This study compared live instructor-led training with video-based instruction in personal protective equipment (PPE) donning and doffing. It assessed the difference in performance between (1) attending 1 instructor-led training session in donning and doffing PPE at 1 month prior to assessment, and (2) watching training videos for 1 month.

This randomized controlled trial pilot study divided 21 medical students and junior doctors into 2 groups. Control group participants attended 1 instructor-led training session. Video group participants watched training videos demonstrating the same procedures, which they could freely watch again at home. After 1 month, a doctor performed a blind evaluation of performance using checklists.

Nineteen participants were assessed after 1 month. The mean donning score was 84.8/100 for the instructor-led group and 88/100 for the video group; mean effect size was 3.2 (95% CI: -7.5 to 9.5). The mean doffing score was 79.1/100 for the instructor-led group and 73.9/100 for the video group; mean effect size was 5.2 (95% CI: -7.6 to 18).

Our study found no significant difference in donning and doffing scores between instructor-led and video lessons. Video training could be a fast and resource-efficient method of training in PPE donning and doffing in responding to the COVID-19 pandemic.

A large-scale public health emergency, such as a severe influenza pandemic, can generate large numbers of critically ill patients in a short time. We modeled the number of mechanical ventilators that could be used in addition to the number of hospital-based ventilators currently in use.

We identified key components of the health care system needed to deliver ventilation therapy, quantified the maximum number of additional ventilators that each key component could support at various capacity levels (ie, conventional, contingency, and crisis), and determined the constraining key component at each capacity level.

Our study results showed that US hospitals could absorb between 26,200 and 56,300 additional ventilators at the peak of a national influenza pandemic outbreak with robust pre-pandemic planning.

The current US health care system may have limited capacity to use additional mechanical ventilators during a large-scale public health emergency. Emergency planners need to understand their health care systems’ capability to absorb additional resources and expand care. This methodology could be adapted by emergency planners to determine stockpiling goals for critical resources or to identify alternatives to manage overwhelming critical care need. (Disaster Med Public Health Preparedness. 2015;9:634–641)

To determine whether a color-coded tourniquet designed for public use increases successful tourniquet application by laypeople.

This was a randomized study conducted on April 25, 2015. The study occurred during the Maryland Day activity at the University of Maryland in College Park, Maryland. Investigators recruited participants with posters displayed at major crosswalks around a central testing area. A total of 157 volunteers aged 18 years or older and without prior military service or medical training were enrolled. A participant stood in front of a waist-down mannequin with an isolated leg injury while an investigator read aloud a mass causality scenario. The investigator then asked the participant to apply a tourniquet to the mannequin’s leg. All participants received a 4-step illustrated just-in-time (JiT) instruction card designed to facilitate layperson tourniquet application. Test participants received a color-coded tourniquet designed for layperson use with instructions printed on the device. Control participants received a black Combat Application Tourniquet (C-A-T; Composite Resources, Rock Hill, SC). Participants were randomized in a 1:1 ratio in blocks of 50. The primary outcome was the proportion of successful tourniquet applications by those who received color-coded tourniquets compared to those who received black tourniquets. Secondary outcomes included validation of previous data analyzing layperson success with tourniquet application, time for successful placement, reasons for failed applications, and participant self-willingness and comfort using tourniquets. We also analyzed demographic data on the study population and inter-rater reliability regarding the assessment of successful tourniquet application.

Participants supplied with color-coded tourniquets successfully placed the device 51.38% of the time, compared to 44.71% of the time for controls using a black tourniquet (risk ratio: 1.15; 95% confidence interval: 0.83-1.59; P=0.404). Participants’ self-reported willingness to use a tourniquet rose from 40.8% before the study to 80.3% after the study (P<0.05).

The color-coded device did not significantly increase laypeople’s proportion of successful tourniquet applications when compared with a standard black device. However, this study reproduced pilot study data showing that laypeople can successfully apply tourniquets about half the time if provided JiT instructions. Age, sex, race, income, and highest level of education were not found to impact one’s ability to properly apply a tourniquet. Laypeople’s willingness to apply tourniquets doubled to 80% after brief exposure to the device. These results affirm the feasibility of engaging laypeople as immediate lifesavers of trauma victims and justify further efforts to boost rates of proper application. (Disaster Med Public Health Preparedness. 2016;10:274–280)

The disaster preparedness of nurses is important as nurses are members of a health care team that needs to work systematically and collaboratively in all conditions. Although education and training naturally underpin effective practice, disaster nursing education is rarely provided to nurses in Iran. Because disaster situations, by definition, overwhelm health services, it is likely that nursing students will be required to join their colleagues in the response. The purpose of this study was to evaluate the competency of nursing students to attend disaster situations.

