MAMATA COLLEGE OF NURSING

KHAMMAM
SUBJECT: NURSING MANAGEMENT
GUIDED BY: Mrs. Dr. Ratna Philip, Principal
DATE:
PRESENTED BY: Mrs. Udaya Sree.G, M.Sc. (N) II year
TIME:
UNIT-III: MANAGEMENT OF NURSING SERVICES IN THE
HOSPITAL AND COMMUNITY
SEMINAR ON DISASTER MANAGEMENT
INTRODUCTION
Emergency and disasters do not only affect health and well being of the
people; frequently large no of people are displaced, killed or injured, or
subjected to greater risk of epidemics. Disaster is not confined to a
particular part of the world; they can occur anywhere and at any time.
Major emergencies and disasters have occurred throughout history and
as the worlds population grows and resources become more limited,
communities are increasingly becoming vulnerable to the hazards that
cause disaster. The disaster is a global phenomenon and no country is
spared from the disaster, whether natural or manmade.
MEANING
A calamitous event, especially one occurring suddenly andcausing great l
oss of life,
damage,
or
hardship, as a flood,
airplane crash, or business failure.
DEFINITIONS
A disaster can be defined as any occurrence that causes damage,
ecological disruption, loss of human life or deterioration of health and
health services on a scale sufficient to warrant an extraordinary response
from outside the affected community or area.
-BT Basavanthappa
A disaster is an occurrence such as hurricane, tornado, storm, flood,
higher water, wind-driven water, tidal wave, earthquake, drought,
blizzard, pestilence, famine, fire, explosion, volcanic eruption, building
collapse, transportation wreck, or other situation that causes human

suffering or creates human needs that the victims cannot alleviate

without assistance
-American Red
Cross
DISASTER MANAGEMENT
Disaster management can be defined as the effective organization,
direction and utilization of available counter disaster recourses.
CLASSIFICATION OF DISASTER
The disaster can be classified into various ways
1. Natural disaster
2. Meteorological disaster
Storms (cyclones, hail storms, hurricanes, tornadoes, typhoons
and snow storms) Cold spells, heat waves and drought
3. Typological disasters
Avalanches, landslides, floods
4. Telluric and Teutonic disaster
Earthquake, tsunamis and volcanic eruption
5. Biological disaster
Insect swarms
diseases.

(Eg:

Locust)

epidemics

of

communicable

MAN MADE DISASTERS

1. Civil disturbance: Riots, demonstration
2. Non conventional warfare: Nuclear, Biological and chemical warfare,
guerrilla warfare, terrorism
3. Warfare: Bombardinats, blockage and siege
4. Refugees: Forced movements of large number of people across the
border

5. Accidents: Transportation accidents like rail, road, air or sea, building

collapse, collapse dams and mines disaster
6. Technology failure: Nuclear power station mishap like Chernobyl,
Bhopal gas leakage like disasters, breaks down of sanitarian system.
DISTINGUISHING BETWEEN AN EMERGENCY AND A DISASTER
SITUATION
An emergency and a disaster are two different situations:
An emergency is a situation in which the community is capable of
coping. It is a situation generated by the real or imminent occurrence of
an event that requires immediate attention and that requires immediate
attention of emergency resources.
A disaster is a situation in which the community is incapable of coping.
It is a natural or human-caused event which causes intense negative
impacts on people, goods, services and/or the environment, exceeding
the affected communitys capability to respond; therefore the community
PHASES OF MANAGEMENT OF DISASTER
In developing strategies to address the problem of disasters, it is helpful
for the community health nurse to consider each of the four phases of
disaster management: prevention, preparedness, response and recovery.
1. PREVENTION PHASE
During the prevention phase, no disaster is expected or anticipated. The
take off during this phase is to identify community risk factors and to
development and implement programs to prevent disaster from
occurring. Prevention of disaster is related to the long term activities,
formulation and implementation long range policies and programs. The
responsibility of the biological disaster prevention lies with ministry of
health.
Disaster prevention may be considered on 3 levels
a) Primary prevention
Health promotion increase community awareness
Increase community preparation through education
Each person is as prepared as possible both physically and
emotionally

