Illinois RNs Remain at Forefront of Disaster Preparedness
Monday February 25, 2008
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Illinois collaborates with hospitals, first responders, local health departments, and other entities involved in caring for citizens in a natural or man-made emergency.
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Preparedness Indicator Questions
1. Mass distribution: Does the state have an adequate plan to distribute emergency vaccines, antidotes, and medical supplies from the Strategic National Stockpile?
2. Mass distribution: Did the state purchase a portion of its share of federally subsidized or non-subsidized antiviral drugs to stockpile for use during an influenza pandemic?
3. Public health laboratories: Does the state lab director report sufficient laboratory capabilities to test for biological threats?
4. Public health laboratories: If needed in an emergency, does the state public health laboratory have the capability to provide 24/7 coverage to analyze samples?
5. Biosurveillance: Does the state use a disease surveillance system that is compatible with Center for Disease Control and Prevention’s national system, including integrating data from multiple sources and using electronic lab reporting and an Internet browser?
6. Healthcare volunteer liability protection: Does the state have laws that reduce or limit liability exposure for healthcare volunteers who serve in a public health emergency?
7. Emergency preparedness drills: Does the state health department engage the state National Guard in public health emergency preparedness drills or training exercises?
8. Community resiliency: Does the state meet a minimum threshold of Medical Reserve Corps volunteers per 100,000 people?
9. Public health progress: Did the state increase its rates for immunizing adults 65 and older for the seasonal flu?
10. Funding commitment: Did the state maintain or increase funding for public health programs for fiscal year 2005-06 to fiscal year 2006-07?
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"Nurses have been the foundation of the Illinois Department of Public Health's medical response teams, and they continue to grow in numbers, capabilities, and in importance," says Gwendolyn Glenn-Woolridge, RN, MPA, director of the Office of Assistant Secretary for Preparedness and Response Grant-Hospital Preparedness Program of the Illinois Department of Public Health.
Glenn-Woolridge reports that Illinois began its disaster planning efforts in the 1980s and stepped up its efforts after 9/11 and subsequent anthrax events in 2001. The state collaborates with hospitals, first responders, local health departments, and other entities involved in caring for citizens in a natural or man-made emergency.
In its "Ready or Not? Protecting the Public's Health from Disease, Disasters, and Bioterrorism" report, the Trust for America's Health assessed states' and the District of Columbia's plans to distribute emergency medications, laboratory facilities, surveillance, medical reserve corps, drills, influenza vaccination rates, and financial commitment to disaster preparedness.
"Nurses play a key role with local health departments and emergency response activities during exercises and in real events, especially in the areas of infectious disease surveillance, the dispensing of medications, and provision of vaccinations," Glenn-Woolridge says.
The report found that 10 states lack adequate plans to distribute emergency medicine and supplies from the Strategic National Stockpile and 21 states do not adequately protect healthcare volunteers from professional liability claims during an emergency. Twelve states lack a disease surveillance system that is compatible with the National Electronic Disease Surveillance System at the Centers for Disease Control and Prevention (CDC).
The organization also conducted a public opinion poll and found that 54% of Americans believe the U.S. is not as safe as before 9/11 and 60% do not believe their community is prepared to respond to a natural disaster. Almost 90% said they would abide by a voluntary quarantine if a pandemic flu outbreak occurred.
The state began planning IMERT, a multidisciplinary group with about 600 current members, in 1999 and received grant funding from the CDC to develop educational programs and an infrastructure so it could deploy to mass casualty events. Interest spiked after 9/11, and additional funding rolled in for recruitment, training opportunities, and credentialing.
Since Hurricane Katrina in August 2005, the teams have completed drills and honed their disaster skills in Baton Rogue, La. The first IMERT teams arrived to masses of people lying on cots in a gymnasium at Louisiana State University.
"I knew the first thing we had to do was organize the room," Connelly says. "When I first walked into the huge gymnasium, it took my breath away."
Connelly took charge and set up triage areas, while the Illinois and other teams began treating patients. Within the first three days, they saw 3,000 people.
"The unique thing we have is the nursing process," Connelly says. "When all the veneer is stripped away, all you have is your experience, common sense, and a little faith in powerful beings to help guide you."
Katrina proved to be a great learning experience for the IMERT teams. The need for INVENT came to light during the Katrina mission, when officials witnessed that post-disaster a community's needs continue.
"It really raised for me how essential the nursing piece is, not only in the response but in the recovery phase," Connelly says.
Once the casualties are moved, all nurses in the community, in all settings and among friends and neighbors, feel the effects.
"We thought we needed a vehicle to provide disaster management discussions and classes focused on nursing," Connelly adds. "In Louisiana, the more nurses we had, the better off it was in terms of patient care. After the first two weeks, all they wanted were nurses."
Most IMERT nurses hail from emergency and critical-care backgrounds. INVENT recruits come from the entire spectrum of nursing. Even nurses whose skills have become rusty are welcomed.
"Starting an IV is not an essential piece; what we need is nurses to apply the nursing process to whatever environment they may be in so patients are taken care of to the highest level possible under those conditions," Connelly says.
About 254 nurses volunteer with INVENT. Connelly encourages all nurses to prepare, develop individual or family plans, and participate in community planning activities.
"Nurses have been the lead trainers in this initiative, reaching out to underserved communities in Illinois and assisting in preparation for influenza or other pandemic events," Glenn-Woolridge says. "They have been very instrumental in those roles."
Nurses also participate in the health department's tabletop exercises and drills. These have included FLUEX 2006, a three-day exercise that simulated a major health crisis occurring simultaneously with a terrorist attack, and Prairie Thunder, a five-day exercise to test the state's ability to respond to a mass evacuation shelter.
"You had an emergency room, units, and the [physical layout] of a hospital," says Tapiador, an assistant clinical manager in clinical operations support at Lutheran General. "You were put into scenarios to test different things that hospitals do to prepare for things we don't think about, such as somebody coming to the emergency room smelling of gasoline."
People acting as victims arrived at the training facility decked out in makeup with equipment to help their conditions seem more realistic. Participants also practiced working at a National Incident Management System command center.
"We don't know what we will get," Tapiador says. "So we have to prepare for things that might be."
Debra Anscombe Wood, RN, is a freelance writer. To comment, e-mail editorIL@nursingspectrum.com.
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