This descriptive, analytical study was conducted in western Iran in 2020. A total of 70 nursing students in the fourth (final) year of their undergraduate nursing education entered the study by a census sampling method. Data collection was undertaken using a validated disaster competency assessment questionnaire. The data were analyzed using SPSS version 21 (IBM Corp, Armonk, NY) with descriptive and analytic tests.

The mean age of participants was 21.4 ± 2.14 and 57.1% of them were women; 45 participants (64.3%) had received no disaster-related training, and 88.6% had no history of participating in disaster exercises. The total score for nursing students’ competence was 125.58 ± 14.19. There was a significant relationship between the mean score of nursing competence in response to disasters and student history of participating in an exercise and training course (P < 0.001).

Students’ competence in disaster situations is poor. Awareness of the competence condition of nurses is the first step to improve their preparedness as the most key members of the disaster health team. Conducting disaster-related training may be appropriate. The results of this study can provide evidence for the development of educational policies in disaster nursing education.

On April 27, 2011, the state of Alabama encountered a horrific day of tornados that left a trail of damage throughout the state. The city of Tuscaloosa was devastated by an EF-4 that resulted in many victims and casualties. Druid City Hospital in Tuscaloosa had a massive inflow of victims with both mild and major injuries. When disasters such as this occur, nurses must respond with efficiency and effectiveness to help as many victims as possible. However, little is known about the psychological effects of disasters on nurses and how these impact nurses both personally and professionally. Because resilience can directly impact how a nurse responds to a situation, this article aimed to examine the resilience levels of nurses working during the disaster.

This study was part of a larger study examining the needs of nurses both before and after disasters. Ten nurses were interviewed and completed a 10-item survey on resilience, the Connor-Davidson Resilience Scale (CD-RISC). The full range of scores on this scale is from 0 to 40, with higher scores reflecting greater resilience.

In this survey of 10 nurses, the scores ranged from 33 to 40, with a mean score of 36.7.

The nurses who were interviewed and completed the survey possessed a high level of resilience. More research should be done on the causes of increased resilience in nurses after disasters. (Disaster Med Public Health Preparedness. 2015;9:601–604)

A disaster is a consequence of natural hazards and terrorist acts, which have significant potential to disrupt the entire wireless communication infrastructure. Therefore, the essential rescue squads and recovery operations during a catastrophic event will be severely debilitated. To provide efficient communication services, and to reduce casualty mortality and morbidity during the catastrophic events, we proposed the Tethered Balloon technology for disaster preparedness, detection, mitigation, and recovery assessment.

The proposed Tethered Balloon is applicable to any type of disaster except for storms. The Tethered Balloon is being actively researched and developed as a simple solution to improve the performance of rescues, facilities, and services of emergency medical communication in the disaster area. The most important requirement for rescue and relief teams during or after the disaster is a high quality of service of delivery communication services to save people’s lives.

Using our proposed technology, we report that the Tethered Balloon has a large disaster coverage area. Therefore, the rescue and research teams are given higher priority, and their performance significantly improved in the particular coverage area.

Tethered Balloon features made it suitable for disaster preparedness, mitigation, and recovery. The performance of rescue and relief teams was effective and efficient before and after the disaster as well as can be continued to coordinate the relief teams until disaster recovery. (Disaster Med Public Health Preparedness. 2018;12:222–231)

To examine their implementation, we analyzed World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) guidelines from 2005 to 2008 for risk communication during an emerging infectious disease outbreak, WHO and CDC reports on implementing the guidelines worldwide after the 2009 H1N1 pandemic; and a case study of a member state.

A qualitative study compared WHO and CDC guidelines from 2005 to 2008 with WHO and CDC reports from 2009 to 2011, documenting their implementation during the H1N1 outbreak and assessed how these guidelines were implemented, based on the reports and Israeli stakeholders (n=70).

Eight risk communication subthemes were identified: trust, empowerment, uncertainty, communicating the vaccine, inclusion, identification of subpopulations and at-risk groups, segmentation, and 2-way communication. The reports and case study disclosed a gap between international guidelines and their local-level implementation. The guidelines were mostly top-down communications, with little consideration for individual member-state implementation. The WHO and CDC recommendations were not always based on formative evaluation studies, which undermined their validity.

