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PREPARE: Kansas Introduction Module – Appendices Appendix I-1: Federal Disaster Occurrences in Kansas, 14 October 1998 through 9 March 2010 Source: Kansas Hazard Mitigation Plan, 2010, p.3.32

Transcript of PREPARE: Kansas - kahsa.org KS/PREPARE - Kansas... · “PREPARE Kansas” is an off-spring of...

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PREPARE: Kansas

Introduction Module – Appendices

Appendix I-1: Federal Disaster Occurrences in Kansas, 14 October 1998 through 9 March 2010

Source: Kansas Hazard Mitigation Plan, 2010, p.3.32

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PREPARE: Kansas

Introduction Module – Appendices

Appendix I-2: Long-Term Care and Assisted Living Facilities in Kansas

Source: KDHE, KDonA, US Census

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PREPARE: Kansas

Introduction Module – Appendices

Appendix I-3: Distribution of Elderly Population in Kansas

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Source: Kansas Hazard Mitigation Plan, 2010, p.3.91

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PREPARE: Kansas – Introduction

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PREPARE: Kansas Introduction

The vulnerability of long term care facilities was

demonstrated during Hurricane Katrina and the

events that followed. Those who care for

vulnerable populations must be aware of and

prepare for all types of disasters. Facilities are

required to plan for various emergencies. “All

hazard” planning is the most effective means to

respond to and recover from the challenges

faced during disasters and is the recognized

national standard for plan development. Planning

begins with:

Identifying possible hazards

Determining the probability that they will

occur in a specific location

Assessing the risk to the facility and

residents

Evaluating current levels of preparedness

Once completed, these hazards are prioritized

and the analysis becomes the foundation for the

Emergency Operations Plan and guides all

planning efforts.

This program was developed specifically for care

providers in the State of Kansas. “PREPARE

Kansas” provides participants:

Information required to plan effectively

based on hazards faced throughout the

State of Kansas.

A tool to assist in the risk assessment

process. This instrument was provided by

the Kansas Bureau of Public Health

Preparedness and Emergency Response

and is currently being used by

organizations throughout the state.

Hazard information provided by the

Adjutant General‟s Department, Kansas

Division of Emergency Management

related to probability of occurrence,

severity, and warning time.

Reference sites to obtain additional

information.

Forms and worksheets that are used in

Kansas and throughout the United States.

Contact information.

A well developed “All Hazard” Emergency

Operations Plan, coordination with community

planners and responders, redundant

communication systems, an administration and

staff knowledgeable of incident command, and a

well trained and exercised workforce are key

components to a successful response.

In any emergency, it is imperative that all

involved know the chain-of- command. The

Incident Command System assures decisions are

made in a timely manner and facilitates

coordination with responding agencies.

Acknowledgments

Many of the materials included in this document

were created by others, those who have intimate

knowledge of the hazards and vulnerabilities of

the state of Kansas, as well as experts in

emergency preparation and management.

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Mather LifeWays would like to thank the Kansas

Association of Homes and Services for the Aging

and all of the agencies who participated in the

development of the 2010 Kansas Hazard

Mitigation Plan. In particular the staff of the:

Adjutant General’s Department

Kansas Division of Emergency Management

and the

Bureau of Public Health Preparedness

Kansas Department of Health and

Environment

It is only through information, coordination, and

cooperation that hazards can be identified and

mitigated.

The content also includes important information

from these and other sources:

Federal Emergency Management Agency

(FEMA)

National Oceanic and Atmospheric

Association (NOAA)

National Weather Service

Various Public Health Agencies, including

the Centers for Disease Control and

Prevention (CDC)

Ready.gov

Flu.gov

Minnesota Department of Public Health,

the Aging Services of Minnesota, Ready

to Respond and Care Providers of

Minnesota

Leading Age

Centers for Medicare and Medicare

Services (CMS)

Kansas Association of Homes and

Services for the Aging (KAHSA)

Others noted throughout the modules.