 Health protection community member know what to do and where

to go, whether at home, work, school, or elsewhere in the
community
Get to safety before the impact- Southwest corner of a homes
basement or an interior room away from windows and under heavy
functions
b) Secondary prevention
Early diagnosis- Remain in your position of safety until a
community all- clear warning signal is sounded or until rescued.
Leave a damaged building cautionary, if able and not seriously
injured, and do not return until it is declared safe.
Prompt treatment- Rescue individuals properly and get
appropriate care for those injured as soon as possible.
The infrastructure of the community becomes remains intact,
keeping community members safe from hazards such as live wires,
broken gas lines and fallen debris
c) Tertiary prevention
Rehabilitation- Remain safe during the immediate recovery period
other
Accept help from others, friends, family and community
Rebuild family lives through counseling and other services to restabilize life physically, emotionally, spiritually and financially.
2. PREPAREDNESS PHASE
It includes formulation of disaster plans, the maintenance of resources,
training of personnel, planning, organizing.
a. Personal preparedness
Health care professionals with client responsibilities can also become
disaster victims. Conflicts arise between client related and work related
responsibilities. Personal and family preparation can help to care of some
of the conflicts.
b. Professional preparedness
Professional preparedness requires that health care professionals become
aware of and understand the disaster plans at their work place and
community. Adequately prepared professionals can function as leaders in
the disaster management areas. Personal items that are recommended
for a professional to keep for the disaster management are copy of

professional license, personal equipments such as stethoscope, flash light

and extra batteries, cellular phone, warm clothing or heavy jackets,
protective shoes, packet sized reference books, watch ect.
c. Community preparedness
The level of community preparedness for a disaster is only as high as the
people and organization in the community make it. Some communities
stay prepare for disaster with written plans and by participating in
disaster drills. Community must have adequate warning system and a
back up evaluation plan to remove people from the area of danger.
d. Health preparedness
A 200 bedded mobile hospital, fully trained and equipped is set up and
attached to a leading government hospital in Delhi. Three additional
mobile hospital with all medical and emergency equipments are proposed
to be located in different parts of the country.
e. Hospital preparedness
Hospital preparedness is crucial to any disaster response system. Each
hospital need to have an emergency preparedness plan to deal with mass
casualty incidents and the hospital administration/ doctor trained for this
emergency. Therefore, capacity building through in service training of the
current health manager and medical personnel in hospital preparedness
for emergencies or mass casualty incident management is essential.
3. RESPONSE PHASE
At the disaster sites policies, fire fighters, nurses and relief workers
develop a coordinated response to rescue, triage, and treat disaster
victims
a. Rescue
One of the first obligations of relief workers is to remove victims from
danger. This job typically falls to firefighters and personnel with special
training in search and rescue. Depending on the disaster agent,
protective wear, heavy equipment and special vehicle may be needed
and dogs trained to locate dead bodies may be brought.
b. Triage
Whereas emergency nurses daily determine which clients require priority
care, the community health nurse may be at a loss as to where to start
when faced with multiple victims of disaster.

Triage is the process of strong multiple casualties in the event of a war or

major disaster. It is required when the number of causalities exceeds
immediately resources. The goal of triage is to affect the greatest amount
of good for the greatest number of people.
c. Disaster victims
Red: Urgent / Critical
Victims in this category have injuries or medical problems that will likely
lead to death if not treated (Eg: An unconscious victim signs of internal
bleeding)
Yellow: Delayed
Victims in the category have injuries that will require medical attention.
However, time to medical treatment is not yet critical (Eg: Conscious
patient with fracture femur)
Green: Minor/ Walking Wounded
Victims in this category have sustained minor injury or are presenting
with minimal signs of illness. Prolonged delay in care most likely will not
adversely affect their long term outcome. (Eg: A conscious victim with
superficial cute, scrapes)
Black: Dead
Victims in this category are obviously dead or have suffered mortal
wounds becomes of which death is imminent (Eg: An unconscious victim
with an open skull fracture with brain matter showing)
Immediate treatment and support. Care of bodies and notification of
families
4. RECOVERY PHASE
During this phase the community takes actions to repair, rebuilt or
reallocates damaged homes and business and restores health and
economic vitality to the community. Psychological recovery must be
addressed. The emotional scars of witnessing a disaster may persist for
long duration. Both victims and relief workers should be offered mental
health and services.
DISASTER MANAGEEMENT PLANS

Although no disaster management plans can be made to fit every

emergency but protocols and chronological action plans to prove to deal
emergency situation efficiently if executed in coordinated manner.
AIMS OF DISASTER PLANS
To provide prompt and effective medical care to the maximum possible in
order to minimize morbidity and mortality
OBJECTIVES
To optimally prepare the staff and institutional resources for effective
performance in disaster situation
To make the community aware of the sequential steps that could be at
individual and organizational levels.
CONSTITUTION OF DISASTER MANAGEMENT COMMITTEE
The following members would comprise the disaster management
committee under the chairmanship of medical superintendent / director