In formulating effective communication strategies, the first step is to define the goal of a vaccination program. We recommend implementing conceptual elements from the most current theoretical literature when planning communication strategies and increasing organizational involvement in implementing guidelines in future health crises. (Disaster Med Public Health Preparedness. 2014;0:1–12)

Elderly individuals are considered at elevated risk of disaster impacts owing to increased health concerns, reduced mobility, and fixed economic resources. Social capital can counteract these vulnerabilities by increasing the likelihood of hearing disaster warnings, providing social ties to assist with preparation and evacuation, and providing access to financial or nonfinancial resources. I aimed to analyze the relationship between age and perceptions of disaster-related social capital.

I used mailed surveys and in-person interviews with a sample of residents from 2 Florida counties to study perceptions of social capital available for disaster.

The results showed that age has a negative effect on perceptions of social capital resources available during a disaster. The elderly reported fewer social ties overall and much fewer social ties that could provide financial assistance, if necessary, during a disaster.

These results indicate that social capital may not counteract the social vulnerabilities of elderly persons to disaster impacts. (Disaster Med Public Health Preparedness. 2017;11:48–55)

To evaluate the effectiveness of a capacity-building intervention administered through a primary health care (PHC) system on community disaster preparedness in Iran.

A controlled community intervention trial with pre- and postassessments was conducted in 2011 in 3 provinces of Iran. In each province, 2 areas were chosen and randomly selected as an intervention or control group. A total of 9200 households were in the intervention area and 10 010 were in the control area. In each study group in each province 250 households were sampled for pre- and postassessment surveys. Community health volunteers led by PHC staff administered an educational intervention covering elements of hazard awareness and preparedness, with a focus on earthquakes and floods. Relative changes for awareness and readiness scores were assessed to demonstrate changes in outcome variables from pre- to postassessments in intervention and control groups. An effectiveness test of significance was based on interaction between time and area.

Households in intervention communities exhibited improved disaster awareness and readiness with respect to all outcome measures. Relative changes in awareness in intervention and control areas were 2.94 and -0.08, respectively (P < .001). Relative changes for readiness scores were 5.52 in intervention areas and 0.56 in control areas (P < .001). Relative changes for awareness and readiness were significantly correlated with a community's baseline risk perception and previous experience with natural disasters (P < .001).

An educational intervention administered through the PHC system effectively improved disaster awareness and readiness at a community level. For sustainability, community disaster reduction programs must be integrated into routine public health service delivery. (Disaster Med Public Health Preparedness. 2013;7:481-490)

The aim was to evaluate nurses’ self-efficacy, confidence, and nurse-patient interaction during caring of patients with coronavirus disease 2019 (COVID-19).

A cross-sectional design with online survey was used with a Self-efficacy scale, Self-confidence scale, and Caring nurse-patient interaction scale: 23-item Version-Nurse (CNPI-23 N).

A sample of 120 nurses participated in the current study. The results showed that the participants had a moderate level of self-efficacy, self-confidence and interaction (M = 28.84 (SD = 7.7), M = 47.41 (SD = 9.0), and M = 93.59 (SD = 16.3), respectively). Positive relationships were found between nurse’ self-efficacy, self-confidence, and nurse-patient interaction (r = 0.81; P < 0.0001 and 0.79; P < 0.0001, respectively). Significant differences were found in self-efficacy according to years of experience, academic qualifications and position (F = 2.10; P = 0.003; F = 3.60; P = 0.002, and F = 2.60; P =0.007, respectively). Furthermore, the results indicated that there was a significant difference in self-confidence and nurse-patient interaction also.

Nurse educators and administrators should develop and implement further strategies, such as continuing education and training, compensatory payment, organizational support, and availability of protective measures to increase their self-efficacy, self-confidence, and interaction with COVID-19 patients.

Awareness and attentiveness have implications for the acceptance and adoption of disease prevention and control measures. Social media posts provide a record of the public’s attention to an outbreak. To measure the attention of Chinese netizens to coronavirus disease 2019 (COVID-19), a pre-established nationally representative cohort of Weibo users was searched for COVID-19-related key words in their posts.

COVID-19-related posts (N = 1101) were retrieved from a longitudinal cohort of 52 268 randomly sampled Weibo accounts (December 31, 2019–February 12, 2020).

Attention to COVID-19 was limited prior to China openly acknowledging human-to-human transmission on January 20. Following this date, attention quickly increased and has remained high over time. Particularly high levels of social media traffic appeared around when Wuhan was first placed in quarantine (January 23–24, 8–9% of the overall posts), when a scandal associated with the Red Cross Society of China occurred (February 1, 8%), and, following the death of Dr Li Wenliang (February 6–7, 11%), one of the whistleblowers who was reprimanded by the Chinese police in early January for discussing this outbreak online.

Limited early warnings represent missed opportunities to engage citizens earlier in the outbreak. Governments should more proactively communicate early warnings to the public in a transparent manner.