Long-Term Care Facilities

In this document, the term long-term care

facilities is used as a grouping term for long-term

care, assisted living, and other facilities that

provide residential services for vulnerable

populations.

PREPARE: Kansas

“PREPARE Kansas” is an off-spring of “PREPARE”,

the award winning preparedness training

program developed and presented by the staff of

Mather Lifeways, Evanston, IL.

“PREPARE” was created to equip senior

living and long-term care professionals

with the core competencies to address

the medical and psychosocial

consequences of natural disasters and

other public health emergency

preparedness and response concerns.”

Due to the efforts of KAHSA and a grant from the

Kansas Department of Health and Environment,

“PREPARE” was made available to the long term

care and assisted living facilities throughout the

state. “PREPARE Kansas” was created as the next

step and provides more specific information

related to the hazards faced by those who care

for the frail and the elderly in long-term care and

assisted living facilities all over the State of

Kansas.

Through data, maps, charts, and references, we

provide some of the background information

necessary to develop a Risk Assessment for your

facility, the basis for your Emergency Operations

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Plan. However, it is important to note that it is

only one portion. Risk Assessments must include

facility risks, as well as those unique to your

county and state. These may include:

the age and working of heating/air

conditioning systems

wells and water systems fire alarm and

sprinkler systems

roof age and repair

staffing issues

security and safety issues

union strikes

intruders

bomb threats

subsidence

proximity to highways, railroad tracks,

nuclear power facilities, airports, and

underground pipelines

health and acuity of residents

To identify the risks requires team work. Utilizing

internal and external teams is beneficial.

Professional assistance may be necessary to

critically assess your facility.

Also paramount to the success of any emergency

response, is that facilities plan and regularly

communicate with those expected to respond:

local emergency management agencies

police

fire

emergency medical services

hospitals

public health

political leaders

community businesses

volunteer agencies

others

They possess knowledge and the abilities to

assist in planning and responding.

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Maybe Not Everyone –

BUT YOU!

Introduction

When developing this guide, the critical hazards

faced by most residents were addressed. There

are many more. The Adjutant General‟s

Department, Kansas Division of Emergency

Management in the Kansas Hazard Mitigation

Plan created the following list. Hazards were

ranked by: weighing the probability of

occurrence, plus the magnitude or severity, plus

the warning time, and duration.

Many considerations are addressed in PREPARE

Kansas. It is the responsibility of your planning

team to decide your facility‟s vulnerabilities and

plan accordingly. There are hazards that may not

have a high rating. However, if you are facing this

problem, it requires you develop an annex to

your Emergency Operations Plan (EOP). Different

communities in Kansas have different

vulnerabilities to the identified hazards.

Disasters may not affect the entire population

but your facility may be very much at risk.

Hazards

In 2010 flooding was the hazard of most

significance to the State of Kansas. Tornadoes

were ranked second. 1 The others, in order are:

Major Disease Outbreak

Windstorm

Hailstorm

Winter Storm

Lightning

Hazardous Materials

Utility Infrastructure Failure

Drought

Terrorism, Agri-terrorism, Civil Disorder

Land Subsidence

Agricultural Infestation

Extreme Temperatures

Dam and Levee Failure

Landslide

Expansive Soils

Soil Erosion and Dust

Radiological

Earthquake

Fog

One hazard can result in a different hazard. For

example:

Drought can lead to wildfire, soil erosion,

and dust storms.

1 Kansas State Hazard Mitigation Plan, p. 3.27

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Severe winter storms and high wind

event often may cause utility and

infrastructure failures.

Some hazards can occur simultaneously, as a

result of the same storm, such as:

Tornado, hailstorm, lightning, flood, and

windstorms.