Medical superintendent / director

Additional medical superintendent
Nursing superintendent / chief nursing officer
Chief medical officer
Head of the departments-Surgery, medicine, orthopedics, radiology,
anesthesiology, neurosurgery
Blood bank in charge
Security officers
Dietician
Transport officer
Sanitary personnel

The disaster management committee is overall responsible for managing

the disaster situation, take administrative decisions, review the disaster
plans and inform authorities.
DISASTER CONTROL ROOM
In the eventuality of a disaster the existing casualty would referred as the
disaster control room. It would be managed round the clock.
RAPID RESPONSE TEAM
The medical superintendent will identify various specialists, nurses and
pharmacological staff to respond within a short notice depending up on
the time and type of disaster. The list of members and their telephone
numbers should be displayed in disaster control room.

INFORMATION AND COMMUNICATION

The disaster control team would be responsible for collecting,
coordinating and disseminating the information about the disaster
situation to all the concerned. Information would be sort on time, place
and nature of the disaster, approximately number of casualties.
EFFECTIVE COMMUNICATION
To be effective communication during disaster must elicit action.
Communication that elicits action provides information that is:
Believable
Current
Authoritative
Predictive of the probability of future events (what is going to
happen next?)
Interactive it allows for and address questions
Conclusive- it eliminates room for speculation and catastrophizing
Urgent conveys seriousness without resorting to fear tactics
Clear, simple and repetitive
Characterized by solutions and suggestions for success
Personal- it uses peoples names if possible and addresses their real
and perceived needs

DISASTER BEDS
Requirements of beds depend up on the magnitude of the disaster. Some
beds can ear marked as disaster beds. The efforts should be created to
allocated additional beds by
Utilization of vacant beds, day care beds, and pre operative beds
Convalescing patients, elective surgical cases and patients who can
have domiciliary care or OPD management should be discharged
Utility areas to be converted into temporary wards such as wards
with side rooms, corridors, seminar halls etc
Creating additional bed capacity by using trolley, folding beds and
floor beds.
LOGISTIC SUPPORT SYSTEM

Separate cupboard marked as disaster shelf and should be kept in

disaster control rooms, equipped with all essential medicine and surgical
supplies.
EMERGENCY HEALTH SERVICES IN DISASTERS
During the first few days following a disaster, the priority is usually to
treat casualties and the sick or injured. Disasters like earthquakes
often involve the management of mass casualties which normally
requires the following activities: Search, rescue and first aid; Transport
of health facilities and treatment; Triage; Tagging; and redistribution of
patients between hospitals when necessary. Usually within 30 minutes
of a disaster, up to 75% of the healthy survivors are actually engaged
in urgent rescue activities.
The demand for curative care is highest during the acute emergency
stage, when the affected population is most vulnerable to their new
environment and before basic public health measures (e.g., water,
sanitation and shelter) have been implemented. Thereafter, the
priority should shift toward preventive measures, which can
dramatically improve the overall health of the affected population.
Otherwise, any prolonged. Introduction to Disaster Management
interruption in routine immunisations and other disease-control
measures may result in serious outbreaks of measles, cholera etc.
EMERGENCY MANAGEMENT
Emergency management is a discipline that involves the avoidance of
risks, while simultaneously putting plans in place to deal with disasters
and emergency situations if and when they do occur with a view to
rebuild and restore society to a functional level in as short a time as
possible after a disaster. Emergency management is therefore a
shared responsibility between government and citizens of a country
towards building a sustainable, disaster-resilient society.
PURPOSE OF EMERGENCY MANAGEMENT
Save lives
Preserve the environment
Protect property
Protect the economy

EMERGENCY MANAGEMENT SYSTEMS (EMS)

Emergency management systems are technological aids that facilitate
the effective management of disasters. EMS technology can assist in
several areas that are critical to effective disaster management, such
as:
Drafting and testing of evacuation and general disaster plans
(Evacuation Plans).
Establishment of shelters as well as informing the public of shelter
locations, items that should be taken to the shelter and general
shelter behaviour.
Training personnel in effective shelter management, basic first aid
and other response skills (Manpower).
Establish a national warehouse and ensure that it is stocked with
items for national survival in the immediate aftermath of the
disaster, before the arrival of overseas help (Materials).
Setting-up reliable communication systems, such as, the traditional
two-way CB-type radios (Communication). 100 Unit 8 The Role of
Technology in Disaster Management
Putting transportation plans in place, which should include air
transportation to facilitate air-lifts and rescues, delivery of food
supplies to severely affected areas cut-off from vehicular traffic and
comprehensive damage assessment activity (Transportation).
USEFUL IS EMS
EMS can also add tremendous value to disaster management in the
following generic areas:
Hazardous Materials Management
Emergency Medical Services
Response and Recovery

ORGANISATIONS INVOLVED IN DISASTER MANAGEMENT

Disaster management is a complex process involving international,
national and local organisations each with a distinct role to play. To
respond to disaster situations a coordinated effort is required.

