond to an MCI.

Methods:

A systematic, evidence-based process was conducted incorporating expert panel input and a literature review with the key terms: “mass casualty”, “disaster”, “disaster planning”, and “drill”. Paired investigators reviewed citation abstracts to identify articles that included evaluation of disaster training for hospital staff. Data were abstracted from the studies (e.g., MCI type, training intervention, staff targeted, objectives, evaluation methods, and results). Study quality was reviewed using standardized criteria.

Results:

Of 243 potentially relevant citations, twenty-one met the defined criteria. Studies varied in terms of targeted staff, learning objectives, outcomes, and evaluation methods. Most were characterized by significant limitations in design and evaluation methods. Seventeen addressed the effectiveness of disaster drills in training hospital staff in responding to an MCI, four addressed technology-based interventions, and none addressed tabletop exercises. The existing evidence suggests that hospital disaster drills are effective in allowing hospital employees to become familiar with disaster procedures, identify problems in different components of response (e.g., incident command, communications, triage, patient flow, materials and resources, and security) and provide the opportunity to apply lessons learned to disaster response. The strength of evidence on other training methods is insufficient to draw valid recommendations.

Conclusions:

Current evidence on the effectiveness of MCI training for hospital staff is limited. A number of studies suggest that disaster drills can be effective in training hospital staff. However, more attention should be directed to evaluating the effectiveness of disaster training activities in a scientifically rigorous manner.

Keywords

disasterdrillseducationeffectivenessevaluationexercisehospital staffknowledgemass-casualty incidentoutcomepreparednesstraining
Type
Comprehensive Review
Information
Prehospital and Disaster Medicine , Volume 19 , Issue 3 , September 2004 , pp. 191 - 199
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2004