Presidential Declarations

The extent of storm damage and devastation may

cause the Governor to request disaster assistance

from the federal government. Many Kansas

disasters have received “Presidential

Declarations”. Some of the most recent were the

Severe Winter Storms and Snowstorms

experienced by 45 Kansas counties in March of

2010. 2

“Once a disaster has occurred, and the

State has declared a state of emergency,

the State will evaluate the recovery

capabilities of the State and local

governments. If it is determined that the

damage is beyond their recovery

capability, the governor will normally

send a request letter to the President,

directed through the Regional Director of

the appropriate FEMA region. The

President then makes the decision

whether or not to declare a major

disaster or emergency.

After a presidential declaration has been

made, FEMA will designate the area

eligible for assistance and announce the

2 FEMA, Public Entity Risk Institute

types of assistance available. FEMA

provides supplemental assistance for

State and local government recovery

expenses, and the Federal share will

always be at least 75 percent of the

eligible costs.”3

The following maps illustrate the number of

Federal “Presidential Declarations” that have

occurred in Kansas during the period of October

14, 1998 through March 9, 2010.4

To be eligible for any federal assistance requires

appropriate documentation. Before an event,

check with your local Emergency Management

Agency to determine: information required,

procedures, and forms that require completion.

Long-Term Care and Assisted Living

Facilities in Kansas

The following illustrates that there are vulnerable

populations residing in long-term care and

assisted living facilities throughout the state.

3 FEMA.gov/presidential declarations

4 Kansas Hazard Mitigation Plan, 2010

Appendix I-1

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There are approximately 2,818,747 residents of

Kansas, of that number 13%, more than 360,000

residents are 65 years and over.5

5 Quickfacts.census.gov. U.S. Census

Appendix I-2

Appendix I-3

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Introduction to

PREPARE

The PREPARE train-the-trainer modules and in-

person workshops introduced long-term

care/senior living (LTC) facility management and

staff to the essential elements of developing and

implementing effective emergency plans.

Prepare: Getting Ready

Respond

Recover: Putting it Back Together

This recap of PREPARE, provides a short review of

these essential elements. In “PREPARE: Kansas”

these principles are applied to hazards that have

a high probability of occurring in Kansas.

Prepare: Getting Ready

Getting Ready refers to: identifying risks;

developing an emergency operations plan;

identifying personnel to perform critical roles;

training and exercising all staff; procuring

necessary supplies and equipment; building

relationships and planning with community

partners. For LTC facilities Getting Ready

includes:

Developing a plan that considers the

special vulnerabilities of older adults.

Conducting a risk assessment to identify

the hazards to which the LTC is most

vulnerable.

Identifying individuals to fill key roles and

assure they understand the Incident

Command System.

Respond

Responding includes:

Implementing Incident Command.

Activating the plan.

Performing necessary tasks to react

appropriately to the event and assure

continuity of operations.

Taking steps to assure the safety of staff

and residents.

Communicating with staff, residents,

responders and necessary others.

Recover: Getting Back to Normal

Recovery incorporates the necessary steps to re-

establish a safe, familiar environment for

residents and staff. It includes:

Assuring safe re-entry.

Administering Psychological First Aid to

residents and staff who were affected by

the event.

Holding an after- action conference to

identify areas where disaster response

went well and areas of weakness.

Vulnerabilities of Older Adults

The aftermath of Hurricane Katrina and other

disasters have highlighted the unique needs of

the frail and elderly residing in LTC facilities

during emergencies. Studies show that older

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adults are vulnerable and at risk for physical and

psychosocial problems. Aging changes may

increase older adults‟ vulnerability to biologic

agents, confound early diagnosis, and increase

the severity of responses to the disaster. Also

contributing to the risks to older adults is the

prevalence of chronic health conditions, such as

heart disease and arthritis.

In developing an effective emergency operations

plan, it is important to identify strategies that

address their special vulnerabilities and

incorporate those strategies into the emergency

operations plan.

1. Sensory deprivation

2. Delayed response time

3. Chronic illness and medication use

4. Mobility impairment

5. Memory disorder

6. Hyper/hypothermia vulnerability

7. Issues pertaining to diversity

8. Generational differences in accepting

assistance

9. Fear of victimization

10. Mental health stigma

11. Fear of loss of independence

12. Fear of evacuations

The PREPARE training manual provides a more

detailed explanation of these vulnerabilities.