The United Nations and its organisations

The International Federation of Red Cross and Red Crescent
Societies
The International Committee of the Red Cross
International non-governmental agencies
National organisations

CONCLUSION
Disaster Management has to be a multi-disciplinary and pro-active
approach. Besides various measures for putting in place institutional and
policy framework, disaster prevention, mitigation and preparedness
enunciated and initiatives being taken by the Government, the
community, civil society organizations and media also have a key role to
play in achieving our goal of moving together, towards a safer country.
The message being put across is that, in order to move towards safer and
sustainable national development, development projects should be
sensitive towards disaster mitigation.
Disasters call for a co-ordinated response between curative and
preventive health services, including food supply, water and
sanitation, etc. In order to minimise mortality and morbidity it is also
necessary to organize the relief response according to three levels of
preventive health measures; namely primary, secondary and tertiary
prevention.

BIBLIOGRAPHY
Gabriel Carrillo (2010), Introduction to Disaster Management, 1 ST
edition, Canada.
Don Schramm and Richard Hansen (1993), Aim & Scope of Disaster
Management, Prehospital and Disaster Medicine publications, USA.
www.wikipedia.com

MAMATA COLLEGE OF NURSING

KHAMMAM
SUBJECT: NURSING MANAGEMENT
GUIDED BY: Mrs. Dr. Ratna Philip, Principal

DATE:

PRESENTED BY: Mrs. Udaya Sree.G, M.Sc. (N) II year

TIME:

UNIT-III: MANAGEMENT OF NURSING SERVICES IN THE

HOSPITAL AND COMMUNITY
MASTER PLAN ON DISASTER MANAGEMENT
I.

INTRODUCTION

II.

MEANING

III.

DEFINITION
According to BT. Basavanthappa
According to American Red Cross

IV.
V.

DISASTER MANAGEMENT
CLASSIFICATION OF DISASTER

VI.

MAN MADE DISASTERS

VII.

DISTINGUISHING BETWEEN AN EMERGENCY AND A DISASTER

SITUATION

VIII.

PHASES OF MANAGEMENT OF DISASTER

IX.

DISASTER MANAGEEMENT PLANS

X.

CONSTITUTION OF DISASTER MANAGEMENT COMMITTEE

XI.

DISASTER CONTROL ROOM

XII.

RAPID RESPONSE TEAM

XIII.

INFORMATION AND COMMUNICATION

XIV.

EFFECTIVE COMMUNICATION

XV.

DISASTER BEDS

XVI.

LOGISTIC SUPPORT SYSTEM

XVII.

EMERGENCY HEALTH SERVICES IN DISASTERS

XVIII.

EMERGENCY MANAGEMENT

XIX.

PURPOSE OF EMERGENCY MANAGEMENT

XX.

EMERGENCY MANAGEMENT SYSTEMS (EMS)

XXI.

USEFUL IS EMS

XXII.

ORGANISATIONS INVOLVED IN DISASTER MANAGEMENT

XXIII.

CONCLUSION

XXIV.

BIBLIOGRAPHY

SEMINAR ON
DISASTER MANAGEMENT
SUBMITTED TO
MRS. Dr. Ratna Philip. M.Sc (N), Ph.D.,
SREE.G
Principal
MAMATA COLLEGE OF NURSING
NURSING
KHAMMAM

SUBMITTED BY
MRS.UDAYA
M.Sc. (N) II YEAR
MAMATA COLLEGE OF
KHAMMAM

SEMINAR ON
HUMAN RESOURCE FOR HEALTH

SUBMITTED TO
SUBMITTED BY
MRS. Dr. Ratna Philip. M.Sc (N), Ph.D.,
MRS.UDAYA
SREE.G
Principal
M.Sc. (N) II YEAR
MAMATA COLLEGE OF NURSING
MAMATA COLLEGE OF NURSING
KHAMMAM
KHAMMAM