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References

1.Milsten, A: Hospital responses to acute-onset disasters: A review. Prehosp Disast Med 2000;15(1): 32–45.CrossRefGoogle ScholarPubMed
2.Alibek, K, Handelman, S: Biohazard: The chilling true story of the largest covert biological weapons program in the world—told from inside by the man who ran it. New York: Random House, 1999.Google Scholar
3.Joint Commission on Accreditation of Healthcare Organizations: Comprehensive Accreditation Manual for Hospitals: The Official Handbook. Oakbrook Terrace, IL: Joint Commission Resources; 2003. p EC–9.Google Scholar
4.Joint Commission on Accreditation of Healthcare Organizations: Comprehensive Accreditation Manual for Hospitals: The Official Handbook. Oakbrook Terrace, IL: Joint Commission Resources; 2003. p EC–21.Google Scholar
5.Hsu, E, Jenckes, MW, Catlett, CL, et al. : Training of Hospital Staff to Respond to a mass-casualty incident. Available at http://www.ahcpr.gov/clinic/epcix.htm. In Press.Google Scholar
6.Chobin, N, Engle, L: Are you ready for an ethylene oxide spill? J Healthc Mater Manage 1989;7(3):56–57:60.Google ScholarPubMed
7.Tur-Kaspa, I, Lev, EI, Hendler, I, et al. : Preparing hospitals for toxicological mass casualties events. Crit Care Med 1999;27(5):1004–1008.CrossRefGoogle ScholarPubMed
8.Gretenkort, P, Harke, H, Blazejak, J, et al. : Interface between hospital and fire authorities—a concept for management of incidents in hospitals. Prehosp Disast Med 2002;17(1):42–47.CrossRefGoogle ScholarPubMed
9.Baughman, KS, Calvert, DR: Internal disaster drill critique. J Emerg Nurs 1990;16(4):240–241.Google ScholarPubMed
10.Halstead MA: Fire drill in the operating room. Role playing as a learning tool. AORN J 1993;58(4):697–706.CrossRefGoogle Scholar
11.Weston, CJ: The operating theatre's on fire. Health Serv Manage 1988;84(3):20–23.Google Scholar
12.Classic, KL, Knutson, AH, Smith, GD: Radiation safety role in institutional disaster planning. Health Phys 2000;78(5 Suppl):S35–S39.CrossRefGoogle ScholarPubMed
13.Cook, L: Hospital disaster drill game: a strategy for teaching disaster proto- cols to hospital staff. J Emerg Nurs 1990;16(4):269–273.Google Scholar
14.Eisner, ME, Waxman, K, Mason GR: Evaluation of possible patient survival in a mock airplane disaster. Am J Surg 1985;150(3):321–323.CrossRefGoogle Scholar
15.Lau, PF, Lau, CC: A disaster drill in Hong Kong. Accid Emerg Nurs 1997;5(1):34–38.CrossRefGoogle ScholarPubMed
16.Paris, PM, Stewart, RD, Pelton, GH, et al. : Triage success in disasters: dynamic victim-tracking cards. Am J Emerg Med 1985;3(4):323–326.CrossRefGoogle ScholarPubMed
17.Gofrit, ON, Leibovici, D, Shemer, J, et al. : The efficacy of integrating “smart simulated casualties” in hospital disaster drills. Prehosp Disast Med 1997;12(2):97–101.CrossRefGoogle ScholarPubMed
18.Saxena, K, Cicero, JJ, Hass, WF: Chemical disaster drill in the State of Minnesota. Minn Med 1986;69(3):137–139.Google ScholarPubMed
19.Menczer, LF: The Hartford disaster exercise. N Engl J Med 1968; 278(15):822–824.CrossRefGoogle ScholarPubMed
20.Fishel, ER: Exercise “Med-Ex” 73. Md State Med J 1974;23(9):46–48.Google ScholarPubMed
21.Maxwell, C., Cherneski, M: Post-disaster drill analysis. Using victim-tracking cards. J Emerg Med Serv 1987;12(2):43–46.Google ScholarPubMed
22.Levi, L, Bregman, D, Geva, H, et al: Hospital disaster management simulation system. Prehosp Disast Med 1998;13(1):29–34.CrossRefGoogle ScholarPubMed
23.Levy, K, Aghababian, RV, Hirsch, EF, et al. : An Internet-based exercise as a component of an overall training program addressing medical aspects of radiation emergency management. Prehosp Disast Med 2000;15(2):18–25.CrossRefGoogle ScholarPubMed
24.Gray, D: Disaster plan education: How we made and tested a video. J Accid Emerg Med 1996;13(1):21–22.CrossRefGoogle ScholarPubMed
25.Inglesby, TV, Grossman, R, O'Toole, T: A plague on your city: Observations from TOPOFF. Clin Infect Dis 2001;32(3):436–445.Google ScholarPubMed
26.Burns, KA: Experience in the use of gaming and simulation as an evaluation tool for nurses. J Contin Educ Nurs 1984;5(6):213–217.CrossRefGoogle Scholar
27.Hogan, DE, Burstein, JL (eds): Disaster Medicine. Baltimore, MD: Lippincott Williams & Wilkins; 2002.Google Scholar
28.Rutherford, WH: The place of exercises in disaster management. Injury 1990;21(1):58–60; discussion 63–64.CrossRefGoogle ScholarPubMed
29.Nigro, CM: Economical citywide tabletop disaster preparedness drill. J Emerg Nurs 1995;21(2):137–139.CrossRefGoogle ScholarPubMed
30.Chi, CH, Chao, WH, Chuang, CC, et al. : Emergency medical technicians' disaster training by tabletop exercise. Am J Emerg Med 2001;19(5):433–436.CrossRefGoogle ScholarPubMed
31.Idris, AH, Becker, LB, Ornato, JP, et al. : Utstein-style guidelines for uniform reporting of laboratory CPR research. A statement for healthcare profes- sionals from a task force of the American Heart Association, the American College of Emergency Physicians, the American College of Cardiology, the European Resuscitation Council, the Heart and Stroke Foundation of Canada, the Institute of Critical Care Medicine, the Safar Center for Resuscitation Research, and the Society for Academic Emergency Medicine. Writing Group. Circulation 1996;94(9):2324–2336.CrossRefGoogle Scholar