The Emergency Planning Process

Emergency planning is not a one-time event. It is

a continual cycle of planning, training, exercising,

and revising. A comprehensive, effective

emergency operations plan is an important tool

and necessary to improve the preparedness and

response by managers and staff of LTC facilities

to all types of hazards.

Determining who will be in charge, staff member

roles and responsibilities, how all will

communicate during the event, and the chain-of-

command is part of the Incident Command

System (ICS). By Presidential Directive, all

responding agencies must implement ICS. It is

necessary that all staff of LTC facilities know and

utilize ICS during an emergency situation.

It is essential that the various components of the

plan are regularly tested and improved. This

process of continuous improvement relies on

updating procedures and contact information, re-

evaluation, development of an improvement plan

and continuous testing of the plan.

There are federal requirements for LTC facilities

to have detailed, written emergency and disaster

procedures and that managers and staff are

regularly trained and tested. This must be an “all

hazards” approach to address natural and man-

made external hazards, as well as, internal

hazards, such as fire, intruders, strikes, heat/air

conditioning failure, and others.

Who Should be Involved in Emergency

Operations Planning?

Emergency planning is a team effort. A successful

response may require coordination between

many community agencies and organizations.

Each type of emergency requires different

expertise and response capabilities. Therefore,

the first step in emergency planning is

identification of all that may be involved.

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The specific individuals and organizations

involved in the response to an emergency will

depend on the type and magnitude of the event.

Law enforcement will probably have a role to play

in most events, as will Fire, Emergency Medical

Services (EMS), voluntary agencies, and the

media. On the other hand, hazardous materials

(HazMat) personnel may or may not be involved

in a given incident but should be involved in the

planning process due to their specialized

expertise. Input from local public health,

emergency management, and community

hospitals is also vital to the success of your

planning and response.

What is an Emergency Operations Plan?

According to the Federal Emergency

Management Agency (FEMA), an Emergency

Operations Plan (EOP):

Assigns responsibility to organizations

and individuals for carrying out specific

actions at projected times and places in

an emergency or disaster.

Sets forth lines of authority and

organizational relationships and explains

how all actions will be coordinated.

Describes how people and property will

be protected in emergencies and

disasters.

Identifies personnel, equipment, facilities,

supplies, and other resources available,

within the jurisdiction or by agreement

with other jurisdictions, for use during

response and recovery operations.

Identifies steps to address mitigation

concerns during response and recovery

activities.

Conducting a Risk Assessment

A risk assessment is the foundation: for the

development of strategies to deal with potential

disasters, both manmade and natural; for

determining and allocating resources; and for

establishing priorities and standards to assure the

safety of residents and staff.

Identifying potential emergencies requires the

use of all available information to determine the

type, magnitude, effect, and time to react.

Effective Emergency Operations Plans (EOP)

should begin with a risk assessment based on the

location and characteristics of the LTC. Possible

considerations: rural or urban location; age of the

facility, the roof and heating system; in flood

zone; susceptible to winter storms, tornadoes, or

wildfires; wooden or cement structure; one story

or high-rise building.

Other major events including: fire, terrorism,

infectious disease outbreaks, floods, intruder,

chemical spill, radiological accident, and labor

strikes must be considered.

Module 2 of “PREPARE Kansas” describes the key

elements in conducting a risk assessment and

includes a Kansas-specific risk assessment tool.

Developing a Disaster Preparedness Plan

Planning can help save lives, reduce injury,

protect property, and help the facility and

residents recover more quickly.

It is never easy to care for the frail and those with

functional needs. In a time of crisis it can become

especially difficult. Unfortunately disasters,

whether acts of terrorism, violent weather,

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infectious disease outbreaks, or other unforeseen

event, are part of our lives and we must be

prepared to respond.

Advantages of Using an All-Hazards Model

All-hazards planning has several advantages:

Cost effective in terms of time and

money.

Builds capacity to deal with the most

probable events.

Encourages managers and staff to think

with a broader perspective about real

and potential emergencies.

Critical Issues in Planning

Events of 9/11 provided “lessons learned”

regarding critical issues necessary in disaster

preparedness. Some of these issues are important

to consider in developing an effective Emergency

Operations plan.

Need for backup communication systems

to receive and disseminate emergency

information.

Arrangements for continuation of

essential services (i.e., food and water,

healthcare, medications, shelter).

System to identify and track residents.

Need for Memorandum of

Understanding among LTC facilities,

businesses, and other agencies to

provide a coordinated response.

System to identify those with mobility

issues and to assure proper modes of

transportation is based on their

limitations.

Need for geriatric mental health services,

post-disaster, to address the

psychological impact of the disaster.

Plan with local EMS so they are aware of

the unique needs of your population.

Key Components of an Emergency

Operations Plan

There are fundamental components that need to

be addressed in an emergency operations plan.

These components include:

Direction and control

o Designate who has the authority

to make decisions; system for

managing resources; and

analyzing information.

Internal and external resources

o Internal resources may include:

personnel; equipment;

communications devices;

and

emergency supplies. External

resources include: transportation,

supplies, community support,

and volunteers.

24/7 communication and contact

information

o A well-designed Emergency

Operations Plan should clarify

flow of communication with 24

hour coverage, seven days a

week.

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Life safety, evacuation and shelters

o Evacuation plans should be part

of the facility‟s Emergency

Operations Plan. Section 4 of

this manual discusses evacuation

considerations and planning.

Agreements

o The organization‟s relationship

with the community may impact

the ability to protect residents,

staff, and property. To avoid

confusion and conflict mutual aid

agreements or memorandum of

understanding with local

response agencies and

businesses should be developed

pre-event.

Property protection

o During a disaster or emergency

situation safety and security

conditions may be unfamiliar and

unpredictable. Standard security

may be inadequate. Procedures

for additional security or lock

down may be necessary.

Response and recovery

o Response and recovery includes

procedures for reacting to

various disasters and returning

your facility to normal operations

after the disaster.

Responding to Emergencies

We are all vulnerable to a variety of hazards. Each

day emergencies occur. Most are handled locally,

within the organization or with the assistance of

those who respond to emergency calls. Many

require the support of agencies with additional

resources and/or different skills. These may

include: tornadoes, wind, rain, snow and ice

storms, fires, floods, earthquakes, power outages,

hurricanes, tsunamis, civil unrest, hazardous

material spills, personnel issues, vehicle accidents,

violent intruders, terrorism, or highly

communicable diseases, such as a pandemic

influenza. Those who respond must be able to

coordinate their activities. Success is based on

everyone who responds being aware of accepted

procedures, terms, and communication methods.

Through a Presidential Directive (HSPD5), all

Federal, State, local, and tribal entities are

required to adopt and utilize the National

Incident Management System, of which Incident

Command System is a key element. Hospitals and

health care organization have also realized the

importance of a coordinated effort and have

adopted the Hospital Incident Command System

(HICS). Businesses, faith-based and other

volunteer organizations, social services agencies,

and all who may respond to an emergency or

disaster, are expected to know and use Incident

Command. It is equally important that those who

care for vulnerable populations know and utilize

this nationally accepted method to manage

incidents. It is critical for all involved, staff and

those who may be called upon to assist, to clearly

understand who is in charge. The rapid

establishment of the chain-of- command and

knowing how to communicate during the event

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promotes timely actions, reduces stress, and may

save lives.

Activating Your Emergency Operations

Plan

According to the Federal Emergency

Management Agency (FEMA) an Emergency

Operations Plan will do the following:

Assign responsibility to organizations

and individuals for carrying out specific

actions at projected times and places in a

disaster.

Set forth lines of authority and

organizational relationships.

Explain how all actions will be

coordinated

Describe how people and property will

be protected.

Identify personnel, equipment, facilities,

supplies, and other resources available.

Identify steps to address mitigation

concerns during response and recover

activities.

The Incident Command System

The Incident Command System allows all sectors

within the LTC and those who may be called

upon to assist during an emergency or disaster,

to respond effectively. Through command and

control, communication, and utilization of

common terminology, all involved can form a

well functioning team. All levels of government,

private businesses, health care and volunteer

organizations have adopted this system.

Utilization of ICS by those who care for this

vulnerable population, establishes the foundation

for an integrated response.

The system is a standard, yet flexible, framework

that allows Federal, State, local and tribal

governments, private entities, and non-

governmental organizations to work together to

prepare for, respond to, and recover from

domestic incidents regardless of their size, cause,

or location. This includes acts of terrorism.

ICS provides a means for coordinated and

collaborative incident management. ICS may be

used in any event that requires actions to prevent

or minimize loss of life, damage to property

and/or the environment.

A detailed description of the structure and

function of the Incident Command System, as

well as guidelines on how to implement the

Incident Command System are included in

Section 6 of the “PREPARE: Kansas” manual.

Evacuation

The decision to move residents from a long term

care facility is not easy and in many cases must

be made with little time for contemplation. Many

considerations must be factored into the

decision. The hazard, time to react, staffing,

number and condition of residents,

transportation, shelter location, and available

resources all must be considered. With this in

mind, the primary concern must always be the

safety of staff and residents.

Those caring for vulnerable populations have an

obligation to plan for emergencies and respond

appropriately. Due to the nature of emergencies,

no guidance document is perfect for every event.

This module discusses the risks and provides

suggestions from numerous experts. However, at

the time of the emergency, the decision is yours.

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Guidelines for developing an effective evacuation

plan for your Kansas-specific geographic area

and your facility are outlined in detail in Section 4

of this manual.

Sheltering-in-Place

As with evacuation, the decision to shelter-in-

place requires considering many factors.

Guidelines for developing an effective shelter-in-

place plan for your Kansas location are discussed

in Section 4 of this manual.

Recovery – Mental Health Issues

Once the immediate danger of the disaster or

emergency has passed, LTC facilities will face the

challenge of returning to normal operations and

helping residents and employees cope with the

consequences of the disaster.

It is necessary to understand the unique

psychological effects of disasters on older adults

and be prepared to provide support and/or

interventions to ease the trauma for this at-risk

population.

The emotional effects of the aftermath of

disasters have the potential to be long-lasting

and the resulting trauma can reverberate to those

not directly affected by the disaster. Emergency

operations plans need to include methods to

manage potential psychological issues related to

the disaster. This section discusses the

psychological impact of catastrophic events and

how to deal with them. Methods for dealing with

potential psychological aftermath of disasters

should be included in the emergency operations

plan.

Typical Reactions to Disasters

There are a number of typical reactions that have

been documented in crisis situations. While many

of these reactions are found across population

groups, these reactions may be exacerbated or

may present differently in older adults.

Knowledge about the typical psychological

reactions to disasters help LTC staff offers a

proactive response to residents in distress. Some

typical psychological reactions to disasters are:

Anxiety and depression

Withdrawal and isolation

Irrational fears

Problems going to sleep

Alcohol or other drug use

Demoralization

Sensitivity to loud noises

Somatic complaints

Guilt, anger and grief

Understanding Older Adults’ Recovery

Process

All age groups experience a range of reactions to

disasters. Older groups, however, may have

barriers to asking for and accepting mental

health support. Older adults grew up during a

time when any emotional issues were a source of

embarrassment. Bringing older adults together to

talk about feelings and reactions to a crisis

situation can be helpful in helping emphasize

that these feelings are normal. Discussing how

people have coped with past crises serves as an

example of how group members may begin to

draw on their own strengths in the current

situation. Functioning older adults can be a

community resource to help others in the healing

process.

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Facts to remember about the older adult‟s

recovery process include:

Reactions are similar among all age

groups.

Reactions to a disaster are normal.

Acknowledging feelings helps recovery.

Focusing on strengths is helpful.

Asking for help is important in the

healing process.

Accepting help is healthy.

People heal at their own pace.

Psychological First Aid

Psychological First Aid is an evidence-based

strategy for assisting people in the immediate

aftermath of a disaster or emergency that can be

used with any aged population. Psychological

First Aid is intended to decrease initial distress

caused by the trauma of disaster events to

promote short and long term adaptive

functioning.

The principal areas of Psychological First Aid

include:

Contacting and engaging

Providing comfort care, recognizing basic

needs, and maintaining safety

Helping with problem solving and

providing practical assistance

Validating feelings and thoughts

Connecting people with their support

systems

Providing information about anticipated

stress reactions and reinforcing strengths

and positive coping strategies

Guidelines for Delivering Psychological

First Aid

Politely observe first, don‟t intrude.

Initiate contact only after you have

observed the situation and resident and

have determined that contact is not likely

to be an intrusion or disruptive.

Speak calmly. Be patient, responsive, and

sensitive.

Speak in simple, concrete terms; don‟t

use acronyms or responder „jargon‟. If

necessary, speak slowly.

If survivors want to talk, be prepared to

listen.

Acknowledge the positive features of

what the person has done to keep safe

and reach the current setting.

Give information that is accurate and

age-appropriate for your audience, and

correct inaccurate beliefs. If you don‟t

know, tell them this and offer to find out.

When communicating through a

translator or interpreter, look at and talk

to the person you are addressing, not at

the translator or interpreter.

The goal of Psychological First Aid is to

reduce distress, assist with current needs,

and promote adaptive functioning, not to

elicit details of traumatic experiences and

losses.

Referrals to Mental Health Professionals

There may be survivors who need more

additional help; those exhibiting symptoms of:

Depression

Aggression

Alcohol and drug use

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Homicidal or suicidal threats

Healthcare Workers During and After a

Disaster

Engaging in rescue and recovery efforts in the

wake of disasters is inevitably stressful for

healthcare workers. The long hours, breadth of

needs and demands, and exposure to human

suffering can adversely affect even the most

experienced professional. While the work is

personally rewarding and challenging, it also has

the potential for affecting workers in harmful

ways. Too often, the stress experienced by

healthcare workers is addressed as an

afterthought. Steps should be taken to minimize

the effects of stress.

Evaluating Plans Post-Disaster

For an emergency management system to be

effective, it is critical that the personnel, plans,

procedures, facilities, and equipment are

evaluated to identify successes and shortfalls.

Evaluation can help the organization identify:

Whether the plan needs improvements.

If there are training and staffing

deficiencies.

If needed equipment was available.

If additional training and exercising of

the plans are necessary.

Documentation

Developing a log during the disaster is an

important tool for documenting any observed

action. Events and problems can then be

analyzed after the disaster to determine if

corrective action is required. Emergency

Management may assist in determining

documentation necessary for any reimbursement.

After Event Debriefing

The debriefing is an opportunity for participants

to talk immediately after the disaster. Participants

can have their say about how things went, what

they think should be changed, and commitments

they need to make to improve competencies. A

Debriefing Log may be used to document a

summary of problems, actions recommended,

and responsible persons/departments.

After Action Conference

The After Action Conference is a more formal

meeting of key administrators and managers,

post- event, to analyze the response and develop

an accurate account of what worked and what

did not. The team analyzes responses, logs, any

other data, and discusses how well objectives

were met.

The After Action Report

An individual is identified to prepare the After

Action Report. This report documents

effectiveness of the plan and staff during the

disaster, actions required to improve the process

and outcome.

Recommendations for future actions are the

primary reason for evaluating the plan after a

disaster. The purpose of the evaluation is to

improve the Emergency Operations Plan and staff

performance.